hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|IL,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,
Hopedale Medical Complex,9/25/2024,2.0.0,Hopedale Medical Complex,"107 Tremont Street, Hopedale, IL, 61747",0001024,TRUE,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,modifiers,setting,standard_charge|gross,standard_charge|discounted_cash,payer_name,plan_name,standard_charge|methodology,standard_charge|negotiated_dollar,standard_charge|negotiated_percentage,standard_charge|negotiated_algorithm,additional_generic_notes,standard_charge|min,standard_charge|max
ANESTH EXTERN MIDDLE & INNER EAR W/BX,00120,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH EXTERN MIDDLE & INNER EAR W/BX,00120,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH EXTERN MIDDLE & INNER EAR W/BX,00120,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
REMOVAL OF SKIN TAGS UP TO 15,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
REMOVAL OF SKIN TAGS UP TO 15,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
REMOVAL OF SKIN TAGS UP TO 15,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
EXCISION OF NEVUS SINGLE OR MULTIPLE >5,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
EXCISION OF NEVUS SINGLE OR MULTIPLE >5,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
EXCISION OF NEVUS SINGLE OR MULTIPLE >5,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
EXCISION OF LESION SINGLE OR MULTIPLE L5,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
EXCISION OF LESION SINGLE OR MULTIPLE L5,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
EXCISION OF LESION SINGLE OR MULTIPLE L5,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
SIMPLE WOUND DEBRIDEMENT CLEAN,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
SIMPLE WOUND DEBRIDEMENT CLEAN,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
SIMPLE WOUND DEBRIDEMENT CLEAN,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
SONO GUIDED ASPIRATION BIOPSY,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
SONO GUIDED ASPIRATION BIOPSY,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
SONO GUIDED ASPIRATION BIOPSY,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
SIMPLE WOUND EXPLORATION,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
SIMPLE WOUND EXPLORATION,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
SIMPLE WOUND EXPLORATION,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
SMPL WOUND EXPLOR W/ RMVL FOREIGN BD,360,RC,,,,both,855.25,769.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.68,,,,504.6,697.88
SMPL WOUND EXPLOR W/ RMVL FOREIGN BD,360,RC,,,,both,855.25,769.73,Cigna,Default,Percent of Total Billed Charges,504.6,,,,504.6,697.88
SMPL WOUND EXPLOR W/ RMVL FOREIGN BD,360,RC,,,,both,855.25,769.73,United Healthcare,Default,Fee Schedule,697.88,,,,504.6,697.88
EXCISION SINGLE NAIL MATRIX FNG TOE,360,RC,,,,both,1644.5,1480.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1151.15,,,,970.26,1341.91
EXCISION SINGLE NAIL MATRIX FNG TOE,360,RC,,,,both,1644.5,1480.05,Cigna,Default,Percent of Total Billed Charges,970.26,,,,970.26,1341.91
EXCISION SINGLE NAIL MATRIX FNG TOE,360,RC,,,,both,1644.5,1480.05,United Healthcare,Default,Fee Schedule,1341.91,,,,970.26,1341.91
EXCISION OF NEVUS MULTIPLE >4,360,RC,,,,both,1644.5,1480.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1151.15,,,,970.26,1341.91
EXCISION OF NEVUS MULTIPLE >4,360,RC,,,,both,1644.5,1480.05,Cigna,Default,Percent of Total Billed Charges,970.26,,,,970.26,1341.91
EXCISION OF NEVUS MULTIPLE >4,360,RC,,,,both,1644.5,1480.05,United Healthcare,Default,Fee Schedule,1341.91,,,,970.26,1341.91
EXCISION OF LESION MULTIPLE >4,360,RC,,,,both,1644.5,1480.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1151.15,,,,970.26,1341.91
EXCISION OF LESION MULTIPLE >4,360,RC,,,,both,1644.5,1480.05,Cigna,Default,Percent of Total Billed Charges,970.26,,,,970.26,1341.91
EXCISION OF LESION MULTIPLE >4,360,RC,,,,both,1644.5,1480.05,United Healthcare,Default,Fee Schedule,1341.91,,,,970.26,1341.91
INCISION DRAINAGE ABSCESS OR WOUND,360,RC,,,,both,1644.5,1480.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1151.15,,,,970.26,1341.91
INCISION DRAINAGE ABSCESS OR WOUND,360,RC,,,,both,1644.5,1480.05,Cigna,Default,Percent of Total Billed Charges,970.26,,,,970.26,1341.91
INCISION DRAINAGE ABSCESS OR WOUND,360,RC,,,,both,1644.5,1480.05,United Healthcare,Default,Fee Schedule,1341.91,,,,970.26,1341.91
WOUND DEBRIDEMENT CONTAMINATION,360,RC,,,,both,1644.5,1480.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1151.15,,,,970.26,1341.91
WOUND DEBRIDEMENT CONTAMINATION,360,RC,,,,both,1644.5,1480.05,Cigna,Default,Percent of Total Billed Charges,970.26,,,,970.26,1341.91
WOUND DEBRIDEMENT CONTAMINATION,360,RC,,,,both,1644.5,1480.05,United Healthcare,Default,Fee Schedule,1341.91,,,,970.26,1341.91
VASECTOMY,55250,HCPCS,360,RC,,both,6155.63,5540.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4308.94,,,,3631.82,5022.99
VASECTOMY,55250,HCPCS,360,RC,,both,6155.63,5540.07,Cigna,Default,Percent of Total Billed Charges,3631.82,,,,3631.82,5022.99
VASECTOMY,55250,HCPCS,360,RC,,both,6155.63,5540.07,United Healthcare,Default,Fee Schedule,5022.99,,,,3631.82,5022.99
SCLEROTHERAPY SPIDER VEINS,360,RC,,,,both,1644.5,1480.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1151.15,,,,970.26,1341.91
SCLEROTHERAPY SPIDER VEINS,360,RC,,,,both,1644.5,1480.05,Cigna,Default,Percent of Total Billed Charges,970.26,,,,970.26,1341.91
SCLEROTHERAPY SPIDER VEINS,360,RC,,,,both,1644.5,1480.05,United Healthcare,Default,Fee Schedule,1341.91,,,,970.26,1341.91
SPECIAL PROCEDURE FIRST 30 MIN.,761,RC,,,,both,157.25,141.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.08,,,,92.78,128.32
SPECIAL PROCEDURE FIRST 30 MIN.,761,RC,,,,both,157.25,141.53,Cigna,Default,Percent of Total Billed Charges,92.78,,,,92.78,128.32
SPECIAL PROCEDURE FIRST 30 MIN.,761,RC,,,,both,157.25,141.53,United Healthcare,Default,Fee Schedule,128.32,,,,92.78,128.32
SPECIAL PROCEDURE EACH ADDITIONAL 15,761,RC,,,,both,78.75,70.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.12,,,,46.46,64.26
SPECIAL PROCEDURE EACH ADDITIONAL 15,761,RC,,,,both,78.75,70.88,Cigna,Default,Percent of Total Billed Charges,46.46,,,,46.46,64.26
SPECIAL PROCEDURE EACH ADDITIONAL 15,761,RC,,,,both,78.75,70.88,United Healthcare,Default,Fee Schedule,64.26,,,,46.46,64.26
CARDIO VASCULAR LEVEL 1,360,RC,,,,both,176.75,159.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.72,,,,104.28,144.23
CARDIO VASCULAR LEVEL 1,360,RC,,,,both,176.75,159.08,Cigna,Default,Percent of Total Billed Charges,104.28,,,,104.28,144.23
CARDIO VASCULAR LEVEL 1,360,RC,,,,both,176.75,159.08,United Healthcare,Default,Fee Schedule,144.23,,,,104.28,144.23
CARDIO VASCULAR LEVEL 2,360,RC,,,,both,163.81,147.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.67,,,,96.65,133.67
CARDIO VASCULAR LEVEL 2,360,RC,,,,both,163.81,147.43,Cigna,Default,Percent of Total Billed Charges,96.65,,,,96.65,133.67
CARDIO VASCULAR LEVEL 2,360,RC,,,,both,163.81,147.43,United Healthcare,Default,Fee Schedule,133.67,,,,96.65,133.67
CARDIO VASCULAR LEVEL 3,360,RC,,,,both,185.77,167.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,130.04,,,,109.6,151.59
CARDIO VASCULAR LEVEL 3,360,RC,,,,both,185.77,167.19,Cigna,Default,Percent of Total Billed Charges,109.6,,,,109.6,151.59
CARDIO VASCULAR LEVEL 3,360,RC,,,,both,185.77,167.19,United Healthcare,Default,Fee Schedule,151.59,,,,109.6,151.59
CARDIO VASCULAR LEVEL 4,360,RC,,,,both,198.68,178.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.08,,,,117.22,162.12
CARDIO VASCULAR LEVEL 4,360,RC,,,,both,198.68,178.81,Cigna,Default,Percent of Total Billed Charges,117.22,,,,117.22,162.12
CARDIO VASCULAR LEVEL 4,360,RC,,,,both,198.68,178.81,United Healthcare,Default,Fee Schedule,162.12,,,,117.22,162.12
CARDIO VASCULAR LEVEL 5,360,RC,,,,both,206.15,185.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.3,,,,121.63,168.22
CARDIO VASCULAR LEVEL 5,360,RC,,,,both,206.15,185.54,Cigna,Default,Percent of Total Billed Charges,121.63,,,,121.63,168.22
CARDIO VASCULAR LEVEL 5,360,RC,,,,both,206.15,185.54,United Healthcare,Default,Fee Schedule,168.22,,,,121.63,168.22
ENDOCRINE LEVEL 1,360,RC,,,,both,160.69,144.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.48,,,,94.81,131.12
ENDOCRINE LEVEL 1,360,RC,,,,both,160.69,144.62,Cigna,Default,Percent of Total Billed Charges,94.81,,,,94.81,131.12
ENDOCRINE LEVEL 1,360,RC,,,,both,160.69,144.62,United Healthcare,Default,Fee Schedule,131.12,,,,94.81,131.12
ENDOCRINE LEVEL 2,360,RC,,,,both,162.27,146.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.59,,,,95.74,132.41
ENDOCRINE LEVEL 2,360,RC,,,,both,162.27,146.04,Cigna,Default,Percent of Total Billed Charges,95.74,,,,95.74,132.41
ENDOCRINE LEVEL 2,360,RC,,,,both,162.27,146.04,United Healthcare,Default,Fee Schedule,132.41,,,,95.74,132.41
ENDOCRINE LEVEL 3,360,RC,,,,both,182.62,164.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.83,,,,107.75,149.02
ENDOCRINE LEVEL 3,360,RC,,,,both,182.62,164.36,Cigna,Default,Percent of Total Billed Charges,107.75,,,,107.75,149.02
ENDOCRINE LEVEL 3,360,RC,,,,both,182.62,164.36,United Healthcare,Default,Fee Schedule,149.02,,,,107.75,149.02
ENDOCRINE LEVEL 4,360,RC,,,,both,198.68,178.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.08,,,,117.22,162.12
ENDOCRINE LEVEL 4,360,RC,,,,both,198.68,178.81,Cigna,Default,Percent of Total Billed Charges,117.22,,,,117.22,162.12
ENDOCRINE LEVEL 4,360,RC,,,,both,198.68,178.81,United Healthcare,Default,Fee Schedule,162.12,,,,117.22,162.12
ENDOCRINE LEVEL 5,360,RC,,,,both,206.15,185.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.3,,,,121.63,168.22
ENDOCRINE LEVEL 5,360,RC,,,,both,206.15,185.54,Cigna,Default,Percent of Total Billed Charges,121.63,,,,121.63,168.22
ENDOCRINE LEVEL 5,360,RC,,,,both,206.15,185.54,United Healthcare,Default,Fee Schedule,168.22,,,,121.63,168.22
GASTROINTESTINAL LEVEL 1,360,RC,,,,both,160.69,144.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.48,,,,94.81,131.12
GASTROINTESTINAL LEVEL 1,360,RC,,,,both,160.69,144.62,Cigna,Default,Percent of Total Billed Charges,94.81,,,,94.81,131.12
GASTROINTESTINAL LEVEL 1,360,RC,,,,both,160.69,144.62,United Healthcare,Default,Fee Schedule,131.12,,,,94.81,131.12
GASTROINTESTINAL LEVEL 2,360,RC,,,,both,162.26,146.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.58,,,,95.73,132.4
GASTROINTESTINAL LEVEL 2,360,RC,,,,both,162.26,146.03,Cigna,Default,Percent of Total Billed Charges,95.73,,,,95.73,132.4
GASTROINTESTINAL LEVEL 2,360,RC,,,,both,162.26,146.03,United Healthcare,Default,Fee Schedule,132.4,,,,95.73,132.4
GASTROINTESTINAL LEVEL 3,360,RC,,,,both,182.62,164.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.83,,,,107.75,149.02
GASTROINTESTINAL LEVEL 3,360,RC,,,,both,182.62,164.36,Cigna,Default,Percent of Total Billed Charges,107.75,,,,107.75,149.02
GASTROINTESTINAL LEVEL 3,360,RC,,,,both,182.62,164.36,United Healthcare,Default,Fee Schedule,149.02,,,,107.75,149.02
GASTROINTESTINAL LEVEL 4,360,RC,,,,both,195.57,176.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.9,,,,115.39,159.59
GASTROINTESTINAL LEVEL 4,360,RC,,,,both,195.57,176.01,Cigna,Default,Percent of Total Billed Charges,115.39,,,,115.39,159.59
GASTROINTESTINAL LEVEL 4,360,RC,,,,both,195.57,176.01,United Healthcare,Default,Fee Schedule,159.59,,,,115.39,159.59
GASTROINTESTINAL LEVEL 5,360,RC,,,,both,203.03,182.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.12,,,,119.79,165.67
GASTROINTESTINAL LEVEL 5,360,RC,,,,both,203.03,182.73,Cigna,Default,Percent of Total Billed Charges,119.79,,,,119.79,165.67
GASTROINTESTINAL LEVEL 5,360,RC,,,,both,203.03,182.73,United Healthcare,Default,Fee Schedule,165.67,,,,119.79,165.67
GYNECOLOGICAL LEVEL 1,360,RC,,,,both,160.69,144.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.48,,,,94.81,131.12
GYNECOLOGICAL LEVEL 1,360,RC,,,,both,160.69,144.62,Cigna,Default,Percent of Total Billed Charges,94.81,,,,94.81,131.12
GYNECOLOGICAL LEVEL 1,360,RC,,,,both,160.69,144.62,United Healthcare,Default,Fee Schedule,131.12,,,,94.81,131.12
GYNECOLOGICAL LEVEL 2,360,RC,,,,both,162.26,146.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.58,,,,95.73,132.4
GYNECOLOGICAL LEVEL 2,360,RC,,,,both,162.26,146.03,Cigna,Default,Percent of Total Billed Charges,95.73,,,,95.73,132.4
GYNECOLOGICAL LEVEL 2,360,RC,,,,both,162.26,146.03,United Healthcare,Default,Fee Schedule,132.4,,,,95.73,132.4
GYNECOLOGICAL LEVEL 3,360,RC,,,,both,182.62,164.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.83,,,,107.75,149.02
GYNECOLOGICAL LEVEL 3,360,RC,,,,both,182.62,164.36,Cigna,Default,Percent of Total Billed Charges,107.75,,,,107.75,149.02
GYNECOLOGICAL LEVEL 3,360,RC,,,,both,182.62,164.36,United Healthcare,Default,Fee Schedule,149.02,,,,107.75,149.02
GYNECOLOGICAL LEVEL 4,360,RC,,,,both,195.57,176.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.9,,,,115.39,159.59
GYNECOLOGICAL LEVEL 4,360,RC,,,,both,195.57,176.01,Cigna,Default,Percent of Total Billed Charges,115.39,,,,115.39,159.59
GYNECOLOGICAL LEVEL 4,360,RC,,,,both,195.57,176.01,United Healthcare,Default,Fee Schedule,159.59,,,,115.39,159.59
GYNECOLOGICAL LEVEL 5,360,RC,,,,both,203.03,182.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.12,,,,119.79,165.67
GYNECOLOGICAL LEVEL 5,360,RC,,,,both,203.03,182.73,Cigna,Default,Percent of Total Billed Charges,119.79,,,,119.79,165.67
GYNECOLOGICAL LEVEL 5,360,RC,,,,both,203.03,182.73,United Healthcare,Default,Fee Schedule,165.67,,,,119.79,165.67
URINARY LEVEL 1,360,RC,,,,both,172.15,154.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.5,,,,101.57,140.47
URINARY LEVEL 1,360,RC,,,,both,172.15,154.94,Cigna,Default,Percent of Total Billed Charges,101.57,,,,101.57,140.47
URINARY LEVEL 1,360,RC,,,,both,172.15,154.94,United Healthcare,Default,Fee Schedule,140.47,,,,101.57,140.47
URINARY LEVEL 2,360,RC,,,,both,178.3,160.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.81,,,,105.2,145.49
URINARY LEVEL 2,360,RC,,,,both,178.3,160.47,Cigna,Default,Percent of Total Billed Charges,105.2,,,,105.2,145.49
URINARY LEVEL 2,360,RC,,,,both,178.3,160.47,United Healthcare,Default,Fee Schedule,145.49,,,,105.2,145.49
URINARY LEVEL 3,360,RC,,,,both,184.45,166.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.12,,,,108.83,150.51
URINARY LEVEL 3,360,RC,,,,both,184.45,166.01,Cigna,Default,Percent of Total Billed Charges,108.83,,,,108.83,150.51
URINARY LEVEL 3,360,RC,,,,both,184.45,166.01,United Healthcare,Default,Fee Schedule,150.51,,,,108.83,150.51
URINARY LEVEL 4,360,RC,,,,both,193.05,173.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.14,,,,113.9,157.53
URINARY LEVEL 4,360,RC,,,,both,193.05,173.75,Cigna,Default,Percent of Total Billed Charges,113.9,,,,113.9,157.53
URINARY LEVEL 4,360,RC,,,,both,193.05,173.75,United Healthcare,Default,Fee Schedule,157.53,,,,113.9,157.53
URINARY LEVEL 5,360,RC,,,,both,200.43,180.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.3,,,,118.25,163.55
URINARY LEVEL 5,360,RC,,,,both,200.43,180.39,Cigna,Default,Percent of Total Billed Charges,118.25,,,,118.25,163.55
URINARY LEVEL 5,360,RC,,,,both,200.43,180.39,United Healthcare,Default,Fee Schedule,163.55,,,,118.25,163.55
INTEGUMENTARY LEVEL 1,360,RC,,,,both,160.69,144.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.48,,,,94.81,131.12
INTEGUMENTARY LEVEL 1,360,RC,,,,both,160.69,144.62,Cigna,Default,Percent of Total Billed Charges,94.81,,,,94.81,131.12
INTEGUMENTARY LEVEL 1,360,RC,,,,both,160.69,144.62,United Healthcare,Default,Fee Schedule,131.12,,,,94.81,131.12
INTEGUMENTARY LEVEL 2,360,RC,,,,both,162.27,146.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.59,,,,95.74,132.41
INTEGUMENTARY LEVEL 2,360,RC,,,,both,162.27,146.04,Cigna,Default,Percent of Total Billed Charges,95.74,,,,95.74,132.41
INTEGUMENTARY LEVEL 2,360,RC,,,,both,162.27,146.04,United Healthcare,Default,Fee Schedule,132.41,,,,95.74,132.41
INTEGUMENTARY LEVEL 3,360,RC,,,,both,182.62,164.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.83,,,,107.75,149.02
INTEGUMENTARY LEVEL 3,360,RC,,,,both,182.62,164.36,Cigna,Default,Percent of Total Billed Charges,107.75,,,,107.75,149.02
INTEGUMENTARY LEVEL 3,360,RC,,,,both,182.62,164.36,United Healthcare,Default,Fee Schedule,149.02,,,,107.75,149.02
INTEGUMENTARY LEVEL 4,360,RC,,,,both,195.57,176.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.9,,,,115.39,159.59
INTEGUMENTARY LEVEL 4,360,RC,,,,both,195.57,176.01,Cigna,Default,Percent of Total Billed Charges,115.39,,,,115.39,159.59
INTEGUMENTARY LEVEL 4,360,RC,,,,both,195.57,176.01,United Healthcare,Default,Fee Schedule,159.59,,,,115.39,159.59
INTEGUMENTARY LEVEL 5,360,RC,,,,both,203.03,182.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.12,,,,119.79,165.67
INTEGUMENTARY LEVEL 5,360,RC,,,,both,203.03,182.73,Cigna,Default,Percent of Total Billed Charges,119.79,,,,119.79,165.67
INTEGUMENTARY LEVEL 5,360,RC,,,,both,203.03,182.73,United Healthcare,Default,Fee Schedule,165.67,,,,119.79,165.67
NEUROLOGICAL LEVEL 1,360,RC,,,,both,161.48,145.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.04,,,,95.27,131.77
NEUROLOGICAL LEVEL 1,360,RC,,,,both,161.48,145.33,Cigna,Default,Percent of Total Billed Charges,95.27,,,,95.27,131.77
NEUROLOGICAL LEVEL 1,360,RC,,,,both,161.48,145.33,United Healthcare,Default,Fee Schedule,131.77,,,,95.27,131.77
NEUROLOGICAL LEVEL 2,360,RC,,,,both,163.03,146.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.12,,,,96.19,133.03
NEUROLOGICAL LEVEL 2,360,RC,,,,both,163.03,146.73,Cigna,Default,Percent of Total Billed Charges,96.19,,,,96.19,133.03
NEUROLOGICAL LEVEL 2,360,RC,,,,both,163.03,146.73,United Healthcare,Default,Fee Schedule,133.03,,,,96.19,133.03
NEUROLOGICAL LEVEL 3,360,RC,,,,both,183.82,165.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.67,,,,108.45,150
NEUROLOGICAL LEVEL 3,360,RC,,,,both,183.82,165.44,Cigna,Default,Percent of Total Billed Charges,108.45,,,,108.45,150
NEUROLOGICAL LEVEL 3,360,RC,,,,both,183.82,165.44,United Healthcare,Default,Fee Schedule,150,,,,108.45,150
NEUROLOGICAL LEVEL 4,360,RC,,,,both,195.57,176.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.9,,,,115.39,159.59
NEUROLOGICAL LEVEL 4,360,RC,,,,both,195.57,176.01,Cigna,Default,Percent of Total Billed Charges,115.39,,,,115.39,159.59
NEUROLOGICAL LEVEL 4,360,RC,,,,both,195.57,176.01,United Healthcare,Default,Fee Schedule,159.59,,,,115.39,159.59
NEUROLOGICAL LEVEL 5,360,RC,,,,both,203.03,182.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.12,,,,119.79,165.67
NEUROLOGICAL LEVEL 5,360,RC,,,,both,203.03,182.73,Cigna,Default,Percent of Total Billed Charges,119.79,,,,119.79,165.67
NEUROLOGICAL LEVEL 5,360,RC,,,,both,203.03,182.73,United Healthcare,Default,Fee Schedule,165.67,,,,119.79,165.67
RESPIRATORY LEVEL 1,360,RC,,,,both,160.69,144.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.48,,,,94.81,131.12
RESPIRATORY LEVEL 1,360,RC,,,,both,160.69,144.62,Cigna,Default,Percent of Total Billed Charges,94.81,,,,94.81,131.12
RESPIRATORY LEVEL 1,360,RC,,,,both,160.69,144.62,United Healthcare,Default,Fee Schedule,131.12,,,,94.81,131.12
RESPIRATORY LEVEL 2,360,RC,,,,both,162.27,146.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.59,,,,95.74,132.41
RESPIRATORY LEVEL 2,360,RC,,,,both,162.27,146.04,Cigna,Default,Percent of Total Billed Charges,95.74,,,,95.74,132.41
RESPIRATORY LEVEL 2,360,RC,,,,both,162.27,146.04,United Healthcare,Default,Fee Schedule,132.41,,,,95.74,132.41
RESPIRATORY LEVEL 3,360,RC,,,,both,182.62,164.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.83,,,,107.75,149.02
RESPIRATORY LEVEL 3,360,RC,,,,both,182.62,164.36,Cigna,Default,Percent of Total Billed Charges,107.75,,,,107.75,149.02
RESPIRATORY LEVEL 3,360,RC,,,,both,182.62,164.36,United Healthcare,Default,Fee Schedule,149.02,,,,107.75,149.02
RESPIRATORY LEVEL 4,360,RC,,,,both,194,174.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.8,,,,114.46,158.3
RESPIRATORY LEVEL 4,360,RC,,,,both,194,174.6,Cigna,Default,Percent of Total Billed Charges,114.46,,,,114.46,158.3
RESPIRATORY LEVEL 4,360,RC,,,,both,194,174.6,United Healthcare,Default,Fee Schedule,158.3,,,,114.46,158.3
RESPIRATORY LEVEL 5,360,RC,,,,both,210.46,189.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.32,,,,124.17,171.74
RESPIRATORY LEVEL 5,360,RC,,,,both,210.46,189.41,Cigna,Default,Percent of Total Billed Charges,124.17,,,,124.17,171.74
RESPIRATORY LEVEL 5,360,RC,,,,both,210.46,189.41,United Healthcare,Default,Fee Schedule,171.74,,,,124.17,171.74
SKELETAL LEVEL 1 SCHEDULED,360,RC,,,,both,102.5,92.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.75,,,,60.48,83.64
SKELETAL LEVEL 1 SCHEDULED,360,RC,,,,both,102.5,92.25,Cigna,Default,Percent of Total Billed Charges,60.48,,,,60.48,83.64
SKELETAL LEVEL 1 SCHEDULED,360,RC,,,,both,102.5,92.25,United Healthcare,Default,Fee Schedule,83.64,,,,60.48,83.64
SKELETAL LEVEL 2 SCHEDULED,360,RC,,,,both,103.5,93.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.45,,,,61.06,84.46
SKELETAL LEVEL 2 SCHEDULED,360,RC,,,,both,103.5,93.15,Cigna,Default,Percent of Total Billed Charges,61.06,,,,61.06,84.46
SKELETAL LEVEL 2 SCHEDULED,360,RC,,,,both,103.5,93.15,United Healthcare,Default,Fee Schedule,84.46,,,,61.06,84.46
SKELETAL LEVEL 3 SCHEDULED,360,RC,,,,both,116.5,104.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.55,,,,68.74,95.06
SKELETAL LEVEL 3 SCHEDULED,360,RC,,,,both,116.5,104.85,Cigna,Default,Percent of Total Billed Charges,68.74,,,,68.74,95.06
SKELETAL LEVEL 3 SCHEDULED,360,RC,,,,both,116.5,104.85,United Healthcare,Default,Fee Schedule,95.06,,,,68.74,95.06
SKELETAL LEVEL 4,360,RC,,,,both,185.28,166.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.7,,,,109.32,151.19
SKELETAL LEVEL 4,360,RC,,,,both,185.28,166.75,Cigna,Default,Percent of Total Billed Charges,109.32,,,,109.32,151.19
SKELETAL LEVEL 4,360,RC,,,,both,185.28,166.75,United Healthcare,Default,Fee Schedule,151.19,,,,109.32,151.19
SKELETAL LEVEL 5,360,RC,,,,both,200.59,180.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.41,,,,118.35,163.68
SKELETAL LEVEL 5,360,RC,,,,both,200.59,180.53,Cigna,Default,Percent of Total Billed Charges,118.35,,,,118.35,163.68
SKELETAL LEVEL 5,360,RC,,,,both,200.59,180.53,United Healthcare,Default,Fee Schedule,163.68,,,,118.35,163.68
SKELETAL LEVEL 1,360,RC,,,,both,153.2,137.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.24,,,,90.39,125.01
SKELETAL LEVEL 1,360,RC,,,,both,153.2,137.88,Cigna,Default,Percent of Total Billed Charges,90.39,,,,90.39,125.01
SKELETAL LEVEL 1,360,RC,,,,both,153.2,137.88,United Healthcare,Default,Fee Schedule,125.01,,,,90.39,125.01
SKELETAL LEVEL 2,360,RC,,,,both,154.98,139.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.49,,,,91.44,126.46
SKELETAL LEVEL 2,360,RC,,,,both,154.98,139.48,Cigna,Default,Percent of Total Billed Charges,91.44,,,,91.44,126.46
SKELETAL LEVEL 2,360,RC,,,,both,154.98,139.48,United Healthcare,Default,Fee Schedule,126.46,,,,91.44,126.46
SKELETAL LEVEL 3,360,RC,,,,both,180.27,162.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.19,,,,106.36,147.1
SKELETAL LEVEL 3,360,RC,,,,both,180.27,162.24,Cigna,Default,Percent of Total Billed Charges,106.36,,,,106.36,147.1
SKELETAL LEVEL 3,360,RC,,,,both,180.27,162.24,United Healthcare,Default,Fee Schedule,147.1,,,,106.36,147.1
BRONCHOSCOPY,360,RC,,,,both,5392.87,4853.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3775.01,,,,3181.79,4400.58
BRONCHOSCOPY,360,RC,,,,both,5392.87,4853.58,Cigna,Default,Percent of Total Billed Charges,3181.79,,,,3181.79,4400.58
BRONCHOSCOPY,360,RC,,,,both,5392.87,4853.58,United Healthcare,Default,Fee Schedule,4400.58,,,,3181.79,4400.58
UPPER GI ENDOSCOPY,360,RC,,,,both,3763.01,3386.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2634.11,,,,2220.18,3070.62
UPPER GI ENDOSCOPY,360,RC,,,,both,3763.01,3386.71,Cigna,Default,Percent of Total Billed Charges,2220.18,,,,2220.18,3070.62
UPPER GI ENDOSCOPY,360,RC,,,,both,3763.01,3386.71,United Healthcare,Default,Fee Schedule,3070.62,,,,2220.18,3070.62
PACU PHASE 1,710,RC,,,,both,56.66,50.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.66,,,,33.43,46.23
PACU PHASE 1,710,RC,,,,both,56.66,50.99,Cigna,Default,Percent of Total Billed Charges,33.43,,,,33.43,46.23
PACU PHASE 1,710,RC,,,,both,56.66,50.99,United Healthcare,Default,Fee Schedule,46.23,,,,33.43,46.23
ASD PHASE 2 GENERAL,710,RC,,,,both,17.1,15.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.97,,,,10.09,13.95
ASD PHASE 2 GENERAL,710,RC,,,,both,17.1,15.39,Cigna,Default,Percent of Total Billed Charges,10.09,,,,10.09,13.95
ASD PHASE 2 GENERAL,710,RC,,,,both,17.1,15.39,United Healthcare,Default,Fee Schedule,13.95,,,,10.09,13.95
EDG COLONOSCOPY W/ DILAT,360,RC,,,,both,6506.73,5856.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4554.71,,,,3838.97,5309.49
EDG COLONOSCOPY W/ DILAT,360,RC,,,,both,6506.73,5856.06,Cigna,Default,Percent of Total Billed Charges,3838.97,,,,3838.97,5309.49
EDG COLONOSCOPY W/ DILAT,360,RC,,,,both,6506.73,5856.06,United Healthcare,Default,Fee Schedule,5309.49,,,,3838.97,5309.49
COLONOSCOPY,360,RC,,,,both,3763.01,3386.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2634.11,,,,2220.18,3070.62
COLONOSCOPY,360,RC,,,,both,3763.01,3386.71,Cigna,Default,Percent of Total Billed Charges,2220.18,,,,2220.18,3070.62
COLONOSCOPY,360,RC,,,,both,3763.01,3386.71,United Healthcare,Default,Fee Schedule,3070.62,,,,2220.18,3070.62
EDG COLONOSCOPY,360,RC,,,,both,4750.48,4275.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3325.34,,,,2802.78,3876.39
EDG COLONOSCOPY,360,RC,,,,both,4750.48,4275.43,Cigna,Default,Percent of Total Billed Charges,2802.78,,,,2802.78,3876.39
EDG COLONOSCOPY,360,RC,,,,both,4750.48,4275.43,United Healthcare,Default,Fee Schedule,3876.39,,,,2802.78,3876.39
DX. SINGLE ENDOSCOPY W / WO  BX.,360,RC,,,,both,3176.47,2858.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2223.53,,,,1874.12,2592
DX. SINGLE ENDOSCOPY W / WO  BX.,360,RC,,,,both,3176.47,2858.82,Cigna,Default,Percent of Total Billed Charges,1874.12,,,,1874.12,2592
DX. SINGLE ENDOSCOPY W / WO  BX.,360,RC,,,,both,3176.47,2858.82,United Healthcare,Default,Fee Schedule,2592,,,,1874.12,2592
MULTIPLE ENDOSCOPIES W/WO BIOPSY,360,RC,,,,both,3811.9,3430.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2668.33,,,,2249.02,3110.51
MULTIPLE ENDOSCOPIES W/WO BIOPSY,360,RC,,,,both,3811.9,3430.71,Cigna,Default,Percent of Total Billed Charges,2249.02,,,,2249.02,3110.51
MULTIPLE ENDOSCOPIES W/WO BIOPSY,360,RC,,,,both,3811.9,3430.71,United Healthcare,Default,Fee Schedule,3110.51,,,,2249.02,3110.51
THERAPEUTIC SINGLE ENDO PLUS MINOR,360,RC,,,,both,4447.32,4002.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3113.12,,,,2623.92,3629.01
THERAPEUTIC SINGLE ENDO PLUS MINOR,360,RC,,,,both,4447.32,4002.59,Cigna,Default,Percent of Total Billed Charges,2623.92,,,,2623.92,3629.01
THERAPEUTIC SINGLE ENDO PLUS MINOR,360,RC,,,,both,4447.32,4002.59,United Healthcare,Default,Fee Schedule,3629.01,,,,2623.92,3629.01
ERCP,360,RC,,,,both,9397.06,8457.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6577.94,,,,5544.27,7668
ERCP,360,RC,,,,both,9397.06,8457.35,Cigna,Default,Percent of Total Billed Charges,5544.27,,,,5544.27,7668
ERCP,360,RC,,,,both,9397.06,8457.35,United Healthcare,Default,Fee Schedule,7668,,,,5544.27,7668
SPINE LEVEL 1,360,RC,,,,both,163.42,147.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.39,,,,96.42,133.35
SPINE LEVEL 1,360,RC,,,,both,163.42,147.08,Cigna,Default,Percent of Total Billed Charges,96.42,,,,96.42,133.35
SPINE LEVEL 1,360,RC,,,,both,163.42,147.08,United Healthcare,Default,Fee Schedule,133.35,,,,96.42,133.35
SPINE LEVEL 2,360,RC,,,,both,165.31,148.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.72,,,,97.53,134.89
SPINE LEVEL 2,360,RC,,,,both,165.31,148.78,Cigna,Default,Percent of Total Billed Charges,97.53,,,,97.53,134.89
SPINE LEVEL 2,360,RC,,,,both,165.31,148.78,United Healthcare,Default,Fee Schedule,134.89,,,,97.53,134.89
SPINE LEVEL 3,360,RC,,,,both,192.3,173.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.61,,,,113.46,156.92
SPINE LEVEL 3,360,RC,,,,both,192.3,173.07,Cigna,Default,Percent of Total Billed Charges,113.46,,,,113.46,156.92
SPINE LEVEL 3,360,RC,,,,both,192.3,173.07,United Healthcare,Default,Fee Schedule,156.92,,,,113.46,156.92
SPINE LEVEL 4,360,RC,,,,both,197.62,177.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,138.33,,,,116.6,161.26
SPINE LEVEL 4,360,RC,,,,both,197.62,177.86,Cigna,Default,Percent of Total Billed Charges,116.6,,,,116.6,161.26
SPINE LEVEL 4,360,RC,,,,both,197.62,177.86,United Healthcare,Default,Fee Schedule,161.26,,,,116.6,161.26
SPINE LEVEL 5,360,RC,,,,both,246.91,222.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.84,,,,145.68,201.48
SPINE LEVEL 5,360,RC,,,,both,246.91,222.22,Cigna,Default,Percent of Total Billed Charges,145.68,,,,145.68,201.48
SPINE LEVEL 5,360,RC,,,,both,246.91,222.22,United Healthcare,Default,Fee Schedule,201.48,,,,145.68,201.48
OPERATING MICROSCOPE ADD ON,69990,HCPCS,360,RC,,both,4172.84,3755.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2920.99,,,,2461.98,3405.04
OPERATING MICROSCOPE ADD ON,69990,HCPCS,360,RC,,both,4172.84,3755.56,Cigna,Default,Percent of Total Billed Charges,2461.98,,,,2461.98,3405.04
OPERATING MICROSCOPE ADD ON,69990,HCPCS,360,RC,,both,4172.84,3755.56,United Healthcare,Default,Fee Schedule,3405.04,,,,2461.98,3405.04
OPERATING MICROSCOPE ADD ON,69990,HCPCS,360,RC,,both,4172.84,3755.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2920.99,,,,2461.98,3405.04
OPERATING MICROSCOPE ADD ON,69990,HCPCS,360,RC,,both,4172.84,3755.56,Cigna,Default,Percent of Total Billed Charges,2461.98,,,,2461.98,3405.04
OPERATING MICROSCOPE ADD ON,69990,HCPCS,360,RC,,both,4172.84,3755.56,United Healthcare,Default,Fee Schedule,3405.04,,,,2461.98,3405.04
PAIN CLINIC LEVEL 2 BILAT,360,RC,,,,both,4954.11,4458.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3467.88,,,,2922.92,4042.55
PAIN CLINIC LEVEL 2 BILAT,360,RC,,,,both,4954.11,4458.7,Cigna,Default,Percent of Total Billed Charges,2922.92,,,,2922.92,4042.55
PAIN CLINIC LEVEL 2 BILAT,360,RC,,,,both,4954.11,4458.7,United Healthcare,Default,Fee Schedule,4042.55,,,,2922.92,4042.55
PODIATRY LEVEL 1,360,RC,,,,both,136.19,122.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.33,,,,80.35,111.13
PODIATRY LEVEL 1,360,RC,,,,both,136.19,122.57,Cigna,Default,Percent of Total Billed Charges,80.35,,,,80.35,111.13
PODIATRY LEVEL 1,360,RC,,,,both,136.19,122.57,United Healthcare,Default,Fee Schedule,111.13,,,,80.35,111.13
PODIATRY LEVEL 2,360,RC,,,,both,137.76,123.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.43,,,,81.28,112.41
PODIATRY LEVEL 2,360,RC,,,,both,137.76,123.98,Cigna,Default,Percent of Total Billed Charges,81.28,,,,81.28,112.41
PODIATRY LEVEL 2,360,RC,,,,both,137.76,123.98,United Healthcare,Default,Fee Schedule,112.41,,,,81.28,112.41
PODIATRY LEVEL 3,360,RC,,,,both,160.25,144.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.18,,,,94.55,130.76
PODIATRY LEVEL 3,360,RC,,,,both,160.25,144.23,Cigna,Default,Percent of Total Billed Charges,94.55,,,,94.55,130.76
PODIATRY LEVEL 3,360,RC,,,,both,160.25,144.23,United Healthcare,Default,Fee Schedule,130.76,,,,94.55,130.76
PODIATRY LEVEL 4,360,RC,,,,both,164.69,148.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.28,,,,97.17,134.39
PODIATRY LEVEL 4,360,RC,,,,both,164.69,148.22,Cigna,Default,Percent of Total Billed Charges,97.17,,,,97.17,134.39
PODIATRY LEVEL 4,360,RC,,,,both,164.69,148.22,United Healthcare,Default,Fee Schedule,134.39,,,,97.17,134.39
PODIATRY LEVEL 5,360,RC,,,,both,178.31,160.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.82,,,,105.2,145.5
PODIATRY LEVEL 5,360,RC,,,,both,178.31,160.48,Cigna,Default,Percent of Total Billed Charges,105.2,,,,105.2,145.5
PODIATRY LEVEL 5,360,RC,,,,both,178.31,160.48,United Healthcare,Default,Fee Schedule,145.5,,,,105.2,145.5
THORACENTESIS W/IMAGING,360,RC,,,,both,1926.4,1733.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1348.48,,,,1136.58,1571.94
THORACENTESIS W/IMAGING,360,RC,,,,both,1926.4,1733.76,Cigna,Default,Percent of Total Billed Charges,1136.58,,,,1136.58,1571.94
THORACENTESIS W/IMAGING,360,RC,,,,both,1926.4,1733.76,United Healthcare,Default,Fee Schedule,1571.94,,,,1136.58,1571.94
MINOR PROCEDURE RAD,360,RC,,,,both,2843.03,2558.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1990.12,,,,1677.39,2319.91
MINOR PROCEDURE RAD,360,RC,,,,both,2843.03,2558.73,Cigna,Default,Percent of Total Billed Charges,1677.39,,,,1677.39,2319.91
MINOR PROCEDURE RAD,360,RC,,,,both,2843.03,2558.73,United Healthcare,Default,Fee Schedule,2319.91,,,,1677.39,2319.91
MINOR PROCEDURE,360,RC,,,,both,2925.48,2632.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2047.84,,,,1726.03,2387.19
MINOR PROCEDURE,360,RC,,,,both,2925.48,2632.93,Cigna,Default,Percent of Total Billed Charges,1726.03,,,,1726.03,2387.19
MINOR PROCEDURE,360,RC,,,,both,2925.48,2632.93,United Healthcare,Default,Fee Schedule,2387.19,,,,1726.03,2387.19
PAIN CLINIC PROCEDURE,360,RC,,,,both,2565.96,2309.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1796.17,,,,1513.92,2093.82
PAIN CLINIC PROCEDURE,360,RC,,,,both,2565.96,2309.36,Cigna,Default,Percent of Total Billed Charges,1513.92,,,,1513.92,2093.82
PAIN CLINIC PROCEDURE,360,RC,,,,both,2565.96,2309.36,United Healthcare,Default,Fee Schedule,2093.82,,,,1513.92,2093.82
PAIN CLINIC LEVEL 2,360,RC,,,,both,3302.75,2972.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2311.92,,,,1948.62,2695.04
PAIN CLINIC LEVEL 2,360,RC,,,,both,3302.75,2972.48,Cigna,Default,Percent of Total Billed Charges,1948.62,,,,1948.62,2695.04
PAIN CLINIC LEVEL 2,360,RC,,,,both,3302.75,2972.48,United Healthcare,Default,Fee Schedule,2695.04,,,,1948.62,2695.04
BEDSIDE PROCEDURE,360,RC,,,,both,2229.45,2006.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1560.62,,,,1315.38,1819.23
BEDSIDE PROCEDURE,360,RC,,,,both,2229.45,2006.51,Cigna,Default,Percent of Total Billed Charges,1315.38,,,,1315.38,1819.23
BEDSIDE PROCEDURE,360,RC,,,,both,2229.45,2006.51,United Healthcare,Default,Fee Schedule,1819.23,,,,1315.38,1819.23
PILLCAM PLACEMENT,91110,HCPCS,750,RC,,both,2925.59,2633.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2047.91,,,,1726.1,2387.28
PILLCAM PLACEMENT,91110,HCPCS,750,RC,,both,2925.59,2633.03,Cigna,Default,Percent of Total Billed Charges,1726.1,,,,1726.1,2387.28
PILLCAM PLACEMENT,91110,HCPCS,750,RC,,both,2925.59,2633.03,United Healthcare,Default,Fee Schedule,2387.28,,,,1726.1,2387.28
ASD NURSING SERVICE,99211,HCPCS,761,RC,,outpatient,208.44,187.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.91,,,,122.98,170.09
ASD NURSING SERVICE,99211,HCPCS,761,RC,,outpatient,208.44,187.6,Cigna,Default,Percent of Total Billed Charges,122.98,,,,122.98,170.09
ASD NURSING SERVICE,99211,HCPCS,761,RC,,outpatient,208.44,187.6,United Healthcare,Default,Fee Schedule,170.09,,,,122.98,170.09
CT GUIDED MINOR PROCEDURE,360,RC,,,,both,5063.79,4557.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3544.65,,,,2987.64,4132.05
CT GUIDED MINOR PROCEDURE,360,RC,,,,both,5063.79,4557.41,Cigna,Default,Percent of Total Billed Charges,2987.64,,,,2987.64,4132.05
CT GUIDED MINOR PROCEDURE,360,RC,,,,both,5063.79,4557.41,United Healthcare,Default,Fee Schedule,4132.05,,,,2987.64,4132.05
ACL RECONSTRUCTION,360,RC,,,,both,20116,18104.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14081.2,,,,11868.44,16414.66
ACL RECONSTRUCTION,360,RC,,,,both,20116,18104.4,Cigna,Default,Percent of Total Billed Charges,11868.44,,,,11868.44,16414.66
ACL RECONSTRUCTION,360,RC,,,,both,20116,18104.4,United Healthcare,Default,Fee Schedule,16414.66,,,,11868.44,16414.66
KNEE ARTHROSCOPY,360,RC,,,,both,10186.26,9167.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7130.38,,,,6009.89,8311.99
KNEE ARTHROSCOPY,360,RC,,,,both,10186.26,9167.63,Cigna,Default,Percent of Total Billed Charges,6009.89,,,,6009.89,8311.99
KNEE ARTHROSCOPY,360,RC,,,,both,10186.26,9167.63,United Healthcare,Default,Fee Schedule,8311.99,,,,6009.89,8311.99
ORIF DISTAL EXTREMITY,360,RC,,,,both,10281.5,9253.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7197.05,,,,6066.08,8389.7
ORIF DISTAL EXTREMITY,360,RC,,,,both,10281.5,9253.35,Cigna,Default,Percent of Total Billed Charges,6066.08,,,,6066.08,8389.7
ORIF DISTAL EXTREMITY,360,RC,,,,both,10281.5,9253.35,United Healthcare,Default,Fee Schedule,8389.7,,,,6066.08,8389.7
ORIF HIP,360,RC,,,,both,12797.75,11517.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8958.42,,,,7550.67,10442.96
ORIF HIP,360,RC,,,,both,12797.75,11517.98,Cigna,Default,Percent of Total Billed Charges,7550.67,,,,7550.67,10442.96
ORIF HIP,360,RC,,,,both,12797.75,11517.98,United Healthcare,Default,Fee Schedule,10442.96,,,,7550.67,10442.96
ORIF PATELLA,360,RC,,,,both,13601.25,12241.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9520.88,,,,8024.74,11098.62
ORIF PATELLA,360,RC,,,,both,13601.25,12241.13,Cigna,Default,Percent of Total Billed Charges,8024.74,,,,8024.74,11098.62
ORIF PATELLA,360,RC,,,,both,13601.25,12241.13,United Healthcare,Default,Fee Schedule,11098.62,,,,8024.74,11098.62
QUADRICEP TENDON REPAIR,360,RC,,,,both,11821.25,10639.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8274.88,,,,6974.54,9646.14
QUADRICEP TENDON REPAIR,360,RC,,,,both,11821.25,10639.13,Cigna,Default,Percent of Total Billed Charges,6974.54,,,,6974.54,9646.14
QUADRICEP TENDON REPAIR,360,RC,,,,both,11821.25,10639.13,United Healthcare,Default,Fee Schedule,9646.14,,,,6974.54,9646.14
ROTATOR CUFF REPAIR,360,RC,,,,both,21027.34,18924.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14719.14,,,,12406.13,17158.31
ROTATOR CUFF REPAIR,360,RC,,,,both,21027.34,18924.61,Cigna,Default,Percent of Total Billed Charges,12406.13,,,,12406.13,17158.31
ROTATOR CUFF REPAIR,360,RC,,,,both,21027.34,18924.61,United Healthcare,Default,Fee Schedule,17158.31,,,,12406.13,17158.31
SHOULDER ARTHROSCOPY,360,RC,,,,both,20520.46,18468.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14364.32,,,,12107.07,16744.7
SHOULDER ARTHROSCOPY,360,RC,,,,both,20520.46,18468.41,Cigna,Default,Percent of Total Billed Charges,12107.07,,,,12107.07,16744.7
SHOULDER ARTHROSCOPY,360,RC,,,,both,20520.46,18468.41,United Healthcare,Default,Fee Schedule,16744.7,,,,12107.07,16744.7
SHOULDER DECOMPRESSION DIS CLAVICAL,360,RC,,,,both,18253.46,16428.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12777.42,,,,10769.54,14894.82
SHOULDER DECOMPRESSION DIS CLAVICAL,360,RC,,,,both,18253.46,16428.11,Cigna,Default,Percent of Total Billed Charges,10769.54,,,,10769.54,14894.82
SHOULDER DECOMPRESSION DIS CLAVICAL,360,RC,,,,both,18253.46,16428.11,United Healthcare,Default,Fee Schedule,14894.82,,,,10769.54,14894.82
SHOULDER RESURFACE/ARTHROPLASTY,360,RC,,,,both,17784,16005.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12448.8,,,,10492.56,14511.74
SHOULDER RESURFACE/ARTHROPLASTY,360,RC,,,,both,17784,16005.6,Cigna,Default,Percent of Total Billed Charges,10492.56,,,,10492.56,14511.74
SHOULDER RESURFACE/ARTHROPLASTY,360,RC,,,,both,17784,16005.6,United Healthcare,Default,Fee Schedule,14511.74,,,,10492.56,14511.74
TOPAZ TENOTOMY,360,RC,,,,both,11367.28,10230.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7957.1,,,,6706.7,9275.7
TOPAZ TENOTOMY,360,RC,,,,both,11367.28,10230.55,Cigna,Default,Percent of Total Billed Charges,6706.7,,,,6706.7,9275.7
TOPAZ TENOTOMY,360,RC,,,,both,11367.28,10230.55,United Healthcare,Default,Fee Schedule,9275.7,,,,6706.7,9275.7
TOTAL KNEE REPLACEMENT,360,RC,,,,both,17639.75,15875.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12347.82,,,,10407.45,14394.04
TOTAL KNEE REPLACEMENT,360,RC,,,,both,17639.75,15875.78,Cigna,Default,Percent of Total Billed Charges,10407.45,,,,10407.45,14394.04
TOTAL KNEE REPLACEMENT,360,RC,,,,both,17639.75,15875.78,United Healthcare,Default,Fee Schedule,14394.04,,,,10407.45,14394.04
TOTAL HIP REPLACEMENT,360,RC,,,,both,15779.5,14201.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11045.65,,,,9309.9,12876.07
TOTAL HIP REPLACEMENT,360,RC,,,,both,15779.5,14201.55,Cigna,Default,Percent of Total Billed Charges,9309.9,,,,9309.9,12876.07
TOTAL HIP REPLACEMENT,360,RC,,,,both,15779.5,14201.55,United Healthcare,Default,Fee Schedule,12876.07,,,,9309.9,12876.07
ARTHRODESIS,360,RC,,,,both,9126.22,8213.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6388.35,,,,5384.47,7447
ARTHRODESIS,360,RC,,,,both,9126.22,8213.6,Cigna,Default,Percent of Total Billed Charges,5384.47,,,,5384.47,7447
ARTHRODESIS,360,RC,,,,both,9126.22,8213.6,United Healthcare,Default,Fee Schedule,7447,,,,5384.47,7447
BUNIONECTOMY,360,RC,,,,both,11264.11,10137.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7884.88,,,,6645.82,9191.51
BUNIONECTOMY,360,RC,,,,both,11264.11,10137.7,Cigna,Default,Percent of Total Billed Charges,6645.82,,,,6645.82,9191.51
BUNIONECTOMY,360,RC,,,,both,11264.11,10137.7,United Healthcare,Default,Fee Schedule,9191.51,,,,6645.82,9191.51
CYSTOSCOPY,360,RC,,,,both,8837.46,7953.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6186.22,,,,5214.1,7211.37
CYSTOSCOPY,360,RC,,,,both,8837.46,7953.71,Cigna,Default,Percent of Total Billed Charges,5214.1,,,,5214.1,7211.37
CYSTOSCOPY,360,RC,,,,both,8837.46,7953.71,United Healthcare,Default,Fee Schedule,7211.37,,,,5214.1,7211.37
LITHOTRIPSY,360,RC,,,,both,18532.89,16679.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12973.02,,,,10934.41,15122.84
LITHOTRIPSY,360,RC,,,,both,18532.89,16679.6,Cigna,Default,Percent of Total Billed Charges,10934.41,,,,10934.41,15122.84
LITHOTRIPSY,360,RC,,,,both,18532.89,16679.6,United Healthcare,Default,Fee Schedule,15122.84,,,,10934.41,15122.84
BLADDER INSTILLATION,51700,HCPCS,360,RC,,both,353.75,318.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,247.62,,,,208.71,288.66
BLADDER INSTILLATION,51700,HCPCS,360,RC,,both,353.75,318.38,Cigna,Default,Percent of Total Billed Charges,208.71,,,,208.71,288.66
BLADDER INSTILLATION,51700,HCPCS,360,RC,,both,353.75,318.38,United Healthcare,Default,Fee Schedule,288.66,,,,208.71,288.66
ESWL Rental,360,RC,,,,both,6260.08,5634.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4382.06,,,,3693.45,5108.23
ESWL Rental,360,RC,,,,both,6260.08,5634.07,Cigna,Default,Percent of Total Billed Charges,3693.45,,,,3693.45,5108.23
ESWL Rental,360,RC,,,,both,6260.08,5634.07,United Healthcare,Default,Fee Schedule,5108.23,,,,3693.45,5108.23
CYSTO INSERTION TRANSPROSTATIC IMPLANT S,52441,HCPCS,360,RC,,both,5998.34,5398.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4198.84,,,,3539.02,4894.65
CYSTO INSERTION TRANSPROSTATIC IMPLANT S,52441,HCPCS,360,RC,,both,5998.34,5398.51,Cigna,Default,Percent of Total Billed Charges,3539.02,,,,3539.02,4894.65
CYSTO INSERTION TRANSPROSTATIC IMPLANT S,52441,HCPCS,360,RC,,both,5998.34,5398.51,United Healthcare,Default,Fee Schedule,4894.65,,,,3539.02,4894.65
ADDL TRANSPROSTATIC IMPLANT,52442,HCPCS,360,RC,,both,1581.38,1423.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1106.97,,,,933.01,1290.41
ADDL TRANSPROSTATIC IMPLANT,52442,HCPCS,360,RC,,both,1581.38,1423.24,Cigna,Default,Percent of Total Billed Charges,933.01,,,,933.01,1290.41
ADDL TRANSPROSTATIC IMPLANT,52442,HCPCS,360,RC,,both,1581.38,1423.24,United Healthcare,Default,Fee Schedule,1290.41,,,,933.01,1290.41
CYSTO W/ INSERT 1 TO 3 IMPLANTS MC,C9739,HCPCS,360,RC,,both,14920.45,13428.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10444.32,,,,8803.07,12175.09
CYSTO W/ INSERT 1 TO 3 IMPLANTS MC,C9739,HCPCS,360,RC,,both,14920.45,13428.41,Cigna,Default,Percent of Total Billed Charges,8803.07,,,,8803.07,12175.09
CYSTO W/ INSERT 1 TO 3 IMPLANTS MC,C9739,HCPCS,360,RC,,both,14920.45,13428.41,United Healthcare,Default,Fee Schedule,12175.09,,,,8803.07,12175.09
CYSTO W/ INSERT TRANSPROSTATIC IMPLANT 4,C9740,HCPCS,360,RC,,both,29036.48,26132.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20325.54,,,,17131.52,23693.77
CYSTO W/ INSERT TRANSPROSTATIC IMPLANT 4,C9740,HCPCS,360,RC,,both,29036.48,26132.83,Cigna,Default,Percent of Total Billed Charges,17131.52,,,,17131.52,23693.77
CYSTO W/ INSERT TRANSPROSTATIC IMPLANT 4,C9740,HCPCS,360,RC,,both,29036.48,26132.83,United Healthcare,Default,Fee Schedule,23693.77,,,,17131.52,23693.77
CYSTOSCOPY W/ URETEROSCOPY,360,RC,,,,both,15885.63,14297.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11119.94,,,,9372.52,12962.67
CYSTOSCOPY W/ URETEROSCOPY,360,RC,,,,both,15885.63,14297.07,Cigna,Default,Percent of Total Billed Charges,9372.52,,,,9372.52,12962.67
CYSTOSCOPY W/ URETEROSCOPY,360,RC,,,,both,15885.63,14297.07,United Healthcare,Default,Fee Schedule,12962.67,,,,9372.52,12962.67
INFERIOR VENA CAVA FILTER,C1880,HCPCS,278,RC,,both,9922.44,8930.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6945.71,,,,5854.24,8096.71
INFERIOR VENA CAVA FILTER,C1880,HCPCS,278,RC,,both,9922.44,8930.2,Cigna,Default,Percent of Total Billed Charges,5854.24,,,,5854.24,8096.71
INFERIOR VENA CAVA FILTER,C1880,HCPCS,278,RC,,both,9922.44,8930.2,United Healthcare,Default,Fee Schedule,8096.71,,,,5854.24,8096.71
MEDIPORT PLACEMENT,360,RC,,,,both,10914.7,9823.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7640.29,,,,6439.67,8906.4
MEDIPORT PLACEMENT,360,RC,,,,both,10914.7,9823.23,Cigna,Default,Percent of Total Billed Charges,6439.67,,,,6439.67,8906.4
MEDIPORT PLACEMENT,360,RC,,,,both,10914.7,9823.23,United Healthcare,Default,Fee Schedule,8906.4,,,,6439.67,8906.4
LAPAROSCOPIC CHOLECYSTECTOMY,360,RC,,,,both,18376.49,16538.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12863.54,,,,10842.13,14995.22
LAPAROSCOPIC CHOLECYSTECTOMY,360,RC,,,,both,18376.49,16538.84,Cigna,Default,Percent of Total Billed Charges,10842.13,,,,10842.13,14995.22
LAPAROSCOPIC CHOLECYSTECTOMY,360,RC,,,,both,18376.49,16538.84,United Healthcare,Default,Fee Schedule,14995.22,,,,10842.13,14995.22
LAPAROSCOPIC NISSEN FUNDOPLICATION,360,RC,,,,both,26086.72,23478.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18260.7,,,,15391.16,21286.76
LAPAROSCOPIC NISSEN FUNDOPLICATION,360,RC,,,,both,26086.72,23478.05,Cigna,Default,Percent of Total Billed Charges,15391.16,,,,15391.16,21286.76
LAPAROSCOPIC NISSEN FUNDOPLICATION,360,RC,,,,both,26086.72,23478.05,United Healthcare,Default,Fee Schedule,21286.76,,,,15391.16,21286.76
LAPAROSCOPIC NISSEN CHOLECYSTECTOMY,360,RC,,,,both,26086.72,23478.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18260.7,,,,15391.16,21286.76
LAPAROSCOPIC NISSEN CHOLECYSTECTOMY,360,RC,,,,both,26086.72,23478.05,Cigna,Default,Percent of Total Billed Charges,15391.16,,,,15391.16,21286.76
LAPAROSCOPIC NISSEN CHOLECYSTECTOMY,360,RC,,,,both,26086.72,23478.05,United Healthcare,Default,Fee Schedule,21286.76,,,,15391.16,21286.76
PACEMAKER GENERATOR REPLACEMENT,360,RC,,,,both,27182.02,24463.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19027.41,,,,16037.39,22180.53
PACEMAKER GENERATOR REPLACEMENT,360,RC,,,,both,27182.02,24463.82,Cigna,Default,Percent of Total Billed Charges,16037.39,,,,16037.39,22180.53
PACEMAKER GENERATOR REPLACEMENT,360,RC,,,,both,27182.02,24463.82,United Healthcare,Default,Fee Schedule,22180.53,,,,16037.39,22180.53
LAP PARAESOPHAG HERN REPAIR,360,RC,,,,both,32056.3,28850.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22439.41,,,,18913.22,26157.94
LAP PARAESOPHAG HERN REPAIR,360,RC,,,,both,32056.3,28850.67,Cigna,Default,Percent of Total Billed Charges,18913.22,,,,18913.22,26157.94
LAP PARAESOPHAG HERN REPAIR,360,RC,,,,both,32056.3,28850.67,United Healthcare,Default,Fee Schedule,26157.94,,,,18913.22,26157.94
UMBILICAL HERNIA REPAIR,360,RC,,,,both,11233.97,10110.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7863.78,,,,6628.04,9166.92
UMBILICAL HERNIA REPAIR,360,RC,,,,both,11233.97,10110.57,Cigna,Default,Percent of Total Billed Charges,6628.04,,,,6628.04,9166.92
UMBILICAL HERNIA REPAIR,360,RC,,,,both,11233.97,10110.57,United Healthcare,Default,Fee Schedule,9166.92,,,,6628.04,9166.92
CYSTO W/ LITHOTRIPSY,360,RC,,,,both,15899.8,14309.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11129.86,,,,9380.88,12974.24
CYSTO W/ LITHOTRIPSY,360,RC,,,,both,15899.8,14309.82,Cigna,Default,Percent of Total Billed Charges,9380.88,,,,9380.88,12974.24
CYSTO W/ LITHOTRIPSY,360,RC,,,,both,15899.8,14309.82,United Healthcare,Default,Fee Schedule,12974.24,,,,9380.88,12974.24
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,480,RC,,both,210.47,189.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.33,,,,124.18,171.74
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,480,RC,,both,210.47,189.42,Cigna,Default,Percent of Total Billed Charges,124.18,,,,124.18,171.74
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,480,RC,,both,210.47,189.42,United Healthcare,Default,Fee Schedule,171.74,,,,124.18,171.74
RECOVERY RM PHASE I FIRST 1/2 HOUR,710,RC,,,,both,736.75,663.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,515.72,,,,434.68,601.19
RECOVERY RM PHASE I FIRST 1/2 HOUR,710,RC,,,,both,736.75,663.08,Cigna,Default,Percent of Total Billed Charges,434.68,,,,434.68,601.19
RECOVERY RM PHASE I FIRST 1/2 HOUR,710,RC,,,,both,736.75,663.08,United Healthcare,Default,Fee Schedule,601.19,,,,434.68,601.19
RECOVERY ROOM PHASE 1 ADDITIONAL 1/2 HR,710,RC,,,,both,484,435.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.8,,,,285.56,394.94
RECOVERY ROOM PHASE 1 ADDITIONAL 1/2 HR,710,RC,,,,both,484,435.6,Cigna,Default,Percent of Total Billed Charges,285.56,,,,285.56,394.94
RECOVERY ROOM PHASE 1 ADDITIONAL 1/2 HR,710,RC,,,,both,484,435.6,United Healthcare,Default,Fee Schedule,394.94,,,,285.56,394.94
ENEMA,45999,HCPCS,360,RC,,both,285.5,256.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.85,,,,168.44,232.97
ENEMA,45999,HCPCS,360,RC,,both,285.5,256.95,Cigna,Default,Percent of Total Billed Charges,168.44,,,,168.44,232.97
ENEMA,45999,HCPCS,360,RC,,both,285.5,256.95,United Healthcare,Default,Fee Schedule,232.97,,,,168.44,232.97
VENIPUNCTURE CUTDOWN,36425,HCPCS,360,RC,,both,17.25,15.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.08,,,,10.18,14.08
VENIPUNCTURE CUTDOWN,36425,HCPCS,360,RC,,both,17.25,15.53,Cigna,Default,Percent of Total Billed Charges,10.18,,,,10.18,14.08
VENIPUNCTURE CUTDOWN,36425,HCPCS,360,RC,,both,17.25,15.53,United Healthcare,Default,Fee Schedule,14.08,,,,10.18,14.08
CENTRAL VENOUS CATHETER,360,RC,,,,both,4951.15,4456.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3465.8,,,,2921.18,4040.14
CENTRAL VENOUS CATHETER,360,RC,,,,both,4951.15,4456.04,Cigna,Default,Percent of Total Billed Charges,2921.18,,,,2921.18,4040.14
CENTRAL VENOUS CATHETER,360,RC,,,,both,4951.15,4456.04,United Healthcare,Default,Fee Schedule,4040.14,,,,2921.18,4040.14
WITHDRAWAL OF ARTERIAL BLOOD,36600,HCPCS,360,RC,,both,17.25,15.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.08,,,,10.18,14.08
WITHDRAWAL OF ARTERIAL BLOOD,36600,HCPCS,360,RC,,both,17.25,15.53,Cigna,Default,Percent of Total Billed Charges,10.18,,,,10.18,14.08
WITHDRAWAL OF ARTERIAL BLOOD,36600,HCPCS,360,RC,,both,17.25,15.53,United Healthcare,Default,Fee Schedule,14.08,,,,10.18,14.08
DECLOTTING BY THROMBOLYTIC AGENT,36593,HCPCS,360,RC,,both,192.5,173.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.75,,,,113.58,157.08
DECLOTTING BY THROMBOLYTIC AGENT,36593,HCPCS,360,RC,,both,192.5,173.25,Cigna,Default,Percent of Total Billed Charges,113.58,,,,113.58,157.08
DECLOTTING BY THROMBOLYTIC AGENT,36593,HCPCS,360,RC,,both,192.5,173.25,United Healthcare,Default,Fee Schedule,157.08,,,,113.58,157.08
BLOOD TRANSFUSION,36430,HCPCS,360,RC,,both,263.5,237.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.45,,,,155.46,215.02
BLOOD TRANSFUSION,36430,HCPCS,360,RC,,both,263.5,237.15,Cigna,Default,Percent of Total Billed Charges,155.46,,,,155.46,215.02
BLOOD TRANSFUSION,36430,HCPCS,360,RC,,both,263.5,237.15,United Healthcare,Default,Fee Schedule,215.02,,,,155.46,215.02
GLUCOSE BLOOD REAGENT STRIP,82948,HCPCS,360,RC,,both,4.5,4.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.15,,,,2.66,3.67
GLUCOSE BLOOD REAGENT STRIP,82948,HCPCS,360,RC,,both,4.5,4.05,Cigna,Default,Percent of Total Billed Charges,2.66,,,,2.66,3.67
GLUCOSE BLOOD REAGENT STRIP,82948,HCPCS,360,RC,,both,4.5,4.05,United Healthcare,Default,Fee Schedule,3.67,,,,2.66,3.67
IV PUSH MEDICATION INITIAL,96374,HCPCS,360,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
IV PUSH MEDICATION INITIAL,96374,HCPCS,360,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
IV PUSH MEDICATION INITIAL,96374,HCPCS,360,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
IM INJ ANTIBIOTIC,96372,HCPCS,360,RC,,both,122.5,110.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.75,,,,72.28,99.96
IM INJ ANTIBIOTIC,96372,HCPCS,360,RC,,both,122.5,110.25,Cigna,Default,Percent of Total Billed Charges,72.28,,,,72.28,99.96
IM INJ ANTIBIOTIC,96372,HCPCS,360,RC,,both,122.5,110.25,United Healthcare,Default,Fee Schedule,99.96,,,,72.28,99.96
IV PUSH MEDICATION EACH SUBSEQUENT,96375,HCPCS,360,RC,,both,122.5,110.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.75,,,,72.28,99.96
IV PUSH MEDICATION EACH SUBSEQUENT,96375,HCPCS,360,RC,,both,122.5,110.25,Cigna,Default,Percent of Total Billed Charges,72.28,,,,72.28,99.96
IV PUSH MEDICATION EACH SUBSEQUENT,96375,HCPCS,360,RC,,both,122.5,110.25,United Healthcare,Default,Fee Schedule,99.96,,,,72.28,99.96
BRAVO PH MONITORING,91035,HCPCS,920,RC,,both,1800.04,1620.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1260.03,,,,1062.02,1468.83
BRAVO PH MONITORING,91035,HCPCS,920,RC,,both,1800.04,1620.04,Cigna,Default,Percent of Total Billed Charges,1062.02,,,,1062.02,1468.83
BRAVO PH MONITORING,91035,HCPCS,920,RC,,both,1800.04,1620.04,United Healthcare,Default,Fee Schedule,1468.83,,,,1062.02,1468.83
ASD PHASE 2 MAC ANESTH,710,RC,,,,both,14.1,12.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.87,,,,8.32,11.51
ASD PHASE 2 MAC ANESTH,710,RC,,,,both,14.1,12.69,Cigna,Default,Percent of Total Billed Charges,8.32,,,,8.32,11.51
ASD PHASE 2 MAC ANESTH,710,RC,,,,both,14.1,12.69,United Healthcare,Default,Fee Schedule,11.51,,,,8.32,11.51
ASD PHASE 2 SCOPE,710,RC,,,,both,650,585,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,455,,,,383.5,530.4
ASD PHASE 2 SCOPE,710,RC,,,,both,650,585,Cigna,Default,Percent of Total Billed Charges,383.5,,,,383.5,530.4
ASD PHASE 2 SCOPE,710,RC,,,,both,650,585,United Healthcare,Default,Fee Schedule,530.4,,,,383.5,530.4
INFUSION THER OTHER THAN CHEMO,96365,HCPCS,360,RC,,both,362.5,326.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,253.75,,,,213.88,295.8
INFUSION THER OTHER THAN CHEMO,96365,HCPCS,360,RC,,both,362.5,326.25,Cigna,Default,Percent of Total Billed Charges,213.88,,,,213.88,295.8
INFUSION THER OTHER THAN CHEMO,96365,HCPCS,360,RC,,both,362.5,326.25,United Healthcare,Default,Fee Schedule,295.8,,,,213.88,295.8
GLUCOSE BLOOD REAGENT STRIP,82948,HCPCS,360,RC,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
GLUCOSE BLOOD REAGENT STRIP,82948,HCPCS,360,RC,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
GLUCOSE BLOOD REAGENT STRIP,82948,HCPCS,360,RC,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
COLORECTAL SCRN; HI RISK IND,82270,HCPCS,360,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
COLORECTAL SCRN; HI RISK IND,82270,HCPCS,360,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
COLORECTAL SCRN; HI RISK IND,82270,HCPCS,360,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
LITHOTRIPSY UNILATERAL,50590,HCPCS,360,RC,,both,12332.09,11098.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8632.46,,,,7275.93,10062.99
LITHOTRIPSY UNILATERAL,50590,HCPCS,360,RC,,both,12332.09,11098.88,Cigna,Default,Percent of Total Billed Charges,7275.93,,,,7275.93,10062.99
LITHOTRIPSY UNILATERAL,50590,HCPCS,360,RC,,both,12332.09,11098.88,United Healthcare,Default,Fee Schedule,10062.99,,,,7275.93,10062.99
ESOPHAGEAL MANOMETRY,91010,HCPCS,750,RC,,both,1807.69,1626.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1265.38,,,,1066.54,1475.08
ESOPHAGEAL MANOMETRY,91010,HCPCS,750,RC,,both,1807.69,1626.92,Cigna,Default,Percent of Total Billed Charges,1066.54,,,,1066.54,1475.08
ESOPHAGEAL MANOMETRY,91010,HCPCS,750,RC,,both,1807.69,1626.92,United Healthcare,Default,Fee Schedule,1475.08,,,,1066.54,1475.08
ARTHROSCOPY,50590,HCPCS,360,RC,,both,11323.03,10190.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7926.12,,,,6680.59,9239.59
ARTHROSCOPY,50590,HCPCS,360,RC,,both,11323.03,10190.73,Cigna,Default,Percent of Total Billed Charges,6680.59,,,,6680.59,9239.59
ARTHROSCOPY,50590,HCPCS,360,RC,,both,11323.03,10190.73,United Healthcare,Default,Fee Schedule,9239.59,,,,6680.59,9239.59
RESTECH GASTROESOPH REFLUX W NASAL PH,91034,HCPCS,750,RC,,both,1807.69,1626.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1265.38,,,,1066.54,1475.08
RESTECH GASTROESOPH REFLUX W NASAL PH,91034,HCPCS,750,RC,,both,1807.69,1626.92,Cigna,Default,Percent of Total Billed Charges,1066.54,,,,1066.54,1475.08
RESTECH GASTROESOPH REFLUX W NASAL PH,91034,HCPCS,750,RC,,both,1807.69,1626.92,United Healthcare,Default,Fee Schedule,1475.08,,,,1066.54,1475.08
FLEXIBLE SIGMOIDOSCOPY,360,RC,,,,both,2623.89,2361.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1836.72,,,,1548.1,2141.09
FLEXIBLE SIGMOIDOSCOPY,360,RC,,,,both,2623.89,2361.5,Cigna,Default,Percent of Total Billed Charges,1548.1,,,,1548.1,2141.09
FLEXIBLE SIGMOIDOSCOPY,360,RC,,,,both,2623.89,2361.5,United Healthcare,Default,Fee Schedule,2141.09,,,,1548.1,2141.09
LAP GASTROESOPH SPHINC AUG,360,RC,,,,both,26086.72,23478.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18260.7,,,,15391.16,21286.76
LAP GASTROESOPH SPHINC AUG,360,RC,,,,both,26086.72,23478.05,Cigna,Default,Percent of Total Billed Charges,15391.16,,,,15391.16,21286.76
LAP GASTROESOPH SPHINC AUG,360,RC,,,,both,26086.72,23478.05,United Healthcare,Default,Fee Schedule,21286.76,,,,15391.16,21286.76
DESTRUCTION INTERNAL HEMORRHOID THERMAL,46930,HCPCS,360,RC,,both,3737.81,3364.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2616.47,,,,2205.31,3050.05
DESTRUCTION INTERNAL HEMORRHOID THERMAL,46930,HCPCS,360,RC,,both,3737.81,3364.03,Cigna,Default,Percent of Total Billed Charges,2205.31,,,,2205.31,3050.05
DESTRUCTION INTERNAL HEMORRHOID THERMAL,46930,HCPCS,360,RC,,both,3737.81,3364.03,United Healthcare,Default,Fee Schedule,3050.05,,,,2205.31,3050.05
HOLMIUM LASER,360,RC,,,,both,3088.2,2779.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2161.74,,,,1822.04,2519.97
HOLMIUM LASER,360,RC,,,,both,3088.2,2779.38,Cigna,Default,Percent of Total Billed Charges,1822.04,,,,1822.04,2519.97
HOLMIUM LASER,360,RC,,,,both,3088.2,2779.38,United Healthcare,Default,Fee Schedule,2519.97,,,,1822.04,2519.97
GREENLIGHT LASER,360,RC,,,,both,6120.75,5508.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4284.52,,,,3611.24,4994.53
GREENLIGHT LASER,360,RC,,,,both,6120.75,5508.68,Cigna,Default,Percent of Total Billed Charges,3611.24,,,,3611.24,4994.53
GREENLIGHT LASER,360,RC,,,,both,6120.75,5508.68,United Healthcare,Default,Fee Schedule,4994.53,,,,3611.24,4994.53
200 MICRON FIBER,360,RC,,,,both,1241.65,1117.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,869.16,,,,732.57,1013.19
200 MICRON FIBER,360,RC,,,,both,1241.65,1117.49,Cigna,Default,Percent of Total Billed Charges,732.57,,,,732.57,1013.19
200 MICRON FIBER,360,RC,,,,both,1241.65,1117.49,United Healthcare,Default,Fee Schedule,1013.19,,,,732.57,1013.19
EWSL UNILAT LITHOTRIPS RENTAL,360,RC,,,,both,5487.84,4939.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3841.49,,,,3237.83,4478.08
EWSL UNILAT LITHOTRIPS RENTAL,360,RC,,,,both,5487.84,4939.06,Cigna,Default,Percent of Total Billed Charges,3237.83,,,,3237.83,4478.08
EWSL UNILAT LITHOTRIPS RENTAL,360,RC,,,,both,5487.84,4939.06,United Healthcare,Default,Fee Schedule,4478.08,,,,3237.83,4478.08
LAP NISSEN,43280,HCPCS,360,RC,,both,32056.3,28850.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22439.41,,,,18913.22,26157.94
LAP NISSEN,43280,HCPCS,360,RC,,both,32056.3,28850.67,Cigna,Default,Percent of Total Billed Charges,18913.22,,,,18913.22,26157.94
LAP NISSEN,43280,HCPCS,360,RC,,both,32056.3,28850.67,United Healthcare,Default,Fee Schedule,26157.94,,,,18913.22,26157.94
LAP SLEEVE GASTRECTOMY,43775,HCPCS,360,RC,,both,15813.79,14232.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11069.65,,,,9330.14,12904.05
LAP SLEEVE GASTRECTOMY,43775,HCPCS,360,RC,,both,15813.79,14232.41,Cigna,Default,Percent of Total Billed Charges,9330.14,,,,9330.14,12904.05
LAP SLEEVE GASTRECTOMY,43775,HCPCS,360,RC,,both,15813.79,14232.41,United Healthcare,Default,Fee Schedule,12904.05,,,,9330.14,12904.05
TAP BLOCK BILAT,64488,HCPCS,360,RC,,both,2344.81,2110.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1641.37,,,,1383.44,1913.36
TAP BLOCK BILAT,64488,HCPCS,360,RC,,both,2344.81,2110.33,Cigna,Default,Percent of Total Billed Charges,1383.44,,,,1383.44,1913.36
TAP BLOCK BILAT,64488,HCPCS,360,RC,,both,2344.81,2110.33,United Healthcare,Default,Fee Schedule,1913.36,,,,1383.44,1913.36
NJX AA&/STRD BRACH PLEXUS,64415,HCPCS,360,RC,,both,2960.02,2664.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2072.01,,,,1746.41,2415.38
NJX AA&/STRD BRACH PLEXUS,64415,HCPCS,360,RC,,both,2960.02,2664.02,Cigna,Default,Percent of Total Billed Charges,1746.41,,,,1746.41,2415.38
NJX AA&/STRD BRACH PLEXUS,64415,HCPCS,360,RC,,both,2960.02,2664.02,United Healthcare,Default,Fee Schedule,2415.38,,,,1746.41,2415.38
LAP APPENDECTOMY,360,RC,,,,both,11455.62,10310.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8018.93,,,,6758.82,9347.79
LAP APPENDECTOMY,360,RC,,,,both,11455.62,10310.06,Cigna,Default,Percent of Total Billed Charges,6758.82,,,,6758.82,9347.79
LAP APPENDECTOMY,360,RC,,,,both,11455.62,10310.06,United Healthcare,Default,Fee Schedule,9347.79,,,,6758.82,9347.79
CARPAL TUNNEL - Non ORTHO,360,RC,,,,both,6312.65,5681.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4418.86,,,,3724.46,5151.12
CARPAL TUNNEL - Non ORTHO,360,RC,,,,both,6312.65,5681.39,Cigna,Default,Percent of Total Billed Charges,3724.46,,,,3724.46,5151.12
CARPAL TUNNEL - Non ORTHO,360,RC,,,,both,6312.65,5681.39,United Healthcare,Default,Fee Schedule,5151.12,,,,3724.46,5151.12
INGUINAL HERNIA REPAIR,49505,HCPCS,360,RC,,both,11132.77,10019.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7792.94,,,,6568.33,9084.34
INGUINAL HERNIA REPAIR,49505,HCPCS,360,RC,,both,11132.77,10019.49,Cigna,Default,Percent of Total Billed Charges,6568.33,,,,6568.33,9084.34
INGUINAL HERNIA REPAIR,49505,HCPCS,360,RC,,both,11132.77,10019.49,United Healthcare,Default,Fee Schedule,9084.34,,,,6568.33,9084.34
LESION REMOVAL 1-5 LESIONS,360,RC,,,,both,4965.82,4469.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3476.07,,,,2929.83,4052.11
LESION REMOVAL 1-5 LESIONS,360,RC,,,,both,4965.82,4469.24,Cigna,Default,Percent of Total Billed Charges,2929.83,,,,2929.83,4052.11
LESION REMOVAL 1-5 LESIONS,360,RC,,,,both,4965.82,4469.24,United Healthcare,Default,Fee Schedule,4052.11,,,,2929.83,4052.11
LESION REMOVAL 6-10 LESIONA,360,RC,,,,both,9931.64,8938.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6952.15,,,,5859.67,8104.22
LESION REMOVAL 6-10 LESIONA,360,RC,,,,both,9931.64,8938.48,Cigna,Default,Percent of Total Billed Charges,5859.67,,,,5859.67,8104.22
LESION REMOVAL 6-10 LESIONA,360,RC,,,,both,9931.64,8938.48,United Healthcare,Default,Fee Schedule,8104.22,,,,5859.67,8104.22
"LAP REPAIR VENTRAL, UMBILICAL, AND/OR EP",360,RC,,,,both,17724.66,15952.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12407.26,,,,10457.55,14463.32
"LAP REPAIR VENTRAL, UMBILICAL, AND/OR EP",360,RC,,,,both,17724.66,15952.19,Cigna,Default,Percent of Total Billed Charges,10457.55,,,,10457.55,14463.32
"LAP REPAIR VENTRAL, UMBILICAL, AND/OR EP",360,RC,,,,both,17724.66,15952.19,United Healthcare,Default,Fee Schedule,14463.32,,,,10457.55,14463.32
NJX AA&/STRD FEM NERVE NFS,64448,HCPCS,360,RC,,both,2799.63,2519.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1959.74,,,,1651.78,2284.5
NJX AA&/STRD FEM NERVE NFS,64448,HCPCS,360,RC,,both,2799.63,2519.67,Cigna,Default,Percent of Total Billed Charges,1651.78,,,,1651.78,2284.5
NJX AA&/STRD FEM NERVE NFS,64448,HCPCS,360,RC,,both,2799.63,2519.67,United Healthcare,Default,Fee Schedule,2284.5,,,,1651.78,2284.5
TOTAL ABDOMINAL HYSTERECTOMY (TAH),360,RC,,,,both,30259,27233.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21181.3,,,,17852.81,24691.34
TOTAL ABDOMINAL HYSTERECTOMY (TAH),360,RC,,,,both,30259,27233.1,Cigna,Default,Percent of Total Billed Charges,17852.81,,,,17852.81,24691.34
TOTAL ABDOMINAL HYSTERECTOMY (TAH),360,RC,,,,both,30259,27233.1,United Healthcare,Default,Fee Schedule,24691.34,,,,17852.81,24691.34
SMALL BOWEL RESECTION,360,RC,,,,both,16225,14602.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11357.5,,,,9572.75,13239.6
SMALL BOWEL RESECTION,360,RC,,,,both,16225,14602.5,Cigna,Default,Percent of Total Billed Charges,9572.75,,,,9572.75,13239.6
SMALL BOWEL RESECTION,360,RC,,,,both,16225,14602.5,United Healthcare,Default,Fee Schedule,13239.6,,,,9572.75,13239.6
BX BREAST 1ST LESION W IMG GUIDE,360,RC,,,,both,4993.5,4494.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3495.45,,,,2946.16,4074.7
BX BREAST 1ST LESION W IMG GUIDE,360,RC,,,,both,4993.5,4494.15,Cigna,Default,Percent of Total Billed Charges,2946.16,,,,2946.16,4074.7
BX BREAST 1ST LESION W IMG GUIDE,360,RC,,,,both,4993.5,4494.15,United Healthcare,Default,Fee Schedule,4074.7,,,,2946.16,4074.7
NEEDLE BX LYMPH NODES,360,RC,,,,both,4993.5,4494.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3495.45,,,,2946.16,4074.7
NEEDLE BX LYMPH NODES,360,RC,,,,both,4993.5,4494.15,Cigna,Default,Percent of Total Billed Charges,2946.16,,,,2946.16,4074.7
NEEDLE BX LYMPH NODES,360,RC,,,,both,4993.5,4494.15,United Healthcare,Default,Fee Schedule,4074.7,,,,2946.16,4074.7
REMOVE INT &/OR EXT HEMORRHOID,360,RC,,,,both,8556.34,7700.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5989.44,,,,5048.24,6981.97
REMOVE INT &/OR EXT HEMORRHOID,360,RC,,,,both,8556.34,7700.71,Cigna,Default,Percent of Total Billed Charges,5048.24,,,,5048.24,6981.97
REMOVE INT &/OR EXT HEMORRHOID,360,RC,,,,both,8556.34,7700.71,United Healthcare,Default,Fee Schedule,6981.97,,,,5048.24,6981.97
"BX LYMPH NODES-AXLRY, CRVCL, INGNL",360,RC,,,,both,4993.5,4494.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3495.45,,,,2946.16,4074.7
"BX LYMPH NODES-AXLRY, CRVCL, INGNL",360,RC,,,,both,4993.5,4494.15,Cigna,Default,Percent of Total Billed Charges,2946.16,,,,2946.16,4074.7
"BX LYMPH NODES-AXLRY, CRVCL, INGNL",360,RC,,,,both,4993.5,4494.15,United Healthcare,Default,Fee Schedule,4074.7,,,,2946.16,4074.7
PARTIAL RELEASE OF LUNG,32225,HCPCS,360,RC,,inpatient,9056,8150.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6339.2,,,,5343.04,7389.7
PARTIAL RELEASE OF LUNG,32225,HCPCS,360,RC,,inpatient,9056,8150.4,Cigna,Default,Percent of Total Billed Charges,5343.04,,,,5343.04,7389.7
PARTIAL RELEASE OF LUNG,32225,HCPCS,360,RC,,inpatient,9056,8150.4,United Healthcare,Default,Fee Schedule,7389.7,,,,5343.04,7389.7
OPEN CHOLECYSTECTOMY,360,RC,,,,both,31206.38,28085.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21844.47,,,,18411.76,25464.41
OPEN CHOLECYSTECTOMY,360,RC,,,,both,31206.38,28085.74,Cigna,Default,Percent of Total Billed Charges,18411.76,,,,18411.76,25464.41
OPEN CHOLECYSTECTOMY,360,RC,,,,both,31206.38,28085.74,United Healthcare,Default,Fee Schedule,25464.41,,,,18411.76,25464.41
REPAIR FEMORAL HERNIA,360,RC,,,,both,10976.81,9879.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7683.77,,,,6476.32,8957.08
REPAIR FEMORAL HERNIA,360,RC,,,,both,10976.81,9879.13,Cigna,Default,Percent of Total Billed Charges,6476.32,,,,6476.32,8957.08
REPAIR FEMORAL HERNIA,360,RC,,,,both,10976.81,9879.13,United Healthcare,Default,Fee Schedule,8957.08,,,,6476.32,8957.08
THYROID BIOPSY,360,RC,,,,both,2232.3,2009.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1562.61,,,,1317.06,1821.56
THYROID BIOPSY,360,RC,,,,both,2232.3,2009.07,Cigna,Default,Percent of Total Billed Charges,1317.06,,,,1317.06,1821.56
THYROID BIOPSY,360,RC,,,,both,2232.3,2009.07,United Healthcare,Default,Fee Schedule,1821.56,,,,1317.06,1821.56
SUPPLIES/DEVICES,274,RC,,,,both,1061,954.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,742.7,,,,625.99,865.78
SUPPLIES/DEVICES,274,RC,,,,both,1061,954.9,Cigna,Default,Percent of Total Billed Charges,625.99,,,,625.99,865.78
SUPPLIES/DEVICES,274,RC,,,,both,1061,954.9,United Healthcare,Default,Fee Schedule,865.78,,,,625.99,865.78
ISOLATION,164,RC,,,,both,71.77,64.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.24,,,,42.34,51.6
ISOLATION,164,RC,,,,both,71.77,64.59,Cigna,Default,Percent of Total Billed Charges,42.34,,,,42.34,51.6
ISOLATION,164,RC,,,,both,71.77,64.59,United Healthcare,Default,Percent of Total Billed Charges,51.6,,,,42.34,51.6
LEVEL 1 OBSERVATION EACH ADDL HR,G0378,HCPCS,762,RC,,outpatient,106.21,95.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.35,,,,62.66,86.67
LEVEL 1 OBSERVATION EACH ADDL HR,G0378,HCPCS,762,RC,,outpatient,106.21,95.59,Cigna,Default,Percent of Total Billed Charges,62.66,,,,62.66,86.67
LEVEL 1 OBSERVATION EACH ADDL HR,G0378,HCPCS,762,RC,,outpatient,106.21,95.59,United Healthcare,Default,Fee Schedule,86.67,,,,62.66,86.67
LEVEL 1 OBSERVATION FIRST HR,G0378,HCPCS,762,RC,,outpatient,296.49,266.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.54,,,,174.93,241.94
LEVEL 1 OBSERVATION FIRST HR,G0378,HCPCS,762,RC,,outpatient,296.49,266.84,Cigna,Default,Percent of Total Billed Charges,174.93,,,,174.93,241.94
LEVEL 1 OBSERVATION FIRST HR,G0378,HCPCS,762,RC,,outpatient,296.49,266.84,United Healthcare,Default,Fee Schedule,241.94,,,,174.93,241.94
LEVEL 2 OBSERVATION FIRST HR,99222,HCPCS,762,RC,,outpatient,363.31,326.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,254.32,,,,214.35,296.46
LEVEL 2 OBSERVATION FIRST HR,99222,HCPCS,762,RC,,outpatient,363.31,326.98,Cigna,Default,Percent of Total Billed Charges,214.35,,,,214.35,296.46
LEVEL 2 OBSERVATION FIRST HR,99222,HCPCS,762,RC,,outpatient,363.31,326.98,United Healthcare,Default,Fee Schedule,296.46,,,,214.35,296.46
PHASE II RECOVERY FIRST 1/2 HR,710,RC,,,,both,573.24,515.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,401.27,,,,338.21,467.76
PHASE II RECOVERY FIRST 1/2 HR,710,RC,,,,both,573.24,515.92,Cigna,Default,Percent of Total Billed Charges,338.21,,,,338.21,467.76
PHASE II RECOVERY FIRST 1/2 HR,710,RC,,,,both,573.24,515.92,United Healthcare,Default,Fee Schedule,467.76,,,,338.21,467.76
PHASE II RECOVERY ADDL 1/2 HR,710,RC,,,,both,321.15,289.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,224.8,,,,189.48,262.06
PHASE II RECOVERY ADDL 1/2 HR,710,RC,,,,both,321.15,289.04,Cigna,Default,Percent of Total Billed Charges,189.48,,,,189.48,262.06
PHASE II RECOVERY ADDL 1/2 HR,710,RC,,,,both,321.15,289.04,United Healthcare,Default,Fee Schedule,262.06,,,,189.48,262.06
ROUTINE VENIPUNCTURE,36415,HCPCS,300,RC,,both,122.97,110.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.08,,,,72.55,100.34
ROUTINE VENIPUNCTURE,36415,HCPCS,300,RC,,both,122.97,110.67,Cigna,Default,Percent of Total Billed Charges,72.55,,,,72.55,100.34
ROUTINE VENIPUNCTURE,36415,HCPCS,300,RC,,both,122.97,110.67,United Healthcare,Default,Fee Schedule,100.34,,,,72.55,100.34
TRANSFUSION BLOOD PRODUCTS,36430,HCPCS,391,RC,,both,1313.13,1181.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,919.19,,,,774.75,1071.51
TRANSFUSION BLOOD PRODUCTS,36430,HCPCS,391,RC,,both,1313.13,1181.82,Cigna,Default,Percent of Total Billed Charges,774.75,,,,774.75,1071.51
TRANSFUSION BLOOD PRODUCTS,36430,HCPCS,391,RC,,both,1313.13,1181.82,United Healthcare,Default,Fee Schedule,1071.51,,,,774.75,1071.51
HYDRATION IV INFUSION INIT 31-60 MINS,96360,HCPCS,260,RC,,both,437.04,393.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,305.93,,,,257.85,356.62
HYDRATION IV INFUSION INIT 31-60 MINS,96360,HCPCS,260,RC,,both,437.04,393.34,Cigna,Default,Percent of Total Billed Charges,257.85,,,,257.85,356.62
HYDRATION IV INFUSION INIT 31-60 MINS,96360,HCPCS,260,RC,,both,437.04,393.34,United Healthcare,Default,Fee Schedule,356.62,,,,257.85,356.62
HYDRATE IV INFUSION ADD-ON,96361,HCPCS,260,RC,,both,229.2,206.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.44,,,,135.23,187.03
HYDRATE IV INFUSION ADD-ON,96361,HCPCS,260,RC,,both,229.2,206.28,Cigna,Default,Percent of Total Billed Charges,135.23,,,,135.23,187.03
HYDRATE IV INFUSION ADD-ON,96361,HCPCS,260,RC,,both,229.2,206.28,United Healthcare,Default,Fee Schedule,187.03,,,,135.23,187.03
THER/PROPH/DIAG IV INF INIT =<1 HR,96365,HCPCS,260,RC,,both,632.38,569.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.67,,,,373.1,516.02
THER/PROPH/DIAG IV INF INIT =<1 HR,96365,HCPCS,260,RC,,both,632.38,569.14,Cigna,Default,Percent of Total Billed Charges,373.1,,,,373.1,516.02
THER/PROPH/DIAG IV INF INIT =<1 HR,96365,HCPCS,260,RC,,both,632.38,569.14,United Healthcare,Default,Fee Schedule,516.02,,,,373.1,516.02
THER/PROPH/DIAG IV INF ADDON,96366,HCPCS,260,RC,,both,222.74,200.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.92,,,,131.42,181.76
THER/PROPH/DIAG IV INF ADDON,96366,HCPCS,260,RC,,both,222.74,200.47,Cigna,Default,Percent of Total Billed Charges,131.42,,,,131.42,181.76
THER/PROPH/DIAG IV INF ADDON,96366,HCPCS,260,RC,,both,222.74,200.47,United Healthcare,Default,Fee Schedule,181.76,,,,131.42,181.76
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,185.07,166.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.55,,,,109.19,151.02
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,185.07,166.56,Cigna,Default,Percent of Total Billed Charges,109.19,,,,109.19,151.02
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,185.07,166.56,United Healthcare,Default,Fee Schedule,151.02,,,,109.19,151.02
TCTANUS/DIPTH TOX-ADULT-IM/JET INJ,90715,HCPCS,761,RC,,both,45,40.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.5,,,,26.55,36.72
TCTANUS/DIPTH TOX-ADULT-IM/JET INJ,90715,HCPCS,761,RC,,both,45,40.5,Cigna,Default,Percent of Total Billed Charges,26.55,,,,26.55,36.72
TCTANUS/DIPTH TOX-ADULT-IM/JET INJ,90715,HCPCS,761,RC,,both,45,40.5,United Healthcare,Default,Fee Schedule,36.72,,,,26.55,36.72
DIRECT REFERRAL FOR OBSERVATION SVCS,G0379,HCPCS,762,RC,,outpatient,1908.66,1717.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1336.06,,,,1126.11,1557.47
DIRECT REFERRAL FOR OBSERVATION SVCS,G0379,HCPCS,762,RC,,outpatient,1908.66,1717.79,Cigna,Default,Percent of Total Billed Charges,1126.11,,,,1126.11,1557.47
DIRECT REFERRAL FOR OBSERVATION SVCS,G0379,HCPCS,762,RC,,outpatient,1908.66,1717.79,United Healthcare,Default,Fee Schedule,1557.47,,,,1126.11,1557.47
INJECTION SC/IM,96372,HCPCS,260,RC,,both,158.55,142.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.98,,,,93.54,129.38
INJECTION SC/IM,96372,HCPCS,260,RC,,both,158.55,142.7,Cigna,Default,Percent of Total Billed Charges,93.54,,,,93.54,129.38
INJECTION SC/IM,96372,HCPCS,260,RC,,both,158.55,142.7,United Healthcare,Default,Fee Schedule,129.38,,,,93.54,129.38
"IV PUSH, INITIAL",96374,HCPCS,260,RC,,both,347.52,312.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.26,,,,205.04,283.58
"IV PUSH, INITIAL",96374,HCPCS,260,RC,,both,347.52,312.77,Cigna,Default,Percent of Total Billed Charges,205.04,,,,205.04,283.58
"IV PUSH, INITIAL",96374,HCPCS,260,RC,,both,347.52,312.77,United Healthcare,Default,Fee Schedule,283.58,,,,205.04,283.58
"IV PUSH, SEQUENTIAL, SAME DRUG+30 MIN",96376,HCPCS,260,RC,,both,190.62,171.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.43,,,,112.47,155.55
"IV PUSH, SEQUENTIAL, SAME DRUG+30 MIN",96376,HCPCS,260,RC,,both,190.62,171.56,Cigna,Default,Percent of Total Billed Charges,112.47,,,,112.47,155.55
"IV PUSH, SEQUENTIAL, SAME DRUG+30 MIN",96376,HCPCS,260,RC,,both,190.62,171.56,United Healthcare,Default,Fee Schedule,155.55,,,,112.47,155.55
GAMMA PROBE RENTAL,279,RC,,,,both,3100,2790,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2170,,,,1829,2529.6
GAMMA PROBE RENTAL,279,RC,,,,both,3100,2790,Cigna,Default,Percent of Total Billed Charges,1829,,,,1829,2529.6
GAMMA PROBE RENTAL,279,RC,,,,both,3100,2790,United Healthcare,Default,Fee Schedule,2529.6,,,,1829,2529.6
HEMOCCULT,82272,HCPCS,300,RC,,both,17.56,15.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.29,,,,10.36,14.33
HEMOCCULT,82272,HCPCS,300,RC,,both,17.56,15.8,Cigna,Default,Percent of Total Billed Charges,10.36,,,,10.36,14.33
HEMOCCULT,82272,HCPCS,300,RC,,both,17.56,15.8,United Healthcare,Default,Fee Schedule,14.33,,,,10.36,14.33
CAPILLARY BLOOD GLUCOSE,82948,HCPCS,300,RC,,both,29.65,26.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.76,,,,17.49,24.19
CAPILLARY BLOOD GLUCOSE,82948,HCPCS,300,RC,,both,29.65,26.69,Cigna,Default,Percent of Total Billed Charges,17.49,,,,17.49,24.19
CAPILLARY BLOOD GLUCOSE,82948,HCPCS,300,RC,,both,29.65,26.69,United Healthcare,Default,Fee Schedule,24.19,,,,17.49,24.19
DECLOTTING BY THROMBOLYTIC AGENT,36593,HCPCS,761,RC,,both,747.8,673.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,523.46,,,,441.2,610.2
DECLOTTING BY THROMBOLYTIC AGENT,36593,HCPCS,761,RC,,both,747.8,673.02,Cigna,Default,Percent of Total Billed Charges,441.2,,,,441.2,610.2
DECLOTTING BY THROMBOLYTIC AGENT,36593,HCPCS,761,RC,,both,747.8,673.02,United Healthcare,Default,Fee Schedule,610.2,,,,441.2,610.2
COLLECTION OF BLOOD FROM VENOUS ACC,36591,HCPCS,761,RC,,both,341.27,307.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.89,,,,201.35,278.48
COLLECTION OF BLOOD FROM VENOUS ACC,36591,HCPCS,761,RC,,both,341.27,307.14,Cigna,Default,Percent of Total Billed Charges,201.35,,,,201.35,278.48
COLLECTION OF BLOOD FROM VENOUS ACC,36591,HCPCS,761,RC,,both,341.27,307.14,United Healthcare,Default,Fee Schedule,278.48,,,,201.35,278.48
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,158.35,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.84,,,,93.43,110.84
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,158.35,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,110.84
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,158.35,142.52,United Healthcare,Default,Fee Schedule,,,,,93.43,110.84
TX/PROPH/DG ADDL SEQ IV INF,96367,HCPCS,260,RC,,both,222.74,200.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.92,,,,131.42,181.76
TX/PROPH/DG ADDL SEQ IV INF,96367,HCPCS,260,RC,,both,222.74,200.47,Cigna,Default,Percent of Total Billed Charges,131.42,,,,131.42,181.76
TX/PROPH/DG ADDL SEQ IV INF,96367,HCPCS,260,RC,,both,222.74,200.47,United Healthcare,Default,Fee Schedule,181.76,,,,131.42,181.76
IMMUNIZATION ADMIN EA ADDL,90472,HCPCS,771,RC,,both,96.35,86.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.44,,,,56.85,67.44
IMMUNIZATION ADMIN EA ADDL,90472,HCPCS,771,RC,,both,96.35,86.72,Cigna,Default,Percent of Total Billed Charges,56.85,,,,56.85,67.44
IMMUNIZATION ADMIN EA ADDL,90472,HCPCS,771,RC,,both,96.35,86.72,United Healthcare,Default,Fee Schedule,,,,,56.85,67.44
INITIAL HOSP IP/OBS LOW 40,99221,HCPCS,960,RC,,both,315.5,283.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.85,,,,186.14,220.85
INITIAL HOSP IP/OBS LOW 40,99221,HCPCS,960,RC,,both,315.5,283.95,Cigna,Default,Percent of Total Billed Charges,186.14,,,,186.14,220.85
INITIAL HOSP IP/OBS LOW 40,99221,HCPCS,960,RC,,both,315.5,283.95,United Healthcare,Default,Fee Schedule,,,,,186.14,220.85
INITIAL HOSP IP/OBS HIGH 75,99223,HCPCS,960,RC,,inpatient,649.27,584.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.49,,,,383.07,454.49
INITIAL HOSP IP/OBS HIGH 75,99223,HCPCS,960,RC,,inpatient,649.27,584.34,Cigna,Default,Percent of Total Billed Charges,383.07,,,,383.07,454.49
INITIAL HOSP IP/OBS HIGH 75,99223,HCPCS,960,RC,,inpatient,649.27,584.34,United Healthcare,Default,Fee Schedule,,,,,383.07,454.49
HOSP IP/OBS SAME DAY DC LOW 45,99234,HCPCS,960,RC,,inpatient,466.8,420.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,326.76,,,,275.41,326.76
HOSP IP/OBS SAME DAY DC LOW 45,99234,HCPCS,960,RC,,inpatient,466.8,420.12,Cigna,Default,Percent of Total Billed Charges,275.41,,,,275.41,326.76
HOSP IP/OBS SAME DAY DC LOW 45,99234,HCPCS,960,RC,,inpatient,466.8,420.12,United Healthcare,Default,Fee Schedule,,,,,275.41,326.76
HOSP IP/OBS SAME DAY DC LOW 45,99235,HCPCS,960,RC,,inpatient,596.23,536.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,417.36,,,,351.78,417.36
HOSP IP/OBS SAME DAY DC LOW 45,99235,HCPCS,960,RC,,inpatient,596.23,536.61,Cigna,Default,Percent of Total Billed Charges,351.78,,,,351.78,417.36
HOSP IP/OBS SAME DAY DC LOW 45,99235,HCPCS,960,RC,,inpatient,596.23,536.61,United Healthcare,Default,Fee Schedule,,,,,351.78,417.36
HOSP IP/OBS DC SAME DAY HIGH 85,99236,HCPCS,761,RC,,inpatient,741.04,666.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,518.73,,,,437.21,604.69
HOSP IP/OBS DC SAME DAY HIGH 85,99236,HCPCS,761,RC,,inpatient,741.04,666.94,Cigna,Default,Percent of Total Billed Charges,437.21,,,,437.21,604.69
HOSP IP/OBS DC SAME DAY HIGH 85,99236,HCPCS,761,RC,,inpatient,741.04,666.94,United Healthcare,Default,Fee Schedule,604.69,,,,437.21,604.69
HOPS IP/OBS DSCHRG MGMT 30<,99238,HCPCS,960,RC,,inpatient,219.48,197.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.64,,,,129.49,153.64
HOPS IP/OBS DSCHRG MGMT 30<,99238,HCPCS,960,RC,,inpatient,219.48,197.53,Cigna,Default,Percent of Total Billed Charges,129.49,,,,129.49,153.64
HOPS IP/OBS DSCHRG MGMT 30<,99238,HCPCS,960,RC,,inpatient,219.48,197.53,United Healthcare,Default,Fee Schedule,,,,,129.49,153.64
HOSP IP/OBS DSCHRG MGMT >30,99239,HCPCS,762,RC,,inpatient,327.28,294.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,229.1,,,,193.1,267.06
HOSP IP/OBS DSCHRG MGMT >30,99239,HCPCS,762,RC,,inpatient,327.28,294.55,Cigna,Default,Percent of Total Billed Charges,193.1,,,,193.1,267.06
HOSP IP/OBS DSCHRG MGMT >30,99239,HCPCS,762,RC,,inpatient,327.28,294.55,United Healthcare,Default,Fee Schedule,267.06,,,,193.1,267.06
IP/OBS CONSULT SF 35,99245,HCPCS,969,RC,,outpatient,167.62,150.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.33,,,,98.9,117.33
IP/OBS CONSULT SF 35,99245,HCPCS,969,RC,,outpatient,167.62,150.86,Cigna,Default,Percent of Total Billed Charges,98.9,,,,98.9,117.33
IP/OBS CONSULT SF 35,99245,HCPCS,969,RC,,outpatient,167.62,150.86,United Healthcare,Default,Fee Schedule,,,,,98.9,117.33
IP/OBS CONSULT LOW 45,99253,HCPCS,969,RC,,outpatient,336.94,303.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,235.86,,,,198.79,235.86
IP/OBS CONSULT LOW 45,99253,HCPCS,969,RC,,outpatient,336.94,303.25,Cigna,Default,Percent of Total Billed Charges,198.79,,,,198.79,235.86
IP/OBS CONSULT LOW 45,99253,HCPCS,969,RC,,outpatient,336.94,303.25,United Healthcare,Default,Fee Schedule,,,,,198.79,235.86
IP/OBS CONSULT MOD 60,99254,HCPCS,969,RC,,outpatient,433.27,389.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,303.29,,,,255.63,303.29
IP/OBS CONSULT MOD 60,99254,HCPCS,969,RC,,outpatient,433.27,389.94,Cigna,Default,Percent of Total Billed Charges,255.63,,,,255.63,303.29
IP/OBS CONSULT MOD 60,99254,HCPCS,969,RC,,outpatient,433.27,389.94,United Healthcare,Default,Fee Schedule,,,,,255.63,303.29
TRANSFUSION BLD/BLD COMPONENTS,36430,HCPCS,391,RC,,both,716,644.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.2,,,,422.44,584.26
TRANSFUSION BLD/BLD COMPONENTS,36430,HCPCS,391,RC,,both,716,644.4,Cigna,Default,Percent of Total Billed Charges,422.44,,,,422.44,584.26
TRANSFUSION BLD/BLD COMPONENTS,36430,HCPCS,391,RC,,both,716,644.4,United Healthcare,Default,Fee Schedule,584.26,,,,422.44,584.26
"OP VISIT, EST PT, LEVEL 1",99211,HCPCS,761,RC,,outpatient,208.44,187.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.91,,,,122.98,170.09
"OP VISIT, EST PT, LEVEL 1",99211,HCPCS,761,RC,,outpatient,208.44,187.6,Cigna,Default,Percent of Total Billed Charges,122.98,,,,122.98,170.09
"OP VISIT, EST PT, LEVEL 1",99211,HCPCS,761,RC,,outpatient,208.44,187.6,United Healthcare,Default,Fee Schedule,170.09,,,,122.98,170.09
"OP VISIT, EST PT, LEVEL 2",99212,HCPCS,510,RC,,outpatient,228.5,205.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.95,,,,134.82,186.46
"OP VISIT, EST PT, LEVEL 2",99212,HCPCS,510,RC,,outpatient,228.5,205.65,Cigna,Default,Percent of Total Billed Charges,134.82,,,,134.82,186.46
"OP VISIT, EST PT, LEVEL 2",99212,HCPCS,510,RC,,outpatient,228.5,205.65,United Healthcare,Default,Fee Schedule,186.46,,,,134.82,186.46
"OP VISIT, EST PT, LEVEL 3",99213,HCPCS,510,RC,,outpatient,228.5,205.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.95,,,,134.82,186.46
"OP VISIT, EST PT, LEVEL 3",99213,HCPCS,510,RC,,outpatient,228.5,205.65,Cigna,Default,Percent of Total Billed Charges,134.82,,,,134.82,186.46
"OP VISIT, EST PT, LEVEL 3",99213,HCPCS,510,RC,,outpatient,228.5,205.65,United Healthcare,Default,Fee Schedule,186.46,,,,134.82,186.46
"OP VISIT, EST PT, LEVEL 4",99214,HCPCS,510,RC,,outpatient,297.25,267.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.08,,,,175.38,242.56
"OP VISIT, EST PT, LEVEL 4",99214,HCPCS,510,RC,,outpatient,297.25,267.53,Cigna,Default,Percent of Total Billed Charges,175.38,,,,175.38,242.56
"OP VISIT, EST PT, LEVEL 4",99214,HCPCS,510,RC,,outpatient,297.25,267.53,United Healthcare,Default,Fee Schedule,242.56,,,,175.38,242.56
"OP VISIT, EST PT, LEVEL 5",99215,HCPCS,510,RC,,outpatient,376,338.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.2,,,,221.84,306.82
"OP VISIT, EST PT, LEVEL 5",99215,HCPCS,510,RC,,outpatient,376,338.4,Cigna,Default,Percent of Total Billed Charges,221.84,,,,221.84,306.82
"OP VISIT, EST PT, LEVEL 5",99215,HCPCS,510,RC,,outpatient,376,338.4,United Healthcare,Default,Fee Schedule,306.82,,,,221.84,306.82
BLADDER INSTILLATION,51700,HCPCS,510,RC,,both,353.75,318.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,247.62,,,,208.71,288.66
BLADDER INSTILLATION,51700,HCPCS,510,RC,,both,353.75,318.38,Cigna,Default,Percent of Total Billed Charges,208.71,,,,208.71,288.66
BLADDER INSTILLATION,51700,HCPCS,510,RC,,both,353.75,318.38,United Healthcare,Default,Fee Schedule,288.66,,,,208.71,288.66
ADULT TETANUS TOXOID,90718,HCPCS,510,RC,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
ADULT TETANUS TOXOID,90718,HCPCS,510,RC,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
ADULT TETANUS TOXOID,90718,HCPCS,510,RC,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
THER/PROPH/DIAG INJ SC/IM,96372,HCPCS,510,RC,,both,158.35,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.84,,,,93.43,129.21
THER/PROPH/DIAG INJ SC/IM,96372,HCPCS,510,RC,,both,158.35,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,129.21
THER/PROPH/DIAG INJ SC/IM,96372,HCPCS,510,RC,,both,158.35,142.52,United Healthcare,Default,Fee Schedule,129.21,,,,93.43,129.21
HYDRATION IV INFUSION INIT 31-60 MINS,96360,HCPCS,260,RC,,both,437.04,393.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,305.93,,,,257.85,356.62
HYDRATION IV INFUSION INIT 31-60 MINS,96360,HCPCS,260,RC,,both,437.04,393.34,Cigna,Default,Percent of Total Billed Charges,257.85,,,,257.85,356.62
HYDRATION IV INFUSION INIT 31-60 MINS,96360,HCPCS,260,RC,,both,437.04,393.34,United Healthcare,Default,Fee Schedule,356.62,,,,257.85,356.62
HYDRATE IV INFUSION ADD-ON,96361,HCPCS,260,RC,,both,229.2,206.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.44,,,,135.23,187.03
HYDRATE IV INFUSION ADD-ON,96361,HCPCS,260,RC,,both,229.2,206.28,Cigna,Default,Percent of Total Billed Charges,135.23,,,,135.23,187.03
HYDRATE IV INFUSION ADD-ON,96361,HCPCS,260,RC,,both,229.2,206.28,United Healthcare,Default,Fee Schedule,187.03,,,,135.23,187.03
THER/PROPH/DIAG IV INF INIT =<1 HR,96365,HCPCS,260,RC,,both,632.38,569.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.67,,,,373.1,516.02
THER/PROPH/DIAG IV INF INIT =<1 HR,96365,HCPCS,260,RC,,both,632.38,569.14,Cigna,Default,Percent of Total Billed Charges,373.1,,,,373.1,516.02
THER/PROPH/DIAG IV INF INIT =<1 HR,96365,HCPCS,260,RC,,both,632.38,569.14,United Healthcare,Default,Fee Schedule,516.02,,,,373.1,516.02
THER/PROPH/DIAG IV INF ADDON,96366,HCPCS,260,RC,,both,222.74,200.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.92,,,,131.42,181.76
THER/PROPH/DIAG IV INF ADDON,96366,HCPCS,260,RC,,both,222.74,200.47,Cigna,Default,Percent of Total Billed Charges,131.42,,,,131.42,181.76
THER/PROPH/DIAG IV INF ADDON,96366,HCPCS,260,RC,,both,222.74,200.47,United Healthcare,Default,Fee Schedule,181.76,,,,131.42,181.76
THER/PROPH/DIAG INJ IV PUSH,96374,HCPCS,260,RC,,both,337.4,303.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.18,,,,199.07,275.32
THER/PROPH/DIAG INJ IV PUSH,96374,HCPCS,260,RC,,both,337.4,303.66,Cigna,Default,Percent of Total Billed Charges,199.07,,,,199.07,275.32
THER/PROPH/DIAG INJ IV PUSH,96374,HCPCS,260,RC,,both,337.4,303.66,United Healthcare,Default,Fee Schedule,275.32,,,,199.07,275.32
TX/PRO/DX INJ SAME DRUG ADDON,96376,HCPCS,510,RC,,both,129.39,116.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.57,,,,76.34,105.58
TX/PRO/DX INJ SAME DRUG ADDON,96376,HCPCS,510,RC,,both,129.39,116.45,Cigna,Default,Percent of Total Billed Charges,76.34,,,,76.34,105.58
TX/PRO/DX INJ SAME DRUG ADDON,96376,HCPCS,510,RC,,both,129.39,116.45,United Healthcare,Default,Fee Schedule,105.58,,,,76.34,105.58
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,150.14,135.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.1,,,,88.58,122.51
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,150.14,135.13,Cigna,Default,Percent of Total Billed Charges,88.58,,,,88.58,122.51
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,150.14,135.13,United Healthcare,Default,Fee Schedule,122.51,,,,88.58,122.51
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,158.35,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.84,,,,93.43,110.84
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,158.35,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,110.84
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,158.35,142.52,United Healthcare,Default,Fee Schedule,,,,,93.43,110.84
BLOOD COLLECTION/IMPLANTABLE DEVICE,36591,HCPCS,510,RC,,both,341.27,307.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.89,,,,201.35,278.48
BLOOD COLLECTION/IMPLANTABLE DEVICE,36591,HCPCS,510,RC,,both,341.27,307.14,Cigna,Default,Percent of Total Billed Charges,201.35,,,,201.35,278.48
BLOOD COLLECTION/IMPLANTABLE DEVICE,36591,HCPCS,510,RC,,both,341.27,307.14,United Healthcare,Default,Fee Schedule,278.48,,,,201.35,278.48
IMPLANTED DEVICE DECLOTTING,36593,HCPCS,510,RC,,both,747.8,673.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,523.46,,,,441.2,610.2
IMPLANTED DEVICE DECLOTTING,36593,HCPCS,510,RC,,both,747.8,673.02,Cigna,Default,Percent of Total Billed Charges,441.2,,,,441.2,610.2
IMPLANTED DEVICE DECLOTTING,36593,HCPCS,510,RC,,both,747.8,673.02,United Healthcare,Default,Fee Schedule,610.2,,,,441.2,610.2
CAPILLARY BLOOD GLUCOSE,82962,HCPCS,300,RC,,both,28.79,25.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.15,,,,16.99,23.49
CAPILLARY BLOOD GLUCOSE,82962,HCPCS,300,RC,,both,28.79,25.91,Cigna,Default,Percent of Total Billed Charges,16.99,,,,16.99,23.49
CAPILLARY BLOOD GLUCOSE,82962,HCPCS,300,RC,,both,28.79,25.91,United Healthcare,Default,Fee Schedule,23.49,,,,16.99,23.49
"OCCULT BLOOD,FECES,SINGLE-DIAGNOSTIC",82272,HCPCS,300,RC,,both,17.57,15.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.3,,,,10.37,14.34
"OCCULT BLOOD,FECES,SINGLE-DIAGNOSTIC",82272,HCPCS,300,RC,,both,17.57,15.81,Cigna,Default,Percent of Total Billed Charges,10.37,,,,10.37,14.34
"OCCULT BLOOD,FECES,SINGLE-DIAGNOSTIC",82272,HCPCS,300,RC,,both,17.57,15.81,United Healthcare,Default,Fee Schedule,14.34,,,,10.37,14.34
"IV INFUSION, CONCURRENT",96368,HCPCS,260,RC,,both,143.12,128.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.18,,,,84.44,116.79
"IV INFUSION, CONCURRENT",96368,HCPCS,260,RC,,both,143.12,128.81,Cigna,Default,Percent of Total Billed Charges,84.44,,,,84.44,116.79
"IV INFUSION, CONCURRENT",96368,HCPCS,260,RC,,both,143.12,128.81,United Healthcare,Default,Fee Schedule,116.79,,,,84.44,116.79
IRRIGATION VAD/PORT FLUSH,96523,HCPCS,260,RC,,both,215.66,194.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,150.96,,,,127.24,175.98
IRRIGATION VAD/PORT FLUSH,96523,HCPCS,260,RC,,both,215.66,194.09,Cigna,Default,Percent of Total Billed Charges,127.24,,,,127.24,175.98
IRRIGATION VAD/PORT FLUSH,96523,HCPCS,260,RC,,both,215.66,194.09,United Healthcare,Default,Fee Schedule,175.98,,,,127.24,175.98
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,260,RC,,both,229.42,206.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.59,,,,135.36,187.21
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,260,RC,,both,229.42,206.48,Cigna,Default,Percent of Total Billed Charges,135.36,,,,135.36,187.21
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,260,RC,,both,229.42,206.48,United Healthcare,Default,Fee Schedule,187.21,,,,135.36,187.21
IMMUNIZATION ADMINISTRATION EA ADDL,90472,HCPCS,771,RC,,both,96.35,86.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.44,,,,56.85,67.44
IMMUNIZATION ADMINISTRATION EA ADDL,90472,HCPCS,771,RC,,both,96.35,86.72,Cigna,Default,Percent of Total Billed Charges,56.85,,,,56.85,67.44
IMMUNIZATION ADMINISTRATION EA ADDL,90472,HCPCS,771,RC,,both,96.35,86.72,United Healthcare,Default,Fee Schedule,,,,,56.85,67.44
Hosp OP Clinic Visit - MC,G0463,HCPCS,761,RC,,outpatient,216.02,194.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.21,,,,127.45,176.27
Hosp OP Clinic Visit - MC,G0463,HCPCS,761,RC,,outpatient,216.02,194.42,Cigna,Default,Percent of Total Billed Charges,127.45,,,,127.45,176.27
Hosp OP Clinic Visit - MC,G0463,HCPCS,761,RC,,outpatient,216.02,194.42,United Healthcare,Default,Fee Schedule,176.27,,,,127.45,176.27
COVID MEDICATION INFUSION,M0243,HCPCS,260,RC,,both,655,589.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,458.5,,,,386.45,534.48
COVID MEDICATION INFUSION,M0243,HCPCS,260,RC,,both,655,589.5,Cigna,Default,Percent of Total Billed Charges,386.45,,,,386.45,534.48
COVID MEDICATION INFUSION,M0243,HCPCS,260,RC,,both,655,589.5,United Healthcare,Default,Fee Schedule,534.48,,,,386.45,534.48
ANES LWR INTST SCR COLSC,00812,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANES LWR INTST SCR COLSC,00812,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANES LWR INTST SCR COLSC,00812,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANES UPR GI NDSC PX NOS,00731,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANES UPR GI NDSC PX NOS,00731,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANES UPR GI NDSC PX NOS,00731,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANES LWR INTST NDSC NOS,00811,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANES LWR INTST NDSC NOS,00811,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANES LWR INTST NDSC NOS,00811,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH LOWER ARM SURGERY,01810,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH LOWER ARM SURGERY,01810,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH LOWER ARM SURGERY,01810,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH HIP ARTHROPLASTY,01214,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH HIP ARTHROPLASTY,01214,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH HIP ARTHROPLASTY,01214,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER,01610,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER,01610,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER,01610,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES UPR LWR GI NDSC PX,00813,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES UPR LWR GI NDSC PX,00813,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES UPR LWR GI NDSC PX,00813,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CATHETERIZE HEART,01920,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CATHETERIZE HEART,01920,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CATHETERIZE HEART,01920,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CATHETERIZED HEART,01920,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CATHETERIZED HEART,01920,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CATHETERIZED HEART,01920,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES LWR INTST SCR COLSC,00812,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES LWR INTST SCR COLSC,00812,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES LWR INTST SCR COLSC,00812,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES UPR GI NDSC PX NOS,00731,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES UPR GI NDSC PX NOS,00731,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES UPR GI NDSC PX NOS,00731,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES LWR INTST NDSC NOS,00811,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES LWR INTST NDSC NOS,00811,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES LWR INTST NDSC NOS,00811,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH VASCULAR ACCESS,00532,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VASCULAR ACCESS,00532,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VASCULAR ACCESS,00532,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH VASCULAR ACCESS,00532,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH VASCULAR ACCESS,00532,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH VASCULAR ACCESS,00532,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CAT OR MRI SCAN,01922,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CAT OR MRI SCAN,01922,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CAT OR MRI SCAN,01922,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CAT OR MRI SCAN,01922,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CAT OR MRI SCAN,01922,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CAT OR MRI SCAN,01922,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER ARM SURGERY,01810,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER ARM SURGERY,01810,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER ARM SURGERY,01810,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES UPR LWR GI NDSC PX,00813,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES UPR LWR GI NDSC PX,00813,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES UPR LWR GI NDSC PX,00813,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BURN 4-9 PERCENT,01952,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BURN 4-9 PERCENT,01952,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BURN 4-9 PERCENT,01952,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BURN 4-9 PERCENT,01952,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BURN 4-9 PERCENT,01952,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BURN 4-9 PERCENT,01952,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CHEST PROCEDURE,00520,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST PROCEDURE,00520,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST PROCEDURE,00520,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST PROCEDURE,00520,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CHEST PROCEDURE,00520,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CHEST PROCEDURE,00520,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ANORECTAL SURGERY,00902,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ANORECTAL SURGERY,00902,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ANORECTAL SURGERY,00902,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ANORECTAL SURGERY,00902,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ANORECTAL SURGERY,00902,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ANORECTAL SURGERY,00902,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH THIGH ARTERIES SURG,01270,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH THIGH ARTERIES SURG,01270,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH THIGH ARTERIES SURG,01270,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH THIGH ARTERIES SURG,01270,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH THIGH ARTERIES SURG,01270,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH THIGH ARTERIES SURG,01270,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH HIP ARTHROPLASTY,01214,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH HIP ARTHROPLASTY,01214,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH HIP ARTHROPLASTY,01214,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER LEG BONE SURG,01480,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER LEG BONE SURG,01480,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER LEG BONE SURG,01480,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER LEG BONE SURG,01480,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER LEG BONE SURG,01480,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER LEG BONE SURG,01480,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH UPPER LEG SURGERY,01250,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH UPPER LEG SURGERY,01250,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH UPPER LEG SURGERY,01250,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH UPPER LEG SURGERY,01250,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH UPPER LEG SURGERY,01250,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH UPPER LEG SURGERY,01250,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KENN ARTERIES SURG,01440,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KENN ARTERIES SURG,01440,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KENN ARTERIES SURG,01440,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE SRTERIES SURG,01440,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE SRTERIES SURG,01440,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE SRTERIES SURG,01440,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH HYSTERECTOMY,00846,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HYSTERECTOMY,00846,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HYSTERECTOMY,00846,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HYSTERECTOMY,00846,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH HYSTERECTOMY,00846,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH HYSTERECTOMY,00846,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH PERINEAL SURGERY,00904,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH PERINEAL SURGERY,00904,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH PERINEAL SURGERY,00904,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH PERINEAL SURGERY,00904,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH PERINEAL SURGERY,00904,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH PERINEAL SURGERY,00904,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH REPAIR OF HERNIA,00752,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REPAIR OF HERNIA,00752,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REPAIR OF HERNIA,00752,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REPAIR OF HERNIA,00752,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH REPAIR OF HERNIA,00752,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH REPAIR OF HERNIA,00752,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CHEST DRAINAGE,00524,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST DRAINAGE,00524,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST DRAINAGE,00524,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST DRAINAGE,00524,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CHEST DRAINAGE,00524,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CHEST DRAINAGE,00524,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH FOR LIVER BIOPSY,00702,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR LIVER BIOPSY,00702,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR LIVER BIOPSY,00702,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR LIVER BIOPSY,00702,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH FOR LIVER BIOPSY,00702,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH FOR LIVER BIOPSY,00702,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KNEE JOINT CASTING,01420,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE JOINT CASTING,01420,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE JOINT CASTING,01420,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE JOINT CASTING,01420,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE JOINT CASTING,01420,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE JOINT CASTING,01420,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ABDOMINAL WALL SURG UPPER POST,00730,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ABDOMINAL WALL SURG UPPER POST,00730,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ABDOMINAL WALL SURG UPPER POST,00730,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ADBOMINAL WALL SURG UPPER POST,00730,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ADBOMINAL WALL SURG UPPER POST,00730,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ADBOMINAL WALL SURG UPPER POST,00730,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ACHILLES TENDON SURG,01472,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ACHILLES TENDON SURG,01472,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ACHILLES TENDON SURG,01472,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ACHILLES TENDON SURG,01472,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ACHILLES TENDON SURG,01472,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ACHILLES TENDON SURG,01472,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SALIVARY GLAND,00100,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SALIVARY GLAND,00100,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SALIVARY GLAND,00100,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SALIVARY GLAND,00100,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SALIVARY GLAND,00100,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SALIVARY GLAND,00100,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH HEART SURG W/O PUMP,00560,HCPCS,963,RC,,inpatient,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH HEART SURG W/O PUMP,00560,HCPCS,963,RC,,inpatient,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH HEART SURG W/O PUMP,00560,HCPCS,963,RC,,inpatient,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH HEART SURG W/O PUMP,00560,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH HEART SURG W/O PUMP,00560,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH HEART SURG W/O PUMP,00560,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,963,RC,,both,159.79,143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.85,,,,94.28,111.85
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,963,RC,,both,159.79,143.81,Cigna,Default,Percent of Total Billed Charges,94.28,,,,94.28,111.85
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,963,RC,,both,159.79,143.81,United Healthcare,Default,Fee Schedule,,,,,94.28,111.85
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
NJX INTERLAMINAR LMBR/SAC,62322,HCPCS,963,RC,,both,829.85,746.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,580.9,,,,489.61,580.9
NJX INTERLAMINAR LMBR/SAC,62322,HCPCS,963,RC,,both,829.85,746.87,Cigna,Default,Percent of Total Billed Charges,489.61,,,,489.61,580.9
NJX INTERLAMINAR LMBR/SAC,62322,HCPCS,963,RC,,both,829.85,746.87,United Healthcare,Default,Fee Schedule,,,,,489.61,580.9
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH VAGINAL PROCEDURES,00940,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VAGINAL PROCEDURES,00940,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VAGINAL PROCEDURES,00940,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH VAGINAL PROCEDURES,00940,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH VAGINAL PROCEDURES,00940,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH VAGINAL PROCEDURES,00940,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SITTING PROCEDURE,00604,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SITTING PROCEDURE,00604,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SITTING PROCEDURE,00604,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SITTING PROCEDURE,00604,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SITTING PROCEDURE,00604,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SITTING PROCEDURE,00604,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH DRG/ASPIR CRV/THRC,01937,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH DRG/ASPIR CRV/THRC,01937,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH DRG/ASPIR CRV/THRC,01937,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH DRG/ASPIR LMBR/SAC,01938,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH DRG/ASPIR LMBR/SAC,01938,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH DRG/ASPIR LMBR/SAC,01938,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH HIP JOINT SURGERY,01210,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH HIP JOINT SURGERY,01210,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SURGERY OF FEMUR,01230,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF FEMUR,01230,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF FEMUR,01230,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF FEMUR,01230,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURGERY OF FEMUR,01230,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURGERY OF FEMUR,01230,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REPAIR OF HERNIA LOWER NOS,00830,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ANORECTAL SURGERY,00902,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ANORECTAL SURGERY,00902,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ANORECTAL SURGERY,00902,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES LWR INTST SCR COLSC,00812,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES LWR INTST SCR COLSC,00812,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES LWR INTST SCR COLSC,00812,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES LWR INTST NDSC NOS,00811,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES LWR INTST NDSC NOS,00811,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES LWR INTST NDSC NOS,00811,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES UPR GI NDSC PX NOS,00731,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES UPR GI NDSC PX NOS,00731,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES UPR GI NDSC PX NOS,00731,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,963,RC,,both,75.05,67.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.54,,,,44.28,52.54
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,963,RC,,both,75.05,67.55,Cigna,Default,Percent of Total Billed Charges,44.28,,,,44.28,52.54
ANESTH SURG UPPER ABDOMEN,00790,HCPCS,963,RC,,both,75.05,67.55,United Healthcare,Default,Fee Schedule,,,,,44.28,52.54
ANESTH LOWER ARM SURGERY,01810,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER ARM SURGERY,01810,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER ARM SURGERY,01810,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SKIN EXT/PER/ATRUNK,00400,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HIP ARTHROPLASTY,01214,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HIP ARTHROPLASTY,01214,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HIP ARTHROPLASTY,01214,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS,99100,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS,99100,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS,99100,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE ARTHROPLASTY,01402,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER,01610,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER,01610,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER,01610,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES UPR LWR GI NDSC PX,00813,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES UPR LWR GI NDSC PX,00813,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES UPR LWR GI NDSC PX,00813,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CATHETERIZE HEART,01920,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CATHETERIZE HEART,01920,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CATHETERIZE HEART,01920,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BLADDER SURGERY,00910,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BLADDER SURGERY,00910,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BLADDER SURGERY,00910,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BLADDER SURGERY,00910,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BLADDER SURGERY,00910,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BLADDER SURGERY,00910,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BLADDER SURGERY,00910,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BLADDER SURGERY,00910,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BLADDER SURGERY,00910,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH EXT SPINE CORD SURGERY,00670,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH NECK ORGAN 1YR/>,00320,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURGERY OF BREAST RADICAL,00404,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH DX ARTERIOGRAPHY,01916,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KIDNEY/URETER SURG,00862,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KIDNEY/URETER SURG,00862,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KIDNEY/URETER SURG,00862,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES TX INTERV RAD HRT/CRAN,01926,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE JOINT SURGERY,01400,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE JOINT SURGERY,01400,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE JOINT SURGERY,01400,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH VASCULAR ACCESS,00532,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VASCULAR ACCESS,00532,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VASCULAR ACCESS,00532,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FAT LAYER REMOVAL,00802,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH FAT LAYER REMOVAL,00802,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH FAT LAYER REMOVAL,00802,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CAT OR MRI SCAN,01922,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CAT OR MRI SCAN,01922,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CAT OR MRI SCAN,01922,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
SIJ ANESTH/SETROID INJ,27096,HCPCS,963,RC,,both,981.11,883,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,686.78,,,,578.85,686.78
SIJ ANESTH/SETROID INJ,27096,HCPCS,963,RC,,both,981.11,883,Cigna,Default,Percent of Total Billed Charges,578.85,,,,578.85,686.78
SIJ ANESTH/SETROID INJ,27096,HCPCS,963,RC,,both,981.11,883,United Healthcare,Default,Fee Schedule,,,,,578.85,686.78
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BURN LESS 4 PERCENT,01951,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURG LOWER ABDOMEN,00840,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER ARM PROCEDURE,01820,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CHEST SURGERY,00540,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST SURGERY,00540,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST SURGERY,00540,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST SURGERY,00540,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST SURGERY,00540,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST SURGERY,00540,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST SURGERY,00540,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CHEST SURGERY,00540,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CHEST SURGERY,00540,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BURN 4-9 PERCENT,01952,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BURN 4-9 PERCENT,01952,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BURN 4-9 PERCENT,01952,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BONE ASPIRATE/BX,01112,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BONE ASPIRATE/BX,01112,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BONE ASPIRATE/BX,01112,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST SURGERY,01112,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST SURGERY,01112,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST SURGERY,01112,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BURN EACH 9 PERCENT,01953,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BONE ASPIRATE/BX,01112,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BONE ASPIRATE/BX,01112,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BONE ASPIRATE/BX,01112,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH PROCEDURES ON EYE,00140,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH PROCEDURES ON EYE,00140,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH PROCEDURES ON EYE,00140,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH PROCEDURES ON EYE,00140,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH PROCEDURES ON EYE,00140,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH PROCEDURES ON EYE,00140,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH PROCEDURE ON EYE,00140,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH PROCEDURE ON EYE,00140,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH PROCEDURE ON EYE,00140,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HIP JOINT PROCEDURE,01200,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VASCULAR SHUNT SURG,01844,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST PROCEDURE,00520,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST PROCEDURE,00520,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST PROCEDURE,00520,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH THIGH ARTERIES SURG,01270,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH THIGH ARTERIES SURG,01270,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH THIGH ARTERIES SURG,01270,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER LEG BONE SURG,01480,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER LEG BONE SURG,01480,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER LEG BONE SURG,01480,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH UPPER LEG SURGERY,01250,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH UPPER LEG SURGERY,01250,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH UPPER LEG SURGERY,01250,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KENN ARTERIES SURG,01440,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KENN ARTERIES SURG,01440,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KENN ARTERIES SURG,01440,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HYSTERECTOMY,00846,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HYSTERECTOMY,00846,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HYSTERECTOMY,00846,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH PERINEAL SURGERY,00904,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH PERINEAL SURGERY,00904,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH PERINEAL SURGERY,00904,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HEAD/NECK/PTRUNK,00300,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REPAIR OF HERNIA,00752,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REPAIR OF HERNIA,00752,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REPAIR OF HERNIA,00752,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CHEST DRAINAGE,00524,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CHEST DRAINAGE,00524,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CHEST DRAINAGE,00524,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER LEG VEIN SURG NOS,01520,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR LIVER BIOPSY,00702,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR LIVER BIOPSY,00702,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR LIVER BIOPSY,00702,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF SHOULDER NOS,01630,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
NJX INTERLAMINAR CRV/THRC,62320,HCPCS,963,RC,,both,733.04,659.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,513.13,,,,432.49,513.13
NJX INTERLAMINAR CRV/THRC,62320,HCPCS,963,RC,,both,733.04,659.74,Cigna,Default,Percent of Total Billed Charges,432.49,,,,432.49,513.13
NJX INTERLAMINAR CRV/THRC,62320,HCPCS,963,RC,,both,733.04,659.74,United Healthcare,Default,Fee Schedule,,,,,432.49,513.13
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH UPPER LEG VEINS SURG,01260,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
NJX INTERLAMINAR LMBR/SAC,62322,HCPCS,964,RC,,both,865.83,779.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,606.08,,,,510.84,606.08
NJX INTERLAMINAR LMBR/SAC,62322,HCPCS,964,RC,,both,865.83,779.25,Cigna,Default,Percent of Total Billed Charges,510.84,,,,510.84,606.08
NJX INTERLAMINAR LMBR/SAC,62322,HCPCS,964,RC,,both,865.83,779.25,United Healthcare,Default,Fee Schedule,,,,,510.84,606.08
NJX INTERLAMINAR LMBR/SAC,62323,HCPCS,963,RC,,both,931.33,838.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,651.93,,,,549.48,651.93
NJX INTERLAMINAR LMBR/SAC,62323,HCPCS,963,RC,,both,931.33,838.2,Cigna,Default,Percent of Total Billed Charges,549.48,,,,549.48,651.93
NJX INTERLAMINAR LMBR/SAC,62323,HCPCS,963,RC,,both,931.33,838.2,United Healthcare,Default,Fee Schedule,,,,,549.48,651.93
ANESTH SHOULDER PROCEDURE,01620,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SHOULDER PROCEDURE,01620,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SHOULDER PROCEDURE,01620,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SHOULDER PROCEDURE,01620,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SHOULDER PROCEDURE,01620,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SHOULDER PROCEDURE,01620,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SHOULDER PROCEDURE,01620,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SHOULDER PROCEDURE,01620,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SHOULDER PROCEDURE,01620,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE JOINT CASTING,01420,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE JOINT CASTING,01420,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE JOINT CASTING,01420,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ABDOMINAL WALL SURG UPPER POST,00730,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ABDOMINAL WALL SURG UPPER POST,00730,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ABDOMINAL WALL SURG UPPER POST,00730,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH CERV SPINE CORD SURGERY,00600,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SURGERY OF FEMUR,01230,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SURGERY OF FEMUR,01230,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SURGERY OF FEMUR,01230,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ACHILLES TENDON SURG,01472,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ACHILLES TENDON SURG,01472,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ACHILLES TENDON SURG,01472,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SALIVARY GLAND,00100,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SALIVARY GLAND,00100,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SALIVARY GLAND,00100,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ABDO WALL SURG LOWER ANT NOS,00800,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH N BLOCK/INJ PRONE,01992,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ABDO WALL SURG UPPER ANT NOS,00700,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES THER INTERVEN RAD ART,01924,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES THER INTERVEN RAD ART,01924,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES THER INTERVEN RAD ART,01924,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES THER INTERVEN RAD ART,01924,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES THER INTERVEN RAD ART,01924,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES THER INTERVEN RAD ART,01924,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES THER INTERVEN RAD ART,01924,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES THER INTERVEN RAD ART,01924,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES THER INTERVEN RAD ART,01924,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HEART SURG W/O PUMP,00560,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HEART SURG W/O PUMP,00560,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HEART SURG W/O PUMP,00560,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BLOOD VESSEL REPAIR,00770,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE AREA SURGERY,01320,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE AREA SURGERY,01320,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE AREA SURGERY,01320,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE AREA SURGERY,01320,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE AREA SURGERY,01320,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE AREA SURGERY,01320,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KNEE AREA SURGERY,01320,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE AREA SURGERY,01320,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE AREA SURGERY,01320,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH NECK VESSEL SURGERY NOS,00350,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LOWER LEG SURGERY NOS,01470,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REPAIR OF HERNIA V&A,00832,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH ESOPHAGEAL SURGERY,00500,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH VAGINAL PROCEDURES,00940,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VAGINAL PROCEDURES,00940,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VAGINAL PROCEDURES,00940,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH SITTING PROCEDURE,00604,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH SITTING PROCEDURE,00604,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH SITTING PROCEDURE,00604,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH NULTY AGT CRV/THRC,01939,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH NULTY AGT CRV/THRC,01939,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH NULTY AGT CRV/THRC,01939,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH HIP JOINT SURGERY,01210,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH LUMBAR SPINE CORD SURGERY,00630,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FEMORAL EMBOLECTOMY,01274,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES TX INTERV RAD TH VEIN,01932,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES TX INTERV RAD TH VEIN,01932,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES TX INTERV RAD TH VEIN,01932,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES TX INTERV RAD TH VEIN,01932,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES TX INTERV RAD TH VEIN,01932,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES TX INTERV RAD TH VEIN,01932,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES TX INTERV RAD TH VEIN,01932,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES TX INTERV RAD TH VEIN,01932,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES TX INTERV RAD TH VEIN,01932,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH REMOVAL OF PROSTATE RESECTION,00914,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANES MEDIASCPY & DX THORSCPY,00528,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
NJX AA&/STRD NTRCOST NRV EA,64421,HCPCS,963,RC,,both,671.97,604.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,470.38,,,,396.46,470.38
NJX AA&/STRD NTRCOST NRV EA,64421,HCPCS,963,RC,,both,671.97,604.77,Cigna,Default,Percent of Total Billed Charges,396.46,,,,396.46,470.38
NJX AA&/STRD NTRCOST NRV EA,64421,HCPCS,963,RC,,both,671.97,604.77,United Healthcare,Default,Fee Schedule,,,,,396.46,470.38
TAP BLOCK BI INJECTION,64488,HCPCS,963,RC,,both,866.49,779.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,606.54,,,,511.23,606.54
TAP BLOCK BI INJECTION,64488,HCPCS,963,RC,,both,866.49,779.84,Cigna,Default,Percent of Total Billed Charges,511.23,,,,511.23,606.54
TAP BLOCK BI INJECTION,64488,HCPCS,963,RC,,both,866.49,779.84,United Healthcare,Default,Fee Schedule,,,,,511.23,606.54
ANESTH VASECTOMY,00921,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH VASECTOMY,00921,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH VASECTOMY,00921,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH VASECTOMY,00921,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VASECTOMY,00921,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VASECTOMY,00921,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH VASECTOMY,00921,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH VASECTOMY,00921,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH VASECTOMY,00921,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BLADDER TUMOR SURG,00912,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BLADDER TUMOR SURG,00912,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BLADDER TUMOR SURG,00912,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BLADDER TUMOR SURG,00912,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BLADDER TUMOR SURG,00912,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BLADDER TUMOR SURG,00912,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH BLADDER TUMOR SURG,00912,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH BLADDER TUMOR SURG,00912,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH BLADDER TUMOR SURG,00912,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,963,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,963,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH KNEE AREA SURGERY UPPER,01392,HCPCS,963,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH GENITALIA SURGERY,00920,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH GENITALIA SURGERY,00920,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH GENITALIA SURGERY,00920,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
TRANSURETHRAL PROCEDURE,00918,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
TRANSURETHRAL PROCEDURE,00918,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
TRANSURETHRAL PROCEDURE,00918,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH THORACOTOMY W 1 LUNG VENT,00541,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH THORACOTOMY W 1 LUNG VENT,00541,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH THORACOTOMY W 1 LUNG VENT,00541,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SHOULDER REPLACEMENT,01638,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SHOULDER REPLACEMENT,01638,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SHOULDER REPLACEMENT,01638,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER ARM SURGERY NOS,01830,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER ARM SURGERY NOS,01830,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER ARM SURGERY NOS,01830,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SURGERY FOR OBESITY,00797,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURGERY FOR OBESITY,00797,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURGERY FOR OBESITY,00797,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH LOWER LEG PROCEDURE,01462,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH LOWER LEG PROCEDURE,01462,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH LOWER LEG PROCEDURE,01462,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ELBOW AREA SURGERY,01710,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ELBOW AREA SURGERY,01710,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ELBOW AREA SURGERY,01710,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CHEST LINING BIOPSY,00522,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CHEST LINING BIOPSY,00522,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CHEST LINING BIOPSY,00522,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SPINE CORD SURGERY,00620,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SPINE CORD SURGERY,00620,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SPINE CORD SURGERY,00620,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ARM-LEG VESSEL SURG,01656,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ARM-LEG VESSEL SURG,01656,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ARM-LEG VESSEL SURG,01656,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH ABDOMEN VESSEL SURG,00880,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH ABDOMEN VESSEL SURG,00880,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH ABDOMEN VESSEL SURG,00880,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH NERVE BLOCK/INJ,01991,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH NERVE BLOCK/INJ,01991,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH NERVE BLOCK/INJ,01991,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH REMOVAL OF TESTIS INGUINAL,00926,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH REMOVAL OF TESTIS INGUINAL,00926,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH REMOVAL OF TESTIS INGUINAL,00926,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SURGERY OF ABDOMEN,00860,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURGERY OF ABDOMEN,00860,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURGERY OF ABDOMEN,00860,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH AMPUTATION OF FEMUR,01232,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH AMPUTATION OF FEMUR,01232,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH AMPUTATION OF FEMUR,01232,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH CLOSED PROCEDURE KNEE JOINT,01380,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH CLOSED PROCEDURE KNEE JOINT,01380,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH CLOSED PROCEDURE KNEE JOINT,01380,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH PROCEDURE ON BONY PELVIS,01120,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH PROCEDURE ON BONY PELVIS,01120,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH PROCEDURE ON BONY PELVIS,01120,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SURGERY OF SHOULDER,01610,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SURGERY OF SHOULDER,01610,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SURGERY OF SHOULDER,01610,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BLADDER STONE SURG,00870,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BLADDER STONE SURG,00870,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BLADDER STONE SURG,00870,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH SKULL DRAINAGE,00214,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH SKULL DRAINAGE,00214,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH SKULL DRAINAGE,00214,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH UPPER ARM SURGERY,01740,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH UPPER ARM SURGERY,01740,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH UPPER ARM SURGERY,01740,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KIDNEY STONE DESTRUCT,00873,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KIDNEY STONE DESTRUCT,00873,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KIDNEY STONE DESTRUCT,00873,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH REPAIR OF HERNIA,00750,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH REPAIR OF HERNIA,00750,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH REPAIR OF HERNIA,00750,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH KNEE AREA SURGERY,01360,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH KNEE AREA SURGERY,01360,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH KNEE AREA SURGERY,01360,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH PANCREAS REMOVAL,00794,HCPCS,964,RC,,inpatient,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH PANCREAS REMOVAL,00794,HCPCS,964,RC,,inpatient,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH PANCREAS REMOVAL,00794,HCPCS,964,RC,,inpatient,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH BABG WO PUMP,00566,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH BABG WO PUMP,00566,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH BABG WO PUMP,00566,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH FOR PERCUT IMAGE-GUIDE DESTRUCTIO,01940,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH FOR PERCUT IMAGE-GUIDE DESTRUCTIO,01940,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH FOR PERCUT IMAGE-GUIDE DESTRUCTIO,01940,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH FOR PERCUT IMAGE-GUIDE NEUROMODUL,01942,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH FOR PERCUT IMAGE-GUIDE NEUROMODUL,01942,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH FOR PERCUT IMAGE-GUIDE NEUROMODUL,01942,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH FOR PERM TRANS PACEMAKER INSERT,00530,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR PERM TRANS PACEMAKER INSERT,00530,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR PERM TRANS PACEMAKER INSERT,00530,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR THERAPEUTIC INTERV RADIOLOGIC,01925,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR THERAPEUTIC INTERV RADIOLOGIC,01925,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR THERAPEUTIC INTERV RADIOLOGIC,01925,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR PROCEDURES ON MALE GENITALIA,00920,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR PROCEDURES ON MALE GENITALIA,00920,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR PROCEDURES ON MALE GENITALIA,00920,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR PROC ON MAJ NECK VESS SIMP LI,00352,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR PROC ON MAJ NECK VESS SIMP LI,00352,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR PROC ON MAJ NECK VESS SIMP LI,00352,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR PROC IN LUMBAR REGION; DX OR,00635,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR PROC IN LUMBAR REGION; DX OR,00635,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR PROC IN LUMBAR REGION; DX OR,00635,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR INTRACRANIAL PROCEDURES; CERE,00220,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR INTRACRANIAL PROCEDURES; CERE,00220,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR INTRACRANIAL PROCEDURES; CERE,00220,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH FOR PERCUTANEOUS IMAGE-GUIDE SPIN,01939,HCPCS,964,RC,,both,135.5,121.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.85,,,,79.94,94.85
ANESTH FOR PERCUTANEOUS IMAGE-GUIDE SPIN,01939,HCPCS,964,RC,,both,135.5,121.95,Cigna,Default,Percent of Total Billed Charges,79.94,,,,79.94,94.85
ANESTH FOR PERCUTANEOUS IMAGE-GUIDE SPIN,01939,HCPCS,964,RC,,both,135.5,121.95,United Healthcare,Default,Fee Schedule,,,,,79.94,94.85
ANESTH FOR VAGINAL PROCEUDRES,00952,HCPCS,964,RC,,both,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR VAGINAL PROCEUDRES,00952,HCPCS,964,RC,,both,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR VAGINAL PROCEUDRES,00952,HCPCS,964,RC,,both,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH PERQ IMG NEUROMD/NTRVRT PX SP C/T,01941,HCPCS,964,RC,,both,240.8,216.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.56,,,,142.07,168.56
ANESTH PERQ IMG NEUROMD/NTRVRT PX SP C/T,01941,HCPCS,964,RC,,both,240.8,216.72,Cigna,Default,Percent of Total Billed Charges,142.07,,,,142.07,168.56
ANESTH PERQ IMG NEUROMD/NTRVRT PX SP C/T,01941,HCPCS,964,RC,,both,240.8,216.72,United Healthcare,Default,Fee Schedule,,,,,142.07,168.56
ANES ESOPH THYRD LARX TRACH & LYMPH NECK,00322,HCPCS,964,RC,,both,94,84.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.8,,,,55.46,65.8
ANES ESOPH THYRD LARX TRACH & LYMPH NECK,00322,HCPCS,964,RC,,both,94,84.6,Cigna,Default,Percent of Total Billed Charges,55.46,,,,55.46,65.8
ANES ESOPH THYRD LARX TRACH & LYMPH NECK,00322,HCPCS,964,RC,,both,94,84.6,United Healthcare,Default,Fee Schedule,,,,,55.46,65.8
ANES SUPPLIES 1ST HOUR,370,RC,,,,both,758.5,682.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,530.95,,,,447.52,618.94
ANES SUPPLIES 1ST HOUR,370,RC,,,,both,758.5,682.65,Cigna,Default,Percent of Total Billed Charges,447.52,,,,447.52,618.94
ANES SUPPLIES 1ST HOUR,370,RC,,,,both,758.5,682.65,United Healthcare,Default,Fee Schedule,618.94,,,,447.52,618.94
ANESTHESIA  FIRST 15 MINS,370,RC,,,,both,1030.71,927.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,721.5,,,,608.12,841.06
ANESTHESIA  FIRST 15 MINS,370,RC,,,,both,1030.71,927.64,Cigna,Default,Percent of Total Billed Charges,608.12,,,,608.12,841.06
ANESTHESIA  FIRST 15 MINS,370,RC,,,,both,1030.71,927.64,United Healthcare,Default,Fee Schedule,841.06,,,,608.12,841.06
ANESTHESIA  EACH ADDITIONAL MINUTE,370,RC,,,,both,68.74,61.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.12,,,,40.56,56.09
ANESTHESIA  EACH ADDITIONAL MINUTE,370,RC,,,,both,68.74,61.87,Cigna,Default,Percent of Total Billed Charges,40.56,,,,40.56,56.09
ANESTHESIA  EACH ADDITIONAL MINUTE,370,RC,,,,both,68.74,61.87,United Healthcare,Default,Fee Schedule,56.09,,,,40.56,56.09
THORACIC EPIDURAL,370,RC,,,,both,2145.65,1931.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1501.96,,,,1265.93,1750.85
THORACIC EPIDURAL,370,RC,,,,both,2145.65,1931.09,Cigna,Default,Percent of Total Billed Charges,1265.93,,,,1265.93,1750.85
THORACIC EPIDURAL,370,RC,,,,both,2145.65,1931.09,United Healthcare,Default,Fee Schedule,1750.85,,,,1265.93,1750.85
ANESTH FOR THORACOTOMY PROC,00542,HCPCS,963,RC,,inpatient,131.55,118.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.08,,,,77.61,92.08
ANESTH FOR THORACOTOMY PROC,00542,HCPCS,963,RC,,inpatient,131.55,118.4,Cigna,Default,Percent of Total Billed Charges,77.61,,,,77.61,92.08
ANESTH FOR THORACOTOMY PROC,00542,HCPCS,963,RC,,inpatient,131.55,118.4,United Healthcare,Default,Fee Schedule,,,,,77.61,92.08
ANESTH NOSE/SINUS SURGERY,00160,HCPCS,964,RC,,both,124.67,112.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.27,,,,73.56,87.27
ANESTH NOSE/SINUS SURGERY,00160,HCPCS,964,RC,,both,124.67,112.2,Cigna,Default,Percent of Total Billed Charges,73.56,,,,73.56,87.27
ANESTH NOSE/SINUS SURGERY,00160,HCPCS,964,RC,,both,124.67,112.2,United Healthcare,Default,Fee Schedule,,,,,73.56,87.27
ANES EQ&SUPP ADD 15 MIN,370,RC,,,,both,129.5,116.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.65,,,,76.4,105.67
ANES EQ&SUPP ADD 15 MIN,370,RC,,,,both,129.5,116.55,Cigna,Default,Percent of Total Billed Charges,76.4,,,,76.4,105.67
ANES EQ&SUPP ADD 15 MIN,370,RC,,,,both,129.5,116.55,United Healthcare,Default,Fee Schedule,105.67,,,,76.4,105.67
APPLIC SHORT LEG CAST,29405,HCPCS,451,RC,,both,267.75,240.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.42,,,,157.97,218.48
APPLIC SHORT LEG CAST,29405,HCPCS,451,RC,,both,267.75,240.98,Cigna,Default,Percent of Total Billed Charges,157.97,,,,157.97,218.48
APPLIC SHORT LEG CAST,29405,HCPCS,451,RC,,both,267.75,240.98,United Healthcare,Default,Fee Schedule,218.48,,,,157.97,218.48
APPLIC SHORT LEG CAST,29405,HCPCS,456,RC,,both,267.75,240.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.42,,,,157.97,218.48
APPLIC SHORT LEG CAST,29405,HCPCS,456,RC,,both,267.75,240.98,Cigna,Default,Percent of Total Billed Charges,157.97,,,,157.97,218.48
APPLIC SHORT LEG CAST,29405,HCPCS,456,RC,,both,267.75,240.98,United Healthcare,Default,Fee Schedule,218.48,,,,157.97,218.48
UNLISTED VASCULAR PROCEDURE,37799,HCPCS,450,RC,,both,0.01,0.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
UNLISTED VASCULAR PROCEDURE,37799,HCPCS,450,RC,,both,0.01,0.01,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
UNLISTED VASCULAR PROCEDURE,37799,HCPCS,450,RC,,both,0.01,0.01,United Healthcare,Default,Fee Schedule,0.01,,,,0.01,0.01
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,450,RC,,both,150.14,135.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.1,,,,88.58,122.51
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,450,RC,,both,150.14,135.13,Cigna,Default,Percent of Total Billed Charges,88.58,,,,88.58,122.51
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,450,RC,,both,150.14,135.13,United Healthcare,Default,Fee Schedule,122.51,,,,88.58,122.51
INJECTION SC/IM,96372,HCPCS,450,RC,,both,158.35,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.84,,,,93.43,129.21
INJECTION SC/IM,96372,HCPCS,450,RC,,both,158.35,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,129.21
INJECTION SC/IM,96372,HCPCS,450,RC,,both,158.35,142.52,United Healthcare,Default,Fee Schedule,129.21,,,,93.43,129.21
"HYDRATION IV,INITIAL,31MIN TO 1HR",96360,HCPCS,450,RC,,both,437.04,393.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,305.93,,,,257.85,356.62
"HYDRATION IV,INITIAL,31MIN TO 1HR",96360,HCPCS,450,RC,,both,437.04,393.34,Cigna,Default,Percent of Total Billed Charges,257.85,,,,257.85,356.62
"HYDRATION IV,INITIAL,31MIN TO 1HR",96360,HCPCS,450,RC,,both,437.04,393.34,United Healthcare,Default,Fee Schedule,356.62,,,,257.85,356.62
"HYDRATION IV, ADDL HR",96361,HCPCS,450,RC,,both,229.2,206.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.44,,,,135.23,187.03
"HYDRATION IV, ADDL HR",96361,HCPCS,450,RC,,both,229.2,206.28,Cigna,Default,Percent of Total Billed Charges,135.23,,,,135.23,187.03
"HYDRATION IV, ADDL HR",96361,HCPCS,450,RC,,both,229.2,206.28,United Healthcare,Default,Fee Schedule,187.03,,,,135.23,187.03
"IV INFUSION, INITIAL, UP TO 1 HR",96365,HCPCS,450,RC,,both,632.38,569.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.67,,,,373.1,516.02
"IV INFUSION, INITIAL, UP TO 1 HR",96365,HCPCS,450,RC,,both,632.38,569.14,Cigna,Default,Percent of Total Billed Charges,373.1,,,,373.1,516.02
"IV INFUSION, INITIAL, UP TO 1 HR",96365,HCPCS,450,RC,,both,632.38,569.14,United Healthcare,Default,Fee Schedule,516.02,,,,373.1,516.02
"IV INFUSION, ADDL HR",96366,HCPCS,450,RC,,both,222.74,200.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.92,,,,131.42,181.76
"IV INFUSION, ADDL HR",96366,HCPCS,450,RC,,both,222.74,200.47,Cigna,Default,Percent of Total Billed Charges,131.42,,,,131.42,181.76
"IV INFUSION, ADDL HR",96366,HCPCS,450,RC,,both,222.74,200.47,United Healthcare,Default,Fee Schedule,181.76,,,,131.42,181.76
"IV PUSH, INITIAL",96374,HCPCS,450,RC,,both,327.98,295.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,229.59,,,,193.51,267.63
"IV PUSH, INITIAL",96374,HCPCS,450,RC,,both,327.98,295.18,Cigna,Default,Percent of Total Billed Charges,193.51,,,,193.51,267.63
"IV PUSH, INITIAL",96374,HCPCS,450,RC,,both,327.98,295.18,United Healthcare,Default,Fee Schedule,267.63,,,,193.51,267.63
"IV PUSH, SEQUENTIAL, SAME DRUG",96376,HCPCS,450,RC,,both,185.07,166.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.55,,,,109.19,151.02
"IV PUSH, SEQUENTIAL, SAME DRUG",96376,HCPCS,450,RC,,both,185.07,166.56,Cigna,Default,Percent of Total Billed Charges,109.19,,,,109.19,151.02
"IV PUSH, SEQUENTIAL, SAME DRUG",96376,HCPCS,450,RC,,both,185.07,166.56,United Healthcare,Default,Fee Schedule,151.02,,,,109.19,151.02
"IV INFUSION, CONCURRENT",96368,HCPCS,450,RC,,both,138.95,125.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.26,,,,81.98,113.38
"IV INFUSION, CONCURRENT",96368,HCPCS,450,RC,,both,138.95,125.06,Cigna,Default,Percent of Total Billed Charges,81.98,,,,81.98,113.38
"IV INFUSION, CONCURRENT",96368,HCPCS,450,RC,,both,138.95,125.06,United Healthcare,Default,Fee Schedule,113.38,,,,81.98,113.38
INJECTION SC/IM,96372,HCPCS,456,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
INJECTION SC/IM,96372,HCPCS,456,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
INJECTION SC/IM,96372,HCPCS,456,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
SQ IM THERA OR PROPH DRUG,451,RC,,,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
SQ IM THERA OR PROPH DRUG,451,RC,,,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
SQ IM THERA OR PROPH DRUG,451,RC,,,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
IV INFUSION 1ST HOUR,456,RC,,,,both,379.5,341.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.65,,,,223.9,309.67
IV INFUSION 1ST HOUR,456,RC,,,,both,379.5,341.55,Cigna,Default,Percent of Total Billed Charges,223.9,,,,223.9,309.67
IV INFUSION 1ST HOUR,456,RC,,,,both,379.5,341.55,United Healthcare,Default,Fee Schedule,309.67,,,,223.9,309.67
IV INFUSION 1ST HOUR,451,RC,,,,both,379.5,341.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.65,,,,223.9,309.67
IV INFUSION 1ST HOUR,451,RC,,,,both,379.5,341.55,Cigna,Default,Percent of Total Billed Charges,223.9,,,,223.9,309.67
IV INFUSION 1ST HOUR,451,RC,,,,both,379.5,341.55,United Healthcare,Default,Fee Schedule,309.67,,,,223.9,309.67
IV INFUSION HYDRATION EACH ADDTL HR,96361,HCPCS,456,RC,,both,204,183.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.8,,,,120.36,166.46
IV INFUSION HYDRATION EACH ADDTL HR,96361,HCPCS,456,RC,,both,204,183.6,Cigna,Default,Percent of Total Billed Charges,120.36,,,,120.36,166.46
IV INFUSION HYDRATION EACH ADDTL HR,96361,HCPCS,456,RC,,both,204,183.6,United Healthcare,Default,Fee Schedule,166.46,,,,120.36,166.46
IV INFUSION HYDRATION EACH ADDTL HR,451,RC,,,,both,204,183.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.8,,,,120.36,166.46
IV INFUSION HYDRATION EACH ADDTL HR,451,RC,,,,both,204,183.6,Cigna,Default,Percent of Total Billed Charges,120.36,,,,120.36,166.46
IV INFUSION HYDRATION EACH ADDTL HR,451,RC,,,,both,204,183.6,United Healthcare,Default,Fee Schedule,166.46,,,,120.36,166.46
INTERDERMAL TUBERCULIN,300,RC,,,,both,17.75,15.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.42,,,,10.47,14.48
INTERDERMAL TUBERCULIN,300,RC,,,,both,17.75,15.98,Cigna,Default,Percent of Total Billed Charges,10.47,,,,10.47,14.48
INTERDERMAL TUBERCULIN,300,RC,,,,both,17.75,15.98,United Healthcare,Default,Fee Schedule,14.48,,,,10.47,14.48
IV INFUSION PROPH 1ST HOUR,456,RC,,,,both,379.5,341.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.65,,,,223.9,309.67
IV INFUSION PROPH 1ST HOUR,456,RC,,,,both,379.5,341.55,Cigna,Default,Percent of Total Billed Charges,223.9,,,,223.9,309.67
IV INFUSION PROPH 1ST HOUR,456,RC,,,,both,379.5,341.55,United Healthcare,Default,Fee Schedule,309.67,,,,223.9,309.67
IV INFUSION PROPH 1ST HOUR,451,RC,,,,both,379.5,341.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.65,,,,223.9,309.67
IV INFUSION PROPH 1ST HOUR,451,RC,,,,both,379.5,341.55,Cigna,Default,Percent of Total Billed Charges,223.9,,,,223.9,309.67
IV INFUSION PROPH 1ST HOUR,451,RC,,,,both,379.5,341.55,United Healthcare,Default,Fee Schedule,309.67,,,,223.9,309.67
IV INFUSION PROPH ADDTL HOUR,456,RC,,,,both,204,183.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.8,,,,120.36,166.46
IV INFUSION PROPH ADDTL HOUR,456,RC,,,,both,204,183.6,Cigna,Default,Percent of Total Billed Charges,120.36,,,,120.36,166.46
IV INFUSION PROPH ADDTL HOUR,456,RC,,,,both,204,183.6,United Healthcare,Default,Fee Schedule,166.46,,,,120.36,166.46
IV INFUSION PROPH ADDTL HOUR,451,RC,,,,both,204,183.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.8,,,,120.36,166.46
IV INFUSION PROPH ADDTL HOUR,451,RC,,,,both,204,183.6,Cigna,Default,Percent of Total Billed Charges,120.36,,,,120.36,166.46
IV INFUSION PROPH ADDTL HOUR,451,RC,,,,both,204,183.6,United Healthcare,Default,Fee Schedule,166.46,,,,120.36,166.46
"IV PUSH, INITIAL",96374,HCPCS,456,RC,,both,169.5,152.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.65,,,,100,138.31
"IV PUSH, INITIAL",96374,HCPCS,456,RC,,both,169.5,152.55,Cigna,Default,Percent of Total Billed Charges,100,,,,100,138.31
"IV PUSH, INITIAL",96374,HCPCS,456,RC,,both,169.5,152.55,United Healthcare,Default,Fee Schedule,138.31,,,,100,138.31
IV PUSH INITIAL DRUG,96374,HCPCS,260,RC,,both,169.5,152.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.65,,,,100,138.31
IV PUSH INITIAL DRUG,96374,HCPCS,260,RC,,both,169.5,152.55,Cigna,Default,Percent of Total Billed Charges,100,,,,100,138.31
IV PUSH INITIAL DRUG,96374,HCPCS,260,RC,,both,169.5,152.55,United Healthcare,Default,Fee Schedule,138.31,,,,100,138.31
"IV PUSH, SEQUENTIAL, SAME DRUG",456,RC,,,,both,169.5,152.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.65,,,,100,138.31
"IV PUSH, SEQUENTIAL, SAME DRUG",456,RC,,,,both,169.5,152.55,Cigna,Default,Percent of Total Billed Charges,100,,,,100,138.31
"IV PUSH, SEQUENTIAL, SAME DRUG",456,RC,,,,both,169.5,152.55,United Healthcare,Default,Fee Schedule,138.31,,,,100,138.31
IV PUSH EACH SEQ DRUG,451,RC,,,,both,169.5,152.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.65,,,,100,138.31
IV PUSH EACH SEQ DRUG,451,RC,,,,both,169.5,152.55,Cigna,Default,Percent of Total Billed Charges,100,,,,100,138.31
IV PUSH EACH SEQ DRUG,451,RC,,,,both,169.5,152.55,United Healthcare,Default,Fee Schedule,138.31,,,,100,138.31
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,456,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,456,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,456,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
"IV PUSH, SEQUENTIAL, NEW DRUG",96375,HCPCS,260,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
"IV INFUSION, SEQUENT, UP TO 1 HR",96367,HCPCS,450,RC,,both,222.74,200.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.92,,,,131.42,181.76
"IV INFUSION, SEQUENT, UP TO 1 HR",96367,HCPCS,450,RC,,both,222.74,200.47,Cigna,Default,Percent of Total Billed Charges,131.42,,,,131.42,181.76
"IV INFUSION, SEQUENT, UP TO 1 HR",96367,HCPCS,450,RC,,both,222.74,200.47,United Healthcare,Default,Fee Schedule,181.76,,,,131.42,181.76
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,451,RC,,both,204,183.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.8,,,,120.36,166.46
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,451,RC,,both,204,183.6,Cigna,Default,Percent of Total Billed Charges,120.36,,,,120.36,166.46
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,451,RC,,both,204,183.6,United Healthcare,Default,Fee Schedule,166.46,,,,120.36,166.46
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,456,RC,,both,204,183.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.8,,,,120.36,166.46
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,456,RC,,both,204,183.6,Cigna,Default,Percent of Total Billed Charges,120.36,,,,120.36,166.46
"IV INFUSION, SEQUENTIAL NEW",96367,HCPCS,456,RC,,both,204,183.6,United Healthcare,Default,Fee Schedule,166.46,,,,120.36,166.46
REPR NAIL BED,11760,HCPCS,456,RC,,both,297.5,267.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.25,,,,175.52,242.76
REPR NAIL BED,11760,HCPCS,456,RC,,both,297.5,267.75,Cigna,Default,Percent of Total Billed Charges,175.52,,,,175.52,242.76
REPR NAIL BED,11760,HCPCS,456,RC,,both,297.5,267.75,United Healthcare,Default,Fee Schedule,242.76,,,,175.52,242.76
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,450,RC,,both,788.87,709.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,552.21,,,,465.43,643.72
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,450,RC,,both,788.87,709.98,Cigna,Default,Percent of Total Billed Charges,465.43,,,,465.43,643.72
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,450,RC,,both,788.87,709.98,United Healthcare,Default,Fee Schedule,643.72,,,,465.43,643.72
APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1,15271,HCPCS,761,RC,,both,5727.24,5154.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4009.07,,,,3379.07,4673.43
APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1,15271,HCPCS,761,RC,,both,5727.24,5154.52,Cigna,Default,Percent of Total Billed Charges,3379.07,,,,3379.07,4673.43
APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1,15271,HCPCS,761,RC,,both,5727.24,5154.52,United Healthcare,Default,Fee Schedule,4673.43,,,,3379.07,4673.43
APP SKN SUB GRFT T/A/L AREA/100SQ CM EA,15272,HCPCS,761,RC,,both,1362.04,1225.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,953.43,,,,803.6,1111.42
APP SKN SUB GRFT T/A/L AREA/100SQ CM EA,15272,HCPCS,761,RC,,both,1362.04,1225.84,Cigna,Default,Percent of Total Billed Charges,803.6,,,,803.6,1111.42
APP SKN SUB GRFT T/A/L AREA/100SQ CM EA,15272,HCPCS,761,RC,,both,1362.04,1225.84,United Healthcare,Default,Fee Schedule,1111.42,,,,803.6,1111.42
SKIN SUB GRFT T/ARM/LG CHILD,15273,HCPCS,761,RC,,both,10507.97,9457.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7355.58,,,,6199.7,8574.5
SKIN SUB GRFT T/ARM/LG CHILD,15273,HCPCS,761,RC,,both,10507.97,9457.17,Cigna,Default,Percent of Total Billed Charges,6199.7,,,,6199.7,8574.5
SKIN SUB GRFT T/ARM/LG CHILD,15273,HCPCS,761,RC,,both,10507.97,9457.17,United Healthcare,Default,Fee Schedule,8574.5,,,,6199.7,8574.5
APP SKN SUB GRFT T/A/L AREA>=100SCM ADL,15274,HCPCS,761,RC,,both,2374.63,2137.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1662.24,,,,1401.03,1937.7
APP SKN SUB GRFT T/A/L AREA>=100SCM ADL,15274,HCPCS,761,RC,,both,2374.63,2137.17,Cigna,Default,Percent of Total Billed Charges,1401.03,,,,1401.03,1937.7
APP SKN SUB GRFT T/A/L AREA>=100SCM ADL,15274,HCPCS,761,RC,,both,2374.63,2137.17,United Healthcare,Default,Fee Schedule,1937.7,,,,1401.03,1937.7
SUB GRFT F/S/N/H/F/G/M/D<100SQ CM 1ST 25,15275,HCPCS,761,RC,,both,5893.33,5304,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4125.33,,,,3477.06,4808.96
SUB GRFT F/S/N/H/F/G/M/D<100SQ CM 1ST 25,15275,HCPCS,761,RC,,both,5893.33,5304,Cigna,Default,Percent of Total Billed Charges,3477.06,,,,3477.06,4808.96
SUB GRFT F/S/N/H/F/G/M/D<100SQ CM 1ST 25,15275,HCPCS,761,RC,,both,5893.33,5304,United Healthcare,Default,Fee Schedule,4808.96,,,,3477.06,4808.96
SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADD,15276,HCPCS,761,RC,,both,1777.4,1599.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1244.18,,,,1048.67,1450.36
SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADD,15276,HCPCS,761,RC,,both,1777.4,1599.66,Cigna,Default,Percent of Total Billed Charges,1048.67,,,,1048.67,1450.36
SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADD,15276,HCPCS,761,RC,,both,1777.4,1599.66,United Healthcare,Default,Fee Schedule,1450.36,,,,1048.67,1450.36
CLO LAC ERATIONMOUTH;OVER 2.5/COMPLEX,40831,HCPCS,450,RC,,both,643.75,579.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,450.62,,,,379.81,525.3
CLO LAC ERATIONMOUTH;OVER 2.5/COMPLEX,40831,HCPCS,450,RC,,both,643.75,579.38,Cigna,Default,Percent of Total Billed Charges,379.81,,,,379.81,525.3
CLO LAC ERATIONMOUTH;OVER 2.5/COMPLEX,40831,HCPCS,450,RC,,both,643.75,579.38,United Healthcare,Default,Fee Schedule,525.3,,,,379.81,525.3
SKN SUB GRFT F/N/H/F/G CH ADD,15278,HCPCS,761,RC,,both,2994.14,2694.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2095.9,,,,1766.54,2443.22
SKN SUB GRFT F/N/H/F/G CH ADD,15278,HCPCS,761,RC,,both,2994.14,2694.73,Cigna,Default,Percent of Total Billed Charges,1766.54,,,,1766.54,2443.22
SKN SUB GRFT F/N/H/F/G CH ADD,15278,HCPCS,761,RC,,both,2994.14,2694.73,United Healthcare,Default,Fee Schedule,2443.22,,,,1766.54,2443.22
CHEMICAL CAUTERIZATION,17250,HCPCS,450,RC,,both,441.03,396.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,308.72,,,,260.21,359.88
CHEMICAL CAUTERIZATION,17250,HCPCS,450,RC,,both,441.03,396.93,Cigna,Default,Percent of Total Billed Charges,260.21,,,,260.21,359.88
CHEMICAL CAUTERIZATION,17250,HCPCS,450,RC,,both,441.03,396.93,United Healthcare,Default,Fee Schedule,359.88,,,,260.21,359.88
SUB GRFT F/S/N/H/F/G/M/D>=100SCM 1STSQ C,15277,HCPCS,761,RC,,both,5727.24,5154.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4009.07,,,,3379.07,4673.43
SUB GRFT F/S/N/H/F/G/M/D>=100SCM 1STSQ C,15277,HCPCS,761,RC,,both,5727.24,5154.52,Cigna,Default,Percent of Total Billed Charges,3379.07,,,,3379.07,4673.43
SUB GRFT F/S/N/H/F/G/M/D>=100SCM 1STSQ C,15277,HCPCS,761,RC,,both,5727.24,5154.52,United Healthcare,Default,Fee Schedule,4673.43,,,,3379.07,4673.43
DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM,11042,HCPCS,761,RC,,both,1189.38,1070.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,832.57,,,,701.73,970.53
DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM,11042,HCPCS,761,RC,,both,1189.38,1070.44,Cigna,Default,Percent of Total Billed Charges,701.73,,,,701.73,970.53
DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM,11042,HCPCS,761,RC,,both,1189.38,1070.44,United Healthcare,Default,Fee Schedule,970.53,,,,701.73,970.53
DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ,11045,HCPCS,761,RC,,both,653.96,588.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,457.77,,,,385.84,533.63
DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ,11045,HCPCS,761,RC,,both,653.96,588.56,Cigna,Default,Percent of Total Billed Charges,385.84,,,,385.84,533.63
DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ,11045,HCPCS,761,RC,,both,653.96,588.56,United Healthcare,Default,Fee Schedule,533.63,,,,385.84,533.63
RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANE,97602,HCPCS,761,RC,,both,649.48,584.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.64,,,,383.19,529.98
RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANE,97602,HCPCS,761,RC,,both,649.48,584.53,Cigna,Default,Percent of Total Billed Charges,383.19,,,,383.19,529.98
RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANE,97602,HCPCS,761,RC,,both,649.48,584.53,United Healthcare,Default,Fee Schedule,529.98,,,,383.19,529.98
NEGATIVE PRESSURE WOUND THERAPY DME <= 5,97605,HCPCS,510,RC,,both,649.48,584.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.64,,,,383.19,529.98
NEGATIVE PRESSURE WOUND THERAPY DME <= 5,97605,HCPCS,510,RC,,both,649.48,584.53,Cigna,Default,Percent of Total Billed Charges,383.19,,,,383.19,529.98
NEGATIVE PRESSURE WOUND THERAPY DME <= 5,97605,HCPCS,510,RC,,both,649.48,584.53,United Healthcare,Default,Fee Schedule,529.98,,,,383.19,529.98
NEGATIVE PRESSURE WOUND THERAPY DME <= 5,97606,HCPCS,761,RC,,both,1189.39,1070.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,832.57,,,,701.74,970.54
NEGATIVE PRESSURE WOUND THERAPY DME <= 5,97606,HCPCS,761,RC,,both,1189.39,1070.45,Cigna,Default,Percent of Total Billed Charges,701.74,,,,701.74,970.54
NEGATIVE PRESSURE WOUND THERAPY DME <= 5,97606,HCPCS,761,RC,,both,1189.39,1070.45,United Healthcare,Default,Fee Schedule,970.54,,,,701.74,970.54
INCISION & DRAIN OF A PERIRECTAL ABSCESS,46060,HCPCS,450,RC,,both,314.5,283.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.15,,,,185.56,256.63
INCISION & DRAIN OF A PERIRECTAL ABSCESS,46060,HCPCS,450,RC,,both,314.5,283.05,Cigna,Default,Percent of Total Billed Charges,185.56,,,,185.56,256.63
INCISION & DRAIN OF A PERIRECTAL ABSCESS,46060,HCPCS,450,RC,,both,314.5,283.05,United Healthcare,Default,Fee Schedule,256.63,,,,185.56,256.63
DEBR EXZ INF SKIN 10% BS,11000,HCPCS,450,RC,,both,1654.5,1489.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1158.15,,,,976.16,1350.07
DEBR EXZ INF SKIN 10% BS,11000,HCPCS,450,RC,,both,1654.5,1489.05,Cigna,Default,Percent of Total Billed Charges,976.16,,,,976.16,1350.07
DEBR EXZ INF SKIN 10% BS,11000,HCPCS,450,RC,,both,1654.5,1489.05,United Healthcare,Default,Fee Schedule,1350.07,,,,976.16,1350.07
DRS&/DBRDMT PRTL-THKNS BURNS 1,16030,HCPCS,450,RC,,both,1095.21,985.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,766.65,,,,646.17,893.69
DRS&/DBRDMT PRTL-THKNS BURNS 1,16030,HCPCS,450,RC,,both,1095.21,985.69,Cigna,Default,Percent of Total Billed Charges,646.17,,,,646.17,893.69
DRS&/DBRDMT PRTL-THKNS BURNS 1,16030,HCPCS,450,RC,,both,1095.21,985.69,United Healthcare,Default,Fee Schedule,893.69,,,,646.17,893.69
REPAIR BLOOD VESSEL HAND OR FINGER,35207,HCPCS,450,RC,,both,314.5,283.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.15,,,,185.56,256.63
REPAIR BLOOD VESSEL HAND OR FINGER,35207,HCPCS,450,RC,,both,314.5,283.05,Cigna,Default,Percent of Total Billed Charges,185.56,,,,185.56,256.63
REPAIR BLOOD VESSEL HAND OR FINGER,35207,HCPCS,450,RC,,both,314.5,283.05,United Healthcare,Default,Fee Schedule,256.63,,,,185.56,256.63
REPAIR BLOOD VESSEL LOWER EXTREMITY,35226,HCPCS,450,RC,,both,337.25,303.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.08,,,,198.98,275.2
REPAIR BLOOD VESSEL LOWER EXTREMITY,35226,HCPCS,450,RC,,both,337.25,303.53,Cigna,Default,Percent of Total Billed Charges,198.98,,,,198.98,275.2
REPAIR BLOOD VESSEL LOWER EXTREMITY,35226,HCPCS,450,RC,,both,337.25,303.53,United Healthcare,Default,Fee Schedule,275.2,,,,198.98,275.2
SURG PROCED NOS FINGER HAND,26989,HCPCS,450,RC,,both,381.5,343.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.05,,,,225.08,311.3
SURG PROCED NOS FINGER HAND,26989,HCPCS,450,RC,,both,381.5,343.35,Cigna,Default,Percent of Total Billed Charges,225.08,,,,225.08,311.3
SURG PROCED NOS FINGER HAND,26989,HCPCS,450,RC,,both,381.5,343.35,United Healthcare,Default,Fee Schedule,311.3,,,,225.08,311.3
OPEN REDUCTION DISSTAL PHALANGEAL FX,26765,HCPCS,450,RC,,both,1011.25,910.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,707.88,,,,596.64,825.18
OPEN REDUCTION DISSTAL PHALANGEAL FX,26765,HCPCS,450,RC,,both,1011.25,910.13,Cigna,Default,Percent of Total Billed Charges,596.64,,,,596.64,825.18
OPEN REDUCTION DISSTAL PHALANGEAL FX,26765,HCPCS,450,RC,,both,1011.25,910.13,United Healthcare,Default,Fee Schedule,825.18,,,,596.64,825.18
DECLOTTING BY THROMBOLYTIC AGENT,451,RC,,,,both,68.5,61.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.95,,,,40.42,55.9
DECLOTTING BY THROMBOLYTIC AGENT,451,RC,,,,both,68.5,61.65,Cigna,Default,Percent of Total Billed Charges,40.42,,,,40.42,55.9
DECLOTTING BY THROMBOLYTIC AGENT,451,RC,,,,both,68.5,61.65,United Healthcare,Default,Fee Schedule,55.9,,,,40.42,55.9
INSERTION TEMPORARY INDWELLING BLADDER,451,RC,,,,both,133.25,119.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.28,,,,78.62,108.73
INSERTION TEMPORARY INDWELLING BLADDER,451,RC,,,,both,133.25,119.93,Cigna,Default,Percent of Total Billed Charges,78.62,,,,78.62,108.73
INSERTION TEMPORARY INDWELLING BLADDER,451,RC,,,,both,133.25,119.93,United Healthcare,Default,Fee Schedule,108.73,,,,78.62,108.73
NB RESUSCITATION,451,RC,,,,both,549.75,494.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,384.82,,,,324.35,448.6
NB RESUSCITATION,451,RC,,,,both,549.75,494.78,Cigna,Default,Percent of Total Billed Charges,324.35,,,,324.35,448.6
NB RESUSCITATION,451,RC,,,,both,549.75,494.78,United Healthcare,Default,Fee Schedule,448.6,,,,324.35,448.6
NB RESUSCITATION,456,RC,,,,both,549.75,494.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,384.82,,,,324.35,448.6
NB RESUSCITATION,456,RC,,,,both,549.75,494.78,Cigna,Default,Percent of Total Billed Charges,324.35,,,,324.35,448.6
NB RESUSCITATION,456,RC,,,,both,549.75,494.78,United Healthcare,Default,Fee Schedule,448.6,,,,324.35,448.6
INSERTION TEMPORARY INDWELLING BLADDER,456,RC,,,,both,133.25,119.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.28,,,,78.62,108.73
INSERTION TEMPORARY INDWELLING BLADDER,456,RC,,,,both,133.25,119.93,Cigna,Default,Percent of Total Billed Charges,78.62,,,,78.62,108.73
INSERTION TEMPORARY INDWELLING BLADDER,456,RC,,,,both,133.25,119.93,United Healthcare,Default,Fee Schedule,108.73,,,,78.62,108.73
INSERT TEMP BLADDER CATH/COMPLCAT,51703,HCPCS,450,RC,,both,173,155.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.1,,,,102.07,141.17
INSERT TEMP BLADDER CATH/COMPLCAT,51703,HCPCS,450,RC,,both,173,155.7,Cigna,Default,Percent of Total Billed Charges,102.07,,,,102.07,141.17
INSERT TEMP BLADDER CATH/COMPLCAT,51703,HCPCS,450,RC,,both,173,155.7,United Healthcare,Default,Fee Schedule,141.17,,,,102.07,141.17
DEBRID; SKIN & SUBQ TISS,11042,HCPCS,456,RC,,both,560.75,504.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,392.52,,,,330.84,457.57
DEBRID; SKIN & SUBQ TISS,11042,HCPCS,456,RC,,both,560.75,504.68,Cigna,Default,Percent of Total Billed Charges,330.84,,,,330.84,457.57
DEBRID; SKIN & SUBQ TISS,11042,HCPCS,456,RC,,both,560.75,504.68,United Healthcare,Default,Fee Schedule,457.57,,,,330.84,457.57
APPLIC SHORT LEG SPLINT,29515,HCPCS,456,RC,,both,230.5,207.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161.35,,,,136,188.09
APPLIC SHORT LEG SPLINT,29515,HCPCS,456,RC,,both,230.5,207.45,Cigna,Default,Percent of Total Billed Charges,136,,,,136,188.09
APPLIC SHORT LEG SPLINT,29515,HCPCS,456,RC,,both,230.5,207.45,United Healthcare,Default,Fee Schedule,188.09,,,,136,188.09
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,456,RC,26,both,322.5,290.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.75,,,,190.28,263.16
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,456,RC,26,both,322.5,290.25,Cigna,Default,Percent of Total Billed Charges,190.28,,,,190.28,263.16
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,456,RC,26,both,322.5,290.25,United Healthcare,Default,Fee Schedule,263.16,,,,190.28,263.16
I&D ABSCESS:COMPLIC/MX,10061,HCPCS,450,RC,,both,854.38,768.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.07,,,,504.08,697.17
I&D ABSCESS:COMPLIC/MX,10061,HCPCS,450,RC,,both,854.38,768.94,Cigna,Default,Percent of Total Billed Charges,504.08,,,,504.08,697.17
I&D ABSCESS:COMPLIC/MX,10061,HCPCS,450,RC,,both,854.38,768.94,United Healthcare,Default,Fee Schedule,697.17,,,,504.08,697.17
I&D ABSCESS; PERINEUM,56405,HCPCS,450,RC,,both,1032.11,928.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,722.48,,,,608.94,842.2
I&D ABSCESS; PERINEUM,56405,HCPCS,450,RC,,both,1032.11,928.9,Cigna,Default,Percent of Total Billed Charges,608.94,,,,608.94,842.2
I&D ABSCESS; PERINEUM,56405,HCPCS,450,RC,,both,1032.11,928.9,United Healthcare,Default,Fee Schedule,842.2,,,,608.94,842.2
I&D ABSCESS BARHOLINS GLAND,56420,HCPCS,450,RC,,both,392.79,353.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.95,,,,231.75,320.52
I&D ABSCESS BARHOLINS GLAND,56420,HCPCS,450,RC,,both,392.79,353.51,Cigna,Default,Percent of Total Billed Charges,231.75,,,,231.75,320.52
I&D ABSCESS BARHOLINS GLAND,56420,HCPCS,450,RC,,both,392.79,353.51,United Healthcare,Default,Fee Schedule,320.52,,,,231.75,320.52
REP ET HAND; W FG EA TENDON,26412,HCPCS,450,RC,,both,9899.86,8909.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6929.9,,,,5840.92,8078.29
REP ET HAND; W FG EA TENDON,26412,HCPCS,450,RC,,both,9899.86,8909.87,Cigna,Default,Percent of Total Billed Charges,5840.92,,,,5840.92,8078.29
REP ET HAND; W FG EA TENDON,26412,HCPCS,450,RC,,both,9899.86,8909.87,United Healthcare,Default,Fee Schedule,8078.29,,,,5840.92,8078.29
ROUTINE VENIPUNCTURE,36415,HCPCS,300,RC,,both,119.39,107.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.57,,,,70.44,97.42
ROUTINE VENIPUNCTURE,36415,HCPCS,300,RC,,both,119.39,107.45,Cigna,Default,Percent of Total Billed Charges,70.44,,,,70.44,97.42
ROUTINE VENIPUNCTURE,36415,HCPCS,300,RC,,both,119.39,107.45,United Healthcare,Default,Fee Schedule,97.42,,,,70.44,97.42
"COLLECT BLOOD, COMPL IMPLANT VAD",36591,HCPCS,450,RC,,both,341.27,307.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.89,,,,201.35,278.48
"COLLECT BLOOD, COMPL IMPLANT VAD",36591,HCPCS,450,RC,,both,341.27,307.14,Cigna,Default,Percent of Total Billed Charges,201.35,,,,201.35,278.48
"COLLECT BLOOD, COMPL IMPLANT VAD",36591,HCPCS,450,RC,,both,341.27,307.14,United Healthcare,Default,Fee Schedule,278.48,,,,201.35,278.48
VENOUS ACCESS DEVICE BLOOD COLL,456,RC,,,,both,120,108,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84,,,,70.8,97.92
VENOUS ACCESS DEVICE BLOOD COLL,456,RC,,,,both,120,108,Cigna,Default,Percent of Total Billed Charges,70.8,,,,70.8,97.92
VENOUS ACCESS DEVICE BLOOD COLL,456,RC,,,,both,120,108,United Healthcare,Default,Fee Schedule,97.92,,,,70.8,97.92
VENOUS ACCESS DEVICE BLOOD COLL,451,RC,,,,both,120,108,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84,,,,70.8,97.92
VENOUS ACCESS DEVICE BLOOD COLL,451,RC,,,,both,120,108,Cigna,Default,Percent of Total Billed Charges,70.8,,,,70.8,97.92
VENOUS ACCESS DEVICE BLOOD COLL,451,RC,,,,both,120,108,United Healthcare,Default,Fee Schedule,97.92,,,,70.8,97.92
EXC BEN LES TRUNK; OVER 4.0 CM,11406,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
EXC BEN LES TRUNK; OVER 4.0 CM,11406,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
EXC BEN LES TRUNK; OVER 4.0 CM,11406,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC BEN LES SCALP; 0.5 CM/LESS,11420,HCPCS,450,RC,,both,3439.66,3095.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2407.76,,,,2029.4,2806.76
EXC BEN LES SCALP; 0.5 CM/LESS,11420,HCPCS,450,RC,,both,3439.66,3095.69,Cigna,Default,Percent of Total Billed Charges,2029.4,,,,2029.4,2806.76
EXC BEN LES SCALP; 0.5 CM/LESS,11420,HCPCS,450,RC,,both,3439.66,3095.69,United Healthcare,Default,Fee Schedule,2806.76,,,,2029.4,2806.76
EMER RM SIGMOIDOSCOP,45330,HCPCS,450,RC,,both,346,311.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.2,,,,204.14,282.34
EMER RM SIGMOIDOSCOP,45330,HCPCS,450,RC,,both,346,311.4,Cigna,Default,Percent of Total Billed Charges,204.14,,,,204.14,282.34
EMER RM SIGMOIDOSCOP,45330,HCPCS,450,RC,,both,346,311.4,United Healthcare,Default,Fee Schedule,282.34,,,,204.14,282.34
DECLOTTING BY THROMBOLYTIC AGENT,36550,HCPCS,450,RC,,both,523.25,470.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,366.28,,,,308.72,426.97
DECLOTTING BY THROMBOLYTIC AGENT,36550,HCPCS,450,RC,,both,523.25,470.93,Cigna,Default,Percent of Total Billed Charges,308.72,,,,308.72,426.97
DECLOTTING BY THROMBOLYTIC AGENT,36550,HCPCS,450,RC,,both,523.25,470.93,United Healthcare,Default,Fee Schedule,426.97,,,,308.72,426.97
DECLOTTING BY THROMBOLYTIC AGENT,456,RC,,,,both,523.25,470.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,366.28,,,,308.72,426.97
DECLOTTING BY THROMBOLYTIC AGENT,456,RC,,,,both,523.25,470.93,Cigna,Default,Percent of Total Billed Charges,308.72,,,,308.72,426.97
DECLOTTING BY THROMBOLYTIC AGENT,456,RC,,,,both,523.25,470.93,United Healthcare,Default,Fee Schedule,426.97,,,,308.72,426.97
REPAIR OF EXTENSOR TENDON DISTAL INSERT.,26433,HCPCS,450,RC,,both,1625.75,1463.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1138.02,,,,959.19,1326.61
REPAIR OF EXTENSOR TENDON DISTAL INSERT.,26433,HCPCS,450,RC,,both,1625.75,1463.18,Cigna,Default,Percent of Total Billed Charges,959.19,,,,959.19,1326.61
REPAIR OF EXTENSOR TENDON DISTAL INSERT.,26433,HCPCS,450,RC,,both,1625.75,1463.18,United Healthcare,Default,Fee Schedule,1326.61,,,,959.19,1326.61
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,450,RC,,both,843.51,759.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,590.46,,,,497.67,688.3
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,450,RC,,both,843.51,759.16,Cigna,Default,Percent of Total Billed Charges,497.67,,,,497.67,688.3
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,450,RC,,both,843.51,759.16,United Healthcare,Default,Fee Schedule,688.3,,,,497.67,688.3
TRIGGER POINT INJ. THREE OR MORE MUSCLES,20553,HCPCS,450,RC,,both,289.5,260.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,202.65,,,,170.8,236.23
TRIGGER POINT INJ. THREE OR MORE MUSCLES,20553,HCPCS,450,RC,,both,289.5,260.55,Cigna,Default,Percent of Total Billed Charges,170.8,,,,170.8,236.23
TRIGGER POINT INJ. THREE OR MORE MUSCLES,20553,HCPCS,450,RC,,both,289.5,260.55,United Healthcare,Default,Fee Schedule,236.23,,,,170.8,236.23
AVULS OF NAIL PLATE PART OR COMPL SIMPLE,11730,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
AVULS OF NAIL PLATE PART OR COMPL SIMPLE,11730,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
AVULS OF NAIL PLATE PART OR COMPL SIMPLE,11730,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,450,RC,,both,441.03,396.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,308.72,,,,260.21,359.88
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,450,RC,,both,441.03,396.93,Cigna,Default,Percent of Total Billed Charges,260.21,,,,260.21,359.88
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,450,RC,,both,441.03,396.93,United Healthcare,Default,Fee Schedule,359.88,,,,260.21,359.88
FNA BX W/O IMG GDN 1ST LES,10021,HCPCS,761,RC,,both,1152.49,1037.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,806.74,,,,679.97,940.43
FNA BX W/O IMG GDN 1ST LES,10021,HCPCS,761,RC,,both,1152.49,1037.24,Cigna,Default,Percent of Total Billed Charges,679.97,,,,679.97,940.43
FNA BX W/O IMG GDN 1ST LES,10021,HCPCS,761,RC,,both,1152.49,1037.24,United Healthcare,Default,Fee Schedule,940.43,,,,679.97,940.43
I & D PILONIDAL CYST: SIMPL,10080,HCPCS,450,RC,,both,243.5,219.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.45,,,,143.66,198.7
I & D PILONIDAL CYST: SIMPL,10080,HCPCS,450,RC,,both,243.5,219.15,Cigna,Default,Percent of Total Billed Charges,143.66,,,,143.66,198.7
I & D PILONIDAL CYST: SIMPL,10080,HCPCS,450,RC,,both,243.5,219.15,United Healthcare,Default,Fee Schedule,198.7,,,,143.66,198.7
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,450,RC,,both,823.6,741.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,576.52,,,,485.92,672.06
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,450,RC,,both,823.6,741.24,Cigna,Default,Percent of Total Billed Charges,485.92,,,,485.92,672.06
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,450,RC,,both,823.6,741.24,United Healthcare,Default,Fee Schedule,672.06,,,,485.92,672.06
INCS & REMOV SUBQ TISS; COMPLIC,10121,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
INCS & REMOV SUBQ TISS; COMPLIC,10121,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
INCS & REMOV SUBQ TISS; COMPLIC,10121,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
I&D HEMATOMA/SEROMA/FLUID COLLEC,10140,HCPCS,450,RC,,both,448.5,403.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,313.95,,,,264.62,365.98
I&D HEMATOMA/SEROMA/FLUID COLLEC,10140,HCPCS,450,RC,,both,448.5,403.65,Cigna,Default,Percent of Total Billed Charges,264.62,,,,264.62,365.98
I&D HEMATOMA/SEROMA/FLUID COLLEC,10140,HCPCS,450,RC,,both,448.5,403.65,United Healthcare,Default,Fee Schedule,365.98,,,,264.62,365.98
PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,450,RC,,both,834.99,751.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,584.49,,,,492.64,681.35
PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,450,RC,,both,834.99,751.49,Cigna,Default,Percent of Total Billed Charges,492.64,,,,492.64,681.35
PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,450,RC,,both,834.99,751.49,United Healthcare,Default,Fee Schedule,681.35,,,,492.64,681.35
FINE NEEDLE ASPIRATION W/GUIDANCE,10022,HCPCS,450,RC,,both,487,438.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,340.9,,,,287.33,397.39
FINE NEEDLE ASPIRATION W/GUIDANCE,10022,HCPCS,450,RC,,both,487,438.3,Cigna,Default,Percent of Total Billed Charges,287.33,,,,287.33,397.39
FINE NEEDLE ASPIRATION W/GUIDANCE,10022,HCPCS,450,RC,,both,487,438.3,United Healthcare,Default,Fee Schedule,397.39,,,,287.33,397.39
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,456,RC,,both,296.75,267.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.72,,,,175.08,242.15
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,456,RC,,both,296.75,267.08,Cigna,Default,Percent of Total Billed Charges,175.08,,,,175.08,242.15
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,456,RC,,both,296.75,267.08,United Healthcare,Default,Fee Schedule,242.15,,,,175.08,242.15
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,456,RC,,both,243.5,219.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.45,,,,143.66,198.7
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,456,RC,,both,243.5,219.15,Cigna,Default,Percent of Total Billed Charges,143.66,,,,143.66,198.7
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,456,RC,,both,243.5,219.15,United Healthcare,Default,Fee Schedule,198.7,,,,143.66,198.7
DEBRID W/REMOV MAT;SKIN & SUBQ,11010,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
DEBRID W/REMOV MAT;SKIN & SUBQ,11010,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
DEBRID W/REMOV MAT;SKIN & SUBQ,11010,HCPCS,450,RC,,both,1522,1369.8,United Healthcare,Default,Fee Schedule,1241.95,,,,897.98,1241.95
DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,11011,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,11011,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,11011,HCPCS,450,RC,,both,1522,1369.8,United Healthcare,Default,Fee Schedule,1241.95,,,,897.98,1241.95
DEBRID W/REM MAT;SKIN-MUSC-BONE,11012,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
DEBRID W/REM MAT;SKIN-MUSC-BONE,11012,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
DEBRID W/REM MAT;SKIN-MUSC-BONE,11012,HCPCS,450,RC,,both,1522,1369.8,United Healthcare,Default,Fee Schedule,1241.95,,,,897.98,1241.95
RMVL DEVITAL TIS 20CM<,97597,HCPCS,450,RC,,both,307.75,276.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.42,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,450,RC,,both,307.75,276.98,Cigna,Default,Percent of Total Billed Charges,181.57,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,450,RC,,both,307.75,276.98,United Healthcare,Default,Fee Schedule,251.12,,,,181.57,251.12
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,450,RC,,both,273,245.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.1,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,450,RC,,both,273,245.7,Cigna,Default,Percent of Total Billed Charges,161.07,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,450,RC,,both,273,245.7,United Healthcare,Default,Fee Schedule,222.77,,,,161.07,222.77
DEBRID; SKIN & SUBQ TISS,11042,HCPCS,450,RC,,both,560.75,504.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,392.52,,,,330.84,457.57
DEBRID; SKIN & SUBQ TISS,11042,HCPCS,450,RC,,both,560.75,504.68,Cigna,Default,Percent of Total Billed Charges,330.84,,,,330.84,457.57
DEBRID; SKIN & SUBQ TISS,11042,HCPCS,450,RC,,both,560.75,504.68,United Healthcare,Default,Fee Schedule,457.57,,,,330.84,457.57
DEBRID; SKIN-SUBQ TISS-MUSCL,11043,HCPCS,450,RC,,both,431.5,388.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.05,,,,254.58,352.1
DEBRID; SKIN-SUBQ TISS-MUSCL,11043,HCPCS,450,RC,,both,431.5,388.35,Cigna,Default,Percent of Total Billed Charges,254.58,,,,254.58,352.1
DEBRID; SKIN-SUBQ TISS-MUSCL,11043,HCPCS,450,RC,,both,431.5,388.35,United Healthcare,Default,Fee Schedule,352.1,,,,254.58,352.1
DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,11044,HCPCS,450,RC,,both,1518,1366.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1062.6,,,,895.62,1238.69
DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,11044,HCPCS,450,RC,,both,1518,1366.2,Cigna,Default,Percent of Total Billed Charges,895.62,,,,895.62,1238.69
DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,11044,HCPCS,450,RC,,both,1518,1366.2,United Healthcare,Default,Fee Schedule,1238.69,,,,895.62,1238.69
PARING/CUTTING BEN LES; 1LES,11055,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
PARING/CUTTING BEN LES; 1LES,11055,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
PARING/CUTTING BEN LES; 1LES,11055,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
PARING//CUTTING BENLES;2-4 LES,11056,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
PARING//CUTTING BENLES;2-4 LES,11056,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
PARING//CUTTING BENLES;2-4 LES,11056,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
PARING/CUTTING BEN LES ;> 4 LES,11057,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
PARING/CUTTING BEN LES ;> 4 LES,11057,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
PARING/CUTTING BEN LES ;> 4 LES,11057,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
REMOVE SKIN TAGS;EA ADD 10 LES,11201,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
REMOVE SKIN TAGS;EA ADD 10 LES,11201,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
REMOVE SKIN TAGS;EA ADD 10 LES,11201,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
SHAVING 1 LES TRUNK; 0.5CM/LESS,11300,HCPCS,450,RC,,both,110.5,99.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.35,,,,65.2,90.17
SHAVING 1 LES TRUNK; 0.5CM/LESS,11300,HCPCS,450,RC,,both,110.5,99.45,Cigna,Default,Percent of Total Billed Charges,65.2,,,,65.2,90.17
SHAVING 1 LES TRUNK; 0.5CM/LESS,11300,HCPCS,450,RC,,both,110.5,99.45,United Healthcare,Default,Fee Schedule,90.17,,,,65.2,90.17
SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,11301,HCPCS,450,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,11301,HCPCS,450,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,11301,HCPCS,450,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,11302,HCPCS,450,RC,,both,182.75,164.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.92,,,,107.82,149.12
SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,11302,HCPCS,450,RC,,both,182.75,164.48,Cigna,Default,Percent of Total Billed Charges,107.82,,,,107.82,149.12
SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,11302,HCPCS,450,RC,,both,182.75,164.48,United Healthcare,Default,Fee Schedule,149.12,,,,107.82,149.12
SHAVING 1 LES TRUNK; OVER 2.0 CM,11303,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
SHAVING 1 LES TRUNK; OVER 2.0 CM,11303,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
SHAVING 1 LES TRUNK; OVER 2.0 CM,11303,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
SHAVING 1 LES SCALP; 0.5CM/LESS,11305,HCPCS,450,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
SHAVING 1 LES SCALP; 0.5CM/LESS,11305,HCPCS,450,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
SHAVING 1 LES SCALP; 0.5CM/LESS,11305,HCPCS,450,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,11306,HCPCS,450,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,11306,HCPCS,450,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,11306,HCPCS,450,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
SHAVING 1 LES SCALP;1.1 TO 2.0 CM,11307,HCPCS,450,RC,,both,182.75,164.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.92,,,,107.82,149.12
SHAVING 1 LES SCALP;1.1 TO 2.0 CM,11307,HCPCS,450,RC,,both,182.75,164.48,Cigna,Default,Percent of Total Billed Charges,107.82,,,,107.82,149.12
SHAVING 1 LES SCALP;1.1 TO 2.0 CM,11307,HCPCS,450,RC,,both,182.75,164.48,United Healthcare,Default,Fee Schedule,149.12,,,,107.82,149.12
SHAVING 1 LES SCALP; OVER 2.0 CM,11308,HCPCS,450,RC,,both,229,206.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.3,,,,135.11,186.86
SHAVING 1 LES SCALP; OVER 2.0 CM,11308,HCPCS,450,RC,,both,229,206.1,Cigna,Default,Percent of Total Billed Charges,135.11,,,,135.11,186.86
SHAVING 1 LES SCALP; OVER 2.0 CM,11308,HCPCS,450,RC,,both,229,206.1,United Healthcare,Default,Fee Schedule,186.86,,,,135.11,186.86
SHAVING  1 LES FACE;0.5CM/LESS,11310,HCPCS,450,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
SHAVING  1 LES FACE;0.5CM/LESS,11310,HCPCS,450,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
SHAVING  1 LES FACE;0.5CM/LESS,11310,HCPCS,450,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
SHAVING 1 LES FACE; 0.6 TO 1.0 CM,11311,HCPCS,450,RC,,both,118.5,106.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.95,,,,69.92,96.7
SHAVING 1 LES FACE; 0.6 TO 1.0 CM,11311,HCPCS,450,RC,,both,118.5,106.65,Cigna,Default,Percent of Total Billed Charges,69.92,,,,69.92,96.7
SHAVING 1 LES FACE; 0.6 TO 1.0 CM,11311,HCPCS,450,RC,,both,118.5,106.65,United Healthcare,Default,Fee Schedule,96.7,,,,69.92,96.7
SHAVING 1 LES FACE;1 TO 2.0 CM,11312,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
SHAVING 1 LES FACE;1 TO 2.0 CM,11312,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
SHAVING 1 LES FACE;1 TO 2.0 CM,11312,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
SHAVING 1 LES FACE; OVER 2.0 CM,11313,HCPCS,450,RC,,both,431.5,388.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.05,,,,254.58,352.1
SHAVING 1 LES FACE; OVER 2.0 CM,11313,HCPCS,450,RC,,both,431.5,388.35,Cigna,Default,Percent of Total Billed Charges,254.58,,,,254.58,352.1
SHAVING 1 LES FACE; OVER 2.0 CM,11313,HCPCS,450,RC,,both,431.5,388.35,United Healthcare,Default,Fee Schedule,352.1,,,,254.58,352.1
EXC BEN LES TRUNK;0.5 CM/LESS,11400,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
EXC BEN LES TRUNK;0.5 CM/LESS,11400,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
EXC BEN LES TRUNK;0.5 CM/LESS,11400,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
EXC BEN LES TRUNK; 0.6 TO 1.0 CM,11401,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
EXC BEN LES TRUNK; 0.6 TO 1.0 CM,11401,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
EXC BEN LES TRUNK; 0.6 TO 1.0 CM,11401,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
EXC TR-EXT B9+MARG 1.1-2 CM,11402,HCPCS,450,RC,,both,2215.39,1993.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1550.77,,,,1307.08,1807.76
EXC TR-EXT B9+MARG 1.1-2 CM,11402,HCPCS,450,RC,,both,2215.39,1993.85,Cigna,Default,Percent of Total Billed Charges,1307.08,,,,1307.08,1807.76
EXC TR-EXT B9+MARG 1.1-2 CM,11402,HCPCS,450,RC,,both,2215.39,1993.85,United Healthcare,Default,Fee Schedule,1807.76,,,,1307.08,1807.76
EXC BEN LES TRUNK; 2.1 TO 3.0 CM,11403,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
EXC BEN LES TRUNK; 2.1 TO 3.0 CM,11403,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
EXC BEN LES TRUNK; 2.1 TO 3.0 CM,11403,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC BEN LES TRUNK; 3.1 TO 4.0 CM,11404,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
EXC BEN LES TRUNK; 3.1 TO 4.0 CM,11404,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
EXC BEN LES TRUNK; 3.1 TO 4.0 CM,11404,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC BEN LES  SCALP 0.6 TO  1.0CM0,11421,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
EXC BEN LES  SCALP 0.6 TO  1.0CM0,11421,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
EXC BEN LES  SCALP 0.6 TO  1.0CM0,11421,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
EXC BEN LES SCALP; 2.1 TO 3.0 CM,11423,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
EXC BEN LES SCALP; 2.1 TO 3.0 CM,11423,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
EXC BEN LES SCALP; 2.1 TO 3.0 CM,11423,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC BEN LES SCALP; OVER 4.0 CM,11426,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
EXC BEN LES SCALP; OVER 4.0 CM,11426,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
EXC BEN LES SCALP; OVER 4.0 CM,11426,HCPCS,450,RC,,both,1522,1369.8,United Healthcare,Default,Fee Schedule,1241.95,,,,897.98,1241.95
EXC BEN LES FACE; 0.5 CM/LESS,11440,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
EXC BEN LES FACE; 0.5 CM/LESS,11440,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
EXC BEN LES FACE; 0.5 CM/LESS,11440,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
EXC BEN LES FACE; 0.6 TO 1.Q CM,11441,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
EXC BEN LES FACE; 0.6 TO 1.Q CM,11441,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
EXC BEN LES FACE; 0.6 TO 1.Q CM,11441,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
TRIM NONDYSTROPHIC NAILS-ANY NUMBER,11719,HCPCS,450,RC,,both,91,81.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.7,,,,53.69,74.26
TRIM NONDYSTROPHIC NAILS-ANY NUMBER,11719,HCPCS,450,RC,,both,91,81.9,Cigna,Default,Percent of Total Billed Charges,53.69,,,,53.69,74.26
TRIM NONDYSTROPHIC NAILS-ANY NUMBER,11719,HCPCS,450,RC,,both,91,81.9,United Healthcare,Default,Fee Schedule,74.26,,,,53.69,74.26
DEBRID NAIL(S) ANY METHOD(S);1 TO 5,11720,HCPCS,450,RC,,both,91,81.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.7,,,,53.69,74.26
DEBRID NAIL(S) ANY METHOD(S);1 TO 5,11720,HCPCS,450,RC,,both,91,81.9,Cigna,Default,Percent of Total Billed Charges,53.69,,,,53.69,74.26
DEBRID NAIL(S) ANY METHOD(S);1 TO 5,11720,HCPCS,450,RC,,both,91,81.9,United Healthcare,Default,Fee Schedule,74.26,,,,53.69,74.26
DEBRID NAIL(S) ANY METHOD(S); 6/MORE,11721,HCPCS,450,RC,,both,91,81.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.7,,,,53.69,74.26
DEBRID NAIL(S) ANY METHOD(S); 6/MORE,11721,HCPCS,450,RC,,both,91,81.9,Cigna,Default,Percent of Total Billed Charges,53.69,,,,53.69,74.26
DEBRID NAIL(S) ANY METHOD(S); 6/MORE,11721,HCPCS,450,RC,,both,91,81.9,United Healthcare,Default,Fee Schedule,74.26,,,,53.69,74.26
AVULSION PLATE PART/COMPLT SIMPL; EA,11732,HCPCS,450,RC,,both,167,150.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.9,,,,98.53,136.27
AVULSION PLATE PART/COMPLT SIMPL; EA,11732,HCPCS,450,RC,,both,167,150.3,Cigna,Default,Percent of Total Billed Charges,98.53,,,,98.53,136.27
AVULSION PLATE PART/COMPLT SIMPL; EA,11732,HCPCS,450,RC,,both,167,150.3,United Healthcare,Default,Fee Schedule,136.27,,,,98.53,136.27
EVACUATION SUBUNGUAL HEMATOMA,11740,HCPCS,450,RC,,both,204.09,183.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.86,,,,120.41,166.54
EVACUATION SUBUNGUAL HEMATOMA,11740,HCPCS,450,RC,,both,204.09,183.68,Cigna,Default,Percent of Total Billed Charges,120.41,,,,120.41,166.54
EVACUATION SUBUNGUAL HEMATOMA,11740,HCPCS,450,RC,,both,204.09,183.68,United Healthcare,Default,Fee Schedule,166.54,,,,120.41,166.54
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,450,RC,,both,854.38,768.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.07,,,,504.08,697.17
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,450,RC,,both,854.38,768.94,Cigna,Default,Percent of Total Billed Charges,504.08,,,,504.08,697.17
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,450,RC,,both,854.38,768.94,United Healthcare,Default,Fee Schedule,697.17,,,,504.08,697.17
BX NAIL UNIT ANY METHD(SEP PRO),11755,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
BX NAIL UNIT ANY METHD(SEP PRO),11755,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
BX NAIL UNIT ANY METHD(SEP PRO),11755,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
REPR NAIL BED,11760,HCPCS,450,RC,,both,1695.85,1526.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1187.1,,,,1000.55,1383.81
REPR NAIL BED,11760,HCPCS,450,RC,,both,1695.85,1526.27,Cigna,Default,Percent of Total Billed Charges,1000.55,,,,1000.55,1383.81
REPR NAIL BED,11760,HCPCS,450,RC,,both,1695.85,1526.27,United Healthcare,Default,Fee Schedule,1383.81,,,,1000.55,1383.81
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,456,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,456,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,456,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
PUNCTASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,456,RC,,both,243.5,219.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.45,,,,143.66,198.7
PUNCTASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,456,RC,,both,243.5,219.15,Cigna,Default,Percent of Total Billed Charges,143.66,,,,143.66,198.7
PUNCTASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,456,RC,,both,243.5,219.15,United Healthcare,Default,Fee Schedule,198.7,,,,143.66,198.7
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA,12001,HCPCS,456,RC,,both,278.75,250.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.12,,,,164.46,227.46
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA,12001,HCPCS,456,RC,,both,278.75,250.88,Cigna,Default,Percent of Total Billed Charges,164.46,,,,164.46,227.46
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA,12001,HCPCS,456,RC,,both,278.75,250.88,United Healthcare,Default,Fee Schedule,227.46,,,,164.46,227.46
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,12001,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,12001,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,12001,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,12002,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,12002,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,12002,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,12004,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,12004,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,12004,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
SREP S/N/A/G/TR/E; 12.6-20.0CM,12005,HCPCS,450,RC,,both,1140.64,1026.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,798.45,,,,672.98,930.76
SREP S/N/A/G/TR/E; 12.6-20.0CM,12005,HCPCS,450,RC,,both,1140.64,1026.58,Cigna,Default,Percent of Total Billed Charges,672.98,,,,672.98,930.76
SREP S/N/A/G/TR/E; 12.6-20.0CM,12005,HCPCS,450,RC,,both,1140.64,1026.58,United Healthcare,Default,Fee Schedule,930.76,,,,672.98,930.76
SIMPL REPR SCLP,12002,HCPCS,456,RC,,both,297.5,267.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.25,,,,175.52,242.76
SIMPL REPR SCLP,12002,HCPCS,456,RC,,both,297.5,267.75,Cigna,Default,Percent of Total Billed Charges,175.52,,,,175.52,242.76
SIMPL REPR SCLP,12002,HCPCS,456,RC,,both,297.5,267.75,United Healthcare,Default,Fee Schedule,242.76,,,,175.52,242.76
SIMPL REPR FACE/MUCOUS; 2.5/LESS,12011,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS; 2.5/LESS,12011,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS; 2.5/LESS,12011,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
SR FCE/EAR/EYE/INSE/LIP 2.6-5,12013,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SR FCE/EAR/EYE/INSE/LIP 2.6-5,12013,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SR FCE/EAR/EYE/INSE/LIP 2.6-5,12013,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS 5.1-7.5CM,12014,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS 5.1-7.5CM,12014,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS 5.1-7.5CM,12014,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS 7.60-12.50CM,12015,HCPCS,450,RC,,both,430.26,387.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,301.18,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS 7.60-12.50CM,12015,HCPCS,450,RC,,both,430.26,387.23,Cigna,Default,Percent of Total Billed Charges,253.85,,,,253.85,351.09
SIMPL REPR FACE/MUCOUS 7.60-12.50CM,12015,HCPCS,450,RC,,both,430.26,387.23,United Healthcare,Default,Fee Schedule,351.09,,,,253.85,351.09
TX SUPERF WOUND DEHISCENCE;SIMPL,12020,HCPCS,450,RC,,both,314.5,283.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.15,,,,185.56,256.63
TX SUPERF WOUND DEHISCENCE;SIMPL,12020,HCPCS,450,RC,,both,314.5,283.05,Cigna,Default,Percent of Total Billed Charges,185.56,,,,185.56,256.63
TX SUPERF WOUND DEHISCENCE;SIMPL,12020,HCPCS,450,RC,,both,314.5,283.05,United Healthcare,Default,Fee Schedule,256.63,,,,185.56,256.63
TX SUPERF WOUND DEHISCENCE; W/PACK,12021,HCPCS,450,RC,,both,298.5,268.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.95,,,,176.12,243.58
TX SUPERF WOUND DEHISCENCE; W/PACK,12021,HCPCS,450,RC,,both,298.5,268.65,Cigna,Default,Percent of Total Billed Charges,176.12,,,,176.12,243.58
TX SUPERF WOUND DEHISCENCE; W/PACK,12021,HCPCS,450,RC,,both,298.5,268.65,United Healthcare,Default,Fee Schedule,243.58,,,,176.12,243.58
LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,12031,HCPCS,450,RC,,both,1068.5,961.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.95,,,,630.42,871.9
LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,12031,HCPCS,450,RC,,both,1068.5,961.65,Cigna,Default,Percent of Total Billed Charges,630.42,,,,630.42,871.9
LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,12031,HCPCS,450,RC,,both,1068.5,961.65,United Healthcare,Default,Fee Schedule,871.9,,,,630.42,871.9
LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,12032,HCPCS,450,RC,,both,823.61,741.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,576.53,,,,485.93,672.07
LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,12032,HCPCS,450,RC,,both,823.61,741.25,Cigna,Default,Percent of Total Billed Charges,485.93,,,,485.93,672.07
LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,12032,HCPCS,450,RC,,both,823.61,741.25,United Healthcare,Default,Fee Schedule,672.07,,,,485.93,672.07
LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,12034,HCPCS,450,RC,,both,1068.5,961.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.95,,,,630.42,871.9
LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,12034,HCPCS,450,RC,,both,1068.5,961.65,Cigna,Default,Percent of Total Billed Charges,630.42,,,,630.42,871.9
LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,12034,HCPCS,450,RC,,both,1068.5,961.65,United Healthcare,Default,Fee Schedule,871.9,,,,630.42,871.9
INTMD WND REPAIR S/A/T/EXT,12035,HCPCS,450,RC,,both,1124.39,1011.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,787.07,,,,663.39,917.5
INTMD WND REPAIR S/A/T/EXT,12035,HCPCS,450,RC,,both,1124.39,1011.95,Cigna,Default,Percent of Total Billed Charges,663.39,,,,663.39,917.5
INTMD WND REPAIR S/A/T/EXT,12035,HCPCS,450,RC,,both,1124.39,1011.95,United Healthcare,Default,Fee Schedule,917.5,,,,663.39,917.5
SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,12006,HCPCS,450,RC,,both,246,221.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.2,,,,145.14,200.74
SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,12006,HCPCS,450,RC,,both,246,221.4,Cigna,Default,Percent of Total Billed Charges,145.14,,,,145.14,200.74
SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,12006,HCPCS,450,RC,,both,246,221.4,United Healthcare,Default,Fee Schedule,200.74,,,,145.14,200.74
INTMD WND REPAIR N-HF/GENIT,12042,HCPCS,450,RC,,both,823.61,741.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,576.53,,,,485.93,672.07
INTMD WND REPAIR N-HF/GENIT,12042,HCPCS,450,RC,,both,823.61,741.25,Cigna,Default,Percent of Total Billed Charges,485.93,,,,485.93,672.07
INTMD WND REPAIR N-HF/GENIT,12042,HCPCS,450,RC,,both,823.61,741.25,United Healthcare,Default,Fee Schedule,672.07,,,,485.93,672.07
LAYER CLO FACE/LIPS; 2.5CM/LESS,12051,HCPCS,450,RC,,both,823.61,741.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,576.53,,,,485.93,672.07
LAYER CLO FACE/LIPS; 2.5CM/LESS,12051,HCPCS,450,RC,,both,823.61,741.25,Cigna,Default,Percent of Total Billed Charges,485.93,,,,485.93,672.07
LAYER CLO FACE/LIPS; 2.5CM/LESS,12051,HCPCS,450,RC,,both,823.61,741.25,United Healthcare,Default,Fee Schedule,672.07,,,,485.93,672.07
INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,HCPCS,450,RC,,both,1068.5,961.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.95,,,,630.42,871.9
INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,HCPCS,450,RC,,both,1068.5,961.65,Cigna,Default,Percent of Total Billed Charges,630.42,,,,630.42,871.9
INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,HCPCS,450,RC,,both,1068.5,961.65,United Healthcare,Default,Fee Schedule,871.9,,,,630.42,871.9
LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,12053,HCPCS,450,RC,,both,314.5,283.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.15,,,,185.56,256.63
LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,12053,HCPCS,450,RC,,both,314.5,283.05,Cigna,Default,Percent of Total Billed Charges,185.56,,,,185.56,256.63
LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,12053,HCPCS,450,RC,,both,314.5,283.05,United Healthcare,Default,Fee Schedule,256.63,,,,185.56,256.63
INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,HCPCS,450,RC,,both,1140.64,1026.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,798.45,,,,672.98,930.76
INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,HCPCS,450,RC,,both,1140.64,1026.58,Cigna,Default,Percent of Total Billed Charges,672.98,,,,672.98,930.76
INTMD WND REPAIR FACE/MM 7.6-12.5 CM,12054,HCPCS,450,RC,,both,1140.64,1026.58,United Healthcare,Default,Fee Schedule,930.76,,,,672.98,930.76
REPR COMPLX SCLP /EXTREM;1.1-2.5CM,13120,HCPCS,450,RC,,both,484,435.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.8,,,,285.56,394.94
REPR COMPLX SCLP /EXTREM;1.1-2.5CM,13120,HCPCS,450,RC,,both,484,435.6,Cigna,Default,Percent of Total Billed Charges,285.56,,,,285.56,394.94
REPR COMPLX SCLP /EXTREM;1.1-2.5CM,13120,HCPCS,450,RC,,both,484,435.6,United Healthcare,Default,Fee Schedule,394.94,,,,285.56,394.94
REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,13121,HCPCS,450,RC,,both,1654.5,1489.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1158.15,,,,976.16,1350.07
REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,13121,HCPCS,450,RC,,both,1654.5,1489.05,Cigna,Default,Percent of Total Billed Charges,976.16,,,,976.16,1350.07
REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,13121,HCPCS,450,RC,,both,1654.5,1489.05,United Healthcare,Default,Fee Schedule,1350.07,,,,976.16,1350.07
C REP S/A/L; EA ADD 5 CM/<,13122,HCPCS,450,RC,,both,550.42,495.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,385.29,,,,324.75,449.14
C REP S/A/L; EA ADD 5 CM/<,13122,HCPCS,450,RC,,both,550.42,495.38,Cigna,Default,Percent of Total Billed Charges,324.75,,,,324.75,449.14
C REP S/A/L; EA ADD 5 CM/<,13122,HCPCS,450,RC,,both,550.42,495.38,United Healthcare,Default,Fee Schedule,449.14,,,,324.75,449.14
REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,13131,HCPCS,450,RC,,both,1565.29,1408.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1095.7,,,,923.52,1277.28
REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,13131,HCPCS,450,RC,,both,1565.29,1408.76,Cigna,Default,Percent of Total Billed Charges,923.52,,,,923.52,1277.28
REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,13131,HCPCS,450,RC,,both,1565.29,1408.76,United Healthcare,Default,Fee Schedule,1277.28,,,,923.52,1277.28
REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,13132,HCPCS,450,RC,,both,1653.8,1488.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1157.66,,,,975.74,1349.5
REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,13132,HCPCS,450,RC,,both,1653.8,1488.42,Cigna,Default,Percent of Total Billed Charges,975.74,,,,975.74,1349.5
REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,13132,HCPCS,450,RC,,both,1653.8,1488.42,United Healthcare,Default,Fee Schedule,1349.5,,,,975.74,1349.5
EXC SACRAL PRESS ULCER W/PRIM SUTUR,15931,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
EXC SACRAL PRESS ULCER W/PRIM SUTUR,15931,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
UNLISTED PROC EXC PRESS ULCER,15999,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
UNLISTED PROC EXC PRESS ULCER,15999,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
UNLISTED PROC EXC PRESS ULCER,15999,HCPCS,450,RC,,both,1522,1369.8,United Healthcare,Default,Fee Schedule,1241.95,,,,897.98,1241.95
INT TX 1ST DEGREE BURN W/LOCAL TX,16000,HCPCS,450,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
INT TX 1ST DEGREE BURN W/LOCAL TX,16000,HCPCS,450,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
INT TX 1ST DEGREE BURN W/LOCAL TX,16000,HCPCS,450,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,450,RC,,both,441.03,396.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,308.72,,,,260.21,359.88
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,450,RC,,both,441.03,396.93,Cigna,Default,Percent of Total Billed Charges,260.21,,,,260.21,359.88
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,450,RC,,both,441.03,396.93,United Healthcare,Default,Fee Schedule,359.88,,,,260.21,359.88
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,456,RC,,both,217,195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.9,,,,128.03,177.07
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,456,RC,,both,217,195.3,Cigna,Default,Percent of Total Billed Charges,128.03,,,,128.03,177.07
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,456,RC,,both,217,195.3,United Healthcare,Default,Fee Schedule,177.07,,,,128.03,177.07
INC SOFT TISSUE ABSC;SPRFCL,10060,HCPCS,450,RC,,both,259.25,233.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,181.48,,,,152.96,211.55
INC SOFT TISSUE ABSC;SPRFCL,10060,HCPCS,450,RC,,both,259.25,233.33,Cigna,Default,Percent of Total Billed Charges,152.96,,,,152.96,211.55
INC SOFT TISSUE ABSC;SPRFCL,10060,HCPCS,450,RC,,both,259.25,233.33,United Healthcare,Default,Fee Schedule,211.55,,,,152.96,211.55
ESPLOR PENETR WOND (SEP PRO) NECK,20100,HCPCS,450,RC,,both,256.75,231.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,179.72,,,,151.48,209.51
ESPLOR PENETR WOND (SEP PRO) NECK,20100,HCPCS,450,RC,,both,256.75,231.08,Cigna,Default,Percent of Total Billed Charges,151.48,,,,151.48,209.51
ESPLOR PENETR WOND (SEP PRO) NECK,20100,HCPCS,450,RC,,both,256.75,231.08,United Healthcare,Default,Fee Schedule,209.51,,,,151.48,209.51
EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,20102,HCPCS,450,RC,,both,1476,1328.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1033.2,,,,870.84,1204.42
EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,20102,HCPCS,450,RC,,both,1476,1328.4,Cigna,Default,Percent of Total Billed Charges,870.84,,,,870.84,1204.42
EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,20102,HCPCS,450,RC,,both,1476,1328.4,United Healthcare,Default,Fee Schedule,1204.42,,,,870.84,1204.42
EXPLO PENTR WOUND (SEP PRO); EXTREM,20103,HCPCS,450,RC,,both,2144.07,1929.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1500.85,,,,1265,1749.56
EXPLO PENTR WOUND (SEP PRO); EXTREM,20103,HCPCS,450,RC,,both,2144.07,1929.66,Cigna,Default,Percent of Total Billed Charges,1265,,,,1265,1749.56
EXPLO PENTR WOUND (SEP PRO); EXTREM,20103,HCPCS,450,RC,,both,2144.07,1929.66,United Healthcare,Default,Fee Schedule,1749.56,,,,1265,1749.56
REMOV FB MUSCL/TENDON; SIMPL,20520,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
REMOV FB MUSCL/TENDON; SIMPL,20520,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
REMOV FB MUSCL/TENDON; SIMPL,20520,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
INJ TENDON SHEATH/LIG/TRIG PT/CYST,20550,HCPCS,450,RC,,both,257.75,231.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.42,,,,152.07,210.32
INJ TENDON SHEATH/LIG/TRIG PT/CYST,20550,HCPCS,450,RC,,both,257.75,231.98,Cigna,Default,Percent of Total Billed Charges,152.07,,,,152.07,210.32
INJ TENDON SHEATH/LIG/TRIG PT/CYST,20550,HCPCS,450,RC,,both,257.75,231.98,United Healthcare,Default,Fee Schedule,210.32,,,,152.07,210.32
ARTHROCENTESIS/ASPRIN/ING; SMJT,20600,HCPCS,450,RC,,both,257.75,231.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.42,,,,152.07,210.32
ARTHROCENTESIS/ASPRIN/ING; SMJT,20600,HCPCS,450,RC,,both,257.75,231.98,Cigna,Default,Percent of Total Billed Charges,152.07,,,,152.07,210.32
ARTHROCENTESIS/ASPRIN/ING; SMJT,20600,HCPCS,450,RC,,both,257.75,231.98,United Healthcare,Default,Fee Schedule,210.32,,,,152.07,210.32
ARTHROCENTESIS/ASPRI/INJ; INTERM JT,20605,HCPCS,450,RC,,both,817.07,735.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,571.95,,,,482.07,666.73
ARTHROCENTESIS/ASPRI/INJ; INTERM JT,20605,HCPCS,450,RC,,both,817.07,735.36,Cigna,Default,Percent of Total Billed Charges,482.07,,,,482.07,666.73
ARTHROCENTESIS/ASPRI/INJ; INTERM JT,20605,HCPCS,450,RC,,both,817.07,735.36,United Healthcare,Default,Fee Schedule,666.73,,,,482.07,666.73
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,450,RC,,both,817.07,735.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,571.95,,,,482.07,666.73
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,450,RC,,both,817.07,735.36,Cigna,Default,Percent of Total Billed Charges,482.07,,,,482.07,666.73
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,450,RC,,both,817.07,735.36,United Healthcare,Default,Fee Schedule,666.73,,,,482.07,666.73
ASPIRAT & INJ TX BONE CYST,20615,HCPCS,450,RC,,both,238.25,214.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.78,,,,140.57,194.41
ASPIRAT & INJ TX BONE CYST,20615,HCPCS,450,RC,,both,238.25,214.43,Cigna,Default,Percent of Total Billed Charges,140.57,,,,140.57,194.41
ASPIRAT & INJ TX BONE CYST,20615,HCPCS,450,RC,,both,238.25,214.43,United Healthcare,Default,Fee Schedule,194.41,,,,140.57,194.41
CLO TX NASAL BONE FX WO MANIP,21310,HCPCS,450,RC,,both,1464.25,1317.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1024.98,,,,863.91,1194.83
CLO TX NASAL BONE FX WO MANIP,21310,HCPCS,450,RC,,both,1464.25,1317.83,Cigna,Default,Percent of Total Billed Charges,863.91,,,,863.91,1194.83
CLO TX NASAL BONE FX WO MANIP,21310,HCPCS,450,RC,,both,1464.25,1317.83,United Healthcare,Default,Fee Schedule,1194.83,,,,863.91,1194.83
CLO TX NASAL BONE FX; WO STABILIZAT,21315,HCPCS,450,RC,,both,1464.25,1317.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1024.98,,,,863.91,1194.83
CLO TX NASAL BONE FX; WO STABILIZAT,21315,HCPCS,450,RC,,both,1464.25,1317.83,Cigna,Default,Percent of Total Billed Charges,863.91,,,,863.91,1194.83
CLO TX NASAL BONE FX; WO STABILIZAT,21315,HCPCS,450,RC,,both,1464.25,1317.83,United Healthcare,Default,Fee Schedule,1194.83,,,,863.91,1194.83
CLO TX NASAL BONE FX; W/STABILAZAT,21320,HCPCS,450,RC,,both,1464.25,1317.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1024.98,,,,863.91,1194.83
CLO TX NASAL BONE FX; W/STABILAZAT,21320,HCPCS,450,RC,,both,1464.25,1317.83,Cigna,Default,Percent of Total Billed Charges,863.91,,,,863.91,1194.83
CLO TX NASAL BONE FX; W/STABILAZAT,21320,HCPCS,450,RC,,both,1464.25,1317.83,United Healthcare,Default,Fee Schedule,1194.83,,,,863.91,1194.83
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,450,RC,,both,257.75,231.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.42,,,,152.07,210.32
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,450,RC,,both,257.75,231.98,Cigna,Default,Percent of Total Billed Charges,152.07,,,,152.07,210.32
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,450,RC,,both,257.75,231.98,United Healthcare,Default,Fee Schedule,210.32,,,,152.07,210.32
CLO TX MANDIB FX; WO MANIP,21450,HCPCS,450,RC,,both,218.25,196.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.78,,,,128.77,178.09
CLO TX MANDIB FX; WO MANIP,21450,HCPCS,450,RC,,both,218.25,196.43,Cigna,Default,Percent of Total Billed Charges,128.77,,,,128.77,178.09
CLO TX MANDIB FX; WO MANIP,21450,HCPCS,450,RC,,both,218.25,196.43,United Healthcare,Default,Fee Schedule,178.09,,,,128.77,178.09
CLO TX MANDIB FX; W/MANIP,21451,HCPCS,450,RC,,both,1518,1366.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1062.6,,,,895.62,1238.69
CLO TX MANDIB FX; W/MANIP,21451,HCPCS,450,RC,,both,1518,1366.2,Cigna,Default,Percent of Total Billed Charges,895.62,,,,895.62,1238.69
CLO TX MANDIB FX; W/MANIP,21451,HCPCS,450,RC,,both,1518,1366.2,United Healthcare,Default,Fee Schedule,1238.69,,,,895.62,1238.69
CLO TX TM DISLOC; INIT/SUBSQT,21480,HCPCS,450,RC,,both,206.75,186.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.72,,,,121.98,168.71
CLO TX TM DISLOC; INIT/SUBSQT,21480,HCPCS,450,RC,,both,206.75,186.08,Cigna,Default,Percent of Total Billed Charges,121.98,,,,121.98,168.71
CLO TX TM DISLOC; INIT/SUBSQT,21480,HCPCS,450,RC,,both,206.75,186.08,United Healthcare,Default,Fee Schedule,168.71,,,,121.98,168.71
CLO TX TM DISLOC; COMPLIC INIT/SUBS,21485,HCPCS,450,RC,,both,1464.25,1317.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1024.98,,,,863.91,1194.83
CLO TX TM DISLOC; COMPLIC INIT/SUBS,21485,HCPCS,450,RC,,both,1464.25,1317.83,Cigna,Default,Percent of Total Billed Charges,863.91,,,,863.91,1194.83
CLO TX TM DISLOC; COMPLIC INIT/SUBS,21485,HCPCS,450,RC,,both,1464.25,1317.83,United Healthcare,Default,Fee Schedule,1194.83,,,,863.91,1194.83
CLO TX HYOID FX; WO MANIP,21493,HCPCS,450,RC,,both,631.5,568.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.05,,,,372.58,515.3
CLO TX HYOID FX; WO MANIP,21493,HCPCS,450,RC,,both,631.5,568.35,Cigna,Default,Percent of Total Billed Charges,372.58,,,,372.58,515.3
CLO TX HYOID FX; WO MANIP,21493,HCPCS,450,RC,,both,631.5,568.35,United Healthcare,Default,Fee Schedule,515.3,,,,372.58,515.3
CLO TX HYOID FX; W/MANIP,21494,HCPCS,450,RC,,both,669.75,602.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,468.82,,,,395.15,546.52
CLO TX HYOID FX; W/MANIP,21494,HCPCS,450,RC,,both,669.75,602.78,Cigna,Default,Percent of Total Billed Charges,395.15,,,,395.15,546.52
CLO TX HYOID FX; W/MANIP,21494,HCPCS,450,RC,,both,669.75,602.78,United Healthcare,Default,Fee Schedule,546.52,,,,395.15,546.52
UNLISTED MS PROC HEAD,21499,HCPCS,450,RC,,both,1464.25,1317.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1024.98,,,,863.91,1194.83
UNLISTED MS PROC HEAD,21499,HCPCS,450,RC,,both,1464.25,1317.83,Cigna,Default,Percent of Total Billed Charges,863.91,,,,863.91,1194.83
UNLISTED MS PROC HEAD,21499,HCPCS,450,RC,,both,1464.25,1317.83,United Healthcare,Default,Fee Schedule,1194.83,,,,863.91,1194.83
I&D DEEP ABSCESS SOFT TISS NECK,21501,HCPCS,450,RC,,both,749.75,674.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.82,,,,442.35,611.8
I&D DEEP ABSCESS SOFT TISS NECK,21501,HCPCS,450,RC,,both,749.75,674.78,Cigna,Default,Percent of Total Billed Charges,442.35,,,,442.35,611.8
I&D DEEP ABSCESS SOFT TISS NECK,21501,HCPCS,450,RC,,both,749.75,674.78,United Healthcare,Default,Fee Schedule,611.8,,,,442.35,611.8
BX SOFT TISS NECK/THORAZ,21550,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
BX SOFT TISS NECK/THORAZ,21550,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
BX SOFT TISS NECK/THORAZ,21550,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
CLO TX RIB FX UNCOMP EA,21800,HCPCS,450,RC,,both,200,180,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140,,,,118,163.2
CLO TX RIB FX UNCOMP EA,21800,HCPCS,450,RC,,both,200,180,Cigna,Default,Percent of Total Billed Charges,118,,,,118,163.2
CLO TX RIB FX UNCOMP EA,21800,HCPCS,450,RC,,both,200,180,United Healthcare,Default,Fee Schedule,163.2,,,,118,163.2
CLO TX STERNUM FX,21820,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX STERNUM FX,21820,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX STERNUM FX,21820,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
UNLISTED PROC NEC/THORAZ,21899,HCPCS,450,RC,,both,631.5,568.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.05,,,,372.58,515.3
UNLISTED PROC NEC/THORAZ,21899,HCPCS,450,RC,,both,631.5,568.35,Cigna,Default,Percent of Total Billed Charges,372.58,,,,372.58,515.3
UNLISTED PROC NEC/THORAZ,21899,HCPCS,450,RC,,both,631.5,568.35,United Healthcare,Default,Fee Schedule,515.3,,,,372.58,515.3
BX SOFT TISS BACK/FLANK; SUPERF,21920,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
BX SOFT TISS BACK/FLANK; SUPERF,21920,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
BX SOFT TISS BACK/FLANK; SUPERF,21920,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC TUMOR SOFT TISS BACK/FLANK,21930,HCPCS,450,RC,,both,1522,1369.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.4,,,,897.98,1241.95
EXC TUMOR SOFT TISS BACK/FLANK,21930,HCPCS,450,RC,,both,1522,1369.8,Cigna,Default,Percent of Total Billed Charges,897.98,,,,897.98,1241.95
EXC TUMOR SOFT TISS BACK/FLANK,21930,HCPCS,450,RC,,both,1522,1369.8,United Healthcare,Default,Fee Schedule,1241.95,,,,897.98,1241.95
CLO TX VERTEBRAL PROCESS FX,22305,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX VERTEBRAL PROCESS FX,22305,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX VERTEBRAL PROCESS FX,22305,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX VERT BODY FX WO MINIP-W/CAST,22310,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX VERT BODY FX WO MINIP-W/CAST,22310,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX VERT BODY FX WO MINIP-W/CAST,22310,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
REMOVE FB SHOULDER; SUBQ,23330,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
REMOVE FB SHOULDER; SUBQ,23330,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
REMOVE FB SHOULDER; SUBQ,23330,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
CLO TX CLAV FX; WO MANIP,23500,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX CLAV FX; WO MANIP,23500,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX CLAV FX; WO MANIP,23500,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX STERNOCLAV DISLOC; W/O MANIP,23520,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX STERNOCLAV DISLOC; W/O MANIP,23520,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX STERNOCLAV DISLOC; W/O MANIP,23520,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX STERNOCLAV DISLOC; W/MANIP,23525,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX STERNOCLAV DISLOC; W/MANIP,23525,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX STERNOCLAV DISLOC; W/MANIP,23525,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX ACROMIOCLAV DISLOC; WO MINIP,23540,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX ACROMIOCLAV DISLOC; WO MINIP,23540,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX ACROMIOCLAV DISLOC; WO MINIP,23540,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX ACROMIOCLAV DISLOC; W/ MINIP,23545,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX ACROMIOCLAV DISLOC; W/ MINIP,23545,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX ACROMIOCLAV DISLOC; W/ MINIP,23545,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX SCAPULAR FX; WO MANIP,23570,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX SCAPULAR FX; WO MANIP,23570,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX SCAPULAR FX; WO MANIP,23570,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX SCAP FX; W/MANIP W/WO TRACT,23575,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX SCAP FX; W/MANIP W/WO TRACT,23575,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX SCAP FX; W/MANIP W/WO TRACT,23575,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX PROX HUMERAL FX; WO MANIP,23600,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX PROX HUMERAL FX; WO MANIP,23600,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX PROX HUMERAL FX; WO MANIP,23600,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX PROX HUMER FX; W/MANIP,23605,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX PROX HUMER FX; W/MANIP,23605,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX PROX HUMER FX; W/MANIP,23605,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX GR HUMERAL TUBER FX; WO,23620,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX GR HUMERAL TUBER FX; WO,23620,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX GR HUMERAL TUBER FX; WO,23620,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX GR HUMERAL TUBER FX; W/MANIP,23625,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX GR HUMERAL TUBER FX; W/MANIP,23625,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX GR HUMERAL TUBER FX; W/MANIP,23625,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX SHLDR DISLOC W/MANIP;WO ANES,23650,HCPCS,450,RC,,both,629.26,566.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.48,,,,371.26,513.48
CLO TX SHLDR DISLOC W/MANIP;WO ANES,23650,HCPCS,450,RC,,both,629.26,566.33,Cigna,Default,Percent of Total Billed Charges,371.26,,,,371.26,513.48
CLO TX SHLDR DISLOC W/MANIP;WO ANES,23650,HCPCS,450,RC,,both,629.26,566.33,United Healthcare,Default,Fee Schedule,513.48,,,,371.26,513.48
CLO TX SHLDR DISLOC W/FX W/MAN,23675,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX SHLDR DISLOC W/FX W/MAN,23675,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX SHLDR DISLOC W/FX W/MAN,23675,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
BX SOFT TISS UP ARM/ELBOW; SUPERF,24065,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
BX SOFT TISS UP ARM/ELBOW; SUPERF,24065,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
BX SOFT TISS UP ARM/ELBOW; SUPERF,24065,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC TUMOR UPPER ARM/ELBOW; SUBSQ,24075,HCPCS,450,RC,,both,1277.25,1149.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,894.08,,,,753.58,1042.24
EXC TUMOR UPPER ARM/ELBOW; SUBSQ,24075,HCPCS,450,RC,,both,1277.25,1149.53,Cigna,Default,Percent of Total Billed Charges,753.58,,,,753.58,1042.24
EXC TUMOR UPPER ARM/ELBOW; SUBSQ,24075,HCPCS,450,RC,,both,1277.25,1149.53,United Healthcare,Default,Fee Schedule,1042.24,,,,753.58,1042.24
REMOV FB UPPER ARM/ELBOW; SUBSQ,24200,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
REMOV FB UPPER ARM/ELBOW; SUBSQ,24200,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
REMOV FB UPPER ARM/ELBOW; SUBSQ,24200,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
CLO TX HUMERAL SHAFT FX; WO MANIP,24500,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX HUMERAL SHAFT FX; WO MANIP,24500,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX HUMERAL SHAFT FX; WO MANIP,24500,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX HUMERAL FX; W/MANIP W/WO TRA,24505,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX HUMERAL FX; W/MANIP W/WO TRA,24505,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX HUMERAL FX; W/MANIP W/WO TRA,24505,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX SUPRACONDYL HUMER FX; W/O MAN,24530,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX SUPRACONDYL HUMER FX; W/O MAN,24530,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX SUPRACONDYL HUMER FX; W/O MAN,24530,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX SYOERCONDYL HUMER FX;W/MAN,24535,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX SYOERCONDYL HUMER FX;W/MAN,24535,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX SYOERCONDYL HUMER FX;W/MAN,24535,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX HUMER EPICOND FX; WO MANIP,24560,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX HUMER EPICOND FX; WO MANIP,24560,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX HUMER EPICOND FX; WO MANIP,24560,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX HUMERAL CONDYL FX; WO MANIP,24576,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX HUMERAL CONDYL FX; WO MANIP,24576,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX HUMERAL CONDYL FX; WO MANIP,24576,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX HUMERAL CONDYL FX; W MAN,24577,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX HUMERAL CONDYL FX; W MAN,24577,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX HUMERAL CONDYL FX; W MAN,24577,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
TX CLO ELBOW DISLOC; WO ANES,24600,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
TX CLO ELBOW DISLOC; WO ANES,24600,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
TX CLO ELBOW DISLOC; WO ANES,24600,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
TX CLOSED ELBOW DISLOC WITH ANESTHESIA,24605,HCPCS,450,RC,,both,3404,3063.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2382.8,,,,2008.36,2777.66
TX CLOSED ELBOW DISLOC WITH ANESTHESIA,24605,HCPCS,450,RC,,both,3404,3063.6,Cigna,Default,Percent of Total Billed Charges,2008.36,,,,2008.36,2777.66
TX CLOSED ELBOW DISLOC WITH ANESTHESIA,24605,HCPCS,450,RC,,both,3404,3063.6,United Healthcare,Default,Fee Schedule,2777.66,,,,2008.36,2777.66
"CL TX ""NURSEMAID ELBOW"" W MANIP",24640,HCPCS,450,RC,,both,804.33,723.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,563.03,,,,474.55,656.33
"CL TX ""NURSEMAID ELBOW"" W MANIP",24640,HCPCS,450,RC,,both,804.33,723.9,Cigna,Default,Percent of Total Billed Charges,474.55,,,,474.55,656.33
"CL TX ""NURSEMAID ELBOW"" W MANIP",24640,HCPCS,450,RC,,both,804.33,723.9,United Healthcare,Default,Fee Schedule,656.33,,,,474.55,656.33
CLO TX RADIAL HEAD/NECK FX; WO MANIP,24650,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIAL HEAD/NECK FX; WO MANIP,24650,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIAL HEAD/NECK FX; WO MANIP,24650,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX RADIAL HEAD/NECK FX; W/MANIP,24655,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIAL HEAD/NECK FX; W/MANIP,24655,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIAL HEAD/NECK FX; W/MANIP,24655,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO RX ULNAR FX PROX END; WO MANIP,24670,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO RX ULNAR FX PROX END; WO MANIP,24670,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO RX ULNAR FX PROX END; WO MANIP,24670,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX ULNAR FX  PROX END; W/MANIP,24675,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX ULNAR FX  PROX END; W/MANIP,24675,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX ULNAR FX  PROX END; W/MANIP,24675,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
BX SOFT TISS FOREARM/WRIST; SUPERF,25065,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
BX SOFT TISS FOREARM/WRIST; SUPERF,25065,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
BX SOFT TISS FOREARM/WRIST; SUPERF,25065,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
EXC TUMOR FOREARM/WRIST AREA; SUBQ,25075,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
EXC TUMOR FOREARM/WRIST AREA; SUBQ,25075,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
EXC TUMOR FOREARM/WRIST AREA; SUBQ,25075,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
CLO TX RADIAL SHAFT FX; WO MANIP,25500,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIAL SHAFT FX; WO MANIP,25500,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIAL SHAFT FX; WO MANIP,25500,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX RADIAL SHAFT FX; W/MANIP,25505,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIAL SHAFT FX; W/MANIP,25505,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIAL SHAFT FX; W/MANIP,25505,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX RADIAL FX W/DISLOC RAD/ULNA,25520,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIAL FX W/DISLOC RAD/ULNA,25520,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIAL FX W/DISLOC RAD/ULNA,25520,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX ULNAR SHAFT FX WO MANIP,25530,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX ULNAR SHAFT FX WO MANIP,25530,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX ULNAR SHAFT FX WO MANIP,25530,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX ULNAR SHAFT FX W/MANIP,25535,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX ULNAR SHAFT FX W/MANIP,25535,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX ULNAR SHAFT FX W/MANIP,25535,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX RAD & ULNA SHAFT FX; WO MANIP,25560,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RAD & ULNA SHAFT FX; WO MANIP,25560,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RAD & ULNA SHAFT FX; WO MANIP,25560,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CL TX RADIAL & ULNA FX W MANIP,25565,HCPCS,450,RC,,both,4953.49,4458.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3467.44,,,,2922.56,4042.05
CL TX RADIAL & ULNA FX W MANIP,25565,HCPCS,450,RC,,both,4953.49,4458.14,Cigna,Default,Percent of Total Billed Charges,2922.56,,,,2922.56,4042.05
CL TX RADIAL & ULNA FX W MANIP,25565,HCPCS,450,RC,,both,4953.49,4458.14,United Healthcare,Default,Fee Schedule,4042.05,,,,2922.56,4042.05
CLO TX DIST RAD FX; WO MANIP,25600,HCPCS,450,RC,,both,372.75,335.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.92,,,,219.92,304.16
CLO TX DIST RAD FX; WO MANIP,25600,HCPCS,450,RC,,both,372.75,335.48,Cigna,Default,Percent of Total Billed Charges,219.92,,,,219.92,304.16
CLO TX DIST RAD FX; WO MANIP,25600,HCPCS,450,RC,,both,372.75,335.48,United Healthcare,Default,Fee Schedule,304.16,,,,219.92,304.16
CLOSED TREATMENT DISRAL RADIAL FRACTURE,25605,HCPCS,450,RC,,both,4554.62,4099.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3188.23,,,,2687.23,3716.57
CLOSED TREATMENT DISRAL RADIAL FRACTURE,25605,HCPCS,450,RC,,both,4554.62,4099.16,Cigna,Default,Percent of Total Billed Charges,2687.23,,,,2687.23,3716.57
CLOSED TREATMENT DISRAL RADIAL FRACTURE,25605,HCPCS,450,RC,,both,4554.62,4099.16,United Healthcare,Default,Fee Schedule,3716.57,,,,2687.23,3716.57
CLO TX CARPAL SCAPHOID FX; WO MANIP,25622,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CARPAL SCAPHOID FX; WO MANIP,25622,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CARPAL SCAPHOID FX; WO MANIP,25622,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX CARPAL SCAPHOID FX; W/MANIP,25624,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CARPAL SCAPHOID FX; W/MANIP,25624,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CARPAL SCAPHOID FX; W/MANIP,25624,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX CARPAL BONE FX; WO MANIP EA,25630,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CARPAL BONE FX; WO MANIP EA,25630,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CARPAL BONE FX; WO MANIP EA,25630,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX CARPAL BONE FX; W/MANIP EA,25635,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CARPAL BONE FX; W/MANIP EA,25635,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CARPAL BONE FX; W/MANIP EA,25635,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX ULNAR STYLOID FX,25650,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX ULNAR STYLOID FX,25650,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX ULNAR STYLOID FX,25650,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX RADIOCARPAL DISLOC W/MANIP,25660,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIOCARPAL DISLOC W/MANIP,25660,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIOCARPAL DISLOC W/MANIP,25660,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX RADIOULNAR DISLOC W/MANIP,25675,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX RADIOULNAR DISLOC W/MANIP,25675,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX RADIOULNAR DISLOC W/MANIP,25675,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TRANS-SCAPHOPERILUNAR W/MANI,25680,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TRANS-SCAPHOPERILUNAR W/MANI,25680,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TRANS-SCAPHOPERILUNAR W/MANI,25680,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX LUNATE DISLOC W/MANIP,25690,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX LUNATE DISLOC W/MANIP,25690,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX LUNATE DISLOC W/MANIP,25690,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
DRAINAGE FINGER ABSCESS; SIMPL,26010,HCPCS,450,RC,,both,285.56,257,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.89,,,,168.48,233.02
DRAINAGE FINGER ABSCESS; SIMPL,26010,HCPCS,450,RC,,both,285.56,257,Cigna,Default,Percent of Total Billed Charges,168.48,,,,168.48,233.02
DRAINAGE FINGER ABSCESS; SIMPL,26010,HCPCS,450,RC,,both,285.56,257,United Healthcare,Default,Fee Schedule,233.02,,,,168.48,233.02
CLO TX METACARP FX 1; WO MANIP,26600,HCPCS,450,RC,,both,372.75,335.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.92,,,,219.92,304.16
CLO TX METACARP FX 1; WO MANIP,26600,HCPCS,450,RC,,both,372.75,335.48,Cigna,Default,Percent of Total Billed Charges,219.92,,,,219.92,304.16
CLO TX METACARP FX 1; WO MANIP,26600,HCPCS,450,RC,,both,372.75,335.48,United Healthcare,Default,Fee Schedule,304.16,,,,219.92,304.16
CLO TX METACARP FX 1; W/MANIP EA,26605,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX METACARP FX 1; W/MANIP EA,26605,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX METACARP FX 1; W/MANIP EA,26605,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX METACARPAL FX W/MANIP W/FIXA,26607,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX METACARPAL FX W/MANIP W/FIXA,26607,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX METACARPAL FX W/MANIP W/FIXA,26607,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX CARPOMETA DISLOC THUMB W/MAN,26641,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CARPOMETA DISLOC THUMB W/MAN,26641,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CARPOMETA DISLOC THUMB W/MAN,26641,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX CARPOMETACAR FX THUMB W/MAN,26645,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CARPOMETACAR FX THUMB W/MAN,26645,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CARPOMETACAR FX THUMB W/MAN,26645,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX DISLOC-NOT THUMB; WO ANES,26670,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX DISLOC-NOT THUMB; WO ANES,26670,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX DISLOC-NOT THUMB; WO ANES,26670,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX MCP DISLOC-1W/MANIP-WO ANES,26700,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX MCP DISLOC-1W/MANIP-WO ANES,26700,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX MCP DISLOC-1W/MANIP-WO ANES,26700,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX PHALANGEAL FX; WO MANIP EA,26720,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX PHALANGEAL FX; WO MANIP EA,26720,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX PHALANGEAL FX; WO MANIP EA,26720,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX PHALANGEAL FX; W/WO TRACT,26725,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX PHALANGEAL FX; W/WO TRACT,26725,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX PHALANGEAL FX; W/WO TRACT,26725,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CL TX D PHAL FX FGRR/THMB; W MANIP,26755,HCPCS,450,RC,,both,747.92,673.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,523.54,,,,441.27,610.3
CL TX D PHAL FX FGRR/THMB; W MANIP,26755,HCPCS,450,RC,,both,747.92,673.13,Cigna,Default,Percent of Total Billed Charges,441.27,,,,441.27,610.3
CL TX D PHAL FX FGRR/THMB; W MANIP,26755,HCPCS,450,RC,,both,747.92,673.13,United Healthcare,Default,Fee Schedule,610.3,,,,441.27,610.3
CLO TX IP JT DISLOC W/WMANIP; WO ANES,26770,HCPCS,450,RC,,both,645,580.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,451.5,,,,380.55,526.32
CLO TX IP JT DISLOC W/WMANIP; WO ANES,26770,HCPCS,450,RC,,both,645,580.5,Cigna,Default,Percent of Total Billed Charges,380.55,,,,380.55,526.32
CLO TX IP JT DISLOC W/WMANIP; WO ANES,26770,HCPCS,450,RC,,both,645,580.5,United Healthcare,Default,Fee Schedule,526.32,,,,380.55,526.32
INTRO VAGINAL PACKING NON OB,57180,HCPCS,450,RC,,both,380.01,342.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,266.01,,,,224.21,310.09
INTRO VAGINAL PACKING NON OB,57180,HCPCS,450,RC,,both,380.01,342.01,Cigna,Default,Percent of Total Billed Charges,224.21,,,,224.21,310.09
INTRO VAGINAL PACKING NON OB,57180,HCPCS,450,RC,,both,380.01,342.01,United Healthcare,Default,Fee Schedule,310.09,,,,224.21,310.09
REMOV FB PELVIS/HIP; SUBQ TISS,27086,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
REMOV FB PELVIS/HIP; SUBQ TISS,27086,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
REMOV FB PELVIS/HIP; SUBQ TISS,27086,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
CLO TX ACETABULUM FX; WO/ MANIP,27220,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX ACETABULUM FX; WO/ MANIP,27220,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX ACETABULUM FX; WO/ MANIP,27220,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX FEM FX PROX END NECK; WO MAN,27230,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX FEM FX PROX END NECK; WO MAN,27230,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX FEM FX PROX END NECK; WO MAN,27230,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX GREATER TROCH FX WO MANIP,27246,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX GREATER TROCH FX WO MANIP,27246,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX GREATER TROCH FX WO MANIP,27246,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX HIP DISLOC TRAUMA; WO ANES,27250,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX HIP DISLOC TRAUMA; WO ANES,27250,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX HIP DISLOC TRAUMA; WO ANES,27250,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
TX SPON HIP DISLOC; WO ANES/MANIP,27258,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
TX SPON HIP DISLOC; WO ANES/MANIP,27258,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
TX SPON HIP DISLOC; WO ANES/MANIP,27258,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO HUMER EPICOND FX; W/MANIP,24565,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO HUMER EPICOND FX; W/MANIP,24565,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO HUMER EPICOND FX; W/MANIP,24565,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX FEMORAL SHAFT FX WO MANIP,27500,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX FEMORAL SHAFT FX WO MANIP,27500,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX FEMORAL SHAFT FX WO MANIP,27500,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX SUPRACONDYL FEM FX WO MANIP,27501,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX SUPRACONDYL FEM FX WO MANIP,27501,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX SUPRACONDYL FEM FX WO MANIP,27501,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX PATELLAR FX WO MANIP,27520,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX PATELLAR FX WO MANIP,27520,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX PATELLAR FX WO MANIP,27520,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TIBIAL FX PROX;WO MANIP,27530,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TIBIAL FX PROX;WO MANIP,27530,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TIBIAL FX PROX;WO MANIP,27530,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TIB FX; W/WO MANIP W/TRACT,27532,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TIB FX; W/WO MANIP W/TRACT,27532,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TIB FX; W/WO MANIP W/TRACT,27532,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX FX KNEE W/WO MANIP,27538,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX FX KNEE W/WO MANIP,27538,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX FX KNEE W/WO MANIP,27538,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX KNEE DISLOC; WO ANES,27550,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX KNEE DISLOC; WO ANES,27550,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX KNEE DISLOC; WO ANES,27550,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX PATELLAR DISLOC; WO ANES,27560,HCPCS,450,RC,,both,747.91,673.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,523.54,,,,441.27,610.29
CLO TX PATELLAR DISLOC; WO ANES,27560,HCPCS,450,RC,,both,747.91,673.12,Cigna,Default,Percent of Total Billed Charges,441.27,,,,441.27,610.29
CLO TX PATELLAR DISLOC; WO ANES,27560,HCPCS,450,RC,,both,747.91,673.12,United Healthcare,Default,Fee Schedule,610.29,,,,441.27,610.29
I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,27603,HCPCS,450,RC,,both,796,716.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,557.2,,,,469.64,649.54
I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,27603,HCPCS,450,RC,,both,796,716.4,Cigna,Default,Percent of Total Billed Charges,469.64,,,,469.64,649.54
I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,27603,HCPCS,450,RC,,both,796,716.4,United Healthcare,Default,Fee Schedule,649.54,,,,469.64,649.54
BX SOFT TISS LEG/ANK AREA; SUPERF,27613,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
BX SOFT TISS LEG/ANK AREA; SUPERF,27613,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
BX SOFT TISS LEG/ANK AREA; SUPERF,27613,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
CLO TX TIBIAL SHAFT FX; WO MANIP,27750,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TIBIAL SHAFT FX; WO MANIP,27750,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TIBIAL SHAFT FX; WO MANIP,27750,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TIB FX; W/MANIP W/WO TRACT,27752,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TIB FX; W/MANIP W/WO TRACT,27752,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TIB FX; W/MANIP W/WO TRACT,27752,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX MEDIAL MALLEOLUS FX; WO MANI,27760,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX MEDIAL MALLEOLUS FX; WO MANI,27760,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX MEDIAL MALLEOLUS FX; WO MANI,27760,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX MED MALLEOLUS FX; W/MANIP,27762,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX MED MALLEOLUS FX; W/MANIP,27762,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX MED MALLEOLUS FX; W/MANIP,27762,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX PROX FIB/SHAFT FX; WO MANIP,27780,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX PROX FIB/SHAFT FX; WO MANIP,27780,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX PROX FIB/SHAFT FX; WO MANIP,27780,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX PROX FIB/SHAFT FX; W MANIP,27781,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX PROX FIB/SHAFT FX; W MANIP,27781,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX PROX FIB/SHAFT FX; W MANIP,27781,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX DISTAL FIBULAR FX; WO MANIP,27786,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX DISTAL FIBULAR FX; WO MANIP,27786,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX DISTAL FIBULAR FX; WO MANIP,27786,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO  TX DISTAL FIBULAR FX; W/MANIP,27788,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO  TX DISTAL FIBULAR FX; W/MANIP,27788,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO  TX DISTAL FIBULAR FX; W/MANIP,27788,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX BIMALLEOLAR ANK FX; WO MANIP,27788,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX BIMALLEOLAR ANK FX; WO MANIP,27788,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX BIMALLEOLAR ANK FX; WO MANIP,27788,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX BIMALLEOLAR ANK FX; W/MANIP,27810,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX BIMALLEOLAR ANK FX; W/MANIP,27810,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX BIMALLEOLAR ANK FX; W/MANIP,27810,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TRIMALLEOLAR ANK FX; WO MANIP,27816,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TRIMALLEOLAR ANK FX; WO MANIP,27816,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TRIMALLEOLAR ANK FX; WO MANIP,27816,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TRIMALLEOLAR ANK FX; W/MANIP,27818,HCPCS,450,RC,,both,4556.57,4100.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3189.6,,,,2688.38,3718.16
CLO TX TRIMALLEOLAR ANK FX; W/MANIP,27818,HCPCS,450,RC,,both,4556.57,4100.91,Cigna,Default,Percent of Total Billed Charges,2688.38,,,,2688.38,3718.16
CLO TX TRIMALLEOLAR ANK FX; W/MANIP,27818,HCPCS,450,RC,,both,4556.57,4100.91,United Healthcare,Default,Fee Schedule,3718.16,,,,2688.38,3718.16
CLO TX FX ARTICUL-DIST TIB; WO ANES,27824,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX FX ARTICUL-DIST TIB; WO ANES,27824,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX FX ARTICUL-DIST TIB; WO ANES,27824,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX FX DIST TIB; W/TRACT/ANES,27825,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX FX DIST TIB; W/TRACT/ANES,27825,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX FX DIST TIB; W/TRACT/ANES,27825,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX PROX TIB-FIB JT DISL; WO ANES,27830,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX PROX TIB-FIB JT DISL; WO ANES,27830,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX PROX TIB-FIB JT DISL; WO ANES,27830,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX ANK DISLOC; WO ANES,27840,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX ANK DISLOC; WO ANES,27840,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX ANK DISLOC; WO ANES,27840,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
REMOV FB FT; SUBQ,28190,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
REMOV FB FT; SUBQ,28190,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
REMOV FB FT; SUBQ,28190,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
CLO TX CALCAN FX; WO MANIP,28400,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CALCAN FX; WO MANIP,28400,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CALCAN FX; WO MANIP,28400,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX CALCAN FX; W/MANIP,28405,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX CALCAN FX; W/MANIP,28405,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX CALCAN FX; W/MANIP,28405,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TALUS FX; WO MANIP,28430,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TALUS FX; WO MANIP,28430,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TALUS FX; WO MANIP,28430,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TALUS FX; W/MANIP,28435,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TALUS FX; W/MANIP,28435,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TALUS FX; W/MANIP,28435,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
TX TARSAL BONE FX; WO MANIP EA,28450,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
TX TARSAL BONE FX; WO MANIP EA,28450,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
TX TARSAL BONE FX; WO MANIP EA,28450,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX METATARSAL FX; WO MANIP EA.,28470,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX METATARSAL FX; WO MANIP EA.,28470,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX METATARSAL FX; WO MANIP EA.,28470,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX METATARSAL FX; W/MANIP EA,28475,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX METATARSAL FX; W/MANIP EA,28475,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX METATARSAL FX; W/MANIP EA,28475,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX FX GRT TOE PHALANX; WO MANIP,28490,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX FX GRT TOE PHALANX; WO MANIP,28490,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX FX GRT TOE PHALANX; WO MANIP,28490,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CL TX FX GT PHALANX(S); W MANIP,28495,HCPCS,450,RC,,both,747.91,673.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,523.54,,,,441.27,610.29
CL TX FX GT PHALANX(S); W MANIP,28495,HCPCS,450,RC,,both,747.91,673.12,Cigna,Default,Percent of Total Billed Charges,441.27,,,,441.27,610.29
CL TX FX GT PHALANX(S); W MANIP,28495,HCPCS,450,RC,,both,747.91,673.12,United Healthcare,Default,Fee Schedule,610.29,,,,441.27,610.29
CLO TX FX PHALNX NOT GR TOE; WO/MAN,28510,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX FX PHALNX NOT GR TOE; WO/MAN,28510,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX FX PHALNX NOT GR TOE; WO/MAN,28510,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX FX PHALNX NOT GR TOE; W/MANI,28515,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX FX PHALNX NOT GR TOE; W/MANI,28515,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX FX PHALNX NOT GR TOE; W/MANI,28515,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLSD TX SESAMOID FX,28530,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLSD TX SESAMOID FX,28530,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLSD TX SESAMOID FX,28530,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TARSAL BONE DISLOC; WO ANES,28540,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TARSAL BONE DISLOC; WO ANES,28540,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TARSAL BONE DISLOC; WO ANES,28540,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TALOTARS JT DISLO; WO ANES,28570,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TALOTARS JT DISLO; WO ANES,28570,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TALOTARS JT DISLO; WO ANES,28570,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX TARSOMETAT JT DISLOC; WO ANES,28600,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
CLO TX TARSOMETAT JT DISLOC; WO ANES,28600,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
CLO TX TARSOMETAT JT DISLOC; WO ANES,28600,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
CLO TX METARSOPHAL JT DISL; WO ANES,28630,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX METARSOPHAL JT DISL; WO ANES,28630,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX METARSOPHAL JT DISL; WO ANES,28630,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
CLO TX IP JT DISLOC; WO ANES,28660,HCPCS,450,RC,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
CLO TX IP JT DISLOC; WO ANES,28660,HCPCS,450,RC,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
CLO TX IP JT DISLOC; WO ANES,28660,HCPCS,450,RC,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
APPLY LONG ARM CAST,29065,HCPCS,450,RC,,both,870.67,783.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,609.47,,,,513.7,710.47
APPLY LONG ARM CAST,29065,HCPCS,450,RC,,both,870.67,783.6,Cigna,Default,Percent of Total Billed Charges,513.7,,,,513.7,710.47
APPLY LONG ARM CAST,29065,HCPCS,450,RC,,both,870.67,783.6,United Healthcare,Default,Fee Schedule,710.47,,,,513.7,710.47
APPLIC; ELBOW TO FINGER,29075,HCPCS,450,RC,,both,778.05,700.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,544.64,,,,459.05,634.89
APPLIC; ELBOW TO FINGER,29075,HCPCS,450,RC,,both,778.05,700.25,Cigna,Default,Percent of Total Billed Charges,459.05,,,,459.05,634.89
APPLIC; ELBOW TO FINGER,29075,HCPCS,450,RC,,both,778.05,700.25,United Healthcare,Default,Fee Schedule,634.89,,,,459.05,634.89
APPLIC; HAND & LOWER FOREARM,29085,HCPCS,450,RC,,both,230.5,207.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161.35,,,,136,188.09
APPLIC; HAND & LOWER FOREARM,29085,HCPCS,450,RC,,both,230.5,207.45,Cigna,Default,Percent of Total Billed Charges,136,,,,136,188.09
APPLIC; HAND & LOWER FOREARM,29085,HCPCS,450,RC,,both,230.5,207.45,United Healthcare,Default,Fee Schedule,188.09,,,,136,188.09
APPLIC; LONG ARM SPLINT,29105,HCPCS,450,RC,,both,468.23,421.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,327.76,,,,276.26,382.08
APPLIC; LONG ARM SPLINT,29105,HCPCS,450,RC,,both,468.23,421.41,Cigna,Default,Percent of Total Billed Charges,276.26,,,,276.26,382.08
APPLIC; LONG ARM SPLINT,29105,HCPCS,450,RC,,both,468.23,421.41,United Healthcare,Default,Fee Schedule,382.08,,,,276.26,382.08
APPLIC; SHORT ARM SPLINT; STATOC,29125,HCPCS,450,RC,,both,341.27,307.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.89,,,,201.35,278.48
APPLIC; SHORT ARM SPLINT; STATOC,29125,HCPCS,450,RC,,both,341.27,307.14,Cigna,Default,Percent of Total Billed Charges,201.35,,,,201.35,278.48
APPLIC; SHORT ARM SPLINT; STATOC,29125,HCPCS,450,RC,,both,341.27,307.14,United Healthcare,Default,Fee Schedule,278.48,,,,201.35,278.48
APPLIC; SHORT ARM SPLINT; STATOC,29125,HCPCS,456,RC,,both,230.5,207.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161.35,,,,136,188.09
APPLIC; SHORT ARM SPLINT; STATOC,29125,HCPCS,456,RC,,both,230.5,207.45,Cigna,Default,Percent of Total Billed Charges,136,,,,136,188.09
APPLIC; SHORT ARM SPLINT; STATOC,29125,HCPCS,456,RC,,both,230.5,207.45,United Healthcare,Default,Fee Schedule,188.09,,,,136,188.09
APPLY FINGER SPLINT; STATIC,29130,HCPCS,450,RC,,both,205.11,184.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.58,,,,121.01,167.37
APPLY FINGER SPLINT; STATIC,29130,HCPCS,450,RC,,both,205.11,184.6,Cigna,Default,Percent of Total Billed Charges,121.01,,,,121.01,167.37
APPLY FINGER SPLINT; STATIC,29130,HCPCS,450,RC,,both,205.11,184.6,United Healthcare,Default,Fee Schedule,167.37,,,,121.01,167.37
STRAPPING; SHOULDER,29240,HCPCS,450,RC,,both,390.72,351.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,273.5,,,,230.52,318.83
STRAPPING; SHOULDER,29240,HCPCS,450,RC,,both,390.72,351.65,Cigna,Default,Percent of Total Billed Charges,230.52,,,,230.52,318.83
STRAPPING; SHOULDER,29240,HCPCS,450,RC,,both,390.72,351.65,United Healthcare,Default,Fee Schedule,318.83,,,,230.52,318.83
APPLIC LONG LEG CAST,29345,HCPCS,450,RC,,both,778.05,700.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,544.64,,,,459.05,634.89
APPLIC LONG LEG CAST,29345,HCPCS,450,RC,,both,778.05,700.25,Cigna,Default,Percent of Total Billed Charges,459.05,,,,459.05,634.89
APPLIC LONG LEG CAST,29345,HCPCS,450,RC,,both,778.05,700.25,United Healthcare,Default,Fee Schedule,634.89,,,,459.05,634.89
APPLIC; LONG ARM SPLINT,29105,HCPCS,456,RC,,both,225,202.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.5,,,,132.75,183.6
APPLIC; LONG ARM SPLINT,29105,HCPCS,456,RC,,both,225,202.5,Cigna,Default,Percent of Total Billed Charges,132.75,,,,132.75,183.6
APPLIC; LONG ARM SPLINT,29105,HCPCS,456,RC,,both,225,202.5,United Healthcare,Default,Fee Schedule,183.6,,,,132.75,183.6
APPLIC LONG LEG CAST BRACE,29358,HCPCS,450,RC,,both,225,202.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.5,,,,132.75,183.6
APPLIC LONG LEG CAST BRACE,29358,HCPCS,450,RC,,both,225,202.5,Cigna,Default,Percent of Total Billed Charges,132.75,,,,132.75,183.6
APPLIC LONG LEG CAST BRACE,29358,HCPCS,450,RC,,both,225,202.5,United Healthcare,Default,Fee Schedule,183.6,,,,132.75,183.6
APPLIC FINGER SPLINT; STATIC,456,RC,,,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
APPLIC FINGER SPLINT; STATIC,456,RC,,,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
APPLIC FINGER SPLINT; STATIC,456,RC,,,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
APPLIC; SHORT ARM SPLINT; STATOC,451,RC,,,,both,230.5,207.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161.35,,,,136,188.09
APPLIC; SHORT ARM SPLINT; STATOC,451,RC,,,,both,230.5,207.45,Cigna,Default,Percent of Total Billed Charges,136,,,,136,188.09
APPLIC; SHORT ARM SPLINT; STATOC,451,RC,,,,both,230.5,207.45,United Healthcare,Default,Fee Schedule,188.09,,,,136,188.09
APPLIC RIGID TOT CONTACT LEG CAST,29445,HCPCS,450,RC,,both,225,202.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.5,,,,132.75,183.6
APPLIC RIGID TOT CONTACT LEG CAST,29445,HCPCS,450,RC,,both,225,202.5,Cigna,Default,Percent of Total Billed Charges,132.75,,,,132.75,183.6
APPLIC RIGID TOT CONTACT LEG CAST,29445,HCPCS,450,RC,,both,225,202.5,United Healthcare,Default,Fee Schedule,183.6,,,,132.75,183.6
APPLIC SHORT LEG SPLINT,451,RC,,,,both,230.5,207.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161.35,,,,136,188.09
APPLIC SHORT LEG SPLINT,451,RC,,,,both,230.5,207.45,Cigna,Default,Percent of Total Billed Charges,136,,,,136,188.09
APPLIC SHORT LEG SPLINT,451,RC,,,,both,230.5,207.45,United Healthcare,Default,Fee Schedule,188.09,,,,136,188.09
APPLIC LONG LEG SPLINT,29505,HCPCS,450,RC,,both,456.98,411.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,319.89,,,,269.62,372.9
APPLIC LONG LEG SPLINT,29505,HCPCS,450,RC,,both,456.98,411.28,Cigna,Default,Percent of Total Billed Charges,269.62,,,,269.62,372.9
APPLIC LONG LEG SPLINT,29505,HCPCS,450,RC,,both,456.98,411.28,United Healthcare,Default,Fee Schedule,372.9,,,,269.62,372.9
APPLIC SHORT LEG SPLINT,29515,HCPCS,450,RC,,both,446.29,401.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,312.4,,,,263.31,364.17
APPLIC SHORT LEG SPLINT,29515,HCPCS,450,RC,,both,446.29,401.66,Cigna,Default,Percent of Total Billed Charges,263.31,,,,263.31,364.17
APPLIC SHORT LEG SPLINT,29515,HCPCS,450,RC,,both,446.29,401.66,United Healthcare,Default,Fee Schedule,364.17,,,,263.31,364.17
STRAPPING; UNNA BOOT,29580,HCPCS,450,RC,,both,132.75,119.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.92,,,,78.32,108.32
STRAPPING; UNNA BOOT,29580,HCPCS,450,RC,,both,132.75,119.48,Cigna,Default,Percent of Total Billed Charges,78.32,,,,78.32,108.32
STRAPPING; UNNA BOOT,29580,HCPCS,450,RC,,both,132.75,119.48,United Healthcare,Default,Fee Schedule,108.32,,,,78.32,108.32
REMOV/BIVALV; SHOULDER/HIP SPICA,29710,HCPCS,450,RC,,both,140.75,126.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.52,,,,83.04,114.85
REMOV/BIVALV; SHOULDER/HIP SPICA,29710,HCPCS,450,RC,,both,140.75,126.68,Cigna,Default,Percent of Total Billed Charges,83.04,,,,83.04,114.85
REMOV/BIVALV; SHOULDER/HIP SPICA,29710,HCPCS,450,RC,,both,140.75,126.68,United Healthcare,Default,Fee Schedule,114.85,,,,83.04,114.85
REMOV/BIVALV; TURNBUCKLE JACKET,29715,HCPCS,450,RC,,both,140.75,126.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.52,,,,83.04,114.85
REMOV/BIVALV; TURNBUCKLE JACKET,29715,HCPCS,450,RC,,both,140.75,126.68,Cigna,Default,Percent of Total Billed Charges,83.04,,,,83.04,114.85
REMOV/BIVALV; TURNBUCKLE JACKET,29715,HCPCS,450,RC,,both,140.75,126.68,United Healthcare,Default,Fee Schedule,114.85,,,,83.04,114.85
WINDOWING CAST,29730,HCPCS,450,RC,,both,132.75,119.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.92,,,,78.32,108.32
WINDOWING CAST,29730,HCPCS,450,RC,,both,132.75,119.48,Cigna,Default,Percent of Total Billed Charges,78.32,,,,78.32,108.32
WINDOWING CAST,29730,HCPCS,450,RC,,both,132.75,119.48,United Healthcare,Default,Fee Schedule,108.32,,,,78.32,108.32
WEDGING CAST,29740,HCPCS,450,RC,,both,140.75,126.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.52,,,,83.04,114.85
WEDGING CAST,29740,HCPCS,450,RC,,both,140.75,126.68,Cigna,Default,Percent of Total Billed Charges,83.04,,,,83.04,114.85
WEDGING CAST,29740,HCPCS,450,RC,,both,140.75,126.68,United Healthcare,Default,Fee Schedule,114.85,,,,83.04,114.85
REMOV FB INTRANASAL; RIGHT,30300,HCPCS,450,RC,,both,406.56,365.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,284.59,,,,239.87,331.75
REMOV FB INTRANASAL; RIGHT,30300,HCPCS,450,RC,,both,406.56,365.9,Cigna,Default,Percent of Total Billed Charges,239.87,,,,239.87,331.75
REMOV FB INTRANASAL; RIGHT,30300,HCPCS,450,RC,,both,406.56,365.9,United Healthcare,Default,Fee Schedule,331.75,,,,239.87,331.75
CNTRL POST EPISTAX INIT,30905,HCPCS,450,RC,,both,385.44,346.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,269.81,,,,227.41,314.52
CNTRL POST EPISTAX INIT,30905,HCPCS,450,RC,,both,385.44,346.9,Cigna,Default,Percent of Total Billed Charges,227.41,,,,227.41,314.52
CNTRL POST EPISTAX INIT,30905,HCPCS,450,RC,,both,385.44,346.9,United Healthcare,Default,Fee Schedule,314.52,,,,227.41,314.52
TRACHEOT TUBE CHANGE BEFOR FISTULA,31502,HCPCS,450,RC,,both,288.25,259.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.78,,,,170.07,235.21
TRACHEOT TUBE CHANGE BEFOR FISTULA,31502,HCPCS,450,RC,,both,288.25,259.43,Cigna,Default,Percent of Total Billed Charges,170.07,,,,170.07,235.21
TRACHEOT TUBE CHANGE BEFOR FISTULA,31502,HCPCS,450,RC,,both,288.25,259.43,United Healthcare,Default,Fee Schedule,235.21,,,,170.07,235.21
LARYNGOSCOPY INDIREC; DX (SEP PROC),31505,HCPCS,450,RC,,both,154,138.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.8,,,,90.86,125.66
LARYNGOSCOPY INDIREC; DX (SEP PROC),31505,HCPCS,450,RC,,both,154,138.6,Cigna,Default,Percent of Total Billed Charges,90.86,,,,90.86,125.66
LARYNGOSCOPY INDIREC; DX (SEP PROC),31505,HCPCS,450,RC,,both,154,138.6,United Healthcare,Default,Fee Schedule,125.66,,,,90.86,125.66
LARYNGOSCOPY INDIRECT; W/BX,31510,HCPCS,450,RC,,both,1658.75,1492.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1161.12,,,,978.66,1353.54
LARYNGOSCOPY INDIRECT; W/BX,31510,HCPCS,450,RC,,both,1658.75,1492.88,Cigna,Default,Percent of Total Billed Charges,978.66,,,,978.66,1353.54
LARYNGOSCOPY INDIRECT; W/BX,31510,HCPCS,450,RC,,both,1658.75,1492.88,United Healthcare,Default,Fee Schedule,1353.54,,,,978.66,1353.54
LARYNGOSCOPY INDIRECT; W/REMOV LES,31512,HCPCS,450,RC,,both,1658.75,1492.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1161.12,,,,978.66,1353.54
LARYNGOSCOPY INDIRECT; W/REMOV LES,31512,HCPCS,450,RC,,both,1658.75,1492.88,Cigna,Default,Percent of Total Billed Charges,978.66,,,,978.66,1353.54
LARYNGOSCOPY INDIRECT; W/REMOV LES,31512,HCPCS,450,RC,,both,1658.75,1492.88,United Healthcare,Default,Fee Schedule,1353.54,,,,978.66,1353.54
LARYNGOSCP DIR W/WO TREACHEO DX NB,31520,HCPCS,450,RC,,both,164.5,148.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.15,,,,97.06,134.23
LARYNGOSCP DIR W/WO TREACHEO DX NB,31520,HCPCS,450,RC,,both,164.5,148.05,Cigna,Default,Percent of Total Billed Charges,97.06,,,,97.06,134.23
LARYNGOSCP DIR W/WO TREACHEO DX NB,31520,HCPCS,450,RC,,both,164.5,148.05,United Healthcare,Default,Fee Schedule,134.23,,,,97.06,134.23
LARYNGOSCOPY  FLEX FIBEROPTIC; DX,31575,HCPCS,450,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
LARYNGOSCOPY  FLEX FIBEROPTIC; DX,31575,HCPCS,450,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
LARYNGOSCOPY  FLEX FIBEROPTIC; DX,31575,HCPCS,450,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
LARYNGOSCPY FIBEROPTIC; W/REMOV FB,31577,HCPCS,450,RC,,both,501.25,451.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,350.88,,,,295.74,409.02
LARYNGOSCPY FIBEROPTIC; W/REMOV FB,31577,HCPCS,450,RC,,both,501.25,451.13,Cigna,Default,Percent of Total Billed Charges,295.74,,,,295.74,409.02
LARYNGOSCPY FIBEROPTIC; W/REMOV FB,31577,HCPCS,450,RC,,both,501.25,451.13,United Healthcare,Default,Fee Schedule,409.02,,,,295.74,409.02
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,450,RC,,both,1518,1366.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1062.6,,,,895.62,1238.69
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,450,RC,,both,1518,1366.2,Cigna,Default,Percent of Total Billed Charges,895.62,,,,895.62,1238.69
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,450,RC,,both,1518,1366.2,United Healthcare,Default,Fee Schedule,1238.69,,,,895.62,1238.69
TRACH EMER PROC; CRICOTHYROID MEMBR,31605,HCPCS,450,RC,,both,1518,1366.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1062.6,,,,895.62,1238.69
TRACH EMER PROC; CRICOTHYROID MEMBR,31605,HCPCS,450,RC,,both,1518,1366.2,Cigna,Default,Percent of Total Billed Charges,895.62,,,,895.62,1238.69
TRACH EMER PROC; CRICOTHYROID MEMBR,31605,HCPCS,450,RC,,both,1518,1366.2,United Healthcare,Default,Fee Schedule,1238.69,,,,895.62,1238.69
THORACENTESIS W/INSRT TUBE (SEP PROC),32422,HCPCS,450,RC,,both,444.75,400.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.32,,,,262.4,362.92
THORACENTESIS W/INSRT TUBE (SEP PROC),32422,HCPCS,450,RC,,both,444.75,400.28,Cigna,Default,Percent of Total Billed Charges,262.4,,,,262.4,362.92
THORACENTESIS W/INSRT TUBE (SEP PROC),32422,HCPCS,450,RC,,both,444.75,400.28,United Healthcare,Default,Fee Schedule,362.92,,,,262.4,362.92
THORACENTESIS,32554,HCPCS,450,RC,,both,1096.75,987.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,767.72,,,,647.08,894.95
THORACENTESIS,32554,HCPCS,450,RC,,both,1096.75,987.08,Cigna,Default,Percent of Total Billed Charges,647.08,,,,647.08,894.95
THORACENTESIS,32554,HCPCS,450,RC,,both,1096.75,987.08,United Healthcare,Default,Fee Schedule,894.95,,,,647.08,894.95
TUBE THORACOSTOMY (SEP PROC),32551,HCPCS,450,RC,,both,469.75,422.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,328.82,,,,277.15,383.32
TUBE THORACOSTOMY (SEP PROC),32551,HCPCS,450,RC,,both,469.75,422.78,Cigna,Default,Percent of Total Billed Charges,277.15,,,,277.15,383.32
TUBE THORACOSTOMY (SEP PROC),32551,HCPCS,450,RC,,both,469.75,422.78,United Healthcare,Default,Fee Schedule,383.32,,,,277.15,383.32
INSRT/REPLC TEMP 1 ELECT (SEP PROC),33210,HCPCS,450,RC,,both,791.75,712.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,554.22,,,,467.13,646.07
INSRT/REPLC TEMP 1 ELECT (SEP PROC),33210,HCPCS,450,RC,,both,791.75,712.58,Cigna,Default,Percent of Total Billed Charges,467.13,,,,467.13,646.07
INSRT/REPLC TEMP 1 ELECT (SEP PROC),33210,HCPCS,450,RC,,both,791.75,712.58,United Healthcare,Default,Fee Schedule,646.07,,,,467.13,646.07
INSRT/REPLC TEMP ELECTROD (SEP PROS),33211,HCPCS,450,RC,,both,791.75,712.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,554.22,,,,467.13,646.07
INSRT/REPLC TEMP ELECTROD (SEP PROS),33211,HCPCS,450,RC,,both,791.75,712.58,Cigna,Default,Percent of Total Billed Charges,467.13,,,,467.13,646.07
INSRT/REPLC TEMP ELECTROD (SEP PROS),33211,HCPCS,450,RC,,both,791.75,712.58,United Healthcare,Default,Fee Schedule,646.07,,,,467.13,646.07
VENIPUNCT CUTDOWN; < 1YR,36420,HCPCS,450,RC,,both,659,593.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,461.3,,,,388.81,537.74
VENIPUNCT CUTDOWN; < 1YR,36420,HCPCS,450,RC,,both,659,593.1,Cigna,Default,Percent of Total Billed Charges,388.81,,,,388.81,537.74
VENIPUNCT CUTDOWN; < 1YR,36420,HCPCS,450,RC,,both,659,593.1,United Healthcare,Default,Fee Schedule,537.74,,,,388.81,537.74
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,450,RC,,both,659,593.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,461.3,,,,388.81,537.74
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,450,RC,,both,659,593.1,Cigna,Default,Percent of Total Billed Charges,388.81,,,,388.81,537.74
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,450,RC,,both,659,593.1,United Healthcare,Default,Fee Schedule,537.74,,,,388.81,537.74
"BLOOD TRANSFUSION, COMPONENTS",36430,HCPCS,391,RC,,both,716,644.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.2,,,,422.44,584.26
"BLOOD TRANSFUSION, COMPONENTS",36430,HCPCS,391,RC,,both,716,644.4,Cigna,Default,Percent of Total Billed Charges,422.44,,,,422.44,584.26
"BLOOD TRANSFUSION, COMPONENTS",36430,HCPCS,391,RC,,both,716,644.4,United Healthcare,Default,Fee Schedule,584.26,,,,422.44,584.26
BLOOD PRODUCT TRANSFUSION,456,RC,,,,both,716,644.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.2,,,,422.44,584.26
BLOOD PRODUCT TRANSFUSION,456,RC,,,,both,716,644.4,Cigna,Default,Percent of Total Billed Charges,422.44,,,,422.44,584.26
BLOOD PRODUCT TRANSFUSION,456,RC,,,,both,716,644.4,United Healthcare,Default,Fee Schedule,584.26,,,,422.44,584.26
BLOOD PRODUCT TRANSFUSION,451,RC,,,,both,716,644.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.2,,,,422.44,584.26
BLOOD PRODUCT TRANSFUSION,451,RC,,,,both,716,644.4,Cigna,Default,Percent of Total Billed Charges,422.44,,,,422.44,584.26
BLOOD PRODUCT TRANSFUSION,451,RC,,,,both,716,644.4,United Healthcare,Default,Fee Schedule,584.26,,,,422.44,584.26
INS CENTRAL VENOUS ACCESS >5,36556,HCPCS,450,RC,,both,659,593.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,461.3,,,,388.81,537.74
INS CENTRAL VENOUS ACCESS >5,36556,HCPCS,450,RC,,both,659,593.1,Cigna,Default,Percent of Total Billed Charges,388.81,,,,388.81,537.74
INS CENTRAL VENOUS ACCESS >5,36556,HCPCS,450,RC,,both,659,593.1,United Healthcare,Default,Fee Schedule,537.74,,,,388.81,537.74
PLCMT CENT VENOUS CATH; PERQ <5YR,36556,HCPCS,761,RC,,both,2300,2070,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1610,,,,1357,1876.8
PLCMT CENT VENOUS CATH; PERQ <5YR,36556,HCPCS,761,RC,,both,2300,2070,Cigna,Default,Percent of Total Billed Charges,1357,,,,1357,1876.8
PLCMT CENT VENOUS CATH; PERQ <5YR,36556,HCPCS,761,RC,,both,2300,2070,United Healthcare,Default,Fee Schedule,1876.8,,,,1357,1876.8
DRAINAGE LYMPH NODE ABSCESS;SIMPL,38300,HCPCS,450,RC,,both,749.75,674.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.82,,,,442.35,611.8
DRAINAGE LYMPH NODE ABSCESS;SIMPL,38300,HCPCS,450,RC,,both,749.75,674.78,Cigna,Default,Percent of Total Billed Charges,442.35,,,,442.35,611.8
DRAINAGE LYMPH NODE ABSCESS;SIMPL,38300,HCPCS,450,RC,,both,749.75,674.78,United Healthcare,Default,Fee Schedule,611.8,,,,442.35,611.8
BX/EXC LYMPH NODE; BY NEEDLE SUPERF,38505,HCPCS,450,RC,,both,660.5,594.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,462.35,,,,389.7,538.97
BX/EXC LYMPH NODE; BY NEEDLE SUPERF,38505,HCPCS,450,RC,,both,660.5,594.45,Cigna,Default,Percent of Total Billed Charges,389.7,,,,389.7,538.97
BX/EXC LYMPH NODE; BY NEEDLE SUPERF,38505,HCPCS,450,RC,,both,660.5,594.45,United Healthcare,Default,Fee Schedule,538.97,,,,389.7,538.97
BX LIP,40490,HCPCS,450,RC,,both,631.5,568.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.05,,,,372.58,515.3
BX LIP,40490,HCPCS,450,RC,,both,631.5,568.35,Cigna,Default,Percent of Total Billed Charges,372.58,,,,372.58,515.3
BX LIP,40490,HCPCS,450,RC,,both,631.5,568.35,United Healthcare,Default,Fee Schedule,515.3,,,,372.58,515.3
DRAIN ABSCESS VESTIBULE MOUTH;SIMPL,40800,HCPCS,450,RC,,both,206.75,186.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.72,,,,121.98,168.71
DRAIN ABSCESS VESTIBULE MOUTH;SIMPL,40800,HCPCS,450,RC,,both,206.75,186.08,Cigna,Default,Percent of Total Billed Charges,121.98,,,,121.98,168.71
DRAIN ABSCESS VESTIBULE MOUTH;SIMPL,40800,HCPCS,450,RC,,both,206.75,186.08,United Healthcare,Default,Fee Schedule,168.71,,,,121.98,168.71
REMOV EMBEDDED FB MOUTH; SIMPL,40804,HCPCS,450,RC,,both,218.25,196.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.78,,,,128.77,178.09
REMOV EMBEDDED FB MOUTH; SIMPL,40804,HCPCS,450,RC,,both,218.25,196.43,Cigna,Default,Percent of Total Billed Charges,128.77,,,,128.77,178.09
REMOV EMBEDDED FB MOUTH; SIMPL,40804,HCPCS,450,RC,,both,218.25,196.43,United Healthcare,Default,Fee Schedule,178.09,,,,128.77,178.09
BX VESTIBULE MOUTH,40808,HCPCS,450,RC,,both,206.75,186.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.72,,,,121.98,168.71
BX VESTIBULE MOUTH,40808,HCPCS,450,RC,,both,206.75,186.08,Cigna,Default,Percent of Total Billed Charges,121.98,,,,121.98,168.71
BX VESTIBULE MOUTH,40808,HCPCS,450,RC,,both,206.75,186.08,United Healthcare,Default,Fee Schedule,168.71,,,,121.98,168.71
CLO LACERATION MOUTH; 2.5 CM/LESS,40830,HCPCS,450,RC,,both,218.25,196.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.78,,,,128.77,178.09
CLO LACERATION MOUTH; 2.5 CM/LESS,40830,HCPCS,450,RC,,both,218.25,196.43,Cigna,Default,Percent of Total Billed Charges,128.77,,,,128.77,178.09
CLO LACERATION MOUTH; 2.5 CM/LESS,40830,HCPCS,450,RC,,both,218.25,196.43,United Healthcare,Default,Fee Schedule,178.09,,,,128.77,178.09
INTRAORAL I&D ABSCESS; SUBLINGUAL,41005,HCPCS,450,RC,,both,218.25,196.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.78,,,,128.77,178.09
INTRAORAL I&D ABSCESS; SUBLINGUAL,41005,HCPCS,450,RC,,both,218.25,196.43,Cigna,Default,Percent of Total Billed Charges,128.77,,,,128.77,178.09
INTRAORAL I&D ABSCESS; SUBLINGUAL,41005,HCPCS,450,RC,,both,218.25,196.43,United Healthcare,Default,Fee Schedule,178.09,,,,128.77,178.09
EXTRAORAL I&D ABSCESS; SUBLINGUAL,41015,HCPCS,450,RC,,both,631.5,568.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.05,,,,372.58,515.3
EXTRAORAL I&D ABSCESS; SUBLINGUAL,41015,HCPCS,450,RC,,both,631.5,568.35,Cigna,Default,Percent of Total Billed Charges,372.58,,,,372.58,515.3
EXTRAORAL I&D ABSCESS; SUBLINGUAL,41015,HCPCS,450,RC,,both,631.5,568.35,United Healthcare,Default,Fee Schedule,515.3,,,,372.58,515.3
DRAIN ABSCESS DENTOALVEOLAR STRUCT,41800,HCPCS,450,RC,,both,206.75,186.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.72,,,,121.98,168.71
DRAIN ABSCESS DENTOALVEOLAR STRUCT,41800,HCPCS,450,RC,,both,206.75,186.08,Cigna,Default,Percent of Total Billed Charges,121.98,,,,121.98,168.71
DRAIN ABSCESS DENTOALVEOLAR STRUCT,41800,HCPCS,450,RC,,both,206.75,186.08,United Healthcare,Default,Fee Schedule,168.71,,,,121.98,168.71
CONTROL OROPHARYNG HEMORR; SIMPL,42960,HCPCS,450,RC,,both,285.5,256.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.85,,,,168.44,232.97
CONTROL OROPHARYNG HEMORR; SIMPL,42960,HCPCS,450,RC,,both,285.5,256.95,Cigna,Default,Percent of Total Billed Charges,168.44,,,,168.44,232.97
CONTROL OROPHARYNG HEMORR; SIMPL,42960,HCPCS,450,RC,,both,285.5,256.95,United Healthcare,Default,Fee Schedule,232.97,,,,168.44,232.97
CONTROL NASOPHARYNG HEMORR; SIMPL,42970,HCPCS,450,RC,,both,285.5,256.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.85,,,,168.44,232.97
CONTROL NASOPHARYNG HEMORR; SIMPL,42970,HCPCS,450,RC,,both,285.5,256.95,Cigna,Default,Percent of Total Billed Charges,168.44,,,,168.44,232.97
CONTROL NASOPHARYNG HEMORR; SIMPL,42970,HCPCS,450,RC,,both,285.5,256.95,United Healthcare,Default,Fee Schedule,232.97,,,,168.44,232.97
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,451,RC,,both,273,245.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.1,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,451,RC,,both,273,245.7,Cigna,Default,Percent of Total Billed Charges,161.07,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,451,RC,,both,273,245.7,United Healthcare,Default,Fee Schedule,222.77,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,456,RC,,both,273,245.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.1,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,456,RC,,both,273,245.7,Cigna,Default,Percent of Total Billed Charges,161.07,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,456,RC,,both,273,245.7,United Healthcare,Default,Fee Schedule,222.77,,,,161.07,222.77
RMVL DEVITAL TIS 20CM<,97597,HCPCS,451,RC,,both,307.75,276.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.42,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,451,RC,,both,307.75,276.98,Cigna,Default,Percent of Total Billed Charges,181.57,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,451,RC,,both,307.75,276.98,United Healthcare,Default,Fee Schedule,251.12,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,456,RC,,both,307.75,276.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.42,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,456,RC,,both,307.75,276.98,Cigna,Default,Percent of Total Billed Charges,181.57,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,456,RC,,both,307.75,276.98,United Healthcare,Default,Fee Schedule,251.12,,,,181.57,251.12
I&D SUBMUCOSAL ABSCESS RECTUM,45005,HCPCS,450,RC,,both,302.5,272.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.75,,,,178.48,246.84
I&D SUBMUCOSAL ABSCESS RECTUM,45005,HCPCS,450,RC,,both,302.5,272.25,Cigna,Default,Percent of Total Billed Charges,178.48,,,,178.48,246.84
I&D SUBMUCOSAL ABSCESS RECTUM,45005,HCPCS,450,RC,,both,302.5,272.25,United Healthcare,Default,Fee Schedule,246.84,,,,178.48,246.84
PROCTOSIG RIGID W/W/O COLLECT,45300,HCPCS,450,RC,,both,229,206.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.3,,,,135.11,186.86
PROCTOSIG RIGID W/W/O COLLECT,45300,HCPCS,450,RC,,both,229,206.1,Cigna,Default,Percent of Total Billed Charges,135.11,,,,135.11,186.86
PROCTOSIG RIGID W/W/O COLLECT,45300,HCPCS,450,RC,,both,229,206.1,United Healthcare,Default,Fee Schedule,186.86,,,,135.11,186.86
PROCSIGMOSCOPY RIGID; W/DILAT,45303,HCPCS,450,RC,,both,346,311.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.2,,,,204.14,282.34
PROCSIGMOSCOPY RIGID; W/DILAT,45303,HCPCS,450,RC,,both,346,311.4,Cigna,Default,Percent of Total Billed Charges,204.14,,,,204.14,282.34
PROCSIGMOSCOPY RIGID; W/DILAT,45303,HCPCS,450,RC,,both,346,311.4,United Healthcare,Default,Fee Schedule,282.34,,,,204.14,282.34
PROCSIGMOSCOPY RIGID; W/BX 1/MX,45305,HCPCS,450,RC,,both,346,311.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.2,,,,204.14,282.34
PROCSIGMOSCOPY RIGID; W/BX 1/MX,45305,HCPCS,450,RC,,both,346,311.4,Cigna,Default,Percent of Total Billed Charges,204.14,,,,204.14,282.34
PROCSIGMOSCOPY RIGID; W/BX 1/MX,45305,HCPCS,450,RC,,both,346,311.4,United Healthcare,Default,Fee Schedule,282.34,,,,204.14,282.34
PROCSIGMOIDOS RIGID;W/CONTROL BLD,45317,HCPCS,450,RC,,both,366,329.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.2,,,,215.94,298.66
PROCSIGMOIDOS RIGID;W/CONTROL BLD,45317,HCPCS,450,RC,,both,366,329.4,Cigna,Default,Percent of Total Billed Charges,215.94,,,,215.94,298.66
PROCSIGMOIDOS RIGID;W/CONTROL BLD,45317,HCPCS,450,RC,,both,366,329.4,United Healthcare,Default,Fee Schedule,298.66,,,,215.94,298.66
I&D PERIANAL ABSCESS SUPERF,46050,HCPCS,450,RC,,both,2300.75,2070.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1610.52,,,,1357.44,1877.41
I&D PERIANAL ABSCESS SUPERF,46050,HCPCS,450,RC,,both,2300.75,2070.68,Cigna,Default,Percent of Total Billed Charges,1357.44,,,,1357.44,1877.41
I&D PERIANAL ABSCESS SUPERF,46050,HCPCS,450,RC,,both,2300.75,2070.68,United Healthcare,Default,Fee Schedule,1877.41,,,,1357.44,1877.41
INCS THROMBOSED HEMORRHOID EXT,46083,HCPCS,450,RC,,both,859.08,773.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,601.36,,,,506.86,701.01
INCS THROMBOSED HEMORRHOID EXT,46083,HCPCS,450,RC,,both,859.08,773.17,Cigna,Default,Percent of Total Billed Charges,506.86,,,,506.86,701.01
INCS THROMBOSED HEMORRHOID EXT,46083,HCPCS,450,RC,,both,859.08,773.17,United Healthcare,Default,Fee Schedule,701.01,,,,506.86,701.01
HEMORRHOIDECTOMY BY SIMPL LIG,46221,HCPCS,450,RC,,both,285.5,256.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.85,,,,168.44,232.97
HEMORRHOIDECTOMY BY SIMPL LIG,46221,HCPCS,450,RC,,both,285.5,256.95,Cigna,Default,Percent of Total Billed Charges,168.44,,,,168.44,232.97
HEMORRHOIDECTOMY BY SIMPL LIG,46221,HCPCS,450,RC,,both,285.5,256.95,United Healthcare,Default,Fee Schedule,232.97,,,,168.44,232.97
ENUCLEATION EXT THROBOTIC HEMORRHO,46320,HCPCS,450,RC,,both,302.5,272.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.75,,,,178.48,246.84
ENUCLEATION EXT THROBOTIC HEMORRHO,46320,HCPCS,450,RC,,both,302.5,272.25,Cigna,Default,Percent of Total Billed Charges,178.48,,,,178.48,246.84
ENUCLEATION EXT THROBOTIC HEMORRHO,46320,HCPCS,450,RC,,both,302.5,272.25,United Healthcare,Default,Fee Schedule,246.84,,,,178.48,246.84
INJ SCLEROSING SOLUTION HEMORRHOIDS,46500,HCPCS,450,RC,,both,285.5,256.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.85,,,,168.44,232.97
INJ SCLEROSING SOLUTION HEMORRHOIDS,46500,HCPCS,450,RC,,both,285.5,256.95,Cigna,Default,Percent of Total Billed Charges,168.44,,,,168.44,232.97
INJ SCLEROSING SOLUTION HEMORRHOIDS,46500,HCPCS,450,RC,,both,285.5,256.95,United Healthcare,Default,Fee Schedule,232.97,,,,168.44,232.97
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,450,RC,,both,280.5,252.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.35,,,,165.5,228.89
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,450,RC,,both,280.5,252.45,Cigna,Default,Percent of Total Billed Charges,165.5,,,,165.5,228.89
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,450,RC,,both,280.5,252.45,United Healthcare,Default,Fee Schedule,228.89,,,,165.5,228.89
DILAT URETHRAL FILLIFORM-MALE; INIT,53620,HCPCS,450,RC,,both,475,427.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,332.5,,,,280.25,387.6
DILAT URETHRAL FILLIFORM-MALE; INIT,53620,HCPCS,450,RC,,both,475,427.5,Cigna,Default,Percent of Total Billed Charges,280.25,,,,280.25,387.6
DILAT URETHRAL FILLIFORM-MALE; INIT,53620,HCPCS,450,RC,,both,475,427.5,United Healthcare,Default,Fee Schedule,387.6,,,,280.25,387.6
DRAINAGE SCROTAL WALL ABSCESS,55100,HCPCS,450,RC,,both,749.75,674.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.82,,,,442.35,611.8
DRAINAGE SCROTAL WALL ABSCESS,55100,HCPCS,450,RC,,both,749.75,674.78,Cigna,Default,Percent of Total Billed Charges,442.35,,,,442.35,611.8
DRAINAGE SCROTAL WALL ABSCESS,55100,HCPCS,450,RC,,both,749.75,674.78,United Healthcare,Default,Fee Schedule,611.8,,,,442.35,611.8
SPINAL PUNCT LUMBAR DX,62270,HCPCS,450,RC,,both,1852,1666.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1296.4,,,,1092.68,1511.23
SPINAL PUNCT LUMBAR DX,62270,HCPCS,450,RC,,both,1852,1666.8,Cigna,Default,Percent of Total Billed Charges,1092.68,,,,1092.68,1511.23
SPINAL PUNCT LUMBAR DX,62270,HCPCS,450,RC,,both,1852,1666.8,United Healthcare,Default,Fee Schedule,1511.23,,,,1092.68,1511.23
LUMBA SACRAL (CAUDAL),62322,HCPCS,450,RC,,both,1255,1129.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,878.5,,,,740.45,1024.08
LUMBA SACRAL (CAUDAL),62322,HCPCS,450,RC,,both,1255,1129.5,Cigna,Default,Percent of Total Billed Charges,740.45,,,,740.45,1024.08
LUMBA SACRAL (CAUDAL),62322,HCPCS,450,RC,,both,1255,1129.5,United Healthcare,Default,Fee Schedule,1024.08,,,,740.45,1024.08
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,450,RC,,both,1898.3,1708.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1328.81,,,,1120,1549.01
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,450,RC,,both,1898.3,1708.47,Cigna,Default,Percent of Total Billed Charges,1120,,,,1120,1549.01
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,450,RC,,both,1898.3,1708.47,United Healthcare,Default,Fee Schedule,1549.01,,,,1120,1549.01
CERVICAL INJECTION,62320,HCPCS,450,RC,,both,297.5,267.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.25,,,,175.52,242.76
CERVICAL INJECTION,62320,HCPCS,450,RC,,both,297.5,267.75,Cigna,Default,Percent of Total Billed Charges,175.52,,,,175.52,242.76
CERVICAL INJECTION,62320,HCPCS,450,RC,,both,297.5,267.75,United Healthcare,Default,Fee Schedule,242.76,,,,175.52,242.76
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,450,RC,,both,362.34,326.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,253.64,,,,213.78,295.67
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,450,RC,,both,362.34,326.11,Cigna,Default,Percent of Total Billed Charges,213.78,,,,213.78,295.67
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,450,RC,,both,362.34,326.11,United Healthcare,Default,Fee Schedule,295.67,,,,213.78,295.67
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,450,RC,,both,322.5,290.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.75,,,,190.28,263.16
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,450,RC,,both,322.5,290.25,Cigna,Default,Percent of Total Billed Charges,190.28,,,,190.28,263.16
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,450,RC,,both,322.5,290.25,United Healthcare,Default,Fee Schedule,263.16,,,,190.28,263.16
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,450,RC,,both,393.86,354.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.7,,,,232.38,321.39
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,450,RC,,both,393.86,354.47,Cigna,Default,Percent of Total Billed Charges,232.38,,,,232.38,321.39
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,450,RC,,both,393.86,354.47,United Healthcare,Default,Fee Schedule,321.39,,,,232.38,321.39
BLEPHAROTOMY DRAIN ABSCESS EYELID,67700,HCPCS,450,RC,,both,361.75,325.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,253.22,,,,213.43,295.19
BLEPHAROTOMY DRAIN ABSCESS EYELID,67700,HCPCS,450,RC,,both,361.75,325.58,Cigna,Default,Percent of Total Billed Charges,213.43,,,,213.43,295.19
BLEPHAROTOMY DRAIN ABSCESS EYELID,67700,HCPCS,450,RC,,both,361.75,325.58,United Healthcare,Default,Fee Schedule,295.19,,,,213.43,295.19
BX EYELID,67810,HCPCS,450,RC,,both,361.75,325.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,253.22,,,,213.43,295.19
BX EYELID,67810,HCPCS,450,RC,,both,361.75,325.58,Cigna,Default,Percent of Total Billed Charges,213.43,,,,213.43,295.19
BX EYELID,67810,HCPCS,450,RC,,both,361.75,325.58,United Healthcare,Default,Fee Schedule,295.19,,,,213.43,295.19
REMOV EMBEDDED FB EYELID,67938,HCPCS,450,RC,,both,1004.9,904.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,703.43,,,,592.89,820
REMOV EMBEDDED FB EYELID,67938,HCPCS,450,RC,,both,1004.9,904.41,Cigna,Default,Percent of Total Billed Charges,592.89,,,,592.89,820
REMOV EMBEDDED FB EYELID,67938,HCPCS,450,RC,,both,1004.9,904.41,United Healthcare,Default,Fee Schedule,820,,,,592.89,820
CTRL POST EPISTAX SQ,30906,HCPCS,450,RC,,both,756.41,680.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,529.49,,,,446.28,617.23
CTRL POST EPISTAX SQ,30906,HCPCS,450,RC,,both,756.41,680.77,Cigna,Default,Percent of Total Billed Charges,446.28,,,,446.28,617.23
CTRL POST EPISTAX SQ,30906,HCPCS,450,RC,,both,756.41,680.77,United Healthcare,Default,Fee Schedule,617.23,,,,446.28,617.23
PROBE NASOLACRIM DUCT W/WO IRRIG.G,68810,HCPCS,450,RC,,both,342,307.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,239.4,,,,201.78,279.07
PROBE NASOLACRIM DUCT W/WO IRRIG.G,68810,HCPCS,450,RC,,both,342,307.8,Cigna,Default,Percent of Total Billed Charges,201.78,,,,201.78,279.07
PROBE NASOLACRIM DUCT W/WO IRRIG.G,68810,HCPCS,450,RC,,both,342,307.8,United Healthcare,Default,Fee Schedule,279.07,,,,201.78,279.07
DRAIN EXT EAR ABSCESS; SIMPL,69000,HCPCS,450,RC,,both,2125.84,1913.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1488.09,,,,1254.25,1734.69
DRAIN EXT EAR ABSCESS; SIMPL,69000,HCPCS,450,RC,,both,2125.84,1913.26,Cigna,Default,Percent of Total Billed Charges,1254.25,,,,1254.25,1734.69
DRAIN EXT EAR ABSCESS; SIMPL,69000,HCPCS,450,RC,,both,2125.84,1913.26,United Healthcare,Default,Fee Schedule,1734.69,,,,1254.25,1734.69
DRAIN EXT AUDITORY CANAL ABSCESS,69020,HCPCS,450,RC,,both,243.5,219.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.45,,,,143.66,198.7
DRAIN EXT AUDITORY CANAL ABSCESS,69020,HCPCS,450,RC,,both,243.5,219.15,Cigna,Default,Percent of Total Billed Charges,143.66,,,,143.66,198.7
DRAIN EXT AUDITORY CANAL ABSCESS,69020,HCPCS,450,RC,,both,243.5,219.15,United Healthcare,Default,Fee Schedule,198.7,,,,143.66,198.7
BX EXT EAR,69100,HCPCS,450,RC,,both,488.25,439.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.78,,,,288.07,398.41
BX EXT EAR,69100,HCPCS,450,RC,,both,488.25,439.43,Cigna,Default,Percent of Total Billed Charges,288.07,,,,288.07,398.41
BX EXT EAR,69100,HCPCS,450,RC,,both,488.25,439.43,United Healthcare,Default,Fee Schedule,398.41,,,,288.07,398.41
DRAIN EXT EAR ABSCESS; SIMPL,69000,HCPCS,981,RC,,both,562.84,506.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,393.99,,,,332.08,393.99
DRAIN EXT EAR ABSCESS; SIMPL,69000,HCPCS,981,RC,,both,562.84,506.56,Cigna,Default,Percent of Total Billed Charges,332.08,,,,332.08,393.99
DRAIN EXT EAR ABSCESS; SIMPL,69000,HCPCS,981,RC,,both,562.84,506.56,United Healthcare,Default,Fee Schedule,,,,,332.08,393.99
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,450,RC,,both,794.75,715.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.32,,,,468.9,648.52
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,450,RC,,both,794.75,715.28,Cigna,Default,Percent of Total Billed Charges,468.9,,,,468.9,648.52
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,450,RC,,both,794.75,715.28,United Healthcare,Default,Fee Schedule,648.52,,,,468.9,648.52
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,450,RC,,both,127.75,114.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.42,,,,75.37,104.24
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,450,RC,,both,127.75,114.98,Cigna,Default,Percent of Total Billed Charges,75.37,,,,75.37,104.24
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,450,RC,,both,127.75,114.98,United Healthcare,Default,Fee Schedule,104.24,,,,75.37,104.24
NG TUBE PLACEMENT W/FLUORO,43752,HCPCS,450,RC,,both,465.75,419.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,326.02,,,,274.79,380.05
NG TUBE PLACEMENT W/FLUORO,43752,HCPCS,450,RC,,both,465.75,419.18,Cigna,Default,Percent of Total Billed Charges,274.79,,,,274.79,380.05
NG TUBE PLACEMENT W/FLUORO,43752,HCPCS,450,RC,,both,465.75,419.18,United Healthcare,Default,Fee Schedule,380.05,,,,274.79,380.05
"IMMUN ADMIN, ONE VACCINE",456,RC,,,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
"IMMUN ADMIN, ONE VACCINE",456,RC,,,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
"IMMUN ADMIN, ONE VACCINE",456,RC,,,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
"IMMUN ADMIN, ONE VACCINE",451,RC,,,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
"IMMUN ADMIN, ONE VACCINE",451,RC,,,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
"IMMUN ADMIN, ONE VACCINE",451,RC,,,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
"IMMUN ADMIN, ONE VACCINE",90471,HCPCS,771,RC,,both,158.35,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.84,,,,93.43,110.84
"IMMUN ADMIN, ONE VACCINE",90471,HCPCS,771,RC,,both,158.35,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,110.84
"IMMUN ADMIN, ONE VACCINE",90471,HCPCS,771,RC,,both,158.35,142.52,United Healthcare,Default,Fee Schedule,,,,,93.43,110.84
ADMIN PNEUMONIA VACCINE- MC,G0009,HCPCS,771,RC,,both,158.35,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.84,,,,93.43,110.84
ADMIN PNEUMONIA VACCINE- MC,G0009,HCPCS,771,RC,,both,158.35,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,110.84
ADMIN PNEUMONIA VACCINE- MC,G0009,HCPCS,771,RC,,both,158.35,142.52,United Healthcare,Default,Fee Schedule,,,,,93.43,110.84
IMMUNIZATION ADMIN EA ADDL,90472,HCPCS,771,RC,,both,93.54,84.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.48,,,,55.19,65.48
IMMUNIZATION ADMIN EA ADDL,90472,HCPCS,771,RC,,both,93.54,84.19,Cigna,Default,Percent of Total Billed Charges,55.19,,,,55.19,65.48
IMMUNIZATION ADMIN EA ADDL,90472,HCPCS,771,RC,,both,93.54,84.19,United Healthcare,Default,Fee Schedule,,,,,55.19,65.48
PNEUMOCOCCAL POLYSACCH VAC-ADULT,90732,HCPCS,636,RC,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
PNEUMOCOCCAL POLYSACCH VAC-ADULT,90732,HCPCS,636,RC,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
PNEUMOCOCCAL POLYSACCH VAC-ADULT,90732,HCPCS,636,RC,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
MENINGOCOCCAL POLYSACCH VAC-SUBSQ,90733,HCPCS,450,RC,,both,226,203.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.2,,,,133.34,184.42
MENINGOCOCCAL POLYSACCH VAC-SUBSQ,90733,HCPCS,450,RC,,both,226,203.4,Cigna,Default,Percent of Total Billed Charges,133.34,,,,133.34,184.42
MENINGOCOCCAL POLYSACCH VAC-SUBSQ,90733,HCPCS,450,RC,,both,226,203.4,United Healthcare,Default,Fee Schedule,184.42,,,,133.34,184.42
JAPANESE ENCEPHALITIS VAC-SUBQ USE,90735,HCPCS,450,RC,,both,226,203.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.2,,,,133.34,184.42
JAPANESE ENCEPHALITIS VAC-SUBQ USE,90735,HCPCS,450,RC,,both,226,203.4,Cigna,Default,Percent of Total Billed Charges,133.34,,,,133.34,184.42
JAPANESE ENCEPHALITIS VAC-SUBQ USE,90735,HCPCS,450,RC,,both,226,203.4,United Healthcare,Default,Fee Schedule,184.42,,,,133.34,184.42
REPLAC CONTACT LENS,92326,HCPCS,920,RC,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
REPLAC CONTACT LENS,92326,HCPCS,920,RC,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
REPLAC CONTACT LENS,92326,HCPCS,920,RC,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,46040,HCPCS,761,RC,,both,3738.21,3364.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2616.75,,,,2205.54,3050.38
I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,46040,HCPCS,761,RC,,both,3738.21,3364.39,Cigna,Default,Percent of Total Billed Charges,2205.54,,,,2205.54,3050.38
I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,46040,HCPCS,761,RC,,both,3738.21,3364.39,United Healthcare,Default,Fee Schedule,3050.38,,,,2205.54,3050.38
ECG-ROUTINE 12 LEAD  TRACING ONLY,93005,HCPCS,730,RC,,both,47.5,42.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.25,,,,28.02,38.76
ECG-ROUTINE 12 LEAD  TRACING ONLY,93005,HCPCS,730,RC,,both,47.5,42.75,Cigna,Default,Percent of Total Billed Charges,28.02,,,,28.02,38.76
ECG-ROUTINE 12 LEAD  TRACING ONLY,93005,HCPCS,730,RC,,both,47.5,42.75,United Healthcare,Default,Fee Schedule,38.76,,,,28.02,38.76
RHYTHM ECG 1-3 LEADS; TRACING ONLY,93041,HCPCS,730,RC,,both,82,73.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.4,,,,48.38,66.91
RHYTHM ECG 1-3 LEADS; TRACING ONLY,93041,HCPCS,730,RC,,both,82,73.8,Cigna,Default,Percent of Total Billed Charges,48.38,,,,48.38,66.91
RHYTHM ECG 1-3 LEADS; TRACING ONLY,93041,HCPCS,730,RC,,both,82,73.8,United Healthcare,Default,Fee Schedule,66.91,,,,48.38,66.91
"ER VISIT, LEVEL 1",99281,HCPCS,450,RC,,outpatient,221.94,199.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.36,,,,130.94,181.1
"ER VISIT, LEVEL 1",99281,HCPCS,450,RC,,outpatient,221.94,199.75,Cigna,Default,Percent of Total Billed Charges,130.94,,,,130.94,181.1
"ER VISIT, LEVEL 1",99281,HCPCS,450,RC,,outpatient,221.94,199.75,United Healthcare,Default,Fee Schedule,181.1,,,,130.94,181.1
"ER VISIT, LEVEL 2",99282,HCPCS,450,RC,,outpatient,409.85,368.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,286.9,,,,241.81,334.44
"ER VISIT, LEVEL 2",99282,HCPCS,450,RC,,outpatient,409.85,368.87,Cigna,Default,Percent of Total Billed Charges,241.81,,,,241.81,334.44
"ER VISIT, LEVEL 2",99282,HCPCS,450,RC,,outpatient,409.85,368.87,United Healthcare,Default,Fee Schedule,334.44,,,,241.81,334.44
"ER VISIT, LEVEL 3",99283,HCPCS,450,RC,25,outpatient,733.51,660.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,513.46,,,,432.77,598.54
"ER VISIT, LEVEL 3",99283,HCPCS,450,RC,25,outpatient,733.51,660.16,Cigna,Default,Percent of Total Billed Charges,432.77,,,,432.77,598.54
"ER VISIT, LEVEL 3",99283,HCPCS,450,RC,25,outpatient,733.51,660.16,United Healthcare,Default,Fee Schedule,598.54,,,,432.77,598.54
"ER VISIT, LEVEL 4",99284,HCPCS,450,RC,25,outpatient,1223.86,1101.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,856.7,,,,722.08,998.67
"ER VISIT, LEVEL 4",99284,HCPCS,450,RC,25,outpatient,1223.86,1101.47,Cigna,Default,Percent of Total Billed Charges,722.08,,,,722.08,998.67
"ER VISIT, LEVEL 4",99284,HCPCS,450,RC,25,outpatient,1223.86,1101.47,United Healthcare,Default,Fee Schedule,998.67,,,,722.08,998.67
"ER VISIT, LEVEL 5",99285,HCPCS,450,RC,25,outpatient,1819.13,1637.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1273.39,,,,1073.29,1484.41
"ER VISIT, LEVEL 5",99285,HCPCS,450,RC,25,outpatient,1819.13,1637.22,Cigna,Default,Percent of Total Billed Charges,1073.29,,,,1073.29,1484.41
"ER VISIT, LEVEL 5",99285,HCPCS,450,RC,25,outpatient,1819.13,1637.22,United Healthcare,Default,Fee Schedule,1484.41,,,,1073.29,1484.41
"CRITICAL CARE, 1ST 30-74 MIN",99291,HCPCS,450,RC,,outpatient,2432.9,2189.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1703.03,,,,1435.41,1985.25
"CRITICAL CARE, 1ST 30-74 MIN",99291,HCPCS,450,RC,,outpatient,2432.9,2189.61,Cigna,Default,Percent of Total Billed Charges,1435.41,,,,1435.41,1985.25
"CRITICAL CARE, 1ST 30-74 MIN",99291,HCPCS,450,RC,,outpatient,2432.9,2189.61,United Healthcare,Default,Fee Schedule,1985.25,,,,1435.41,1985.25
NB RESUSCITATION,99465,HCPCS,450,RC,,both,549.75,494.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,384.82,,,,324.35,448.6
NB RESUSCITATION,99465,HCPCS,450,RC,,both,549.75,494.78,Cigna,Default,Percent of Total Billed Charges,324.35,,,,324.35,448.6
NB RESUSCITATION,99465,HCPCS,450,RC,,both,549.75,494.78,United Healthcare,Default,Fee Schedule,448.6,,,,324.35,448.6
"CRITICAL CARE, ADDL 30 MIN",99292,HCPCS,450,RC,,both,1184.46,1066.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,829.12,,,,698.83,966.52
"CRITICAL CARE, ADDL 30 MIN",99292,HCPCS,450,RC,,both,1184.46,1066.01,Cigna,Default,Percent of Total Billed Charges,698.83,,,,698.83,966.52
"CRITICAL CARE, ADDL 30 MIN",99292,HCPCS,450,RC,,both,1184.46,1066.01,United Healthcare,Default,Fee Schedule,966.52,,,,698.83,966.52
COLORECTAL SCRN; HI RISK IND,82272,HCPCS,300,RC,,both,346,311.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.2,,,,204.14,282.34
COLORECTAL SCRN; HI RISK IND,82272,HCPCS,300,RC,,both,346,311.4,Cigna,Default,Percent of Total Billed Charges,204.14,,,,204.14,282.34
COLORECTAL SCRN; HI RISK IND,82272,HCPCS,300,RC,,both,346,311.4,United Healthcare,Default,Fee Schedule,282.34,,,,204.14,282.34
"OCCULT BLOOD, FECES, SINGLE-DIAGNOSTIC",82272,HCPCS,300,RC,,both,17.57,15.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.3,,,,10.37,14.34
"OCCULT BLOOD, FECES, SINGLE-DIAGNOSTIC",82272,HCPCS,300,RC,,both,17.57,15.81,Cigna,Default,Percent of Total Billed Charges,10.37,,,,10.37,14.34
"OCCULT BLOOD, FECES, SINGLE-DIAGNOSTIC",82272,HCPCS,300,RC,,both,17.57,15.81,United Healthcare,Default,Fee Schedule,14.34,,,,10.37,14.34
CHEMO BY BOTH INFUSION AND O,96542,HCPCS,331,RC,,both,353.75,318.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,247.62,,,,208.71,288.66
CHEMO BY BOTH INFUSION AND O,96542,HCPCS,331,RC,,both,353.75,318.38,Cigna,Default,Percent of Total Billed Charges,208.71,,,,208.71,288.66
CHEMO BY BOTH INFUSION AND O,96542,HCPCS,331,RC,,both,353.75,318.38,United Healthcare,Default,Fee Schedule,288.66,,,,208.71,288.66
INTMD WND REPAIR N-HF/GENIT,12041,HCPCS,450,RC,,both,958.97,863.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,671.28,,,,565.79,782.52
INTMD WND REPAIR N-HF/GENIT,12041,HCPCS,450,RC,,both,958.97,863.07,Cigna,Default,Percent of Total Billed Charges,565.79,,,,565.79,782.52
INTMD WND REPAIR N-HF/GENIT,12041,HCPCS,450,RC,,both,958.97,863.07,United Healthcare,Default,Fee Schedule,782.52,,,,565.79,782.52
VENIPUNCT> 3YR W/MD SKILL (SEP PRO),36410,HCPCS,450,RC,,both,43.5,39.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.45,,,,25.66,35.5
VENIPUNCT> 3YR W/MD SKILL (SEP PRO),36410,HCPCS,450,RC,,both,43.5,39.15,Cigna,Default,Percent of Total Billed Charges,25.66,,,,25.66,35.5
VENIPUNCT> 3YR W/MD SKILL (SEP PRO),36410,HCPCS,450,RC,,both,43.5,39.15,United Healthcare,Default,Fee Schedule,35.5,,,,25.66,35.5
TB INTERDERMAL TEST,86580,HCPCS,300,RC,,both,47.53,42.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.27,,,,28.04,38.78
TB INTERDERMAL TEST,86580,HCPCS,300,RC,,both,47.53,42.78,Cigna,Default,Percent of Total Billed Charges,28.04,,,,28.04,38.78
TB INTERDERMAL TEST,86580,HCPCS,300,RC,,both,47.53,42.78,United Healthcare,Default,Fee Schedule,38.78,,,,28.04,38.78
CATH URETHRA; SIMPLE,451,RC,,,,both,133.25,119.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.28,,,,78.62,108.73
CATH URETHRA; SIMPLE,451,RC,,,,both,133.25,119.93,Cigna,Default,Percent of Total Billed Charges,78.62,,,,78.62,108.73
CATH URETHRA; SIMPLE,451,RC,,,,both,133.25,119.93,United Healthcare,Default,Fee Schedule,108.73,,,,78.62,108.73
"GLUCOSE,QUANT,BLD REAGENT STRP",82962,HCPCS,300,RC,,both,28.79,25.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.15,,,,16.99,23.49
"GLUCOSE,QUANT,BLD REAGENT STRP",82962,HCPCS,300,RC,,both,28.79,25.91,Cigna,Default,Percent of Total Billed Charges,16.99,,,,16.99,23.49
"GLUCOSE,QUANT,BLD REAGENT STRP",82962,HCPCS,300,RC,,both,28.79,25.91,United Healthcare,Default,Fee Schedule,23.49,,,,16.99,23.49
TX SPON HIP DISLOC; WO ANES/MANIP,27256,HCPCS,450,RC,,both,165.75,149.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.02,,,,97.79,135.25
TX SPON HIP DISLOC; WO ANES/MANIP,27256,HCPCS,450,RC,,both,165.75,149.18,Cigna,Default,Percent of Total Billed Charges,97.79,,,,97.79,135.25
TX SPON HIP DISLOC; WO ANES/MANIP,27256,HCPCS,450,RC,,both,165.75,149.18,United Healthcare,Default,Fee Schedule,135.25,,,,97.79,135.25
UNLISTED PX NERVOUS SYSTEM,64999,HCPCS,450,RC,,both,934.54,841.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,654.18,,,,551.38,762.58
UNLISTED PX NERVOUS SYSTEM,64999,HCPCS,450,RC,,both,934.54,841.09,Cigna,Default,Percent of Total Billed Charges,551.38,,,,551.38,762.58
UNLISTED PX NERVOUS SYSTEM,64999,HCPCS,450,RC,,both,934.54,841.09,United Healthcare,Default,Fee Schedule,762.58,,,,551.38,762.58
REMOVE IMPACTED EAR WAX UNI,69209,HCPCS,450,RC,,both,204.19,183.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.93,,,,120.47,166.62
REMOVE IMPACTED EAR WAX UNI,69209,HCPCS,450,RC,,both,204.19,183.77,Cigna,Default,Percent of Total Billed Charges,120.47,,,,120.47,166.62
REMOVE IMPACTED EAR WAX UNI,69209,HCPCS,450,RC,,both,204.19,183.77,United Healthcare,Default,Fee Schedule,166.62,,,,120.47,166.62
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,450,RC,,both,209.45,188.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.62,,,,123.58,170.91
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,450,RC,,both,209.45,188.51,Cigna,Default,Percent of Total Billed Charges,123.58,,,,123.58,170.91
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,450,RC,,both,209.45,188.51,United Healthcare,Default,Fee Schedule,170.91,,,,123.58,170.91
APPLICATION OF FINGER SPLINT: DYNAMIC,29131,HCPCS,450,RC,,both,205.11,184.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.58,,,,121.01,167.37
APPLICATION OF FINGER SPLINT: DYNAMIC,29131,HCPCS,450,RC,,both,205.11,184.6,Cigna,Default,Percent of Total Billed Charges,121.01,,,,121.01,167.37
APPLICATION OF FINGER SPLINT: DYNAMIC,29131,HCPCS,450,RC,,both,205.11,184.6,United Healthcare,Default,Fee Schedule,167.37,,,,121.01,167.37
APPY PATELLAR TENDON BEARING CAST,29435,HCPCS,450,RC,,both,864.44,778,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,605.11,,,,510.02,705.38
APPY PATELLAR TENDON BEARING CAST,29435,HCPCS,450,RC,,both,864.44,778,Cigna,Default,Percent of Total Billed Charges,510.02,,,,510.02,705.38
APPY PATELLAR TENDON BEARING CAST,29435,HCPCS,450,RC,,both,864.44,778,United Healthcare,Default,Fee Schedule,705.38,,,,510.02,705.38
ER PHYSICIAN CRITICAL CARE 1ST HOUR,99291,HCPCS,981,RC,,outpatient,1023.82,921.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,716.67,,,,604.05,716.67
ER PHYSICIAN CRITICAL CARE 1ST HOUR,99291,HCPCS,981,RC,,outpatient,1023.82,921.44,Cigna,Default,Percent of Total Billed Charges,604.05,,,,604.05,716.67
ER PHYSICIAN CRITICAL CARE 1ST HOUR,99291,HCPCS,981,RC,,outpatient,1023.82,921.44,United Healthcare,Default,Fee Schedule,,,,,604.05,716.67
FINE NEEDLE ASPIRATION W/O GUIDANCE,10021,HCPCS,960,RC,,both,517.44,465.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,362.21,,,,305.29,362.21
FINE NEEDLE ASPIRATION W/O GUIDANCE,10021,HCPCS,960,RC,,both,517.44,465.7,Cigna,Default,Percent of Total Billed Charges,305.29,,,,305.29,362.21
FINE NEEDLE ASPIRATION W/O GUIDANCE,10021,HCPCS,960,RC,,both,517.44,465.7,United Healthcare,Default,Fee Schedule,,,,,305.29,362.21
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,981,RC,,both,410.63,369.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.44,,,,242.27,287.44
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,981,RC,,both,410.63,369.57,Cigna,Default,Percent of Total Billed Charges,242.27,,,,242.27,287.44
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,981,RC,,both,410.63,369.57,United Healthcare,Default,Fee Schedule,,,,,242.27,287.44
I&D ABSCESS:COMPLIC/MX,10061,HCPCS,981,RC,,both,805,724.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,563.5,,,,474.95,563.5
I&D ABSCESS:COMPLIC/MX,10061,HCPCS,981,RC,,both,805,724.5,Cigna,Default,Percent of Total Billed Charges,474.95,,,,474.95,563.5
I&D ABSCESS:COMPLIC/MX,10061,HCPCS,981,RC,,both,805,724.5,United Healthcare,Default,Fee Schedule,,,,,474.95,563.5
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,981,RC,,both,452.79,407.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.95,,,,267.15,316.95
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,981,RC,,both,452.79,407.51,Cigna,Default,Percent of Total Billed Charges,267.15,,,,267.15,316.95
INCS & REMOV FB SUBQ TISS; SIMPL,10120,HCPCS,981,RC,,both,452.79,407.51,United Healthcare,Default,Fee Schedule,,,,,267.15,316.95
PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,981,RC,,both,399.84,359.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.89,,,,235.91,279.89
PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,981,RC,,both,399.84,359.86,Cigna,Default,Percent of Total Billed Charges,235.91,,,,235.91,279.89
PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,10160,HCPCS,981,RC,,both,399.84,359.86,United Healthcare,Default,Fee Schedule,,,,,235.91,279.89
EXC TR-EXT B9+MARG 1.1-2 CM,11402,HCPCS,981,RC,,both,401.34,361.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,280.94,,,,236.79,280.94
EXC TR-EXT B9+MARG 1.1-2 CM,11402,HCPCS,981,RC,,both,401.34,361.21,Cigna,Default,Percent of Total Billed Charges,236.79,,,,236.79,280.94
EXC TR-EXT B9+MARG 1.1-2 CM,11402,HCPCS,981,RC,,both,401.34,361.21,United Healthcare,Default,Fee Schedule,,,,,236.79,280.94
EXC BEN LES SCALP; 0.5 CM/LESS,11420,HCPCS,981,RC,,both,382.01,343.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.41,,,,225.39,267.41
EXC BEN LES SCALP; 0.5 CM/LESS,11420,HCPCS,981,RC,,both,382.01,343.81,Cigna,Default,Percent of Total Billed Charges,225.39,,,,225.39,267.41
EXC BEN LES SCALP; 0.5 CM/LESS,11420,HCPCS,981,RC,,both,382.01,343.81,United Healthcare,Default,Fee Schedule,,,,,225.39,267.41
AVULS OF NAIL PLATE PART OR COMPL SIMPLE,11730,HCPCS,981,RC,,both,150.56,135.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.39,,,,88.83,105.39
AVULS OF NAIL PLATE PART OR COMPL SIMPLE,11730,HCPCS,981,RC,,both,150.56,135.5,Cigna,Default,Percent of Total Billed Charges,88.83,,,,88.83,105.39
AVULS OF NAIL PLATE PART OR COMPL SIMPLE,11730,HCPCS,981,RC,,both,150.56,135.5,United Healthcare,Default,Fee Schedule,,,,,88.83,105.39
EVACUATION SUBUNGUAL HEMATOMA,11740,HCPCS,981,RC,,both,104.8,94.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.36,,,,61.83,73.36
EVACUATION SUBUNGUAL HEMATOMA,11740,HCPCS,981,RC,,both,104.8,94.32,Cigna,Default,Percent of Total Billed Charges,61.83,,,,61.83,73.36
EVACUATION SUBUNGUAL HEMATOMA,11740,HCPCS,981,RC,,both,104.8,94.32,United Healthcare,Default,Fee Schedule,,,,,61.83,73.36
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,981,RC,,both,854.38,768.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,598.07,,,,504.08,598.07
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,981,RC,,both,854.38,768.94,Cigna,Default,Percent of Total Billed Charges,504.08,,,,504.08,598.07
EXC NAIL/MATRIX PART/COMPLT PERM,11750,HCPCS,981,RC,,both,854.38,768.94,United Healthcare,Default,Fee Schedule,,,,,504.08,598.07
REPR NAIL BED,11760,HCPCS,981,RC,,both,562,505.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,393.4,,,,331.58,393.4
REPR NAIL BED,11760,HCPCS,981,RC,,both,562,505.8,Cigna,Default,Percent of Total Billed Charges,331.58,,,,331.58,393.4
REPR NAIL BED,11760,HCPCS,981,RC,,both,562,505.8,United Healthcare,Default,Fee Schedule,,,,,331.58,393.4
SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,12002,HCPCS,981,RC,,both,376.1,338.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.27,,,,221.9,263.27
SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,12002,HCPCS,981,RC,,both,376.1,338.49,Cigna,Default,Percent of Total Billed Charges,221.9,,,,221.9,263.27
SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,12002,HCPCS,981,RC,,both,376.1,338.49,United Healthcare,Default,Fee Schedule,,,,,221.9,263.27
SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,12004,HCPCS,981,RC,,both,474.43,426.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,332.1,,,,279.91,332.1
SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,12004,HCPCS,981,RC,,both,474.43,426.99,Cigna,Default,Percent of Total Billed Charges,279.91,,,,279.91,332.1
SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,12004,HCPCS,981,RC,,both,474.43,426.99,United Healthcare,Default,Fee Schedule,,,,,279.91,332.1
SIMPL REPR SCLP/TRUNK; 12.6-20.0CM,12005,HCPCS,981,RC,,both,887.26,798.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,621.08,,,,523.48,621.08
SIMPL REPR SCLP/TRUNK; 12.6-20.0CM,12005,HCPCS,981,RC,,both,887.26,798.53,Cigna,Default,Percent of Total Billed Charges,523.48,,,,523.48,621.08
SIMPL REPR SCLP/TRUNK; 12.6-20.0CM,12005,HCPCS,981,RC,,both,887.26,798.53,United Healthcare,Default,Fee Schedule,,,,,523.48,621.08
SIMPL REPR FACE/MUCOUS; 2.5/LESS,12011,HCPCS,981,RC,,both,306.72,276.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,214.7,,,,180.96,214.7
SIMPL REPR FACE/MUCOUS; 2.5/LESS,12011,HCPCS,981,RC,,both,306.72,276.05,Cigna,Default,Percent of Total Billed Charges,180.96,,,,180.96,214.7
SIMPL REPR FACE/MUCOUS; 2.5/LESS,12011,HCPCS,981,RC,,both,306.72,276.05,United Healthcare,Default,Fee Schedule,,,,,180.96,214.7
SR FCE/EAR/EYE/INSE/LIP 2.6-5,12013,HCPCS,981,RC,,both,376.1,338.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.27,,,,221.9,263.27
SR FCE/EAR/EYE/INSE/LIP 2.6-5,12013,HCPCS,981,RC,,both,376.1,338.49,Cigna,Default,Percent of Total Billed Charges,221.9,,,,221.9,263.27
SR FCE/EAR/EYE/INSE/LIP 2.6-5,12013,HCPCS,981,RC,,both,376.1,338.49,United Healthcare,Default,Fee Schedule,,,,,221.9,263.27
SIMPL REPR FACE/MUCOUS 5.1-7.5CM,12014,HCPCS,981,RC,,both,740.42,666.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,518.29,,,,436.85,518.29
SIMPL REPR FACE/MUCOUS 5.1-7.5CM,12014,HCPCS,981,RC,,both,740.42,666.38,Cigna,Default,Percent of Total Billed Charges,436.85,,,,436.85,518.29
SIMPL REPR FACE/MUCOUS 5.1-7.5CM,12014,HCPCS,981,RC,,both,740.42,666.38,United Healthcare,Default,Fee Schedule,,,,,436.85,518.29
LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,12031,HCPCS,981,RC,,both,655.03,589.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,458.52,,,,386.47,458.52
LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,12031,HCPCS,981,RC,,both,655.03,589.53,Cigna,Default,Percent of Total Billed Charges,386.47,,,,386.47,458.52
LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,12031,HCPCS,981,RC,,both,655.03,589.53,United Healthcare,Default,Fee Schedule,,,,,386.47,458.52
LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,12032,HCPCS,981,RC,,both,810.07,729.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,567.05,,,,477.94,567.05
LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,12032,HCPCS,981,RC,,both,810.07,729.06,Cigna,Default,Percent of Total Billed Charges,477.94,,,,477.94,567.05
LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,12032,HCPCS,981,RC,,both,810.07,729.06,United Healthcare,Default,Fee Schedule,,,,,477.94,567.05
LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,12034,HCPCS,981,RC,,both,1022.43,920.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,715.7,,,,603.23,715.7
LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,12034,HCPCS,981,RC,,both,1022.43,920.19,Cigna,Default,Percent of Total Billed Charges,603.23,,,,603.23,715.7
LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,12034,HCPCS,981,RC,,both,1022.43,920.19,United Healthcare,Default,Fee Schedule,,,,,603.23,715.7
LAYER CLO UNSPECIF,12035,HCPCS,981,RC,,both,797.1,717.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,557.97,,,,470.29,557.97
LAYER CLO UNSPECIF,12035,HCPCS,981,RC,,both,797.1,717.39,Cigna,Default,Percent of Total Billed Charges,470.29,,,,470.29,557.97
LAYER CLO UNSPECIF,12035,HCPCS,981,RC,,both,797.1,717.39,United Healthcare,Default,Fee Schedule,,,,,470.29,557.97
INTMD WND REPAIR N-HF/GENIT,12041,HCPCS,981,RC,,both,765.15,688.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,535.6,,,,451.44,535.6
INTMD WND REPAIR N-HF/GENIT,12041,HCPCS,981,RC,,both,765.15,688.64,Cigna,Default,Percent of Total Billed Charges,451.44,,,,451.44,535.6
INTMD WND REPAIR N-HF/GENIT,12041,HCPCS,981,RC,,both,765.15,688.64,United Healthcare,Default,Fee Schedule,,,,,451.44,535.6
LAYER CLO NECK/FT/GENIT; 2.6-7.5,12042,HCPCS,981,RC,,both,819.07,737.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.35,,,,483.25,573.35
LAYER CLO NECK/FT/GENIT; 2.6-7.5,12042,HCPCS,981,RC,,both,819.07,737.16,Cigna,Default,Percent of Total Billed Charges,483.25,,,,483.25,573.35
LAYER CLO NECK/FT/GENIT; 2.6-7.5,12042,HCPCS,981,RC,,both,819.07,737.16,United Healthcare,Default,Fee Schedule,,,,,483.25,573.35
LAYER CLO FACE/LIPS; 2.5CM/LESS,12051,HCPCS,981,RC,,both,856.15,770.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,599.3,,,,505.13,599.3
LAYER CLO FACE/LIPS; 2.5CM/LESS,12051,HCPCS,981,RC,,both,856.15,770.54,Cigna,Default,Percent of Total Billed Charges,505.13,,,,505.13,599.3
LAYER CLO FACE/LIPS; 2.5CM/LESS,12051,HCPCS,981,RC,,both,856.15,770.54,United Healthcare,Default,Fee Schedule,,,,,505.13,599.3
LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,12054,HCPCS,981,RC,,both,1087.33,978.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,761.13,,,,641.52,761.13
LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,12054,HCPCS,981,RC,,both,1087.33,978.6,Cigna,Default,Percent of Total Billed Charges,641.52,,,,641.52,761.13
LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,12054,HCPCS,981,RC,,both,1087.33,978.6,United Healthcare,Default,Fee Schedule,,,,,641.52,761.13
REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,13121,HCPCS,981,RC,,both,1257.24,1131.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,880.07,,,,741.77,880.07
REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,13121,HCPCS,981,RC,,both,1257.24,1131.52,Cigna,Default,Percent of Total Billed Charges,741.77,,,,741.77,880.07
REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,13121,HCPCS,981,RC,,both,1257.24,1131.52,United Healthcare,Default,Fee Schedule,,,,,741.77,880.07
C REP S/A/L; EA ADD 5 CM/<,13122,HCPCS,981,RC,,both,374.47,337.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.13,,,,220.94,262.13
C REP S/A/L; EA ADD 5 CM/<,13122,HCPCS,981,RC,,both,374.47,337.02,Cigna,Default,Percent of Total Billed Charges,220.94,,,,220.94,262.13
C REP S/A/L; EA ADD 5 CM/<,13122,HCPCS,981,RC,,both,374.47,337.02,United Healthcare,Default,Fee Schedule,,,,,220.94,262.13
REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,13131,HCPCS,981,RC,,both,1064.01,957.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,744.81,,,,627.77,744.81
REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,13131,HCPCS,981,RC,,both,1064.01,957.61,Cigna,Default,Percent of Total Billed Charges,627.77,,,,627.77,744.81
REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,13131,HCPCS,981,RC,,both,1064.01,957.61,United Healthcare,Default,Fee Schedule,,,,,627.77,744.81
REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,13132,HCPCS,981,RC,,both,1560.6,1404.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1092.42,,,,920.75,1092.42
REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,13132,HCPCS,981,RC,,both,1560.6,1404.54,Cigna,Default,Percent of Total Billed Charges,920.75,,,,920.75,1092.42
REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,13132,HCPCS,981,RC,,both,1560.6,1404.54,United Healthcare,Default,Fee Schedule,,,,,920.75,1092.42
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,981,RC,,both,285.6,257.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.92,,,,168.5,199.92
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,981,RC,,both,285.6,257.04,Cigna,Default,Percent of Total Billed Charges,168.5,,,,168.5,199.92
DSG/DEBRID INIT/SUBSQT; WO ANES SM,16020,HCPCS,981,RC,,both,285.6,257.04,United Healthcare,Default,Fee Schedule,,,,,168.5,199.92
DRS&/DBRDMT PRTL-THKNS BURNS 1,16030,HCPCS,981,RC,,both,715.16,643.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,500.61,,,,421.94,500.61
DRS&/DBRDMT PRTL-THKNS BURNS 1,16030,HCPCS,981,RC,,both,715.16,643.64,Cigna,Default,Percent of Total Billed Charges,421.94,,,,421.94,500.61
DRS&/DBRDMT PRTL-THKNS BURNS 1,16030,HCPCS,981,RC,,both,715.16,643.64,United Healthcare,Default,Fee Schedule,,,,,421.94,500.61
EXPLO PENTR WOUND (SEP PRO); EXTREM,20103,HCPCS,981,RC,,both,4222.62,3800.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2955.83,,,,2491.35,2955.83
EXPLO PENTR WOUND (SEP PRO); EXTREM,20103,HCPCS,981,RC,,both,4222.62,3800.36,Cigna,Default,Percent of Total Billed Charges,2491.35,,,,2491.35,2955.83
EXPLO PENTR WOUND (SEP PRO); EXTREM,20103,HCPCS,981,RC,,both,4222.62,3800.36,United Healthcare,Default,Fee Schedule,,,,,2491.35,2955.83
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,981,RC,,both,243.8,219.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.66,,,,143.84,170.66
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,981,RC,,both,243.8,219.42,Cigna,Default,Percent of Total Billed Charges,143.84,,,,143.84,170.66
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,981,RC,,both,243.8,219.42,United Healthcare,Default,Fee Schedule,,,,,143.84,170.66
ARTHROCENTESIS/ASPRI/INJ; INTERM JT,20605,HCPCS,981,RC,,both,246.05,221.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.24,,,,145.17,172.24
ARTHROCENTESIS/ASPRI/INJ; INTERM JT,20605,HCPCS,981,RC,,both,246.05,221.45,Cigna,Default,Percent of Total Billed Charges,145.17,,,,145.17,172.24
ARTHROCENTESIS/ASPRI/INJ; INTERM JT,20605,HCPCS,981,RC,,both,246.05,221.45,United Healthcare,Default,Fee Schedule,,,,,145.17,172.24
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,981,RC,,both,313.48,282.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.44,,,,184.95,219.44
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,981,RC,,both,313.48,282.13,Cigna,Default,Percent of Total Billed Charges,184.95,,,,184.95,219.44
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,981,RC,,both,313.48,282.13,United Healthcare,Default,Fee Schedule,,,,,184.95,219.44
CLO TX SHLDR DISLOC W/MANIP;WO ANES,23650,HCPCS,981,RC,,both,636.49,572.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,445.54,,,,375.53,445.54
CLO TX SHLDR DISLOC W/MANIP;WO ANES,23650,HCPCS,981,RC,,both,636.49,572.84,Cigna,Default,Percent of Total Billed Charges,375.53,,,,375.53,445.54
CLO TX SHLDR DISLOC W/MANIP;WO ANES,23650,HCPCS,981,RC,,both,636.49,572.84,United Healthcare,Default,Fee Schedule,,,,,375.53,445.54
"CL TX ""NURSEMAID ELBOW"" W MANIP",24640,HCPCS,981,RC,,both,549.34,494.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,384.54,,,,324.11,384.54
"CL TX ""NURSEMAID ELBOW"" W MANIP",24640,HCPCS,981,RC,,both,549.34,494.41,Cigna,Default,Percent of Total Billed Charges,324.11,,,,324.11,384.54
"CL TX ""NURSEMAID ELBOW"" W MANIP",24640,HCPCS,981,RC,,both,549.34,494.41,United Healthcare,Default,Fee Schedule,,,,,324.11,384.54
CL TX RADIAL & ULNA FX W MANIP,25565,HCPCS,981,RC,,both,4953.49,4458.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3467.44,,,,2922.56,3467.44
CL TX RADIAL & ULNA FX W MANIP,25565,HCPCS,981,RC,,both,4953.49,4458.14,Cigna,Default,Percent of Total Billed Charges,2922.56,,,,2922.56,3467.44
CL TX RADIAL & ULNA FX W MANIP,25565,HCPCS,981,RC,,both,4953.49,4458.14,United Healthcare,Default,Fee Schedule,,,,,2922.56,3467.44
CLOSED TREATMENT DISRAL RADIAL FRACTURE,25605,HCPCS,981,RC,,both,2213.43,1992.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1549.4,,,,1305.92,1549.4
CLOSED TREATMENT DISRAL RADIAL FRACTURE,25605,HCPCS,981,RC,,both,2213.43,1992.09,Cigna,Default,Percent of Total Billed Charges,1305.92,,,,1305.92,1549.4
CLOSED TREATMENT DISRAL RADIAL FRACTURE,25605,HCPCS,981,RC,,both,2213.43,1992.09,United Healthcare,Default,Fee Schedule,,,,,1305.92,1549.4
DRAINAGE FINGER ABSCESS; SIMPL,26010,HCPCS,450,RC,,both,261.05,234.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,182.74,,,,154.02,213.02
DRAINAGE FINGER ABSCESS; SIMPL,26010,HCPCS,450,RC,,both,261.05,234.95,Cigna,Default,Percent of Total Billed Charges,154.02,,,,154.02,213.02
DRAINAGE FINGER ABSCESS; SIMPL,26010,HCPCS,450,RC,,both,261.05,234.95,United Healthcare,Default,Fee Schedule,213.02,,,,154.02,213.02
ER REPAIR EXT. TENDON FINGER PRI/SEC,26418,HCPCS,981,RC,,both,3035.7,2732.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2124.99,,,,1791.06,2124.99
ER REPAIR EXT. TENDON FINGER PRI/SEC,26418,HCPCS,981,RC,,both,3035.7,2732.13,Cigna,Default,Percent of Total Billed Charges,1791.06,,,,1791.06,2124.99
ER REPAIR EXT. TENDON FINGER PRI/SEC,26418,HCPCS,981,RC,,both,3035.7,2732.13,United Healthcare,Default,Fee Schedule,,,,,1791.06,2124.99
CLO TX IP JT DISLOC W/WMANIP; WO ANES,26770,HCPCS,981,RC,,both,1104.42,993.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,773.09,,,,651.61,773.09
CLO TX IP JT DISLOC W/WMANIP; WO ANES,26770,HCPCS,981,RC,,both,1104.42,993.98,Cigna,Default,Percent of Total Billed Charges,651.61,,,,651.61,773.09
CLO TX IP JT DISLOC W/WMANIP; WO ANES,26770,HCPCS,981,RC,,both,1104.42,993.98,United Healthcare,Default,Fee Schedule,,,,,651.61,773.09
CLO TX PATELLAR DISLOC; WO ANES,27560,HCPCS,981,RC,,both,1489.06,1340.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1042.34,,,,878.55,1042.34
CLO TX PATELLAR DISLOC; WO ANES,27560,HCPCS,981,RC,,both,1489.06,1340.15,Cigna,Default,Percent of Total Billed Charges,878.55,,,,878.55,1042.34
CLO TX PATELLAR DISLOC; WO ANES,27560,HCPCS,981,RC,,both,1489.06,1340.15,United Healthcare,Default,Fee Schedule,,,,,878.55,1042.34
CLO TX TRIMALLEOLAR ANK FX; W/MANIP,27818,HCPCS,981,RC,,both,2341.27,2107.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1638.89,,,,1381.35,1638.89
CLO TX TRIMALLEOLAR ANK FX; W/MANIP,27818,HCPCS,981,RC,,both,2341.27,2107.14,Cigna,Default,Percent of Total Billed Charges,1381.35,,,,1381.35,1638.89
CLO TX TRIMALLEOLAR ANK FX; W/MANIP,27818,HCPCS,981,RC,,both,2341.27,2107.14,United Healthcare,Default,Fee Schedule,,,,,1381.35,1638.89
APPLY LONG ARM CAST,29065,HCPCS,981,RC,,both,631.71,568.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.2,,,,372.71,442.2
APPLY LONG ARM CAST,29065,HCPCS,981,RC,,both,631.71,568.54,Cigna,Default,Percent of Total Billed Charges,372.71,,,,372.71,442.2
APPLY LONG ARM CAST,29065,HCPCS,981,RC,,both,631.71,568.54,United Healthcare,Default,Fee Schedule,,,,,372.71,442.2
APPLIC; ELBOW TO FINGER,29075,HCPCS,981,RC,,both,395,355.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.5,,,,233.05,276.5
APPLIC; ELBOW TO FINGER,29075,HCPCS,981,RC,,both,395,355.5,Cigna,Default,Percent of Total Billed Charges,233.05,,,,233.05,276.5
APPLIC; ELBOW TO FINGER,29075,HCPCS,981,RC,,both,395,355.5,United Healthcare,Default,Fee Schedule,,,,,233.05,276.5
APPLIC; LONG ARM SPLINT,29105,HCPCS,981,RC,,both,423.8,381.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,296.66,,,,250.04,296.66
APPLIC; LONG ARM SPLINT,29105,HCPCS,981,RC,,both,423.8,381.42,Cigna,Default,Percent of Total Billed Charges,250.04,,,,250.04,296.66
APPLIC; LONG ARM SPLINT,29105,HCPCS,981,RC,,both,423.8,381.42,United Healthcare,Default,Fee Schedule,,,,,250.04,296.66
APPLIC; SHORT ARM SPLINT; STATIC,29125,HCPCS,981,RC,,both,266.89,240.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.82,,,,157.47,186.82
APPLIC; SHORT ARM SPLINT; STATIC,29125,HCPCS,981,RC,,both,266.89,240.2,Cigna,Default,Percent of Total Billed Charges,157.47,,,,157.47,186.82
APPLIC; SHORT ARM SPLINT; STATIC,29125,HCPCS,981,RC,,both,266.89,240.2,United Healthcare,Default,Fee Schedule,,,,,157.47,186.82
APPLY FINGER SPLINT; STATIC,29130,HCPCS,981,RC,,both,160.33,144.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.23,,,,94.59,112.23
APPLY FINGER SPLINT; STATIC,29130,HCPCS,981,RC,,both,160.33,144.3,Cigna,Default,Percent of Total Billed Charges,94.59,,,,94.59,112.23
APPLY FINGER SPLINT; STATIC,29130,HCPCS,981,RC,,both,160.33,144.3,United Healthcare,Default,Fee Schedule,,,,,94.59,112.23
STRAPPING; SHOULDER,29240,HCPCS,981,RC,,both,123.83,111.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.68,,,,73.06,86.68
STRAPPING; SHOULDER,29240,HCPCS,981,RC,,both,123.83,111.45,Cigna,Default,Percent of Total Billed Charges,73.06,,,,73.06,86.68
STRAPPING; SHOULDER,29240,HCPCS,981,RC,,both,123.83,111.45,United Healthcare,Default,Fee Schedule,,,,,73.06,86.68
APPLIC LONG LEG CAST,29345,HCPCS,981,RC,,both,593.08,533.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,415.16,,,,349.92,415.16
APPLIC LONG LEG CAST,29345,HCPCS,981,RC,,both,593.08,533.77,Cigna,Default,Percent of Total Billed Charges,349.92,,,,349.92,415.16
APPLIC LONG LEG CAST,29345,HCPCS,981,RC,,both,593.08,533.77,United Healthcare,Default,Fee Schedule,,,,,349.92,415.16
APPLIC SHORT LEG CAST,29405,HCPCS,981,RC,,both,392.71,353.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.9,,,,231.7,274.9
APPLIC SHORT LEG CAST,29405,HCPCS,981,RC,,both,392.71,353.44,Cigna,Default,Percent of Total Billed Charges,231.7,,,,231.7,274.9
APPLIC SHORT LEG CAST,29405,HCPCS,981,RC,,both,392.71,353.44,United Healthcare,Default,Fee Schedule,,,,,231.7,274.9
APPLIC LONG LEG SPLINT,29505,HCPCS,981,RC,,both,384.25,345.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.98,,,,226.71,268.98
APPLIC LONG LEG SPLINT,29505,HCPCS,981,RC,,both,384.25,345.83,Cigna,Default,Percent of Total Billed Charges,226.71,,,,226.71,268.98
APPLIC LONG LEG SPLINT,29505,HCPCS,981,RC,,both,384.25,345.83,United Healthcare,Default,Fee Schedule,,,,,226.71,268.98
APPLIC SHORT LEG SPLINT,29515,HCPCS,981,RC,,both,327.07,294.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.95,,,,192.97,228.95
APPLIC SHORT LEG SPLINT,29515,HCPCS,981,RC,,both,327.07,294.36,Cigna,Default,Percent of Total Billed Charges,192.97,,,,192.97,228.95
APPLIC SHORT LEG SPLINT,29515,HCPCS,981,RC,,both,327.07,294.36,United Healthcare,Default,Fee Schedule,,,,,192.97,228.95
REMOV/BIVALV; FULL ARM/LEG CAST,29705,HCPCS,981,RC,,both,340.88,306.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.62,,,,201.12,238.62
REMOV/BIVALV; FULL ARM/LEG CAST,29705,HCPCS,981,RC,,both,340.88,306.79,Cigna,Default,Percent of Total Billed Charges,201.12,,,,201.12,238.62
REMOV/BIVALV; FULL ARM/LEG CAST,29705,HCPCS,981,RC,,both,340.88,306.79,United Healthcare,Default,Fee Schedule,,,,,201.12,238.62
CONTRL NASAL HEMORR-ANT-SIMPL,30901,HCPCS,981,RC,,both,413.45,372.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,289.42,,,,243.94,289.42
CONTRL NASAL HEMORR-ANT-SIMPL,30901,HCPCS,981,RC,,both,413.45,372.11,Cigna,Default,Percent of Total Billed Charges,243.94,,,,243.94,289.42
CONTRL NASAL HEMORR-ANT-SIMPL,30901,HCPCS,981,RC,,both,413.45,372.11,United Healthcare,Default,Fee Schedule,,,,,243.94,289.42
CNTRL POST EPISTAX INIT,30905,HCPCS,981,RC,,both,575.53,517.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.87,,,,339.56,402.87
CNTRL POST EPISTAX INIT,30905,HCPCS,981,RC,,both,575.53,517.98,Cigna,Default,Percent of Total Billed Charges,339.56,,,,339.56,402.87
CNTRL POST EPISTAX INIT,30905,HCPCS,981,RC,,both,575.53,517.98,United Healthcare,Default,Fee Schedule,,,,,339.56,402.87
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,450,RC,26,both,1076.25,968.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,753.38,,,,634.99,878.22
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,450,RC,26,both,1076.25,968.63,Cigna,Default,Percent of Total Billed Charges,634.99,,,,634.99,878.22
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,450,RC,26,both,1076.25,968.63,United Healthcare,Default,Fee Schedule,878.22,,,,634.99,878.22
THORACENTESIS,32421,HCPCS,450,RC,26,both,772.5,695.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,540.75,,,,455.78,630.36
THORACENTESIS,32421,HCPCS,450,RC,26,both,772.5,695.25,Cigna,Default,Percent of Total Billed Charges,455.78,,,,455.78,630.36
THORACENTESIS,32421,HCPCS,450,RC,26,both,772.5,695.25,United Healthcare,Default,Fee Schedule,630.36,,,,455.78,630.36
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,450,RC,26,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,450,RC,26,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,450,RC,26,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
ART CATH-SAMPL (SEP PRO); PERG,36620,HCPCS,981,RC,,both,357,321.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,249.9,,,,210.63,249.9
ART CATH-SAMPL (SEP PRO); PERG,36620,HCPCS,981,RC,,both,357,321.3,Cigna,Default,Percent of Total Billed Charges,210.63,,,,210.63,249.9
ART CATH-SAMPL (SEP PRO); PERG,36620,HCPCS,981,RC,,both,357,321.3,United Healthcare,Default,Fee Schedule,,,,,210.63,249.9
EMER RM SIGMOIDOSCOP,45330,HCPCS,450,RC,26,both,437.75,393.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,306.42,,,,258.27,357.2
EMER RM SIGMOIDOSCOP,45330,HCPCS,450,RC,26,both,437.75,393.98,Cigna,Default,Percent of Total Billed Charges,258.27,,,,258.27,357.2
EMER RM SIGMOIDOSCOP,45330,HCPCS,450,RC,26,both,437.75,393.98,United Healthcare,Default,Fee Schedule,357.2,,,,258.27,357.2
BLADDER IRRIGA SIMPL LAVAGE,51700,HCPCS,450,RC,26,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
BLADDER IRRIGA SIMPL LAVAGE,51700,HCPCS,450,RC,26,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
BLADDER IRRIGA SIMPL LAVAGE,51700,HCPCS,450,RC,26,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
INSERTION TEMPORARY INDWELLING BLADDER,51702,HCPCS,981,RC,,both,345,310.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,241.5,,,,203.55,241.5
INSERTION TEMPORARY INDWELLING BLADDER,51702,HCPCS,981,RC,,both,345,310.5,Cigna,Default,Percent of Total Billed Charges,203.55,,,,203.55,241.5
INSERTION TEMPORARY INDWELLING BLADDER,51702,HCPCS,981,RC,,both,345,310.5,United Healthcare,Default,Fee Schedule,,,,,203.55,241.5
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,981,RC,,both,382.01,343.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.41,,,,225.39,267.41
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,981,RC,,both,382.01,343.81,Cigna,Default,Percent of Total Billed Charges,225.39,,,,225.39,267.41
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,981,RC,,both,382.01,343.81,United Healthcare,Default,Fee Schedule,,,,,225.39,267.41
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,450,RC,,both,207,186.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.9,,,,122.13,168.91
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,450,RC,,both,207,186.3,Cigna,Default,Percent of Total Billed Charges,122.13,,,,122.13,168.91
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,450,RC,,both,207,186.3,United Healthcare,Default,Fee Schedule,168.91,,,,122.13,168.91
I&D ABSCESS; PERINEUM,56405,HCPCS,981,RC,,both,482.52,434.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,337.76,,,,284.69,337.76
I&D ABSCESS; PERINEUM,56405,HCPCS,981,RC,,both,482.52,434.27,Cigna,Default,Percent of Total Billed Charges,284.69,,,,284.69,337.76
I&D ABSCESS; PERINEUM,56405,HCPCS,981,RC,,both,482.52,434.27,United Healthcare,Default,Fee Schedule,,,,,284.69,337.76
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,450,RC,26,both,314.25,282.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.98,,,,185.41,256.43
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,450,RC,26,both,314.25,282.83,Cigna,Default,Percent of Total Billed Charges,185.41,,,,185.41,256.43
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,450,RC,26,both,314.25,282.83,United Healthcare,Default,Fee Schedule,256.43,,,,185.41,256.43
SPINAL PUNCT LUMBAR DX,62270,HCPCS,981,RC,,both,613.46,552.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,429.42,,,,361.94,429.42
SPINAL PUNCT LUMBAR DX,62270,HCPCS,981,RC,,both,613.46,552.11,Cigna,Default,Percent of Total Billed Charges,361.94,,,,361.94,429.42
SPINAL PUNCT LUMBAR DX,62270,HCPCS,981,RC,,both,613.46,552.11,United Healthcare,Default,Fee Schedule,,,,,361.94,429.42
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,981,RC,,both,302.87,272.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,212.01,,,,178.69,212.01
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,981,RC,,both,302.87,272.58,Cigna,Default,Percent of Total Billed Charges,178.69,,,,178.69,212.01
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,981,RC,,both,302.87,272.58,United Healthcare,Default,Fee Schedule,,,,,178.69,212.01
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,981,RC,,both,182.62,164.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.83,,,,107.75,127.83
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,981,RC,,both,182.62,164.36,Cigna,Default,Percent of Total Billed Charges,107.75,,,,107.75,127.83
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,981,RC,,both,182.62,164.36,United Healthcare,Default,Fee Schedule,,,,,107.75,127.83
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,450,RC,26,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,450,RC,26,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,450,RC,26,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,981,RC,,both,182.29,164.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.6,,,,107.55,127.6
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,981,RC,,both,182.29,164.06,Cigna,Default,Percent of Total Billed Charges,107.55,,,,107.55,127.6
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,981,RC,,both,182.29,164.06,United Healthcare,Default,Fee Schedule,,,,,107.55,127.6
BX EYELID,67810,HCPCS,450,RC,26,both,283.25,254.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.28,,,,167.12,231.13
BX EYELID,67810,HCPCS,450,RC,26,both,283.25,254.93,Cigna,Default,Percent of Total Billed Charges,167.12,,,,167.12,231.13
BX EYELID,67810,HCPCS,450,RC,26,both,283.25,254.93,United Healthcare,Default,Fee Schedule,231.13,,,,167.12,231.13
BX EXT EAR,69100,HCPCS,450,RC,26,both,293.5,264.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,205.45,,,,173.16,239.5
BX EXT EAR,69100,HCPCS,450,RC,26,both,293.5,264.15,Cigna,Default,Percent of Total Billed Charges,173.16,,,,173.16,239.5
BX EXT EAR,69100,HCPCS,450,RC,26,both,293.5,264.15,United Healthcare,Default,Fee Schedule,239.5,,,,173.16,239.5
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,450,RC,26,both,1179.25,1061.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,825.48,,,,695.76,962.27
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,450,RC,26,both,1179.25,1061.33,Cigna,Default,Percent of Total Billed Charges,695.76,,,,695.76,962.27
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,450,RC,26,both,1179.25,1061.33,United Healthcare,Default,Fee Schedule,962.27,,,,695.76,962.27
REM FB EXT AUDITORY CANAL; WO ANESTH,69200,HCPCS,981,RC,,both,365.06,328.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.54,,,,215.39,255.54
REM FB EXT AUDITORY CANAL; WO ANESTH,69200,HCPCS,981,RC,,both,365.06,328.55,Cigna,Default,Percent of Total Billed Charges,215.39,,,,215.39,255.54
REM FB EXT AUDITORY CANAL; WO ANESTH,69200,HCPCS,981,RC,,both,365.06,328.55,United Healthcare,Default,Fee Schedule,,,,,215.39,255.54
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,450,RC,26,both,77.25,69.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.08,,,,45.58,63.04
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,450,RC,26,both,77.25,69.53,Cigna,Default,Percent of Total Billed Charges,45.58,,,,45.58,63.04
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,450,RC,26,both,77.25,69.53,United Healthcare,Default,Fee Schedule,63.04,,,,45.58,63.04
I&D ABSCESS BARHOLINS GLAND,56420,HCPCS,981,RC,26,both,274.56,247.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,192.19,,,,161.99,192.19
I&D ABSCESS BARHOLINS GLAND,56420,HCPCS,981,RC,26,both,274.56,247.1,Cigna,Default,Percent of Total Billed Charges,161.99,,,,161.99,192.19
I&D ABSCESS BARHOLINS GLAND,56420,HCPCS,981,RC,26,both,274.56,247.1,United Healthcare,Default,Fee Schedule,,,,,161.99,192.19
REMOVE EMBEDDED FB EYLID,67938,HCPCS,981,RC,,both,967.37,870.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,677.16,,,,570.75,677.16
REMOVE EMBEDDED FB EYLID,67938,HCPCS,981,RC,,both,967.37,870.63,Cigna,Default,Percent of Total Billed Charges,570.75,,,,570.75,677.16
REMOVE EMBEDDED FB EYLID,67938,HCPCS,981,RC,,both,967.37,870.63,United Healthcare,Default,Fee Schedule,,,,,570.75,677.16
SIMPL REPR FACE/MUCOUS 7.60-12.50 cm,12015,HCPCS,981,RC,,both,931.43,838.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,652,,,,549.54,652
SIMPL REPR FACE/MUCOUS 7.60-12.50 cm,12015,HCPCS,981,RC,,both,931.43,838.29,Cigna,Default,Percent of Total Billed Charges,549.54,,,,549.54,652
SIMPL REPR FACE/MUCOUS 7.60-12.50 cm,12015,HCPCS,981,RC,,both,931.43,838.29,United Healthcare,Default,Fee Schedule,,,,,549.54,652
INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,HCPCS,981,RC,,both,913.43,822.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,639.4,,,,538.92,639.4
INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,HCPCS,981,RC,,both,913.43,822.09,Cigna,Default,Percent of Total Billed Charges,538.92,,,,538.92,639.4
INTMD WND REPAIR FACE/MM 2.6-5.0 CM,12052,HCPCS,981,RC,,both,913.43,822.09,United Healthcare,Default,Fee Schedule,,,,,538.92,639.4
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,12001,HCPCS,981,RC,,both,280.05,252.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.04,,,,165.23,196.04
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,12001,HCPCS,981,RC,,both,280.05,252.05,Cigna,Default,Percent of Total Billed Charges,165.23,,,,165.23,196.04
SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,12001,HCPCS,981,RC,,both,280.05,252.05,United Healthcare,Default,Fee Schedule,,,,,165.23,196.04
CHEMICAL CAUTERIZATION PRO FEE,17250,HCPCS,981,RC,,both,159.23,143.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.46,,,,93.95,111.46
CHEMICAL CAUTERIZATION PRO FEE,17250,HCPCS,981,RC,,both,159.23,143.31,Cigna,Default,Percent of Total Billed Charges,93.95,,,,93.95,111.46
CHEMICAL CAUTERIZATION PRO FEE,17250,HCPCS,981,RC,,both,159.23,143.31,United Healthcare,Default,Fee Schedule,,,,,93.95,111.46
RMVL DEVITAL TIS 20CM<,97597,HCPCS,450,RC,,both,307.75,276.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.42,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,450,RC,,both,307.75,276.98,Cigna,Default,Percent of Total Billed Charges,181.57,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,450,RC,,both,307.75,276.98,United Healthcare,Default,Fee Schedule,251.12,,,,181.57,251.12
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,450,RC,,both,273,245.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.1,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,450,RC,,both,273,245.7,Cigna,Default,Percent of Total Billed Charges,161.07,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,450,RC,,both,273,245.7,United Healthcare,Default,Fee Schedule,222.77,,,,161.07,222.77
INSERT TEMP BLADDER CATH/COMPLCAT,51703,HCPCS,450,RC,26,both,180.25,162.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.18,,,,106.35,147.08
INSERT TEMP BLADDER CATH/COMPLCAT,51703,HCPCS,450,RC,26,both,180.25,162.23,Cigna,Default,Percent of Total Billed Charges,106.35,,,,106.35,147.08
INSERT TEMP BLADDER CATH/COMPLCAT,51703,HCPCS,450,RC,26,both,180.25,162.23,United Healthcare,Default,Fee Schedule,147.08,,,,106.35,147.08
CL TX D PHAL FX FGRR/THMB; W MANIP,26755,HCPCS,981,RC,,both,1254.14,1128.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,877.9,,,,739.94,877.9
CL TX D PHAL FX FGRR/THMB; W MANIP,26755,HCPCS,981,RC,,both,1254.14,1128.73,Cigna,Default,Percent of Total Billed Charges,739.94,,,,739.94,877.9
CL TX D PHAL FX FGRR/THMB; W MANIP,26755,HCPCS,981,RC,,both,1254.14,1128.73,United Healthcare,Default,Fee Schedule,,,,,739.94,877.9
DEBR EXZ INF SKIN 10% BS,11000,HCPCS,981,RC,,both,173.02,155.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.11,,,,102.08,121.11
DEBR EXZ INF SKIN 10% BS,11000,HCPCS,981,RC,,both,173.02,155.72,Cigna,Default,Percent of Total Billed Charges,102.08,,,,102.08,121.11
DEBR EXZ INF SKIN 10% BS,11000,HCPCS,981,RC,,both,173.02,155.72,United Healthcare,Default,Fee Schedule,,,,,102.08,121.11
CL TX FX GT PHALANX(S); W MANIP,28495,HCPCS,981,RC,,both,710.55,639.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,497.38,,,,419.22,497.38
CL TX FX GT PHALANX(S); W MANIP,28495,HCPCS,981,RC,,both,710.55,639.5,Cigna,Default,Percent of Total Billed Charges,419.22,,,,419.22,497.38
CL TX FX GT PHALANX(S); W MANIP,28495,HCPCS,981,RC,,both,710.55,639.5,United Healthcare,Default,Fee Schedule,,,,,419.22,497.38
ER REPAIR EXT. TENDON FINGER PRI/SEC,26418,HCPCS,450,RC,,both,9126.21,8213.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6388.35,,,,5384.46,7446.99
ER REPAIR EXT. TENDON FINGER PRI/SEC,26418,HCPCS,450,RC,,both,9126.21,8213.59,Cigna,Default,Percent of Total Billed Charges,5384.46,,,,5384.46,7446.99
ER REPAIR EXT. TENDON FINGER PRI/SEC,26418,HCPCS,450,RC,,both,9126.21,8213.59,United Healthcare,Default,Fee Schedule,7446.99,,,,5384.46,7446.99
REP ET HAND; W FG EA TENDON,26412,HCPCS,981,RC,,both,3156.62,2840.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2209.63,,,,1862.41,2209.63
REP ET HAND; W FG EA TENDON,26412,HCPCS,981,RC,,both,3156.62,2840.96,Cigna,Default,Percent of Total Billed Charges,1862.41,,,,1862.41,2209.63
REP ET HAND; W FG EA TENDON,26412,HCPCS,981,RC,,both,3156.62,2840.96,United Healthcare,Default,Fee Schedule,,,,,1862.41,2209.63
APPY PATELLAR TENDON BEARING CAST,29435,HCPCS,981,RC,,both,482.1,433.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,337.47,,,,284.44,337.47
APPY PATELLAR TENDON BEARING CAST,29435,HCPCS,981,RC,,both,482.1,433.89,Cigna,Default,Percent of Total Billed Charges,284.44,,,,284.44,337.47
APPY PATELLAR TENDON BEARING CAST,29435,HCPCS,981,RC,,both,482.1,433.89,United Healthcare,Default,Fee Schedule,,,,,284.44,337.47
CTRL POST EPISTAX SQ,30906,HCPCS,981,RC,,both,834.37,750.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,584.06,,,,492.28,584.06
CTRL POST EPISTAX SQ,30906,HCPCS,981,RC,,both,834.37,750.93,Cigna,Default,Percent of Total Billed Charges,492.28,,,,492.28,584.06
CTRL POST EPISTAX SQ,30906,HCPCS,981,RC,,both,834.37,750.93,United Healthcare,Default,Fee Schedule,,,,,492.28,584.06
INFUSION THERAPY EXCEPT CHEMO 1ST HOUR,96365,HCPCS,260,RC,,both,134.25,120.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.98,,,,79.21,109.55
INFUSION THERAPY EXCEPT CHEMO 1ST HOUR,96365,HCPCS,260,RC,,both,134.25,120.83,Cigna,Default,Percent of Total Billed Charges,79.21,,,,79.21,109.55
INFUSION THERAPY EXCEPT CHEMO 1ST HOUR,96365,HCPCS,260,RC,,both,134.25,120.83,United Healthcare,Default,Fee Schedule,109.55,,,,79.21,109.55
UNLISTED PX NERVOUS SYSTEM,64999,HCPCS,981,RC,,both,397.05,357.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,277.94,,,,234.26,277.94
UNLISTED PX NERVOUS SYSTEM,64999,HCPCS,981,RC,,both,397.05,357.35,Cigna,Default,Percent of Total Billed Charges,234.26,,,,234.26,277.94
UNLISTED PX NERVOUS SYSTEM,64999,HCPCS,981,RC,,both,397.05,357.35,United Healthcare,Default,Fee Schedule,,,,,234.26,277.94
CL TX POST HIIP DISLOC WO ANESTH,27265,HCPCS,981,RC,,both,1010.5,909.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,707.35,,,,596.2,707.35
CL TX POST HIIP DISLOC WO ANESTH,27265,HCPCS,981,RC,,both,1010.5,909.45,Cigna,Default,Percent of Total Billed Charges,596.2,,,,596.2,707.35
CL TX POST HIIP DISLOC WO ANESTH,27265,HCPCS,981,RC,,both,1010.5,909.45,United Healthcare,Default,Fee Schedule,,,,,596.2,707.35
APPLICATION OF FINGER SPLING: DYNAMIC,29131,HCPCS,981,RC,,both,290.91,261.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,203.64,,,,171.64,203.64
APPLICATION OF FINGER SPLING: DYNAMIC,29131,HCPCS,981,RC,,both,290.91,261.82,Cigna,Default,Percent of Total Billed Charges,171.64,,,,171.64,203.64
APPLICATION OF FINGER SPLING: DYNAMIC,29131,HCPCS,981,RC,,both,290.91,261.82,United Healthcare,Default,Fee Schedule,,,,,171.64,203.64
STRAPPING HAND/FINGER,29280,HCPCS,981,RC,,both,143.39,129.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.37,,,,84.6,100.37
STRAPPING HAND/FINGER,29280,HCPCS,981,RC,,both,143.39,129.05,Cigna,Default,Percent of Total Billed Charges,84.6,,,,84.6,100.37
STRAPPING HAND/FINGER,29280,HCPCS,981,RC,,both,143.39,129.05,United Healthcare,Default,Fee Schedule,,,,,84.6,100.37
CL TX SHLDR DISL W MANIP W ANESTH,23655,HCPCS,981,RC,,both,1220.71,1098.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,854.5,,,,720.22,854.5
CL TX SHLDR DISL W MANIP W ANESTH,23655,HCPCS,981,RC,,both,1220.71,1098.64,Cigna,Default,Percent of Total Billed Charges,720.22,,,,720.22,854.5
CL TX SHLDR DISL W MANIP W ANESTH,23655,HCPCS,981,RC,,both,1220.71,1098.64,United Healthcare,Default,Fee Schedule,,,,,720.22,854.5
REPR CMPLX-FAC/HAND/FT; EA ADD 5CM,13133,HCPCS,450,RC,,both,463.5,417.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,324.45,,,,273.46,378.22
REPR CMPLX-FAC/HAND/FT; EA ADD 5CM,13133,HCPCS,450,RC,,both,463.5,417.15,Cigna,Default,Percent of Total Billed Charges,273.46,,,,273.46,378.22
REPR CMPLX-FAC/HAND/FT; EA ADD 5CM,13133,HCPCS,450,RC,,both,463.5,417.15,United Healthcare,Default,Fee Schedule,378.22,,,,273.46,378.22
BX BREAST; NEEDLE CORE(SEP PROC),1910026,HCPCS,451,RC,,both,386.25,347.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.38,,,,227.89,315.18
BX BREAST; NEEDLE CORE(SEP PROC),1910026,HCPCS,451,RC,,both,386.25,347.63,Cigna,Default,Percent of Total Billed Charges,227.89,,,,227.89,315.18
BX BREAST; NEEDLE CORE(SEP PROC),1910026,HCPCS,451,RC,,both,386.25,347.63,United Healthcare,Default,Fee Schedule,315.18,,,,227.89,315.18
APPLIC SHORT LEG CAST; WALKING/AMB,29425,HCPCS,451,RC,,both,267.75,240.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.42,,,,157.97,218.48
APPLIC SHORT LEG CAST; WALKING/AMB,29425,HCPCS,451,RC,,both,267.75,240.98,Cigna,Default,Percent of Total Billed Charges,157.97,,,,157.97,218.48
APPLIC SHORT LEG CAST; WALKING/AMB,29425,HCPCS,451,RC,,both,267.75,240.98,United Healthcare,Default,Fee Schedule,218.48,,,,157.97,218.48
REMOV FB INTRANASAL; RIGHT,30300,HCPCS,981,RC,,both,603.11,542.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,422.18,,,,355.83,422.18
REMOV FB INTRANASAL; RIGHT,30300,HCPCS,981,RC,,both,603.11,542.8,Cigna,Default,Percent of Total Billed Charges,355.83,,,,355.83,422.18
REMOV FB INTRANASAL; RIGHT,30300,HCPCS,981,RC,,both,603.11,542.8,United Healthcare,Default,Fee Schedule,,,,,355.83,422.18
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,451,RC,26,both,1076.25,968.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,753.38,,,,634.99,878.22
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,451,RC,26,both,1076.25,968.63,Cigna,Default,Percent of Total Billed Charges,634.99,,,,634.99,878.22
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,451,RC,26,both,1076.25,968.63,United Healthcare,Default,Fee Schedule,878.22,,,,634.99,878.22
THORACENTESIS,32421,HCPCS,451,RC,26,both,772.5,695.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,540.75,,,,455.78,630.36
THORACENTESIS,32421,HCPCS,451,RC,26,both,772.5,695.25,Cigna,Default,Percent of Total Billed Charges,455.78,,,,455.78,630.36
THORACENTESIS,32421,HCPCS,451,RC,26,both,772.5,695.25,United Healthcare,Default,Fee Schedule,630.36,,,,455.78,630.36
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,451,RC,26,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,451,RC,26,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
VENIPUNCT CUTDOWN; AGE 1/OVER,36425,HCPCS,451,RC,26,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
INCS THROMBOSED HEMORRHOID EXT,4608326,HCPCS,451,RC,,both,257.5,231.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.25,,,,151.92,210.12
INCS THROMBOSED HEMORRHOID EXT,4608326,HCPCS,451,RC,,both,257.5,231.75,Cigna,Default,Percent of Total Billed Charges,151.92,,,,151.92,210.12
INCS THROMBOSED HEMORRHOID EXT,4608326,HCPCS,451,RC,,both,257.5,231.75,United Healthcare,Default,Fee Schedule,210.12,,,,151.92,210.12
INSERT BLADDER CATHETER,51701,HCPCS,981,RC,,both,213.52,192.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.46,,,,125.98,149.46
INSERT BLADDER CATHETER,51701,HCPCS,981,RC,,both,213.52,192.17,Cigna,Default,Percent of Total Billed Charges,125.98,,,,125.98,149.46
INSERT BLADDER CATHETER,51701,HCPCS,981,RC,,both,213.52,192.17,United Healthcare,Default,Fee Schedule,,,,,125.98,149.46
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,451,RC,26,both,350.25,315.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,245.18,,,,206.65,285.8
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,451,RC,26,both,350.25,315.23,Cigna,Default,Percent of Total Billed Charges,206.65,,,,206.65,285.8
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,451,RC,26,both,350.25,315.23,United Healthcare,Default,Fee Schedule,285.8,,,,206.65,285.8
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,451,RC,26,both,207,186.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.9,,,,122.13,168.91
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,451,RC,26,both,207,186.3,Cigna,Default,Percent of Total Billed Charges,122.13,,,,122.13,168.91
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,451,RC,26,both,207,186.3,United Healthcare,Default,Fee Schedule,168.91,,,,122.13,168.91
I&D ABSCESS; PERINEUM,56405,HCPCS,451,RC,26,both,309,278.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.3,,,,182.31,252.14
I&D ABSCESS; PERINEUM,56405,HCPCS,451,RC,26,both,309,278.1,Cigna,Default,Percent of Total Billed Charges,182.31,,,,182.31,252.14
I&D ABSCESS; PERINEUM,56405,HCPCS,451,RC,26,both,309,278.1,United Healthcare,Default,Fee Schedule,252.14,,,,182.31,252.14
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,451,RC,26,both,314.25,282.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.98,,,,185.41,256.43
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,451,RC,26,both,314.25,282.83,Cigna,Default,Percent of Total Billed Charges,185.41,,,,185.41,256.43
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,451,RC,26,both,314.25,282.83,United Healthcare,Default,Fee Schedule,256.43,,,,185.41,256.43
SPINAL PUNCT LUMBAR DX,62270,HCPCS,451,RC,26,both,334.75,301.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,234.32,,,,197.5,273.16
SPINAL PUNCT LUMBAR DX,62270,HCPCS,451,RC,26,both,334.75,301.28,Cigna,Default,Percent of Total Billed Charges,197.5,,,,197.5,273.16
SPINAL PUNCT LUMBAR DX,62270,HCPCS,451,RC,26,both,334.75,301.28,United Healthcare,Default,Fee Schedule,273.16,,,,197.5,273.16
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,451,RC,26,both,314.25,282.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.98,,,,185.41,256.43
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,451,RC,26,both,314.25,282.83,Cigna,Default,Percent of Total Billed Charges,185.41,,,,185.41,256.43
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,451,RC,26,both,314.25,282.83,United Healthcare,Default,Fee Schedule,256.43,,,,185.41,256.43
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,451,RC,26,both,144.25,129.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.98,,,,85.11,117.71
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,451,RC,26,both,144.25,129.83,Cigna,Default,Percent of Total Billed Charges,85.11,,,,85.11,117.71
REMOV FB EXT EYE; CONJUNC SUPERF,65205,HCPCS,451,RC,26,both,144.25,129.83,United Healthcare,Default,Fee Schedule,117.71,,,,85.11,117.71
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,451,RC,26,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,451,RC,26,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,451,RC,26,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,451,RC,26,both,200.75,180.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.52,,,,118.44,163.81
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,451,RC,26,both,200.75,180.68,Cigna,Default,Percent of Total Billed Charges,118.44,,,,118.44,163.81
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,451,RC,26,both,200.75,180.68,United Healthcare,Default,Fee Schedule,163.81,,,,118.44,163.81
BX EYELID,67810,HCPCS,451,RC,,both,283.25,254.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.28,,,,167.12,231.13
BX EYELID,67810,HCPCS,451,RC,,both,283.25,254.93,Cigna,Default,Percent of Total Billed Charges,167.12,,,,167.12,231.13
BX EYELID,67810,HCPCS,451,RC,,both,283.25,254.93,United Healthcare,Default,Fee Schedule,231.13,,,,167.12,231.13
BX EXT EAR,69100,HCPCS,451,RC,26,both,293.5,264.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,205.45,,,,173.16,239.5
BX EXT EAR,69100,HCPCS,451,RC,26,both,293.5,264.15,Cigna,Default,Percent of Total Billed Charges,173.16,,,,173.16,239.5
BX EXT EAR,69100,HCPCS,451,RC,26,both,293.5,264.15,United Healthcare,Default,Fee Schedule,239.5,,,,173.16,239.5
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,451,RC,26,both,1179.25,1061.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,825.48,,,,695.76,962.27
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,451,RC,26,both,1179.25,1061.33,Cigna,Default,Percent of Total Billed Charges,695.76,,,,695.76,962.27
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,451,RC,26,both,1179.25,1061.33,United Healthcare,Default,Fee Schedule,962.27,,,,695.76,962.27
REM FB EXT AUDITORY CANAL; WO ANESTH,69200,HCPCS,450,RC,,both,393.1,353.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.17,,,,231.93,320.77
REM FB EXT AUDITORY CANAL; WO ANESTH,69200,HCPCS,450,RC,,both,393.1,353.79,Cigna,Default,Percent of Total Billed Charges,231.93,,,,231.93,320.77
REM FB EXT AUDITORY CANAL; WO ANESTH,69200,HCPCS,450,RC,,both,393.1,353.79,United Healthcare,Default,Fee Schedule,320.77,,,,231.93,320.77
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,451,RC,25,both,77.25,69.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.08,,,,45.58,63.04
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,451,RC,25,both,77.25,69.53,Cigna,Default,Percent of Total Billed Charges,45.58,,,,45.58,63.04
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,451,RC,25,both,77.25,69.53,United Healthcare,Default,Fee Schedule,63.04,,,,45.58,63.04
CL TX POST HIP DISLOC WO ANESTH,27265,HCPCS,450,RC,,both,788.55,709.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,551.98,,,,465.24,643.46
CL TX POST HIP DISLOC WO ANESTH,27265,HCPCS,450,RC,,both,788.55,709.7,Cigna,Default,Percent of Total Billed Charges,465.24,,,,465.24,643.46
CL TX POST HIP DISLOC WO ANESTH,27265,HCPCS,450,RC,,both,788.55,709.7,United Healthcare,Default,Fee Schedule,643.46,,,,465.24,643.46
STRAPPING HAND/FINGER,29280,HCPCS,450,RC,,both,117.85,106.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.5,,,,69.53,96.17
STRAPPING HAND/FINGER,29280,HCPCS,450,RC,,both,117.85,106.07,Cigna,Default,Percent of Total Billed Charges,69.53,,,,69.53,96.17
STRAPPING HAND/FINGER,29280,HCPCS,450,RC,,both,117.85,106.07,United Healthcare,Default,Fee Schedule,96.17,,,,69.53,96.17
CL TX SHLDR DISL W MANIP W ANESTH,23655,HCPCS,450,RC,,both,4888.93,4400.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3422.25,,,,2884.47,3989.37
CL TX SHLDR DISL W MANIP W ANESTH,23655,HCPCS,450,RC,,both,4888.93,4400.04,Cigna,Default,Percent of Total Billed Charges,2884.47,,,,2884.47,3989.37
CL TX SHLDR DISL W MANIP W ANESTH,23655,HCPCS,450,RC,,both,4888.93,4400.04,United Healthcare,Default,Fee Schedule,3989.37,,,,2884.47,3989.37
STRAPPING ELBOW OR WRIST,29260,HCPCS,450,RC,,both,124.43,111.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.1,,,,73.41,101.53
STRAPPING ELBOW OR WRIST,29260,HCPCS,450,RC,,both,124.43,111.99,Cigna,Default,Percent of Total Billed Charges,73.41,,,,73.41,101.53
STRAPPING ELBOW OR WRIST,29260,HCPCS,450,RC,,both,124.43,111.99,United Healthcare,Default,Fee Schedule,101.53,,,,73.41,101.53
STRAPPING ELBOW OR WRIST,29260,HCPCS,981,RC,,both,134.15,120.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.9,,,,79.15,93.9
STRAPPING ELBOW OR WRIST,29260,HCPCS,981,RC,,both,134.15,120.74,Cigna,Default,Percent of Total Billed Charges,79.15,,,,79.15,93.9
STRAPPING ELBOW OR WRIST,29260,HCPCS,981,RC,,both,134.15,120.74,United Healthcare,Default,Fee Schedule,,,,,79.15,93.9
RMVL DEVITAL TIS 20CM<,97597,HCPCS,451,RC,,both,307.75,276.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.42,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,451,RC,,both,307.75,276.98,Cigna,Default,Percent of Total Billed Charges,181.57,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,451,RC,,both,307.75,276.98,United Healthcare,Default,Fee Schedule,251.12,,,,181.57,251.12
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,451,RC,,both,273,245.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.1,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,451,RC,,both,273,245.7,Cigna,Default,Percent of Total Billed Charges,161.07,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,451,RC,,both,273,245.7,United Healthcare,Default,Fee Schedule,222.77,,,,161.07,222.77
TRIGGER POINT INJ. THREE OR MORE MUSCLES,2055326,HCPCS,456,RC,,both,154.5,139.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.15,,,,91.16,126.07
TRIGGER POINT INJ. THREE OR MORE MUSCLES,2055326,HCPCS,456,RC,,both,154.5,139.05,Cigna,Default,Percent of Total Billed Charges,91.16,,,,91.16,126.07
TRIGGER POINT INJ. THREE OR MORE MUSCLES,2055326,HCPCS,456,RC,,both,154.5,139.05,United Healthcare,Default,Fee Schedule,126.07,,,,91.16,126.07
OPEN REDUCTION DISSTAL PHALANGEAL FX,2676526,HCPCS,456,RC,,both,1225.75,1103.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,858.02,,,,723.19,1000.21
OPEN REDUCTION DISSTAL PHALANGEAL FX,2676526,HCPCS,456,RC,,both,1225.75,1103.18,Cigna,Default,Percent of Total Billed Charges,723.19,,,,723.19,1000.21
OPEN REDUCTION DISSTAL PHALANGEAL FX,2676526,HCPCS,456,RC,,both,1225.75,1103.18,United Healthcare,Default,Fee Schedule,1000.21,,,,723.19,1000.21
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,456,RC,26,both,1076.25,968.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,753.38,,,,634.99,878.22
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,456,RC,26,both,1076.25,968.63,Cigna,Default,Percent of Total Billed Charges,634.99,,,,634.99,878.22
TRACHEOSTOMY EMER PROC; TRANSTRACH,31603,HCPCS,456,RC,26,both,1076.25,968.63,United Healthcare,Default,Fee Schedule,878.22,,,,634.99,878.22
VENIPUNCT> 3YR W/MD SKILL (SEP PRO),36410,HCPCS,456,RC,26,both,77.25,69.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.08,,,,45.58,63.04
VENIPUNCT> 3YR W/MD SKILL (SEP PRO),36410,HCPCS,456,RC,26,both,77.25,69.53,Cigna,Default,Percent of Total Billed Charges,45.58,,,,45.58,63.04
VENIPUNCT> 3YR W/MD SKILL (SEP PRO),36410,HCPCS,456,RC,26,both,77.25,69.53,United Healthcare,Default,Fee Schedule,63.04,,,,45.58,63.04
VENIPUNCT CUTDOWN; AGE 1/OVER,3642526,HCPCS,456,RC,,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
VENIPUNCT CUTDOWN; AGE 1/OVER,3642526,HCPCS,456,RC,,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
VENIPUNCT CUTDOWN; AGE 1/OVER,3642526,HCPCS,456,RC,,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
NG TUBE PLACEMENT W/FLUORO,43752,HCPCS,456,RC,26,both,180.25,162.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.18,,,,106.35,147.08
NG TUBE PLACEMENT W/FLUORO,43752,HCPCS,456,RC,26,both,180.25,162.23,Cigna,Default,Percent of Total Billed Charges,106.35,,,,106.35,147.08
NG TUBE PLACEMENT W/FLUORO,43752,HCPCS,456,RC,26,both,180.25,162.23,United Healthcare,Default,Fee Schedule,147.08,,,,106.35,147.08
DESTRCT HEMORRHOIDS ANY METHOD:EXT,46935,HCPCS,456,RC,26,both,525.25,472.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,367.68,,,,309.9,428.6
DESTRCT HEMORRHOIDS ANY METHOD:EXT,46935,HCPCS,456,RC,26,both,525.25,472.73,Cigna,Default,Percent of Total Billed Charges,309.9,,,,309.9,428.6
DESTRCT HEMORRHOIDS ANY METHOD:EXT,46935,HCPCS,456,RC,26,both,525.25,472.73,United Healthcare,Default,Fee Schedule,428.6,,,,309.9,428.6
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,456,RC,26,both,350.25,315.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,245.18,,,,206.65,285.8
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,456,RC,26,both,350.25,315.23,Cigna,Default,Percent of Total Billed Charges,206.65,,,,206.65,285.8
CYSTOSTOMY TUBE CHANGE,51705,HCPCS,456,RC,26,both,350.25,315.23,United Healthcare,Default,Fee Schedule,285.8,,,,206.65,285.8
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,456,RC,26,both,207,186.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.9,,,,122.13,168.91
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,456,RC,26,both,207,186.3,Cigna,Default,Percent of Total Billed Charges,122.13,,,,122.13,168.91
DILAT URETHRAL STRICT-MALE; INIT,53600,HCPCS,456,RC,26,both,207,186.3,United Healthcare,Default,Fee Schedule,168.91,,,,122.13,168.91
INCISION & DRAINAGE OF EPIDIDYMIS,54700,HCPCS,456,RC,26,both,463.5,417.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,324.45,,,,273.46,378.22
INCISION & DRAINAGE OF EPIDIDYMIS,54700,HCPCS,456,RC,26,both,463.5,417.15,Cigna,Default,Percent of Total Billed Charges,273.46,,,,273.46,378.22
INCISION & DRAINAGE OF EPIDIDYMIS,54700,HCPCS,456,RC,26,both,463.5,417.15,United Healthcare,Default,Fee Schedule,378.22,,,,273.46,378.22
I&D ABSCESS; PERINEUM,56405,HCPCS,456,RC,26,both,309,278.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.3,,,,182.31,252.14
I&D ABSCESS; PERINEUM,56405,HCPCS,456,RC,26,both,309,278.1,Cigna,Default,Percent of Total Billed Charges,182.31,,,,182.31,252.14
I&D ABSCESS; PERINEUM,56405,HCPCS,456,RC,26,both,309,278.1,United Healthcare,Default,Fee Schedule,252.14,,,,182.31,252.14
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,456,RC,26,both,314.25,282.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.98,,,,185.41,256.43
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,456,RC,26,both,314.25,282.83,Cigna,Default,Percent of Total Billed Charges,185.41,,,,185.41,256.43
BX THYROID PERCUT CORE NEEDLE,60100,HCPCS,456,RC,26,both,314.25,282.83,United Healthcare,Default,Fee Schedule,256.43,,,,185.41,256.43
SPINAL PUNCT LUMBAR DX,62270,HCPCS,456,RC,26,both,334.75,301.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,234.32,,,,197.5,273.16
SPINAL PUNCT LUMBAR DX,62270,HCPCS,456,RC,26,both,334.75,301.28,Cigna,Default,Percent of Total Billed Charges,197.5,,,,197.5,273.16
SPINAL PUNCT LUMBAR DX,62270,HCPCS,456,RC,26,both,334.75,301.28,United Healthcare,Default,Fee Schedule,273.16,,,,197.5,273.16
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,456,RC,26,both,314.25,282.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.98,,,,185.41,256.43
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,456,RC,26,both,314.25,282.83,Cigna,Default,Percent of Total Billed Charges,185.41,,,,185.41,256.43
INJ ANES AGENT; OTHER PERIPHERAL,64450,HCPCS,456,RC,26,both,314.25,282.83,United Healthcare,Default,Fee Schedule,256.43,,,,185.41,256.43
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,456,RC,26,both,164.75,148.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.32,,,,97.2,134.44
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,456,RC,26,both,164.75,148.28,Cigna,Default,Percent of Total Billed Charges,97.2,,,,97.2,134.44
REMOV FB EXT EYE; CONJUNC EMBEDDED,65210,HCPCS,456,RC,26,both,164.75,148.28,United Healthcare,Default,Fee Schedule,134.44,,,,97.2,134.44
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,456,RC,26,both,200.75,180.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.52,,,,118.44,163.81
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,456,RC,26,both,200.75,180.68,Cigna,Default,Percent of Total Billed Charges,118.44,,,,118.44,163.81
REMOV FB EXT EYE;CORNEAL WO LAMP,65220,HCPCS,456,RC,26,both,200.75,180.68,United Healthcare,Default,Fee Schedule,163.81,,,,118.44,163.81
BX EYELID,67810,HCPCS,456,RC,26,both,283.25,254.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.28,,,,167.12,231.13
BX EYELID,67810,HCPCS,456,RC,26,both,283.25,254.93,Cigna,Default,Percent of Total Billed Charges,167.12,,,,167.12,231.13
BX EYELID,67810,HCPCS,456,RC,26,both,283.25,254.93,United Healthcare,Default,Fee Schedule,231.13,,,,167.12,231.13
BX EXT EAR,69100,HCPCS,456,RC,26,both,293.5,264.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,205.45,,,,173.16,239.5
BX EXT EAR,69100,HCPCS,456,RC,26,both,293.5,264.15,Cigna,Default,Percent of Total Billed Charges,173.16,,,,173.16,239.5
BX EXT EAR,69100,HCPCS,456,RC,26,both,293.5,264.15,United Healthcare,Default,Fee Schedule,239.5,,,,173.16,239.5
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,456,RC,26,both,1179.25,1061.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,825.48,,,,695.76,962.27
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,456,RC,26,both,1179.25,1061.33,Cigna,Default,Percent of Total Billed Charges,695.76,,,,695.76,962.27
EXC EXT EAR; PART SIMPL REPR,69110,HCPCS,456,RC,26,both,1179.25,1061.33,United Healthcare,Default,Fee Schedule,962.27,,,,695.76,962.27
"REMOV FB-EXT AUDIT CANAL; WO ANES, RIGHT",69200,HCPCS,456,RC,26,both,216.25,194.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.38,,,,127.59,176.46
"REMOV FB-EXT AUDIT CANAL; WO ANES, RIGHT",69200,HCPCS,456,RC,26,both,216.25,194.63,Cigna,Default,Percent of Total Billed Charges,127.59,,,,127.59,176.46
"REMOV FB-EXT AUDIT CANAL; WO ANES, RIGHT",69200,HCPCS,456,RC,26,both,216.25,194.63,United Healthcare,Default,Fee Schedule,176.46,,,,127.59,176.46
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,456,RC,26,both,77.25,69.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.08,,,,45.58,63.04
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,456,RC,26,both,77.25,69.53,Cigna,Default,Percent of Total Billed Charges,45.58,,,,45.58,63.04
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,456,RC,26,both,77.25,69.53,United Healthcare,Default,Fee Schedule,63.04,,,,45.58,63.04
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,456,RC,,both,273,245.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.1,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,456,RC,,both,273,245.7,Cigna,Default,Percent of Total Billed Charges,161.07,,,,161.07,222.77
RMVL DEVITAL TIS ADDL 20CM,97598,HCPCS,456,RC,,both,273,245.7,United Healthcare,Default,Fee Schedule,222.77,,,,161.07,222.77
RMVL DEVITAL TIS 20CM<,97597,HCPCS,456,RC,,both,307.75,276.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.42,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,456,RC,,both,307.75,276.98,Cigna,Default,Percent of Total Billed Charges,181.57,,,,181.57,251.12
RMVL DEVITAL TIS 20CM<,97597,HCPCS,456,RC,,both,307.75,276.98,United Healthcare,Default,Fee Schedule,251.12,,,,181.57,251.12
DRAIN BL W/CATH INSERTION,51102,HCPCS,761,RC,,both,6351.88,5716.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4446.32,,,,3747.61,5183.13
DRAIN BL W/CATH INSERTION,51102,HCPCS,761,RC,,both,6351.88,5716.69,Cigna,Default,Percent of Total Billed Charges,3747.61,,,,3747.61,5183.13
DRAIN BL W/CATH INSERTION,51102,HCPCS,761,RC,,both,6351.88,5716.69,United Healthcare,Default,Fee Schedule,5183.13,,,,3747.61,5183.13
ER PHYSICIAN LEVEL 1,99281,HCPCS,981,RC,,outpatient,190.6,171.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.42,,,,112.45,133.42
ER PHYSICIAN LEVEL 1,99281,HCPCS,981,RC,,outpatient,190.6,171.54,Cigna,Default,Percent of Total Billed Charges,112.45,,,,112.45,133.42
ER PHYSICIAN LEVEL 1,99281,HCPCS,981,RC,,outpatient,190.6,171.54,United Healthcare,Default,Fee Schedule,,,,,112.45,133.42
ER PHYSICIAN LEVEL 2,99282,HCPCS,981,RC,,outpatient,266.89,240.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.82,,,,157.47,186.82
ER PHYSICIAN LEVEL 2,99282,HCPCS,981,RC,,outpatient,266.89,240.2,Cigna,Default,Percent of Total Billed Charges,157.47,,,,157.47,186.82
ER PHYSICIAN LEVEL 2,99282,HCPCS,981,RC,,outpatient,266.89,240.2,United Healthcare,Default,Fee Schedule,,,,,157.47,186.82
ER PHYSICIAN LEVEL 3,99283,HCPCS,981,RC,,outpatient,393.86,354.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.7,,,,232.38,275.7
ER PHYSICIAN LEVEL 3,99283,HCPCS,981,RC,,outpatient,393.86,354.47,Cigna,Default,Percent of Total Billed Charges,232.38,,,,232.38,275.7
ER PHYSICIAN LEVEL 3,99283,HCPCS,981,RC,,outpatient,393.86,354.47,United Healthcare,Default,Fee Schedule,,,,,232.38,275.7
ER PHYSICIAN LEVEL 4,99284,HCPCS,981,RC,,outpatient,564.31,507.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,395.02,,,,332.94,395.02
ER PHYSICIAN LEVEL 4,99284,HCPCS,981,RC,,outpatient,564.31,507.88,Cigna,Default,Percent of Total Billed Charges,332.94,,,,332.94,395.02
ER PHYSICIAN LEVEL 4,99284,HCPCS,981,RC,,outpatient,564.31,507.88,United Healthcare,Default,Fee Schedule,,,,,332.94,395.02
ER PHYSICIAN LEVEL 5,99285,HCPCS,981,RC,,outpatient,839.83,755.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,587.88,,,,495.5,587.88
ER PHYSICIAN LEVEL 5,99285,HCPCS,981,RC,,outpatient,839.83,755.85,Cigna,Default,Percent of Total Billed Charges,495.5,,,,495.5,587.88
ER PHYSICIAN LEVEL 5,99285,HCPCS,981,RC,,outpatient,839.83,755.85,United Healthcare,Default,Fee Schedule,,,,,495.5,587.88
ER PHYSICIAN CRITICAL CARE ADDL 30 MINS,99292,HCPCS,981,RC,,outpatient,471.48,424.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,330.04,,,,278.17,330.04
ER PHYSICIAN CRITICAL CARE ADDL 30 MINS,99292,HCPCS,981,RC,,outpatient,471.48,424.33,Cigna,Default,Percent of Total Billed Charges,278.17,,,,278.17,330.04
ER PHYSICIAN CRITICAL CARE ADDL 30 MINS,99292,HCPCS,981,RC,,outpatient,471.48,424.33,United Healthcare,Default,Fee Schedule,,,,,278.17,330.04
SYNVISC ONE INJ,J7325,HCPCS,636,RC,,both,4295.89,3866.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3007.12,,,,2534.58,3505.45
SYNVISC ONE INJ,J7325,HCPCS,636,RC,,both,4295.89,3866.3,Cigna,Default,Percent of Total Billed Charges,2534.58,,,,2534.58,3505.45
SYNVISC ONE INJ,J7325,HCPCS,636,RC,,both,4295.89,3866.3,United Healthcare,Default,Fee Schedule,3505.45,,,,2534.58,3505.45
OFFICE/OP VISIT NEW II,99202,HCPCS,983,RC,,both,138.87,124.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.21,,,,81.93,97.21
OFFICE/OP VISIT NEW II,99202,HCPCS,983,RC,,both,138.87,124.98,Cigna,Default,Percent of Total Billed Charges,81.93,,,,81.93,97.21
OFFICE/OP VISIT NEW II,99202,HCPCS,983,RC,,both,138.87,124.98,United Healthcare,Default,Fee Schedule,,,,,81.93,97.21
OFFICE/OP VISIT NEW III,99203,HCPCS,983,RC,,both,202.48,182.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.74,,,,119.46,141.74
OFFICE/OP VISIT NEW III,99203,HCPCS,983,RC,,both,202.48,182.23,Cigna,Default,Percent of Total Billed Charges,119.46,,,,119.46,141.74
OFFICE/OP VISIT NEW III,99203,HCPCS,983,RC,,both,202.48,182.23,United Healthcare,Default,Fee Schedule,,,,,119.46,141.74
OFFICE/OP VISIT NEW IV,99204,HCPCS,983,RC,,both,303.18,272.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,212.23,,,,178.88,212.23
OFFICE/OP VISIT NEW IV,99204,HCPCS,983,RC,,both,303.18,272.86,Cigna,Default,Percent of Total Billed Charges,178.88,,,,178.88,212.23
OFFICE/OP VISIT NEW IV,99204,HCPCS,983,RC,,both,303.18,272.86,United Healthcare,Default,Fee Schedule,,,,,178.88,212.23
OFFICE CONSULTATION II,99242,HCPCS,983,RC,,outpatient,207.54,186.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.28,,,,122.45,145.28
OFFICE CONSULTATION II,99242,HCPCS,983,RC,,outpatient,207.54,186.79,Cigna,Default,Percent of Total Billed Charges,122.45,,,,122.45,145.28
OFFICE CONSULTATION II,99242,HCPCS,983,RC,,outpatient,207.54,186.79,United Healthcare,Default,Fee Schedule,,,,,122.45,145.28
OFFICE CONSULTATION III,99243,HCPCS,983,RC,,outpatient,279.25,251.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.48,,,,164.76,195.48
OFFICE CONSULTATION III,99243,HCPCS,983,RC,,outpatient,279.25,251.33,Cigna,Default,Percent of Total Billed Charges,164.76,,,,164.76,195.48
OFFICE CONSULTATION III,99243,HCPCS,983,RC,,outpatient,279.25,251.33,United Healthcare,Default,Fee Schedule,,,,,164.76,195.48
OFFICE CONSULTATION IV,99244,HCPCS,983,RC,,outpatient,388.99,350.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,272.29,,,,229.5,272.29
OFFICE CONSULTATION IV,99244,HCPCS,983,RC,,outpatient,388.99,350.09,Cigna,Default,Percent of Total Billed Charges,229.5,,,,229.5,272.29
OFFICE CONSULTATION IV,99244,HCPCS,983,RC,,outpatient,388.99,350.09,United Healthcare,Default,Fee Schedule,,,,,229.5,272.29
CARPAL TUNNEL TX INJ,20526,HCPCS,983,RC,,both,287.93,259.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.55,,,,169.88,201.55
CARPAL TUNNEL TX INJ,20526,HCPCS,983,RC,,both,287.93,259.14,Cigna,Default,Percent of Total Billed Charges,169.88,,,,169.88,201.55
CARPAL TUNNEL TX INJ,20526,HCPCS,983,RC,,both,287.93,259.14,United Healthcare,Default,Fee Schedule,,,,,169.88,201.55
INJ SGL TENDON SHTH OR LIGAMENT,20550,HCPCS,983,RC,,both,201.42,181.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.99,,,,118.84,140.99
INJ SGL TENDON SHTH OR LIGAMENT,20550,HCPCS,983,RC,,both,201.42,181.28,Cigna,Default,Percent of Total Billed Charges,118.84,,,,118.84,140.99
INJ SGL TENDON SHTH OR LIGAMENT,20550,HCPCS,983,RC,,both,201.42,181.28,United Healthcare,Default,Fee Schedule,,,,,118.84,140.99
INJ TENDON ORIGIN/INSERTION,20550,HCPCS,983,RC,,both,201.42,181.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.99,,,,118.84,140.99
INJ TENDON ORIGIN/INSERTION,20550,HCPCS,983,RC,,both,201.42,181.28,Cigna,Default,Percent of Total Billed Charges,118.84,,,,118.84,140.99
INJ TENDON ORIGIN/INSERTION,20550,HCPCS,983,RC,,both,201.42,181.28,United Healthcare,Default,Fee Schedule,,,,,118.84,140.99
DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,HCPCS,983,RC,,both,183.39,165.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.37,,,,108.2,128.37
DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,HCPCS,983,RC,,both,183.39,165.05,Cigna,Default,Percent of Total Billed Charges,108.2,,,,108.2,128.37
DRAIN/INJ SMALL JOINT/BURSA W/O US,20600,HCPCS,983,RC,,both,183.39,165.05,United Healthcare,Default,Fee Schedule,,,,,108.2,128.37
DRAIN/INJ INTER JOINT/BURSA W/O US,20605,HCPCS,983,RC,,both,207.78,187,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.45,,,,122.59,145.45
DRAIN/INJ INTER JOINT/BURSA W/O US,20605,HCPCS,983,RC,,both,207.78,187,Cigna,Default,Percent of Total Billed Charges,122.59,,,,122.59,145.45
DRAIN/INJ INTER JOINT/BURSA W/O US,20605,HCPCS,983,RC,,both,207.78,187,United Healthcare,Default,Fee Schedule,,,,,122.59,145.45
DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,HCPCS,983,RC,,both,265.02,238.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,185.51,,,,156.36,185.51
DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,HCPCS,983,RC,,both,265.02,238.52,Cigna,Default,Percent of Total Billed Charges,156.36,,,,156.36,185.51
DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,HCPCS,983,RC,,both,265.02,238.52,United Healthcare,Default,Fee Schedule,,,,,156.36,185.51
ASPIRATE/INJ,20612,HCPCS,983,RC,,both,229.26,206.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.48,,,,135.26,160.48
ASPIRATE/INJ,20612,HCPCS,983,RC,,both,229.26,206.33,Cigna,Default,Percent of Total Billed Charges,135.26,,,,135.26,160.48
ASPIRATE/INJ,20612,HCPCS,983,RC,,both,229.26,206.33,United Healthcare,Default,Fee Schedule,,,,,135.26,160.48
N BLOCK INJ PLANTAR DIGIT,64455,HCPCS,983,RC,,both,168.42,151.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.89,,,,99.37,117.89
N BLOCK INJ PLANTAR DIGIT,64455,HCPCS,983,RC,,both,168.42,151.58,Cigna,Default,Percent of Total Billed Charges,99.37,,,,99.37,117.89
N BLOCK INJ PLANTAR DIGIT,64455,HCPCS,983,RC,,both,168.42,151.58,United Healthcare,Default,Fee Schedule,,,,,99.37,117.89
SKIN SUBSTITUTE NOS- AMNIOFIX,J3590,HCPCS,636,RC,,both,2763.91,2487.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1934.74,,,,1630.71,2255.35
SKIN SUBSTITUTE NOS- AMNIOFIX,J3590,HCPCS,636,RC,,both,2763.91,2487.52,Cigna,Default,Percent of Total Billed Charges,1630.71,,,,1630.71,2255.35
SKIN SUBSTITUTE NOS- AMNIOFIX,J3590,HCPCS,636,RC,,both,2763.91,2487.52,United Healthcare,Default,Fee Schedule,2255.35,,,,1630.71,2255.35
SYNVISC SYRINGE 3 x 16mg/2mL PER MG,J7325,HCPCS,636,RC,,both,78.81,70.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.17,,,,46.5,64.31
SYNVISC SYRINGE 3 x 16mg/2mL PER MG,J7325,HCPCS,636,RC,,both,78.81,70.93,Cigna,Default,Percent of Total Billed Charges,46.5,,,,46.5,64.31
SYNVISC SYRINGE 3 x 16mg/2mL PER MG,J7325,HCPCS,636,RC,,both,78.81,70.93,United Healthcare,Default,Fee Schedule,64.31,,,,46.5,64.31
EUFLEXXA INJ PER DOSE,J7323,HCPCS,636,RC,,both,1034.06,930.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,723.84,,,,610.1,843.79
EUFLEXXA INJ PER DOSE,J7323,HCPCS,636,RC,,both,1034.06,930.65,Cigna,Default,Percent of Total Billed Charges,610.1,,,,610.1,843.79
EUFLEXXA INJ PER DOSE,J7323,HCPCS,636,RC,,both,1034.06,930.65,United Healthcare,Default,Fee Schedule,843.79,,,,610.1,843.79
EUFLEXXA INJ PER DOSE,J7323,HCPCS,636,RC,,both,1159.97,1043.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,811.98,,,,684.38,946.54
EUFLEXXA INJ PER DOSE,J7323,HCPCS,636,RC,,both,1159.97,1043.97,Cigna,Default,Percent of Total Billed Charges,684.38,,,,684.38,946.54
EUFLEXXA INJ PER DOSE,J7323,HCPCS,636,RC,,both,1159.97,1043.97,United Healthcare,Default,Fee Schedule,946.54,,,,684.38,946.54
APPLICATION LONG ARM CAST,29065,HCPCS,983,RC,,both,387.9,349.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,271.53,,,,228.86,271.53
APPLICATION LONG ARM CAST,29065,HCPCS,983,RC,,both,387.9,349.11,Cigna,Default,Percent of Total Billed Charges,228.86,,,,228.86,271.53
APPLICATION LONG ARM CAST,29065,HCPCS,983,RC,,both,387.9,349.11,United Healthcare,Default,Fee Schedule,,,,,228.86,271.53
APPLICATION OF FOREARM CAST,29075,HCPCS,983,RC,,both,334.66,301.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,234.26,,,,197.45,234.26
APPLICATION OF FOREARM CAST,29075,HCPCS,983,RC,,both,334.66,301.19,Cigna,Default,Percent of Total Billed Charges,197.45,,,,197.45,234.26
APPLICATION OF FOREARM CAST,29075,HCPCS,983,RC,,both,334.66,301.19,United Healthcare,Default,Fee Schedule,,,,,197.45,234.26
APPLY HAND/WRIST CAST,29085,HCPCS,983,RC,,both,352.04,316.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,246.43,,,,207.7,246.43
APPLY HAND/WRIST CAST,29085,HCPCS,983,RC,,both,352.04,316.84,Cigna,Default,Percent of Total Billed Charges,207.7,,,,207.7,246.43
APPLY HAND/WRIST CAST,29085,HCPCS,983,RC,,both,352.04,316.84,United Healthcare,Default,Fee Schedule,,,,,207.7,246.43
APPLY FINGER CAST,29086,HCPCS,983,RC,,both,234.69,211.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.28,,,,138.47,164.28
APPLY FINGER CAST,29086,HCPCS,983,RC,,both,234.69,211.22,Cigna,Default,Percent of Total Billed Charges,138.47,,,,138.47,164.28
APPLY FINGER CAST,29086,HCPCS,983,RC,,both,234.69,211.22,United Healthcare,Default,Fee Schedule,,,,,138.47,164.28
APPLICATION OF LONG LEG CAST,29345,HCPCS,983,RC,,both,486.79,438.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,340.75,,,,287.21,340.75
APPLICATION OF LONG LEG CAST,29345,HCPCS,983,RC,,both,486.79,438.11,Cigna,Default,Percent of Total Billed Charges,287.21,,,,287.21,340.75
APPLICATION OF LONG LEG CAST,29345,HCPCS,983,RC,,both,486.79,438.11,United Healthcare,Default,Fee Schedule,,,,,287.21,340.75
APPLY SHORT LEG CAST,29405,HCPCS,983,RC,,both,321.62,289.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.13,,,,189.76,225.13
APPLY SHORT LEG CAST,29405,HCPCS,983,RC,,both,321.62,289.46,Cigna,Default,Percent of Total Billed Charges,189.76,,,,189.76,225.13
APPLY SHORT LEG CAST,29405,HCPCS,983,RC,,both,321.62,289.46,United Healthcare,Default,Fee Schedule,,,,,189.76,225.13
APPLY WLKR SHORT LEG CAST,29425,HCPCS,983,RC,,both,348.79,313.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,244.15,,,,205.79,244.15
APPLY WLKR SHORT LEG CAST,29425,HCPCS,983,RC,,both,348.79,313.91,Cigna,Default,Percent of Total Billed Charges,205.79,,,,205.79,244.15
APPLY WLKR SHORT LEG CAST,29425,HCPCS,983,RC,,both,348.79,313.91,United Healthcare,Default,Fee Schedule,,,,,205.79,244.15
APPLY LONG ARM SPLINT,29105,HCPCS,983,RC,,both,358.58,322.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,251.01,,,,211.56,251.01
APPLY LONG ARM SPLINT,29105,HCPCS,983,RC,,both,358.58,322.72,Cigna,Default,Percent of Total Billed Charges,211.56,,,,211.56,251.01
APPLY LONG ARM SPLINT,29105,HCPCS,983,RC,,both,358.58,322.72,United Healthcare,Default,Fee Schedule,,,,,211.56,251.01
APPLY FOREARM SPLINT,29125,HCPCS,983,RC,,both,266.21,239.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.35,,,,157.06,186.35
APPLY FOREARM SPLINT,29125,HCPCS,983,RC,,both,266.21,239.59,Cigna,Default,Percent of Total Billed Charges,157.06,,,,157.06,186.35
APPLY FOREARM SPLINT,29125,HCPCS,983,RC,,both,266.21,239.59,United Healthcare,Default,Fee Schedule,,,,,157.06,186.35
APPLICATION OF FINGER SPLINT,29130,HCPCS,983,RC,,both,154.77,139.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.34,,,,91.31,108.34
APPLICATION OF FINGER SPLINT,29130,HCPCS,983,RC,,both,154.77,139.29,Cigna,Default,Percent of Total Billed Charges,91.31,,,,91.31,108.34
APPLICATION OF FINGER SPLINT,29130,HCPCS,983,RC,,both,154.77,139.29,United Healthcare,Default,Fee Schedule,,,,,91.31,108.34
APPLICATION OF LOWER LEG SPLINT,29515,HCPCS,983,RC,,both,268.38,241.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.87,,,,158.34,187.87
APPLICATION OF LOWER LEG SPLINT,29515,HCPCS,983,RC,,both,268.38,241.54,Cigna,Default,Percent of Total Billed Charges,158.34,,,,158.34,187.87
APPLICATION OF LOWER LEG SPLINT,29515,HCPCS,983,RC,,both,268.38,241.54,United Healthcare,Default,Fee Schedule,,,,,158.34,187.87
HIP IM ROD OR PINNING,360,RC,,,,both,22749.08,20474.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15924.36,,,,13421.96,18563.25
HIP IM ROD OR PINNING,360,RC,,,,both,22749.08,20474.17,Cigna,Default,Percent of Total Billed Charges,13421.96,,,,13421.96,18563.25
HIP IM ROD OR PINNING,360,RC,,,,both,22749.08,20474.17,United Healthcare,Default,Fee Schedule,18563.25,,,,13421.96,18563.25
"PARTIAL HIP REPL, PROSTHESIS",27125,HCPCS,975,RC,,inpatient,4314.5,3883.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3020.15,,,,2545.56,3020.15
"PARTIAL HIP REPL, PROSTHESIS",27125,HCPCS,975,RC,,inpatient,4314.5,3883.05,Cigna,Default,Percent of Total Billed Charges,2545.56,,,,2545.56,3020.15
"PARTIAL HIP REPL, PROSTHESIS",27125,HCPCS,975,RC,,inpatient,4314.5,3883.05,United Healthcare,Default,Fee Schedule,,,,,2545.56,3020.15
TOTAL HIP ARTHROPL,27130,HCPCS,975,RC,,both,5918.41,5326.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4142.89,,,,3491.86,4142.89
TOTAL HIP ARTHROPL,27130,HCPCS,975,RC,,both,5918.41,5326.57,Cigna,Default,Percent of Total Billed Charges,3491.86,,,,3491.86,4142.89
TOTAL HIP ARTHROPL,27130,HCPCS,975,RC,,both,5918.41,5326.57,United Healthcare,Default,Fee Schedule,,,,,3491.86,4142.89
CONV TO TOTAL HIP ARTHROPL,27132,HCPCS,975,RC,,both,7038.91,6335.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4927.24,,,,4152.96,4927.24
CONV TO TOTAL HIP ARTHROPL,27132,HCPCS,975,RC,,both,7038.91,6335.02,Cigna,Default,Percent of Total Billed Charges,4152.96,,,,4152.96,4927.24
CONV TO TOTAL HIP ARTHROPL,27132,HCPCS,975,RC,,both,7038.91,6335.02,United Healthcare,Default,Fee Schedule,,,,,4152.96,4927.24
"REVISE TOTAL HIP ARTHROPL, BOTH COMP",27134,HCPCS,975,RC,,inpatient,8148.81,7333.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5704.17,,,,4807.8,5704.17
"REVISE TOTAL HIP ARTHROPL, BOTH COMP",27134,HCPCS,975,RC,,inpatient,8148.81,7333.93,Cigna,Default,Percent of Total Billed Charges,4807.8,,,,4807.8,5704.17
"REVISE TOTAL HIP ARTHROPL, BOTH COMP",27134,HCPCS,975,RC,,inpatient,8148.81,7333.93,United Healthcare,Default,Fee Schedule,,,,,4807.8,5704.17
"REVISE TOTAL HIP ARTHROPL, ACETABUL",27137,HCPCS,975,RC,,inpatient,6271.41,5644.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4389.99,,,,3700.13,4389.99
"REVISE TOTAL HIP ARTHROPL, ACETABUL",27137,HCPCS,975,RC,,inpatient,6271.41,5644.27,Cigna,Default,Percent of Total Billed Charges,3700.13,,,,3700.13,4389.99
"REVISE TOTAL HIP ARTHROPL, ACETABUL",27137,HCPCS,975,RC,,inpatient,6271.41,5644.27,United Healthcare,Default,Fee Schedule,,,,,3700.13,4389.99
"REVISE TOTAL HIP ARTHROPL, FEMORAL",27138,HCPCS,975,RC,,inpatient,6438.9,5795.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4507.23,,,,3798.95,4507.23
"REVISE TOTAL HIP ARTHROPL, FEMORAL",27138,HCPCS,975,RC,,inpatient,6438.9,5795.01,Cigna,Default,Percent of Total Billed Charges,3798.95,,,,3798.95,4507.23
"REVISE TOTAL HIP ARTHROPL, FEMORAL",27138,HCPCS,975,RC,,inpatient,6438.9,5795.01,United Healthcare,Default,Fee Schedule,,,,,3798.95,4507.23
"ARTHROPL KNEE, CONTRAINED PROSTH",27445,HCPCS,975,RC,,inpatient,5929.01,5336.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4150.31,,,,3498.12,4150.31
"ARTHROPL KNEE, CONTRAINED PROSTH",27445,HCPCS,975,RC,,inpatient,5929.01,5336.11,Cigna,Default,Percent of Total Billed Charges,3498.12,,,,3498.12,4150.31
"ARTHROPL KNEE, CONTRAINED PROSTH",27445,HCPCS,975,RC,,inpatient,5929.01,5336.11,United Healthcare,Default,Fee Schedule,,,,,3498.12,4150.31
"ARTHROPL KNEE C&P, MEDIAL LAT",27446,HCPCS,975,RC,,both,5108.5,4597.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3575.95,,,,3014.02,3575.95
"ARTHROPL KNEE C&P, MEDIAL LAT",27446,HCPCS,975,RC,,both,5108.5,4597.65,Cigna,Default,Percent of Total Billed Charges,3014.02,,,,3014.02,3575.95
"ARTHROPL KNEE C&P, MEDIAL LAT",27446,HCPCS,975,RC,,both,5108.5,4597.65,United Healthcare,Default,Fee Schedule,,,,,3014.02,3575.95
TOT KNEE ARTHROPLASTY,27447,HCPCS,975,RC,,both,6664.7,5998.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4665.29,,,,3932.17,4665.29
TOT KNEE ARTHROPLASTY,27447,HCPCS,975,RC,,both,6664.7,5998.23,Cigna,Default,Percent of Total Billed Charges,3932.17,,,,3932.17,4665.29
TOT KNEE ARTHROPLASTY,27447,HCPCS,975,RC,,both,6664.7,5998.23,United Healthcare,Default,Fee Schedule,,,,,3932.17,4665.29
REVISE/REPLACE KNEE JOINT 1 COMPONENT,27486,HCPCS,975,RC,,inpatient,6066.81,5460.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4246.77,,,,3579.42,4246.77
REVISE/REPLACE KNEE JOINT 1 COMPONENT,27486,HCPCS,975,RC,,inpatient,6066.81,5460.13,Cigna,Default,Percent of Total Billed Charges,3579.42,,,,3579.42,4246.77
REVISE/REPLACE KNEE JOINT 1 COMPONENT,27486,HCPCS,975,RC,,inpatient,6066.81,5460.13,United Healthcare,Default,Fee Schedule,,,,,3579.42,4246.77
REVISE/REPLACE KNEE JOINT TIB&FIB COMPON,27487,HCPCS,975,RC,,inpatient,8051.28,7246.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5635.9,,,,4750.26,5635.9
REVISE/REPLACE KNEE JOINT TIB&FIB COMPON,27487,HCPCS,975,RC,,inpatient,8051.28,7246.15,Cigna,Default,Percent of Total Billed Charges,4750.26,,,,4750.26,5635.9
REVISE/REPLACE KNEE JOINT TIB&FIB COMPON,27487,HCPCS,975,RC,,inpatient,8051.28,7246.15,United Healthcare,Default,Fee Schedule,,,,,4750.26,5635.9
TREAT FX RAD INTRA-ARTICUL; 2 FRAGS,25608,HCPCS,975,RC,,both,3167.38,2850.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2217.17,,,,1868.75,2217.17
TREAT FX RAD INTRA-ARTICUL; 2 FRAGS,25608,HCPCS,975,RC,,both,3167.38,2850.64,Cigna,Default,Percent of Total Billed Charges,1868.75,,,,1868.75,2217.17
TREAT FX RAD INTRA-ARTICUL; 2 FRAGS,25608,HCPCS,975,RC,,both,3167.38,2850.64,United Healthcare,Default,Fee Schedule,,,,,1868.75,2217.17
INSC EXTENSOR TENDON SHEATH,25000,HCPCS,975,RC,,both,1614.66,1453.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1130.26,,,,952.65,1130.26
INSC EXTENSOR TENDON SHEATH,25000,HCPCS,975,RC,,both,1614.66,1453.19,Cigna,Default,Percent of Total Billed Charges,952.65,,,,952.65,1130.26
INSC EXTENSOR TENDON SHEATH,25000,HCPCS,975,RC,,both,1614.66,1453.19,United Healthcare,Default,Fee Schedule,,,,,952.65,1130.26
INJ ANESTH; OTHR PERPHERAL NRV/BRANCH,64450,HCPCS,975,RC,,both,244.48,220.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.14,,,,144.24,171.14
INJ ANESTH; OTHR PERPHERAL NRV/BRANCH,64450,HCPCS,975,RC,,both,244.48,220.03,Cigna,Default,Percent of Total Billed Charges,144.24,,,,144.24,171.14
INJ ANESTH; OTHR PERPHERAL NRV/BRANCH,64450,HCPCS,975,RC,,both,244.48,220.03,United Healthcare,Default,Fee Schedule,,,,,144.24,171.14
OPEN TX ULNAR FRACTURE PROXIMAL END,24685,HCPCS,975,RC,,both,2817.49,2535.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1972.24,,,,1662.32,1972.24
OPEN TX ULNAR FRACTURE PROXIMAL END,24685,HCPCS,975,RC,,both,2817.49,2535.74,Cigna,Default,Percent of Total Billed Charges,1662.32,,,,1662.32,1972.24
OPEN TX ULNAR FRACTURE PROXIMAL END,24685,HCPCS,975,RC,,both,2817.49,2535.74,United Healthcare,Default,Fee Schedule,,,,,1662.32,1972.24
INJ ANESTHETIC AGENT FEMORAL,64447,HCPCS,975,RC,,both,888.82,799.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,622.17,,,,524.4,622.17
INJ ANESTHETIC AGENT FEMORAL,64447,HCPCS,975,RC,,both,888.82,799.94,Cigna,Default,Percent of Total Billed Charges,524.4,,,,524.4,622.17
INJ ANESTHETIC AGENT FEMORAL,64447,HCPCS,975,RC,,both,888.82,799.94,United Healthcare,Default,Fee Schedule,,,,,524.4,622.17
ORTHOPEDICS I,360,RC,,,,both,123.81,111.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.67,,,,73.05,101.03
ORTHOPEDICS I,360,RC,,,,both,123.81,111.43,Cigna,Default,Percent of Total Billed Charges,73.05,,,,73.05,101.03
ORTHOPEDICS I,360,RC,,,,both,123.81,111.43,United Healthcare,Default,Fee Schedule,101.03,,,,73.05,101.03
ORTHOPEDICS II,360,RC,,,,both,125.24,112.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.67,,,,73.89,102.2
ORTHOPEDICS II,360,RC,,,,both,125.24,112.72,Cigna,Default,Percent of Total Billed Charges,73.89,,,,73.89,102.2
ORTHOPEDICS II,360,RC,,,,both,125.24,112.72,United Healthcare,Default,Fee Schedule,102.2,,,,73.89,102.2
ORTHOPEDICS III,360,RC,,,,both,145.68,131.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.98,,,,85.95,118.87
ORTHOPEDICS III,360,RC,,,,both,145.68,131.11,Cigna,Default,Percent of Total Billed Charges,85.95,,,,85.95,118.87
ORTHOPEDICS III,360,RC,,,,both,145.68,131.11,United Healthcare,Default,Fee Schedule,118.87,,,,85.95,118.87
ORTHOPEDICS IV,360,RC,,,,both,149.72,134.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.8,,,,88.33,122.17
ORTHOPEDICS IV,360,RC,,,,both,149.72,134.75,Cigna,Default,Percent of Total Billed Charges,88.33,,,,88.33,122.17
ORTHOPEDICS IV,360,RC,,,,both,149.72,134.75,United Healthcare,Default,Fee Schedule,122.17,,,,88.33,122.17
ORTHOPEDICS V,360,RC,,,,both,162.1,145.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.47,,,,95.64,132.27
ORTHOPEDICS V,360,RC,,,,both,162.1,145.89,Cigna,Default,Percent of Total Billed Charges,95.64,,,,95.64,132.27
ORTHOPEDICS V,360,RC,,,,both,162.1,145.89,United Healthcare,Default,Fee Schedule,132.27,,,,95.64,132.27
TREAT INTER PR SUBTRCHNTRIC FEM FX 1,27245,HCPCS,975,RC,,inpatient,5997.91,5398.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4198.54,,,,3538.77,4198.54
TREAT INTER PR SUBTRCHNTRIC FEM FX 1,27245,HCPCS,975,RC,,inpatient,5997.91,5398.12,Cigna,Default,Percent of Total Billed Charges,3538.77,,,,3538.77,4198.54
TREAT INTER PR SUBTRCHNTRIC FEM FX 1,27245,HCPCS,975,RC,,inpatient,5997.91,5398.12,United Healthcare,Default,Fee Schedule,,,,,3538.77,4198.54
ARTHRS KNEE W/MENISCECTOMY MED,29880,HCPCS,975,RC,,both,4278.47,3850.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2994.93,,,,2524.3,2994.93
ARTHRS KNEE W/MENISCECTOMY MED,29880,HCPCS,975,RC,,both,4278.47,3850.62,Cigna,Default,Percent of Total Billed Charges,2524.3,,,,2524.3,2994.93
ARTHRS KNEE W/MENISCECTOMY MED,29880,HCPCS,975,RC,,both,4278.47,3850.62,United Healthcare,Default,Fee Schedule,,,,,2524.3,2994.93
ORTHOPEDICS MINOR PROCEDURE,360,RC,,,,both,2364,2127.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1654.8,,,,1394.76,1929.02
ORTHOPEDICS MINOR PROCEDURE,360,RC,,,,both,2364,2127.6,Cigna,Default,Percent of Total Billed Charges,1394.76,,,,1394.76,1929.02
ORTHOPEDICS MINOR PROCEDURE,360,RC,,,,both,2364,2127.6,United Healthcare,Default,Fee Schedule,1929.02,,,,1394.76,1929.02
ACROMIOPL/ACROMIONECT PARTIAL,23130,HCPCS,975,RC,,both,2293.76,2064.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1605.63,,,,1353.32,1605.63
ACROMIOPL/ACROMIONECT PARTIAL,23130,HCPCS,975,RC,,both,2293.76,2064.38,Cigna,Default,Percent of Total Billed Charges,1353.32,,,,1353.32,1605.63
ACROMIOPL/ACROMIONECT PARTIAL,23130,HCPCS,975,RC,,both,2293.76,2064.38,United Healthcare,Default,Fee Schedule,,,,,1353.32,1605.63
REPAIR ROTATOR CUFF; CHRONIC,23412,HCPCS,975,RC,,both,3833.45,3450.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2683.42,,,,2261.74,2683.42
REPAIR ROTATOR CUFF; CHRONIC,23412,HCPCS,975,RC,,both,3833.45,3450.11,Cigna,Default,Percent of Total Billed Charges,2261.74,,,,2261.74,2683.42
REPAIR ROTATOR CUFF; CHRONIC,23412,HCPCS,975,RC,,both,3833.45,3450.11,United Healthcare,Default,Fee Schedule,,,,,2261.74,2683.42
FASCT PRTL PALMAR 1 DGT PROX IPHA,26123,HCPCS,975,RC,,both,4199.62,3779.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2939.73,,,,2477.78,2939.73
FASCT PRTL PALMAR 1 DGT PROX IPHA,26123,HCPCS,975,RC,,both,4199.62,3779.66,Cigna,Default,Percent of Total Billed Charges,2477.78,,,,2477.78,2939.73
FASCT PRTL PALMAR 1 DGT PROX IPHA,26123,HCPCS,975,RC,,both,4199.62,3779.66,United Healthcare,Default,Fee Schedule,,,,,2477.78,2939.73
FASCT PRTL PALMAR ADDL DGT PROX IPHA,26125,HCPCS,975,RC,,both,1621.18,1459.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1134.83,,,,956.5,1134.83
FASCT PRTL PALMAR ADDL DGT PROX IPHA,26125,HCPCS,975,RC,,both,1621.18,1459.06,Cigna,Default,Percent of Total Billed Charges,956.5,,,,956.5,1134.83
FASCT PRTL PALMAR ADDL DGT PROX IPHA,26125,HCPCS,975,RC,,both,1621.18,1459.06,United Healthcare,Default,Fee Schedule,,,,,956.5,1134.83
MANIPULATE KNEE JNT UNDER ANESTH,27570,HCPCS,975,RC,,both,834.49,751.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,584.14,,,,492.35,584.14
MANIPULATE KNEE JNT UNDER ANESTH,27570,HCPCS,975,RC,,both,834.49,751.04,Cigna,Default,Percent of Total Billed Charges,492.35,,,,492.35,584.14
MANIPULATE KNEE JNT UNDER ANESTH,27570,HCPCS,975,RC,,both,834.49,751.04,United Healthcare,Default,Fee Schedule,,,,,492.35,584.14
NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL,64721,HCPCS,975,RC,,both,2040.64,1836.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1428.45,,,,1203.98,1428.45
NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL,64721,HCPCS,975,RC,,both,2040.64,1836.58,Cigna,Default,Percent of Total Billed Charges,1203.98,,,,1203.98,1428.45
NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL,64721,HCPCS,975,RC,,both,2040.64,1836.58,United Healthcare,Default,Fee Schedule,,,,,1203.98,1428.45
BIPOLAR HIP REPLACEMENT,27236,HCPCS,975,RC,,inpatient,5378.82,4840.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3765.17,,,,3173.5,3765.17
BIPOLAR HIP REPLACEMENT,27236,HCPCS,975,RC,,inpatient,5378.82,4840.94,Cigna,Default,Percent of Total Billed Charges,3173.5,,,,3173.5,3765.17
BIPOLAR HIP REPLACEMENT,27236,HCPCS,975,RC,,inpatient,5378.82,4840.94,United Healthcare,Default,Fee Schedule,,,,,3173.5,3765.17
TREAT FX RADIAL 3 + FRAG,25609,HCPCS,975,RC,,both,4161.6,3745.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.12,,,,2455.34,2913.12
TREAT FX RADIAL 3 + FRAG,25609,HCPCS,975,RC,,both,4161.6,3745.44,Cigna,Default,Percent of Total Billed Charges,2455.34,,,,2455.34,2913.12
TREAT FX RADIAL 3 + FRAG,25609,HCPCS,975,RC,,both,4161.6,3745.44,United Healthcare,Default,Fee Schedule,,,,,2455.34,2913.12
NEUROPLASTY ULNAR NERVE AT ELBOW,64718,HCPCS,975,RC,,both,2577.05,2319.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1803.94,,,,1520.46,1803.94
NEUROPLASTY ULNAR NERVE AT ELBOW,64718,HCPCS,975,RC,,both,2577.05,2319.35,Cigna,Default,Percent of Total Billed Charges,1520.46,,,,1520.46,1803.94
NEUROPLASTY ULNAR NERVE AT ELBOW,64718,HCPCS,975,RC,,both,2577.05,2319.35,United Healthcare,Default,Fee Schedule,,,,,1520.46,1803.94
EXCISE OLECRANON BURSA,24105,HCPCS,975,RC,,both,1564.68,1408.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1095.28,,,,923.16,1095.28
EXCISE OLECRANON BURSA,24105,HCPCS,975,RC,,both,1564.68,1408.21,Cigna,Default,Percent of Total Billed Charges,923.16,,,,923.16,1095.28
EXCISE OLECRANON BURSA,24105,HCPCS,975,RC,,both,1564.68,1408.21,United Healthcare,Default,Fee Schedule,,,,,923.16,1095.28
ARTHROT KNEE W MENISC MED OR LAT,27332,HCPCS,975,RC,,both,2991.34,2692.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2093.94,,,,1764.89,2093.94
ARTHROT KNEE W MENISC MED OR LAT,27332,HCPCS,975,RC,,both,2991.34,2692.21,Cigna,Default,Percent of Total Billed Charges,1764.89,,,,1764.89,2093.94
ARTHROT KNEE W MENISC MED OR LAT,27332,HCPCS,975,RC,,both,2991.34,2692.21,United Healthcare,Default,Fee Schedule,,,,,1764.89,2093.94
OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL,27792,HCPCS,975,RC,,both,2764.68,2488.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1935.28,,,,1631.16,1935.28
OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL,27792,HCPCS,975,RC,,both,2764.68,2488.21,Cigna,Default,Percent of Total Billed Charges,1631.16,,,,1631.16,1935.28
OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL,27792,HCPCS,975,RC,,both,2764.68,2488.21,United Healthcare,Default,Fee Schedule,,,,,1631.16,1935.28
OPEN TREATMENT MEDIAL MALLEOLUS,27766,HCPCS,975,RC,,both,2715.36,2443.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1900.75,,,,1602.06,1900.75
OPEN TREATMENT MEDIAL MALLEOLUS,27766,HCPCS,975,RC,,both,2715.36,2443.82,Cigna,Default,Percent of Total Billed Charges,1602.06,,,,1602.06,1900.75
OPEN TREATMENT MEDIAL MALLEOLUS,27766,HCPCS,975,RC,,both,2715.36,2443.82,United Healthcare,Default,Fee Schedule,,,,,1602.06,1900.75
ARTHROSCOPY SHOULDER SURGICAL REPAIR OF,29807,HCPCS,975,RC,,both,4489.74,4040.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3142.82,,,,2648.95,3142.82
ARTHROSCOPY SHOULDER SURGICAL REPAIR OF,29807,HCPCS,975,RC,,both,4489.74,4040.77,Cigna,Default,Percent of Total Billed Charges,2648.95,,,,2648.95,3142.82
ARTHROSCOPY SHOULDER SURGICAL REPAIR OF,29807,HCPCS,975,RC,,both,4489.74,4040.77,United Healthcare,Default,Fee Schedule,,,,,2648.95,3142.82
ARTHROSCOPY SHOULDER SURGICAL WITH ROTAT,29827,HCPCS,975,RC,,both,4642.08,4177.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3249.46,,,,2738.83,3249.46
ARTHROSCOPY SHOULDER SURGICAL WITH ROTAT,29827,HCPCS,975,RC,,both,4642.08,4177.87,Cigna,Default,Percent of Total Billed Charges,2738.83,,,,2738.83,3249.46
ARTHROSCOPY SHOULDER SURGICAL WITH ROTAT,29827,HCPCS,975,RC,,both,4642.08,4177.87,United Healthcare,Default,Fee Schedule,,,,,2738.83,3249.46
ARTHROSCOPY KNEE SYNOVECTOMY L,29875,HCPCS,975,RC,,both,2760.99,2484.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1932.69,,,,1628.98,1932.69
ARTHROSCOPY KNEE SYNOVECTOMY L,29875,HCPCS,975,RC,,both,2760.99,2484.89,Cigna,Default,Percent of Total Billed Charges,1628.98,,,,1628.98,1932.69
ARTHROSCOPY KNEE SYNOVECTOMY L,29875,HCPCS,975,RC,,both,2760.99,2484.89,United Healthcare,Default,Fee Schedule,,,,,1628.98,1932.69
ARTHROSCOPY KNEE; ABRAS ARTHROPL,29879,HCPCS,975,RC,,both,3336.87,3003.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2335.81,,,,1968.75,2335.81
ARTHROSCOPY KNEE; ABRAS ARTHROPL,29879,HCPCS,975,RC,,both,3336.87,3003.18,Cigna,Default,Percent of Total Billed Charges,1968.75,,,,1968.75,2335.81
ARTHROSCOPY KNEE; ABRAS ARTHROPL,29879,HCPCS,975,RC,,both,3336.87,3003.18,United Healthcare,Default,Fee Schedule,,,,,1968.75,2335.81
EXC TNDN SHTH LES HND/FING,26160,HCPCS,975,RC,,both,2305.71,2075.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1614,,,,1360.37,1614
EXC TNDN SHTH LES HND/FING,26160,HCPCS,975,RC,,both,2305.71,2075.14,Cigna,Default,Percent of Total Billed Charges,1360.37,,,,1360.37,1614
EXC TNDN SHTH LES HND/FING,26160,HCPCS,975,RC,,both,2305.71,2075.14,United Healthcare,Default,Fee Schedule,,,,,1360.37,1614
TENDON SHEATH INCISION,26055,HCPCS,975,RC,,both,2288.33,2059.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1601.83,,,,1350.11,1601.83
TENDON SHEATH INCISION,26055,HCPCS,975,RC,,both,2288.33,2059.5,Cigna,Default,Percent of Total Billed Charges,1350.11,,,,1350.11,1601.83
TENDON SHEATH INCISION,26055,HCPCS,975,RC,,both,2288.33,2059.5,United Healthcare,Default,Fee Schedule,,,,,1350.11,1601.83
RECONSTRUCTION ROTATOR CUFF AV,23420,HCPCS,975,RC,,both,3814.98,3433.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2670.49,,,,2250.84,2670.49
RECONSTRUCTION ROTATOR CUFF AV,23420,HCPCS,975,RC,,both,3814.98,3433.48,Cigna,Default,Percent of Total Billed Charges,2250.84,,,,2250.84,2670.49
RECONSTRUCTION ROTATOR CUFF AV,23420,HCPCS,975,RC,,both,3814.98,3433.48,United Healthcare,Default,Fee Schedule,,,,,2250.84,2670.49
OPEN REPAIR ROTATOR CUFF,23410,HCPCS,975,RC,,both,3499.87,3149.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2449.91,,,,2064.92,2449.91
OPEN REPAIR ROTATOR CUFF,23410,HCPCS,975,RC,,both,3499.87,3149.88,Cigna,Default,Percent of Total Billed Charges,2064.92,,,,2064.92,2449.91
OPEN REPAIR ROTATOR CUFF,23410,HCPCS,975,RC,,both,3499.87,3149.88,United Healthcare,Default,Fee Schedule,,,,,2064.92,2449.91
TREAT FX RAD EXTRA-ARTICUL,25607,HCPCS,975,RC,,both,8453.57,7608.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5917.5,,,,4987.61,5917.5
TREAT FX RAD EXTRA-ARTICUL,25607,HCPCS,975,RC,,both,8453.57,7608.21,Cigna,Default,Percent of Total Billed Charges,4987.61,,,,4987.61,5917.5
TREAT FX RAD EXTRA-ARTICUL,25607,HCPCS,975,RC,,both,8453.57,7608.21,United Healthcare,Default,Fee Schedule,,,,,4987.61,5917.5
EXCBLES S/N/EX G 3.1-4.0 CM,11424,HCPCS,975,RC,,both,2680.59,2412.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1876.41,,,,1581.55,1876.41
EXCBLES S/N/EX G 3.1-4.0 CM,11424,HCPCS,975,RC,,both,2680.59,2412.53,Cigna,Default,Percent of Total Billed Charges,1581.55,,,,1581.55,1876.41
EXCBLES S/N/EX G 3.1-4.0 CM,11424,HCPCS,975,RC,,both,2680.59,2412.53,United Healthcare,Default,Fee Schedule,,,,,1581.55,1876.41
OPEN TX BIMALLEOLAR ANKLE FX,27814,HCPCS,975,RC,,both,9928.15,8935.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6949.7,,,,5857.61,6949.7
OPEN TX BIMALLEOLAR ANKLE FX,27814,HCPCS,975,RC,,both,9928.15,8935.34,Cigna,Default,Percent of Total Billed Charges,5857.61,,,,5857.61,6949.7
OPEN TX BIMALLEOLAR ANKLE FX,27814,HCPCS,975,RC,,both,9928.15,8935.34,United Healthcare,Default,Fee Schedule,,,,,5857.61,6949.7
OPEN TX PHALANG SHAFT FRACT PROX/MIDDLE,26735,HCPCS,975,RC,,both,5595.37,5035.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3916.76,,,,3301.27,3916.76
OPEN TX PHALANG SHAFT FRACT PROX/MIDDLE,26735,HCPCS,975,RC,,both,5595.37,5035.83,Cigna,Default,Percent of Total Billed Charges,3301.27,,,,3301.27,3916.76
OPEN TX PHALANG SHAFT FRACT PROX/MIDDLE,26735,HCPCS,975,RC,,both,5595.37,5035.83,United Healthcare,Default,Fee Schedule,,,,,3301.27,3916.76
OPEN TX DISTAL PHALANG FRACT EA,26765,HCPCS,975,RC,,both,4117.31,3705.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2882.12,,,,2429.21,2882.12
OPEN TX DISTAL PHALANG FRACT EA,26765,HCPCS,975,RC,,both,4117.31,3705.58,Cigna,Default,Percent of Total Billed Charges,2429.21,,,,2429.21,2882.12
OPEN TX DISTAL PHALANG FRACT EA,26765,HCPCS,975,RC,,both,4117.31,3705.58,United Healthcare,Default,Fee Schedule,,,,,2429.21,2882.12
REP ET HAND WO FG EA TENDON,26410,HCPCS,975,RC,,both,3038.07,2734.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2126.65,,,,1792.46,2126.65
REP ET HAND WO FG EA TENDON,26410,HCPCS,975,RC,,both,3038.07,2734.26,Cigna,Default,Percent of Total Billed Charges,1792.46,,,,1792.46,2126.65
REP ET HAND WO FG EA TENDON,26410,HCPCS,975,RC,,both,3038.07,2734.26,United Healthcare,Default,Fee Schedule,,,,,1792.46,2126.65
REPAIR NAIL BED,11760,HCPCS,975,RC,,both,1049.23,944.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,734.46,,,,619.05,734.46
REPAIR NAIL BED,11760,HCPCS,975,RC,,both,1049.23,944.31,Cigna,Default,Percent of Total Billed Charges,619.05,,,,619.05,734.46
REPAIR NAIL BED,11760,HCPCS,975,RC,,both,1049.23,944.31,United Healthcare,Default,Fee Schedule,,,,,619.05,734.46
TREAT LOWER LEG JOINT,27829,HCPCS,975,RC,,both,2892.21,2602.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2024.55,,,,1706.4,2024.55
TREAT LOWER LEG JOINT,27829,HCPCS,975,RC,,both,2892.21,2602.99,Cigna,Default,Percent of Total Billed Charges,1706.4,,,,1706.4,2024.55
TREAT LOWER LEG JOINT,27829,HCPCS,975,RC,,both,2892.21,2602.99,United Healthcare,Default,Fee Schedule,,,,,1706.4,2024.55
I&D HEMATOMA/FLUID,10140,HCPCS,975,RC,,both,1012.01,910.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,708.41,,,,597.09,708.41
I&D HEMATOMA/FLUID,10140,HCPCS,975,RC,,both,1012.01,910.81,Cigna,Default,Percent of Total Billed Charges,597.09,,,,597.09,708.41
I&D HEMATOMA/FLUID,10140,HCPCS,975,RC,,both,1012.01,910.81,United Healthcare,Default,Fee Schedule,,,,,597.09,708.41
DEB SUBQ TISSUE 20 SQ CM,11042,HCPCS,975,RC,,both,745.69,671.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,521.98,,,,439.96,521.98
DEB SUBQ TISSUE 20 SQ CM,11042,HCPCS,975,RC,,both,745.69,671.12,Cigna,Default,Percent of Total Billed Charges,439.96,,,,439.96,521.98
DEB SUBQ TISSUE 20 SQ CM,11042,HCPCS,975,RC,,both,745.69,671.12,United Healthcare,Default,Fee Schedule,,,,,439.96,521.98
REPAIR ELBOW DEB/ATTCH OPEN,24359,HCPCS,975,RC,,both,4343.83,3909.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3040.68,,,,2562.86,3040.68
REPAIR ELBOW DEB/ATTCH OPEN,24359,HCPCS,975,RC,,both,4343.83,3909.45,Cigna,Default,Percent of Total Billed Charges,2562.86,,,,2562.86,3040.68
REPAIR ELBOW DEB/ATTCH OPEN,24359,HCPCS,975,RC,,both,4343.83,3909.45,United Healthcare,Default,Fee Schedule,,,,,2562.86,3040.68
CL TX POSTOP HIP DISLOC W ANESTH,27266,HCPCS,975,RC,,both,2438.41,2194.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1706.89,,,,1438.66,1706.89
CL TX POSTOP HIP DISLOC W ANESTH,27266,HCPCS,975,RC,,both,2438.41,2194.57,Cigna,Default,Percent of Total Billed Charges,1438.66,,,,1438.66,1706.89
CL TX POSTOP HIP DISLOC W ANESTH,27266,HCPCS,975,RC,,both,2438.41,2194.57,United Healthcare,Default,Fee Schedule,,,,,1438.66,1706.89
PERC FIX FEM PROX NK FX,27235,HCPCS,975,RC,,both,3116.99,2805.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2181.89,,,,1839.02,2181.89
PERC FIX FEM PROX NK FX,27235,HCPCS,975,RC,,both,3116.99,2805.29,Cigna,Default,Percent of Total Billed Charges,1839.02,,,,1839.02,2181.89
PERC FIX FEM PROX NK FX,27235,HCPCS,975,RC,,both,3116.99,2805.29,United Healthcare,Default,Fee Schedule,,,,,1839.02,2181.89
PERC SK FIX UNST PHAL SHFT FX PR/MID PH,26727,HCPCS,975,RC,,both,1443.44,1299.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1010.41,,,,851.63,1010.41
PERC SK FIX UNST PHAL SHFT FX PR/MID PH,26727,HCPCS,975,RC,,both,1443.44,1299.1,Cigna,Default,Percent of Total Billed Charges,851.63,,,,851.63,1010.41
PERC SK FIX UNST PHAL SHFT FX PR/MID PH,26727,HCPCS,975,RC,,both,1443.44,1299.1,United Healthcare,Default,Fee Schedule,,,,,851.63,1010.41
EXC 1' WRITS GANGLION,25111,HCPCS,975,RC,,both,1027.23,924.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,719.06,,,,606.07,719.06
EXC 1' WRITS GANGLION,25111,HCPCS,975,RC,,both,1027.23,924.51,Cigna,Default,Percent of Total Billed Charges,606.07,,,,606.07,719.06
EXC 1' WRITS GANGLION,25111,HCPCS,975,RC,,both,1027.23,924.51,United Healthcare,Default,Fee Schedule,,,,,606.07,719.06
SYNVISC OR SYNVISC-ONE 1 MG,J7325,HCPCS,636,RC,,both,119.89,107.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.92,,,,70.74,97.83
SYNVISC OR SYNVISC-ONE 1 MG,J7325,HCPCS,636,RC,,both,119.89,107.9,Cigna,Default,Percent of Total Billed Charges,70.74,,,,70.74,97.83
SYNVISC OR SYNVISC-ONE 1 MG,J7325,HCPCS,636,RC,,both,119.89,107.9,United Healthcare,Default,Fee Schedule,97.83,,,,70.74,97.83
REM IMPL DEEP,20680,HCPCS,975,RC,,both,1450.1,1305.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1015.07,,,,855.56,1015.07
REM IMPL DEEP,20680,HCPCS,975,RC,,both,1450.1,1305.09,Cigna,Default,Percent of Total Billed Charges,855.56,,,,855.56,1015.07
REM IMPL DEEP,20680,HCPCS,975,RC,,both,1450.1,1305.09,United Healthcare,Default,Fee Schedule,,,,,855.56,1015.07
INJ TENDON ORIGIN/INSERT,20551,HCPCS,975,RC,,both,132.49,119.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.74,,,,78.17,92.74
INJ TENDON ORIGIN/INSERT,20551,HCPCS,975,RC,,both,132.49,119.24,Cigna,Default,Percent of Total Billed Charges,78.17,,,,78.17,92.74
INJ TENDON ORIGIN/INSERT,20551,HCPCS,975,RC,,both,132.49,119.24,United Healthcare,Default,Fee Schedule,,,,,78.17,92.74
CL TX MEDIAL ANKLE FX,27760,HCPCS,975,RC,,both,945.03,850.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,661.52,,,,557.57,661.52
CL TX MEDIAL ANKLE FX,27760,HCPCS,975,RC,,both,945.03,850.53,Cigna,Default,Percent of Total Billed Charges,557.57,,,,557.57,661.52
CL TX MEDIAL ANKLE FX,27760,HCPCS,975,RC,,both,945.03,850.53,United Healthcare,Default,Fee Schedule,,,,,557.57,661.52
DEB BONE 20 SQ CM,11044,HCPCS,975,RC,,both,731.89,658.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,512.32,,,,431.82,512.32
DEB BONE 20 SQ CM,11044,HCPCS,975,RC,,both,731.89,658.7,Cigna,Default,Percent of Total Billed Charges,431.82,,,,431.82,512.32
DEB BONE 20 SQ CM,11044,HCPCS,975,RC,,both,731.89,658.7,United Healthcare,Default,Fee Schedule,,,,,431.82,512.32
CL TX PROX HUMERAL FX WO MANIP,23600,HCPCS,975,RC,,both,960.08,864.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,672.06,,,,566.45,672.06
CL TX PROX HUMERAL FX WO MANIP,23600,HCPCS,975,RC,,both,960.08,864.07,Cigna,Default,Percent of Total Billed Charges,566.45,,,,566.45,672.06
CL TX PROX HUMERAL FX WO MANIP,23600,HCPCS,975,RC,,both,960.08,864.07,United Healthcare,Default,Fee Schedule,,,,,566.45,672.06
TREATMENT OF TIBIA FRACTURE,27758,HCPCS,975,RC,,both,2864.45,2578.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2005.12,,,,1690.03,2005.12
TREATMENT OF TIBIA FRACTURE,27758,HCPCS,975,RC,,both,2864.45,2578.01,Cigna,Default,Percent of Total Billed Charges,1690.03,,,,1690.03,2005.12
TREATMENT OF TIBIA FRACTURE,27758,HCPCS,975,RC,,both,2864.45,2578.01,United Healthcare,Default,Fee Schedule,,,,,1690.03,2005.12
CL TX CARPAL SCAPHOID FX WO MANIP,25622,HCPCS,975,RC,,both,855.96,770.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,599.17,,,,505.02,599.17
CL TX CARPAL SCAPHOID FX WO MANIP,25622,HCPCS,975,RC,,both,855.96,770.36,Cigna,Default,Percent of Total Billed Charges,505.02,,,,505.02,599.17
CL TX CARPAL SCAPHOID FX WO MANIP,25622,HCPCS,975,RC,,both,855.96,770.36,United Healthcare,Default,Fee Schedule,,,,,505.02,599.17
OP TX SP HIP DISLOC W FEM SHORTEN,27259,HCPCS,975,RC,,inpatient,4900.27,4410.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3430.19,,,,2891.16,3430.19
OP TX SP HIP DISLOC W FEM SHORTEN,27259,HCPCS,975,RC,,inpatient,4900.27,4410.24,Cigna,Default,Percent of Total Billed Charges,2891.16,,,,2891.16,3430.19
OP TX SP HIP DISLOC W FEM SHORTEN,27259,HCPCS,975,RC,,inpatient,4900.27,4410.24,United Healthcare,Default,Fee Schedule,,,,,2891.16,3430.19
CLTX DSTL RADIAL FX/SPIPHYSL SEP WO MNP,25600,HCPCS,975,RC,,both,867.53,780.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,607.27,,,,511.84,607.27
CLTX DSTL RADIAL FX/SPIPHYSL SEP WO MNP,25600,HCPCS,975,RC,,both,867.53,780.78,Cigna,Default,Percent of Total Billed Charges,511.84,,,,511.84,607.27
CLTX DSTL RADIAL FX/SPIPHYSL SEP WO MNP,25600,HCPCS,975,RC,,both,867.53,780.78,United Healthcare,Default,Fee Schedule,,,,,511.84,607.27
CL TX D PHAL FX FGR/THMB WO MANIP,26750,HCPCS,975,RC,,both,593.07,533.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,415.15,,,,349.91,415.15
CL TX D PHAL FX FGR/THMB WO MANIP,26750,HCPCS,975,RC,,both,593.07,533.76,Cigna,Default,Percent of Total Billed Charges,349.91,,,,349.91,415.15
CL TX D PHAL FX FGR/THMB WO MANIP,26750,HCPCS,975,RC,,both,593.07,533.76,United Healthcare,Default,Fee Schedule,,,,,349.91,415.15
ARTHROT KNEE W MENISC; MED & LAT,27333,HCPCS,975,RC,,both,2194.6,1975.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1536.22,,,,1294.81,1536.22
ARTHROT KNEE W MENISC; MED & LAT,27333,HCPCS,975,RC,,both,2194.6,1975.14,Cigna,Default,Percent of Total Billed Charges,1294.81,,,,1294.81,1536.22
ARTHROT KNEE W MENISC; MED & LAT,27333,HCPCS,975,RC,,both,2194.6,1975.14,United Healthcare,Default,Fee Schedule,,,,,1294.81,1536.22
OP TX PATEL FX W IF &/REP,27524,HCPCS,975,RC,,both,2559.49,2303.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1791.64,,,,1510.1,1791.64
OP TX PATEL FX W IF &/REP,27524,HCPCS,975,RC,,both,2559.49,2303.54,Cigna,Default,Percent of Total Billed Charges,1510.1,,,,1510.1,1791.64
OP TX PATEL FX W IF &/REP,27524,HCPCS,975,RC,,both,2559.49,2303.54,United Healthcare,Default,Fee Schedule,,,,,1510.1,1791.64
TX S WND DEHISC; SMPL,12020,HCPCS,975,RC,,both,564.28,507.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,395,,,,332.93,395
TX S WND DEHISC; SMPL,12020,HCPCS,975,RC,,both,564.28,507.85,Cigna,Default,Percent of Total Billed Charges,332.93,,,,332.93,395
TX S WND DEHISC; SMPL,12020,HCPCS,975,RC,,both,564.28,507.85,United Healthcare,Default,Fee Schedule,,,,,332.93,395
TX HUMERUS SH FX W IMPANT,24516,HCPCS,975,RC,,both,2819.27,2537.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1973.49,,,,1663.37,1973.49
TX HUMERUS SH FX W IMPANT,24516,HCPCS,975,RC,,both,2819.27,2537.34,Cigna,Default,Percent of Total Billed Charges,1663.37,,,,1663.37,1973.49
TX HUMERUS SH FX W IMPANT,24516,HCPCS,975,RC,,both,2819.27,2537.34,United Healthcare,Default,Fee Schedule,,,,,1663.37,1973.49
OP TX FEM SFT FX W INS IM IMPL,27506,HCPCS,975,RC,,inpatient,4115.54,3703.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2880.88,,,,2428.17,2880.88
OP TX FEM SFT FX W INS IM IMPL,27506,HCPCS,975,RC,,inpatient,4115.54,3703.99,Cigna,Default,Percent of Total Billed Charges,2428.17,,,,2428.17,2880.88
OP TX FEM SFT FX W INS IM IMPL,27506,HCPCS,975,RC,,inpatient,4115.54,3703.99,United Healthcare,Default,Fee Schedule,,,,,2428.17,2880.88
KNEE ARTHROSCOPY/SURGERY 2+ COMPART,29876,HCPCS,975,RC,,both,2365.74,2129.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1656.02,,,,1395.79,1656.02
KNEE ARTHROSCOPY/SURGERY 2+ COMPART,29876,HCPCS,975,RC,,both,2365.74,2129.17,Cigna,Default,Percent of Total Billed Charges,1395.79,,,,1395.79,1656.02
KNEE ARTHROSCOPY/SURGERY 2+ COMPART,29876,HCPCS,975,RC,,both,2365.74,2129.17,United Healthcare,Default,Fee Schedule,,,,,1395.79,1656.02
TOT KNEE ARTHROPLASTY,360,RC,,,,both,43082.23,38774.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30157.56,,,,25418.52,35155.1
TOT KNEE ARTHROPLASTY,360,RC,,,,both,43082.23,38774.01,Cigna,Default,Percent of Total Billed Charges,25418.52,,,,25418.52,35155.1
TOT KNEE ARTHROPLASTY,360,RC,,,,both,43082.23,38774.01,United Healthcare,Default,Fee Schedule,35155.1,,,,25418.52,35155.1
BIPOLAR OR TOT HIP REPLACEMENT,360,RC,,,,both,43082.23,38774.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30157.56,,,,25418.52,35155.1
BIPOLAR OR TOT HIP REPLACEMENT,360,RC,,,,both,43082.23,38774.01,Cigna,Default,Percent of Total Billed Charges,25418.52,,,,25418.52,35155.1
BIPOLAR OR TOT HIP REPLACEMENT,360,RC,,,,both,43082.23,38774.01,United Healthcare,Default,Fee Schedule,35155.1,,,,25418.52,35155.1
KNEE ARTHROSCOPY,360,RC,,,,both,10360.76,9324.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7252.53,,,,6112.85,8454.38
KNEE ARTHROSCOPY,360,RC,,,,both,10360.76,9324.68,Cigna,Default,Percent of Total Billed Charges,6112.85,,,,6112.85,8454.38
KNEE ARTHROSCOPY,360,RC,,,,both,10360.76,9324.68,United Healthcare,Default,Fee Schedule,8454.38,,,,6112.85,8454.38
ORTHO CARPAL TUNNEL,360,RC,,,,both,6312.65,5681.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4418.86,,,,3724.46,5151.12
ORTHO CARPAL TUNNEL,360,RC,,,,both,6312.65,5681.39,Cigna,Default,Percent of Total Billed Charges,3724.46,,,,3724.46,5151.12
ORTHO CARPAL TUNNEL,360,RC,,,,both,6312.65,5681.39,United Healthcare,Default,Fee Schedule,5151.12,,,,3724.46,5151.12
TOT SHOULDER,360,RC,,,,both,44318.09,39886.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31022.66,,,,26147.67,36163.56
TOT SHOULDER,360,RC,,,,both,44318.09,39886.28,Cigna,Default,Percent of Total Billed Charges,26147.67,,,,26147.67,36163.56
TOT SHOULDER,360,RC,,,,both,44318.09,39886.28,United Healthcare,Default,Fee Schedule,36163.56,,,,26147.67,36163.56
ROTATOR CUFF REPAIR & OTHER PROC,360,RC,,,,both,22547.55,20292.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15783.28,,,,13303.05,18398.8
ROTATOR CUFF REPAIR & OTHER PROC,360,RC,,,,both,22547.55,20292.8,Cigna,Default,Percent of Total Billed Charges,13303.05,,,,13303.05,18398.8
ROTATOR CUFF REPAIR & OTHER PROC,360,RC,,,,both,22547.55,20292.8,United Healthcare,Default,Fee Schedule,18398.8,,,,13303.05,18398.8
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-O,360,RC,,,,both,6312.67,5681.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4418.87,,,,3724.48,5151.14
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-O,360,RC,,,,both,6312.67,5681.4,Cigna,Default,Percent of Total Billed Charges,3724.48,,,,3724.48,5151.14
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-O,360,RC,,,,both,6312.67,5681.4,United Healthcare,Default,Fee Schedule,5151.14,,,,3724.48,5151.14
KNEE MANIPULATION,360,RC,,,,both,4869.84,4382.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3408.89,,,,2873.21,3973.79
KNEE MANIPULATION,360,RC,,,,both,4869.84,4382.86,Cigna,Default,Percent of Total Billed Charges,2873.21,,,,2873.21,3973.79
KNEE MANIPULATION,360,RC,,,,both,4869.84,4382.86,United Healthcare,Default,Fee Schedule,3973.79,,,,2873.21,3973.79
WRIST ORIF,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
WRIST ORIF,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
WRIST ORIF,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
REVISION KNEE JOINT; 1 COMPONENT,360,RC,,,,both,21208.22,19087.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14845.75,,,,12512.85,17305.91
REVISION KNEE JOINT; 1 COMPONENT,360,RC,,,,both,21208.22,19087.4,Cigna,Default,Percent of Total Billed Charges,12512.85,,,,12512.85,17305.91
REVISION KNEE JOINT; 1 COMPONENT,360,RC,,,,both,21208.22,19087.4,United Healthcare,Default,Fee Schedule,17305.91,,,,12512.85,17305.91
ANKLE ORIF,360,RC,,,,both,26265,23638.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18385.5,,,,15496.35,21432.24
ANKLE ORIF,360,RC,,,,both,26265,23638.5,Cigna,Default,Percent of Total Billed Charges,15496.35,,,,15496.35,21432.24
ANKLE ORIF,360,RC,,,,both,26265,23638.5,United Healthcare,Default,Fee Schedule,21432.24,,,,15496.35,21432.24
CALCANEAL ORIF,360,RC,,,,both,21941.25,19747.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15358.88,,,,12945.34,17904.06
CALCANEAL ORIF,360,RC,,,,both,21941.25,19747.13,Cigna,Default,Percent of Total Billed Charges,12945.34,,,,12945.34,17904.06
CALCANEAL ORIF,360,RC,,,,both,21941.25,19747.13,United Healthcare,Default,Fee Schedule,17904.06,,,,12945.34,17904.06
OPEN ROTATOR CUFF REPAIR,360,RC,,,,both,22698.38,20428.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15888.87,,,,13392.04,18521.88
OPEN ROTATOR CUFF REPAIR,360,RC,,,,both,22698.38,20428.54,Cigna,Default,Percent of Total Billed Charges,13392.04,,,,13392.04,18521.88
OPEN ROTATOR CUFF REPAIR,360,RC,,,,both,22698.38,20428.54,United Healthcare,Default,Fee Schedule,18521.88,,,,13392.04,18521.88
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,983,RC,,both,235.79,212.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.05,,,,139.12,165.05
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,983,RC,,both,235.79,212.21,Cigna,Default,Percent of Total Billed Charges,139.12,,,,139.12,165.05
INJ TRIGGER POINT 1/2 MUSCL,20552,HCPCS,983,RC,,both,235.79,212.21,United Healthcare,Default,Fee Schedule,,,,,139.12,165.05
STRAPPING ANKLE AND/OR FOOT,29540,HCPCS,983,RC,,both,77,69.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.9,,,,45.43,53.9
STRAPPING ANKLE AND/OR FOOT,29540,HCPCS,983,RC,,both,77,69.3,Cigna,Default,Percent of Total Billed Charges,45.43,,,,45.43,53.9
STRAPPING ANKLE AND/OR FOOT,29540,HCPCS,983,RC,,both,77,69.3,United Healthcare,Default,Fee Schedule,,,,,45.43,53.9
"DNU BAG OSTOMY 1 3/4"" DRAINABLE0",271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" DRAINABLE0",271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" DRAINABLE0",271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"BAG OSTOMY 1 3/4"" DRAINABLE",A4389,HCPCS,270,RC,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"BAG OSTOMY 1 3/4"" DRAINABLE",A4389,HCPCS,270,RC,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"BAG OSTOMY 1 3/4"" DRAINABLE",A4389,HCPCS,270,RC,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE 4-0 PC-5 ETH 8631G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PROLENE 4-0 PC-5 ETH 8631G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PROLENE 4-0 PC-5 ETH 8631G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 4-0 PC-5 ETH 1894G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 4-0 PC-5 ETH 1894G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 4-0 PC-5 ETH 1894G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 5-0 PC-3 ETH 1965G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 5-0 PC-3 ETH 1965G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 5-0 PC-3 ETH 1965G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 6-0 PC-1,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 6-0 PC-1,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 6-0 PC-1,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DNO SUTURE CHROMIC 5-0 P-3 ETH 687G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
DNO SUTURE CHROMIC 5-0 P-3 ETH 687G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
DNO SUTURE CHROMIC 5-0 P-3 ETH 687G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DASH IT HALLOW  DIRECT ACESS,272,RC,,,,both,1378.28,1240.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,964.8,,,,813.19,1124.68
DASH IT HALLOW  DIRECT ACESS,272,RC,,,,both,1378.28,1240.45,Cigna,Default,Percent of Total Billed Charges,813.19,,,,813.19,1124.68
DASH IT HALLOW  DIRECT ACESS,272,RC,,,,both,1378.28,1240.45,United Healthcare,Default,Fee Schedule,1124.68,,,,813.19,1124.68
"SUTURE PROLENE 6-0 BV-1 30"" ETH 8709H",272,RC,,,,both,63.38,57.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.37,,,,37.39,51.72
"SUTURE PROLENE 6-0 BV-1 30"" ETH 8709H",272,RC,,,,both,63.38,57.04,Cigna,Default,Percent of Total Billed Charges,37.39,,,,37.39,51.72
"SUTURE PROLENE 6-0 BV-1 30"" ETH 8709H",272,RC,,,,both,63.38,57.04,United Healthcare,Default,Fee Schedule,51.72,,,,37.39,51.72
FROVA INTUBATING INTRODUCER 8F,272,RC,,,,both,340.2,306.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.14,,,,200.72,277.6
FROVA INTUBATING INTRODUCER 8F,272,RC,,,,both,340.2,306.18,Cigna,Default,Percent of Total Billed Charges,200.72,,,,200.72,277.6
FROVA INTUBATING INTRODUCER 8F,272,RC,,,,both,340.2,306.18,United Healthcare,Default,Fee Schedule,277.6,,,,200.72,277.6
RAPI-FIT FROVA INTUBATING INTRODUCER 14F,272,RC,,,,both,326.6,293.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.62,,,,192.69,266.51
RAPI-FIT FROVA INTUBATING INTRODUCER 14F,272,RC,,,,both,326.6,293.94,Cigna,Default,Percent of Total Billed Charges,192.69,,,,192.69,266.51
RAPI-FIT FROVA INTUBATING INTRODUCER 14F,272,RC,,,,both,326.6,293.94,United Healthcare,Default,Fee Schedule,266.51,,,,192.69,266.51
RAPID-FIT FROVA INTUBATING INTRODUCER 14,272,RC,,,,both,276.67,249,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,193.67,,,,163.24,225.76
RAPID-FIT FROVA INTUBATING INTRODUCER 14,272,RC,,,,both,276.67,249,Cigna,Default,Percent of Total Billed Charges,163.24,,,,163.24,225.76
RAPID-FIT FROVA INTUBATING INTRODUCER 14,272,RC,,,,both,276.67,249,United Healthcare,Default,Fee Schedule,225.76,,,,163.24,225.76
RETOGRADE INTUBATION SET 11F,272,RC,,,,both,570.22,513.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,399.15,,,,336.43,465.3
RETOGRADE INTUBATION SET 11F,272,RC,,,,both,570.22,513.2,Cigna,Default,Percent of Total Billed Charges,336.43,,,,336.43,465.3
RETOGRADE INTUBATION SET 11F,272,RC,,,,both,570.22,513.2,United Healthcare,Default,Fee Schedule,465.3,,,,336.43,465.3
RETROGRADE INTUBATION SET REPLACEMENT WI,272,RC,,,,both,204.21,183.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.95,,,,120.48,166.64
RETROGRADE INTUBATION SET REPLACEMENT WI,272,RC,,,,both,204.21,183.79,Cigna,Default,Percent of Total Billed Charges,120.48,,,,120.48,166.64
RETROGRADE INTUBATION SET REPLACEMENT WI,272,RC,,,,both,204.21,183.79,United Healthcare,Default,Fee Schedule,166.64,,,,120.48,166.64
SUTURE GORTEX 2-0 CV-2 2N08A,272,RC,,,,both,79.81,71.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.87,,,,47.09,65.12
SUTURE GORTEX 2-0 CV-2 2N08A,272,RC,,,,both,79.81,71.83,Cigna,Default,Percent of Total Billed Charges,47.09,,,,47.09,65.12
SUTURE GORTEX 2-0 CV-2 2N08A,272,RC,,,,both,79.81,71.83,United Healthcare,Default,Fee Schedule,65.12,,,,47.09,65.12
SUTURE VICRYL 4-0 RB-1 ETH J214H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE VICRYL 4-0 RB-1 ETH J214H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE VICRYL 4-0 RB-1 ETH J214H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DNO SHIELD EYE WITH GARTER,258,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
DNO SHIELD EYE WITH GARTER,258,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
DNO SHIELD EYE WITH GARTER,258,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE VICRYL 3-0 TIES ETH J110T,272,RC,,,,both,28.73,25.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.11,,,,16.95,23.44
SUTURE VICRYL 3-0 TIES ETH J110T,272,RC,,,,both,28.73,25.86,Cigna,Default,Percent of Total Billed Charges,16.95,,,,16.95,23.44
SUTURE VICRYL 3-0 TIES ETH J110T,272,RC,,,,both,28.73,25.86,United Healthcare,Default,Fee Schedule,23.44,,,,16.95,23.44
SOFT TIPPED AIRWAY EXCHANGE CATHETER 11F,272,RC,,,,both,224.25,201.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,156.98,,,,132.31,182.99
SOFT TIPPED AIRWAY EXCHANGE CATHETER 11F,272,RC,,,,both,224.25,201.83,Cigna,Default,Percent of Total Billed Charges,132.31,,,,132.31,182.99
SOFT TIPPED AIRWAY EXCHANGE CATHETER 11F,272,RC,,,,both,224.25,201.83,United Healthcare,Default,Fee Schedule,182.99,,,,132.31,182.99
SUTURE CHROMIC 3-0 SH ETH G122H,272,RC,,,,both,23.05,20.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.14,,,,13.6,18.81
SUTURE CHROMIC 3-0 SH ETH G122H,272,RC,,,,both,23.05,20.75,Cigna,Default,Percent of Total Billed Charges,13.6,,,,13.6,18.81
SUTURE CHROMIC 3-0 SH ETH G122H,272,RC,,,,both,23.05,20.75,United Healthcare,Default,Fee Schedule,18.81,,,,13.6,18.81
SUTURE MONOCRYL 4-0 PS-2 ETH Y426H,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE MONOCRYL 4-0 PS-2 ETH Y426H,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE MONOCRYL 4-0 PS-2 ETH Y426H,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
ENK OXYGEN FLOW MODULATOR SET 6F,272,RC,,,,both,494.74,445.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,346.32,,,,291.9,403.71
ENK OXYGEN FLOW MODULATOR SET 6F,272,RC,,,,both,494.74,445.27,Cigna,Default,Percent of Total Billed Charges,291.9,,,,291.9,403.71
ENK OXYGEN FLOW MODULATOR SET 6F,272,RC,,,,both,494.74,445.27,United Healthcare,Default,Fee Schedule,403.71,,,,291.9,403.71
"SUTURE SILK 2-0 18"" TIE ETH A185H",272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"SUTURE SILK 2-0 18"" TIE ETH A185H",272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"SUTURE SILK 2-0 18"" TIE ETH A185H",272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE RETENTION BRIDGES ETH RSB5,272,RC,,,,both,37.29,33.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.1,,,,22,30.43
SUTURE RETENTION BRIDGES ETH RSB5,272,RC,,,,both,37.29,33.56,Cigna,Default,Percent of Total Billed Charges,22,,,,22,30.43
SUTURE RETENTION BRIDGES ETH RSB5,272,RC,,,,both,37.29,33.56,United Healthcare,Default,Fee Schedule,30.43,,,,22,30.43
SUTURE PROLENE 4-0 RB-1 ETH 8557H,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE PROLENE 4-0 RB-1 ETH 8557H,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE PROLENE 4-0 RB-1 ETH 8557H,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
CATH SILICONE 16FR 5CC,A4344,HCPCS,272,RC,,both,26.99,24.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.89,,,,15.92,22.02
CATH SILICONE 16FR 5CC,A4344,HCPCS,272,RC,,both,26.99,24.29,Cigna,Default,Percent of Total Billed Charges,15.92,,,,15.92,22.02
CATH SILICONE 16FR 5CC,A4344,HCPCS,272,RC,,both,26.99,24.29,United Healthcare,Default,Fee Schedule,22.02,,,,15.92,22.02
SUTURE PROLENE 5-0 C-1 ETH 8720H,272,RC,,,,both,52.08,46.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.46,,,,30.73,42.5
SUTURE PROLENE 5-0 C-1 ETH 8720H,272,RC,,,,both,52.08,46.87,Cigna,Default,Percent of Total Billed Charges,30.73,,,,30.73,42.5
SUTURE PROLENE 5-0 C-1 ETH 8720H,272,RC,,,,both,52.08,46.87,United Healthcare,Default,Fee Schedule,42.5,,,,30.73,42.5
CATH SILICONE 18FR 10CC,A4344,HCPCS,272,RC,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
CATH SILICONE 18FR 10CC,A4344,HCPCS,272,RC,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
CATH SILICONE 18FR 10CC,A4344,HCPCS,272,RC,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
CATH SILICONE 24FR 5CC,A4344,HCPCS,272,RC,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
CATH SILICONE 24FR 5CC,A4344,HCPCS,272,RC,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
CATH SILICONE 24FR 5CC,A4344,HCPCS,272,RC,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE 5-0 P-3 ETH 8698G,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE PROLENE 5-0 P-3 ETH 8698G,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE PROLENE 5-0 P-3 ETH 8698G,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
*CATH SILICONE 28FR 5CC,A4344,HCPCS,272,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH SILICONE 28FR 5CC,A4344,HCPCS,272,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH SILICONE 28FR 5CC,A4344,HCPCS,272,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 2-0 K-S ETH 623H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE SILK 2-0 K-S ETH 623H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE SILK 2-0 K-S ETH 623H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 6-0 C-2 ETH 667G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 6-0 C-2 ETH 667G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 6-0 C-2 ETH 667G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 2-0 ETH 664G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 2-0 ETH 664G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 2-0 ETH 664G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 3-0 FS-1 ETH 663H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 3-0 FS-1 ETH 663H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 3-0 FS-1 ETH 663H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 4-0 FS-2 ETH 662G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 4-0 FS-2 ETH 662G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 4-0 FS-2 ETH 662G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 6-0 PS-3 ETH 1665G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 6-0 PS-3 ETH 1665G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 6-0 PS-3 ETH 1665G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 4-0 FS-2 ETH 662H,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE ETHILON 4-0 FS-2 ETH 662H,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE ETHILON 4-0 FS-2 ETH 662H,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SUTURE PROLENE #1 TP-1 LOOPED ETH D9487,272,RC,,,,both,169.16,152.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.41,,,,99.8,138.03
SUTURE PROLENE #1 TP-1 LOOPED ETH D9487,272,RC,,,,both,169.16,152.24,Cigna,Default,Percent of Total Billed Charges,99.8,,,,99.8,138.03
SUTURE PROLENE #1 TP-1 LOOPED ETH D9487,272,RC,,,,both,169.16,152.24,United Healthcare,Default,Fee Schedule,138.03,,,,99.8,138.03
SUTURE PROLENE MONO BLUE 1.60 TP-1 ETH 8,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PROLENE MONO BLUE 1.60 TP-1 ETH 8,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PROLENE MONO BLUE 1.60 TP-1 ETH 8,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PDS #1 TP-1 LOOPED ETH Z880G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PDS #1 TP-1 LOOPED ETH Z880G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PDS #1 TP-1 LOOPED ETH Z880G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE 0 SH ETH 8834H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PROLENE 0 SH ETH 8834H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PROLENE 0 SH ETH 8834H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
"DNU BAG BLUE 2 3/4"" (70MM)FLANGE",A4415,HCPCS,272,RC,,both,26.5,23.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.55,,,,15.64,21.62
"DNU BAG BLUE 2 3/4"" (70MM)FLANGE",A4415,HCPCS,272,RC,,both,26.5,23.85,Cigna,Default,Percent of Total Billed Charges,15.64,,,,15.64,21.62
"DNU BAG BLUE 2 3/4"" (70MM)FLANGE",A4415,HCPCS,272,RC,,both,26.5,23.85,United Healthcare,Default,Fee Schedule,21.62,,,,15.64,21.62
"DNU BAG POUCH BLUE 2 3/4"" (70MM)FLANGE",A4425,HCPCS,272,RC,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG POUCH BLUE 2 3/4"" (70MM)FLANGE",A4425,HCPCS,272,RC,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG POUCH BLUE 2 3/4"" (70MM)FLANGE",A4425,HCPCS,272,RC,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
POWDER PREMIUM (OSTOMY CARE),A4371,HCPCS,270,RC,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
POWDER PREMIUM (OSTOMY CARE),A4371,HCPCS,270,RC,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
POWDER PREMIUM (OSTOMY CARE),A4371,HCPCS,270,RC,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
"DNU RINGS BARRIER INSIDE DIA 1 3/16""",A4385,HCPCS,271,RC,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
"DNU RINGS BARRIER INSIDE DIA 1 3/16""",A4385,HCPCS,271,RC,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
"DNU RINGS BARRIER INSIDE DIA 1 3/16""",A4385,HCPCS,271,RC,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
"SUTURE SILK 3-0 18"" TIES  ETH A-184H",272,RC,,,,both,22.05,19.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.44,,,,13.01,17.99
"SUTURE SILK 3-0 18"" TIES  ETH A-184H",272,RC,,,,both,22.05,19.85,Cigna,Default,Percent of Total Billed Charges,13.01,,,,13.01,17.99
"SUTURE SILK 3-0 18"" TIES  ETH A-184H",272,RC,,,,both,22.05,19.85,United Healthcare,Default,Fee Schedule,17.99,,,,13.01,17.99
"SUTURE SILK 3-0 30"" TIES ETH A304H",272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"SUTURE SILK 3-0 30"" TIES ETH A304H",272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"SUTURE SILK 3-0 30"" TIES ETH A304H",272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DNU STRIPS BARRIER SZ/60 GRAMS,A4385,HCPCS,272,RC,,both,31,27.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.7,,,,18.29,25.3
DNU STRIPS BARRIER SZ/60 GRAMS,A4385,HCPCS,272,RC,,both,31,27.9,Cigna,Default,Percent of Total Billed Charges,18.29,,,,18.29,25.3
DNU STRIPS BARRIER SZ/60 GRAMS,A4385,HCPCS,272,RC,,both,31,27.9,United Healthcare,Default,Fee Schedule,25.3,,,,18.29,25.3
SUTURE SILK 2-0 FS ETH 685-G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE SILK 2-0 FS ETH 685-G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE SILK 2-0 FS ETH 685-G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE ETHILON 3-0 FS-1 ETH 663G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON 3-0 FS-1 ETH 663G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON 3-0 FS-1 ETH 663G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE #1 CT-X ETH 8455-H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PROLENE #1 CT-X ETH 8455-H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PROLENE #1 CT-X ETH 8455-H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE 0 V-34 ETH 8444H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PROLENE 0 V-34 ETH 8444H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PROLENE 0 V-34 ETH 8444H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE 3-0 FS-2 ETH 8665G,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE PROLENE 3-0 FS-2 ETH 8665G,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE PROLENE 3-0 FS-2 ETH 8665G,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SUTURE PROLENE 7-0 P-6 ETH 8648G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PROLENE 7-0 P-6 ETH 8648G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PROLENE 7-0 P-6 ETH 8648G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
"SUTURE SILK 2-0 SH 30"" ETH K833H",272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
"SUTURE SILK 2-0 SH 30"" ETH K833H",272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
"SUTURE SILK 2-0 SH 30"" ETH K833H",272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
*BRAVO CAPSULE DELIVERY SYSTEM,A4338,HCPCS,272,RC,,both,1018.54,916.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,712.98,,,,600.94,831.13
*BRAVO CAPSULE DELIVERY SYSTEM,A4338,HCPCS,272,RC,,both,1018.54,916.69,Cigna,Default,Percent of Total Billed Charges,600.94,,,,600.94,831.13
*BRAVO CAPSULE DELIVERY SYSTEM,A4338,HCPCS,272,RC,,both,1018.54,916.69,United Healthcare,Default,Fee Schedule,831.13,,,,600.94,831.13
PATENCY CAPSULE,272,RC,,,,both,133.63,120.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.54,,,,78.84,109.04
PATENCY CAPSULE,272,RC,,,,both,133.63,120.27,Cigna,Default,Percent of Total Billed Charges,78.84,,,,78.84,109.04
PATENCY CAPSULE,272,RC,,,,both,133.63,120.27,United Healthcare,Default,Fee Schedule,109.04,,,,78.84,109.04
*BRAVO CAPSULE DELVRY STM NON CALIBR NEW,A4338,HCPCS,272,RC,,both,1048.05,943.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,733.64,,,,618.35,855.21
*BRAVO CAPSULE DELVRY STM NON CALIBR NEW,A4338,HCPCS,272,RC,,both,1048.05,943.25,Cigna,Default,Percent of Total Billed Charges,618.35,,,,618.35,855.21
*BRAVO CAPSULE DELVRY STM NON CALIBR NEW,A4338,HCPCS,272,RC,,both,1048.05,943.25,United Healthcare,Default,Fee Schedule,855.21,,,,618.35,855.21
CATH MALECOT 26FR,272,RC,,,,both,108.58,97.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.01,,,,64.06,88.6
CATH MALECOT 26FR,272,RC,,,,both,108.58,97.72,Cigna,Default,Percent of Total Billed Charges,64.06,,,,64.06,88.6
CATH MALECOT 26FR,272,RC,,,,both,108.58,97.72,United Healthcare,Default,Fee Schedule,88.6,,,,64.06,88.6
SUTURE PDS #1 TP-1 ETH Z879G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PDS #1 TP-1 ETH Z879G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PDS #1 TP-1 ETH Z879G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PDS 4-0 RB-1 ETH Z304H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PDS 4-0 RB-1 ETH Z304H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PDS 4-0 RB-1 ETH Z304H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PDS 0 CT-2 ETH Z334H,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE PDS 0 CT-2 ETH Z334H,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE PDS 0 CT-2 ETH Z334H,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SUTURE PDS 2-0 CT-1 ETH Z339H,272,RC,,,,both,22.07,19.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.45,,,,13.02,18.01
SUTURE PDS 2-0 CT-1 ETH Z339H,272,RC,,,,both,22.07,19.86,Cigna,Default,Percent of Total Billed Charges,13.02,,,,13.02,18.01
SUTURE PDS 2-0 CT-1 ETH Z339H,272,RC,,,,both,22.07,19.86,United Healthcare,Default,Fee Schedule,18.01,,,,13.02,18.01
SUTURE PDS 3-0 SH ETH Z316H,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE PDS 3-0 SH ETH Z316H,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE PDS 3-0 SH ETH Z316H,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SUTURE PDS 2-0 SH ETH Z317H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PDS 2-0 SH ETH Z317H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PDS 2-0 SH ETH Z317H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PDS 5-0 II P-3 ETH Z493G,272,RC,,,,both,26.05,23.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.24,,,,15.37,21.26
SUTURE PDS 5-0 II P-3 ETH Z493G,272,RC,,,,both,26.05,23.45,Cigna,Default,Percent of Total Billed Charges,15.37,,,,15.37,21.26
SUTURE PDS 5-0 II P-3 ETH Z493G,272,RC,,,,both,26.05,23.45,United Healthcare,Default,Fee Schedule,21.26,,,,15.37,21.26
DNU GASKET OSTOMY LOOP KARAYA,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU GASKET OSTOMY LOOP KARAYA,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU GASKET OSTOMY LOOP KARAYA,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
SUTURE CHROMIC 2-0 CT-3 ETH 893H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE CHROMIC 2-0 CT-3 ETH 893H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE CHROMIC 2-0 CT-3 ETH 893H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PROLENE 6-0 P-1 ETH 8697G,272,RC,,,,both,21.19,19.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.83,,,,12.5,17.29
SUTURE PROLENE 6-0 P-1 ETH 8697G,272,RC,,,,both,21.19,19.07,Cigna,Default,Percent of Total Billed Charges,12.5,,,,12.5,17.29
SUTURE PROLENE 6-0 P-1 ETH 8697G,272,RC,,,,both,21.19,19.07,United Healthcare,Default,Fee Schedule,17.29,,,,12.5,17.29
SUTURE CHROMIC 3-0  RB-1 ETHU204H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE CHROMIC 3-0  RB-1 ETHU204H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE CHROMIC 3-0  RB-1 ETHU204H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE SILK 2-0 SH CR/8 ETH C012D,272,RC,,,,both,31.13,28.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.79,,,,18.37,25.4
SUTURE SILK 2-0 SH CR/8 ETH C012D,272,RC,,,,both,31.13,28.02,Cigna,Default,Percent of Total Billed Charges,18.37,,,,18.37,25.4
SUTURE SILK 2-0 SH CR/8 ETH C012D,272,RC,,,,both,31.13,28.02,United Healthcare,Default,Fee Schedule,25.4,,,,18.37,25.4
SUTURE SILK 3-0 SH CR/8  ETH C013D,272,RC,,,,both,30.23,27.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.16,,,,17.84,24.67
SUTURE SILK 3-0 SH CR/8  ETH C013D,272,RC,,,,both,30.23,27.21,Cigna,Default,Percent of Total Billed Charges,17.84,,,,17.84,24.67
SUTURE SILK 3-0 SH CR/8  ETH C013D,272,RC,,,,both,30.23,27.21,United Healthcare,Default,Fee Schedule,24.67,,,,17.84,24.67
"SUTURE SILK 3-0 SH 30"" CR/8 ETH C017T",272,RC,,,,both,34.51,31.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.16,,,,20.36,28.16
"SUTURE SILK 3-0 SH 30"" CR/8 ETH C017T",272,RC,,,,both,34.51,31.06,Cigna,Default,Percent of Total Billed Charges,20.36,,,,20.36,28.16
"SUTURE SILK 3-0 SH 30"" CR/8 ETH C017T",272,RC,,,,both,34.51,31.06,United Healthcare,Default,Fee Schedule,28.16,,,,20.36,28.16
"SUTURE SILK 4-0 30"" TIES  ETH SA83H",272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"SUTURE SILK 4-0 30"" TIES  ETH SA83H",272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"SUTURE SILK 4-0 30"" TIES  ETH SA83H",272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE VICRYL 2-0 CT1 CR8 J839D,272,RC,,,,both,37.24,33.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.07,,,,21.97,30.39
SUTURE VICRYL 2-0 CT1 CR8 J839D,272,RC,,,,both,37.24,33.52,Cigna,Default,Percent of Total Billed Charges,21.97,,,,21.97,30.39
SUTURE VICRYL 2-0 CT1 CR8 J839D,272,RC,,,,both,37.24,33.52,United Healthcare,Default,Fee Schedule,30.39,,,,21.97,30.39
"SUTURE SILK 4-0 30"" TIES  ETH A303H",272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"SUTURE SILK 4-0 30"" TIES  ETH A303H",272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"SUTURE SILK 4-0 30"" TIES  ETH A303H",272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE MONOCRYL 3-0 PS-1 ETH Y936H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE MONOCRYL 3-0 PS-1 ETH Y936H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE MONOCRYL 3-0 PS-1 ETH Y936H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE MONOCRYL 2-0 ETH Y945H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE MONOCRYL 2-0 ETH Y945H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE MONOCRYL 2-0 ETH Y945H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
CATH FOGARTY BILRY 5F,272,RC,,,,both,366.53,329.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.57,,,,216.25,299.09
CATH FOGARTY BILRY 5F,272,RC,,,,both,366.53,329.88,Cigna,Default,Percent of Total Billed Charges,216.25,,,,216.25,299.09
CATH FOGARTY BILRY 5F,272,RC,,,,both,366.53,329.88,United Healthcare,Default,Fee Schedule,299.09,,,,216.25,299.09
SHEATH 23CM BRITE TI,272,RC,,,,both,164.5,148.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.15,,,,97.06,134.23
SHEATH 23CM BRITE TI,272,RC,,,,both,164.5,148.05,Cigna,Default,Percent of Total Billed Charges,97.06,,,,97.06,134.23
SHEATH 23CM BRITE TI,272,RC,,,,both,164.5,148.05,United Healthcare,Default,Fee Schedule,134.23,,,,97.06,134.23
CATH 7.5FR TAUT CHOLANGOGRAM,272,RC,,,,both,162.05,145.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.44,,,,95.61,132.23
CATH 7.5FR TAUT CHOLANGOGRAM,272,RC,,,,both,162.05,145.85,Cigna,Default,Percent of Total Billed Charges,95.61,,,,95.61,132.23
CATH 7.5FR TAUT CHOLANGOGRAM,272,RC,,,,both,162.05,145.85,United Healthcare,Default,Fee Schedule,132.23,,,,95.61,132.23
STETHOSCOPE ESOPHAGEAL 18FR,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
STETHOSCOPE ESOPHAGEAL 18FR,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
STETHOSCOPE ESOPHAGEAL 18FR,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
GELPORT LAPAROSCOPIC SYSTEM,272,RC,,,,both,2400.93,2160.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1680.65,,,,1416.55,1959.16
GELPORT LAPAROSCOPIC SYSTEM,272,RC,,,,both,2400.93,2160.84,Cigna,Default,Percent of Total Billed Charges,1416.55,,,,1416.55,1959.16
GELPORT LAPAROSCOPIC SYSTEM,272,RC,,,,both,2400.93,2160.84,United Healthcare,Default,Fee Schedule,1959.16,,,,1416.55,1959.16
CATH THORACIC 16FR,272,RC,,,,both,33.09,29.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.16,,,,19.52,27
CATH THORACIC 16FR,272,RC,,,,both,33.09,29.78,Cigna,Default,Percent of Total Billed Charges,19.52,,,,19.52,27
CATH THORACIC 16FR,272,RC,,,,both,33.09,29.78,United Healthcare,Default,Fee Schedule,27,,,,19.52,27
CATH THORACIC 20FR,272,RC,,,,both,32.68,29.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.88,,,,19.28,26.67
CATH THORACIC 20FR,272,RC,,,,both,32.68,29.41,Cigna,Default,Percent of Total Billed Charges,19.28,,,,19.28,26.67
CATH THORACIC 20FR,272,RC,,,,both,32.68,29.41,United Healthcare,Default,Fee Schedule,26.67,,,,19.28,26.67
BRUSH CYTOLOGY DISPOSABLE,272,RC,,,,both,145.29,130.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.7,,,,85.72,118.56
BRUSH CYTOLOGY DISPOSABLE,272,RC,,,,both,145.29,130.76,Cigna,Default,Percent of Total Billed Charges,85.72,,,,85.72,118.56
BRUSH CYTOLOGY DISPOSABLE,272,RC,,,,both,145.29,130.76,United Healthcare,Default,Fee Schedule,118.56,,,,85.72,118.56
NEEDLE INTRAOSSEOUS 15G 25MM 40KGS,272,RC,,,,both,468.53,421.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,327.97,,,,276.43,382.32
NEEDLE INTRAOSSEOUS 15G 25MM 40KGS,272,RC,,,,both,468.53,421.68,Cigna,Default,Percent of Total Billed Charges,276.43,,,,276.43,382.32
NEEDLE INTRAOSSEOUS 15G 25MM 40KGS,272,RC,,,,both,468.53,421.68,United Healthcare,Default,Fee Schedule,382.32,,,,276.43,382.32
NEEDLE INTRAOSSEOUS 15G 15MM 3-39KGS,272,RC,,,,both,491.27,442.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,343.89,,,,289.85,400.88
NEEDLE INTRAOSSEOUS 15G 15MM 3-39KGS,272,RC,,,,both,491.27,442.14,Cigna,Default,Percent of Total Billed Charges,289.85,,,,289.85,400.88
NEEDLE INTRAOSSEOUS 15G 15MM 3-39KGS,272,RC,,,,both,491.27,442.14,United Healthcare,Default,Fee Schedule,400.88,,,,289.85,400.88
DNO NEEDLE INTRAOSSEOUS 15G 45MM BAR,272,RC,,,,both,491.27,442.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,343.89,,,,289.85,400.88
DNO NEEDLE INTRAOSSEOUS 15G 45MM BAR,272,RC,,,,both,491.27,442.14,Cigna,Default,Percent of Total Billed Charges,289.85,,,,289.85,400.88
DNO NEEDLE INTRAOSSEOUS 15G 45MM BAR,272,RC,,,,both,491.27,442.14,United Healthcare,Default,Fee Schedule,400.88,,,,289.85,400.88
DNO EZ-STABILIZER,272,RC,,,,both,80.16,72.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.11,,,,47.29,65.41
DNO EZ-STABILIZER,272,RC,,,,both,80.16,72.14,Cigna,Default,Percent of Total Billed Charges,47.29,,,,47.29,65.41
DNO EZ-STABILIZER,272,RC,,,,both,80.16,72.14,United Healthcare,Default,Fee Schedule,65.41,,,,47.29,65.41
GRAFT BIFURCATED 16 X,C1768,HCPCS,278,RC,,both,1511.71,1360.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1058.2,,,,891.91,1233.56
GRAFT BIFURCATED 16 X,C1768,HCPCS,278,RC,,both,1511.71,1360.54,Cigna,Default,Percent of Total Billed Charges,891.91,,,,891.91,1233.56
GRAFT BIFURCATED 16 X,C1768,HCPCS,278,RC,,both,1511.71,1360.54,United Healthcare,Default,Fee Schedule,1233.56,,,,891.91,1233.56
GRAFT AAA BIFURCATED MAIN BODY,C1768,HCPCS,278,RC,,both,26015.4,23413.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18210.78,,,,15349.09,21228.57
GRAFT AAA BIFURCATED MAIN BODY,C1768,HCPCS,278,RC,,both,26015.4,23413.86,Cigna,Default,Percent of Total Billed Charges,15349.09,,,,15349.09,21228.57
GRAFT AAA BIFURCATED MAIN BODY,C1768,HCPCS,278,RC,,both,26015.4,23413.86,United Healthcare,Default,Fee Schedule,21228.57,,,,15349.09,21228.57
GRAFT AAA ILIAC LEG GRAFT,C1768,HCPCS,278,RC,,both,9492.1,8542.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6644.47,,,,5600.34,7745.55
GRAFT AAA ILIAC LEG GRAFT,C1768,HCPCS,278,RC,,both,9492.1,8542.89,Cigna,Default,Percent of Total Billed Charges,5600.34,,,,5600.34,7745.55
GRAFT AAA ILIAC LEG GRAFT,C1768,HCPCS,278,RC,,both,9492.1,8542.89,United Healthcare,Default,Fee Schedule,7745.55,,,,5600.34,7745.55
GRAFT AAA ILIAC LEG GRAFT,C1768,HCPCS,278,RC,,both,9492.1,8542.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6644.47,,,,5600.34,7745.55
GRAFT AAA ILIAC LEG GRAFT,C1768,HCPCS,278,RC,,both,9492.1,8542.89,Cigna,Default,Percent of Total Billed Charges,5600.34,,,,5600.34,7745.55
GRAFT AAA ILIAC LEG GRAFT,C1768,HCPCS,278,RC,,both,9492.1,8542.89,United Healthcare,Default,Fee Schedule,7745.55,,,,5600.34,7745.55
GRAFT,278,RC,,,,both,1899.22,1709.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1329.45,,,,1120.54,1549.76
GRAFT,278,RC,,,,both,1899.22,1709.3,Cigna,Default,Percent of Total Billed Charges,1120.54,,,,1120.54,1549.76
GRAFT,278,RC,,,,both,1899.22,1709.3,United Healthcare,Default,Fee Schedule,1549.76,,,,1120.54,1549.76
GRAFT HEMASHIELD GOLD 20MMX10MMXL40CM,C1768,HCPCS,278,RC,,both,2404.46,2164.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1683.12,,,,1418.63,1962.04
GRAFT HEMASHIELD GOLD 20MMX10MMXL40CM,C1768,HCPCS,278,RC,,both,2404.46,2164.01,Cigna,Default,Percent of Total Billed Charges,1418.63,,,,1418.63,1962.04
GRAFT HEMASHIELD GOLD 20MMX10MMXL40CM,C1768,HCPCS,278,RC,,both,2404.46,2164.01,United Healthcare,Default,Fee Schedule,1962.04,,,,1418.63,1962.04
GRAFT HEMASHIELD GOLD 22MMX11MMXL40CM,C1768,HCPCS,278,RC,,both,2812.48,2531.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1968.74,,,,1659.36,2294.98
GRAFT HEMASHIELD GOLD 22MMX11MMXL40CM,C1768,HCPCS,278,RC,,both,2812.48,2531.23,Cigna,Default,Percent of Total Billed Charges,1659.36,,,,1659.36,2294.98
GRAFT HEMASHIELD GOLD 22MMX11MMXL40CM,C1768,HCPCS,278,RC,,both,2812.48,2531.23,United Healthcare,Default,Fee Schedule,2294.98,,,,1659.36,2294.98
CONV SUTURE VICRYL 4-0 TF ETH J434H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
CONV SUTURE VICRYL 4-0 TF ETH J434H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
CONV SUTURE VICRYL 4-0 TF ETH J434H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DRESSING HYDROFERA BLUE W/FILM 4X4,272,RC,,,,both,27.91,25.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.54,,,,16.47,22.77
DRESSING HYDROFERA BLUE W/FILM 4X4,272,RC,,,,both,27.91,25.12,Cigna,Default,Percent of Total Billed Charges,16.47,,,,16.47,22.77
DRESSING HYDROFERA BLUE W/FILM 4X4,272,RC,,,,both,27.91,25.12,United Healthcare,Default,Fee Schedule,22.77,,,,16.47,22.77
WIPE INSTRUMENT-MENTR,272,RC,,,,both,34.44,31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.11,,,,20.32,28.1
WIPE INSTRUMENT-MENTR,272,RC,,,,both,34.44,31,Cigna,Default,Percent of Total Billed Charges,20.32,,,,20.32,28.1
WIPE INSTRUMENT-MENTR,272,RC,,,,both,34.44,31,United Healthcare,Default,Fee Schedule,28.1,,,,20.32,28.1
MEDIHONEY 1.5OZ TUBE,271,RC,,,,both,51.81,46.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.27,,,,30.57,42.28
MEDIHONEY 1.5OZ TUBE,271,RC,,,,both,51.81,46.63,Cigna,Default,Percent of Total Billed Charges,30.57,,,,30.57,42.28
MEDIHONEY 1.5OZ TUBE,271,RC,,,,both,51.81,46.63,United Healthcare,Default,Fee Schedule,42.28,,,,30.57,42.28
MEDIFIL PARTICLES COLLAGEN 1GR,A6262,HCPCS,272,RC,,both,73.55,66.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.48,,,,43.39,60.02
MEDIFIL PARTICLES COLLAGEN 1GR,A6262,HCPCS,272,RC,,both,73.55,66.2,Cigna,Default,Percent of Total Billed Charges,43.39,,,,43.39,60.02
MEDIFIL PARTICLES COLLAGEN 1GR,A6262,HCPCS,272,RC,,both,73.55,66.2,United Healthcare,Default,Fee Schedule,60.02,,,,43.39,60.02
MESH FLAT SHEET 6X6,C1781,HCPCS,278,RC,,both,377.29,339.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.1,,,,222.6,307.87
MESH FLAT SHEET 6X6,C1781,HCPCS,278,RC,,both,377.29,339.56,Cigna,Default,Percent of Total Billed Charges,222.6,,,,222.6,307.87
MESH FLAT SHEET 6X6,C1781,HCPCS,278,RC,,both,377.29,339.56,United Healthcare,Default,Fee Schedule,307.87,,,,222.6,307.87
PHASIX PLUG AND PATCH,C1781,HCPCS,278,RC,,both,579.99,521.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,405.99,,,,342.19,473.27
PHASIX PLUG AND PATCH,C1781,HCPCS,278,RC,,both,579.99,521.99,Cigna,Default,Percent of Total Billed Charges,342.19,,,,342.19,473.27
PHASIX PLUG AND PATCH,C1781,HCPCS,278,RC,,both,579.99,521.99,United Healthcare,Default,Fee Schedule,473.27,,,,342.19,473.27
PROLENE HERNIA SYSTEM MESH,C1781,HCPCS,278,RC,,both,1810.52,1629.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1267.36,,,,1068.21,1477.38
PROLENE HERNIA SYSTEM MESH,C1781,HCPCS,278,RC,,both,1810.52,1629.47,Cigna,Default,Percent of Total Billed Charges,1068.21,,,,1068.21,1477.38
PROLENE HERNIA SYSTEM MESH,C1781,HCPCS,278,RC,,both,1810.52,1629.47,United Healthcare,Default,Fee Schedule,1477.38,,,,1068.21,1477.38
PHASIX MESH 3x4,C1781,HCPCS,278,RC,,both,7189.39,6470.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5032.57,,,,4241.74,5866.54
PHASIX MESH 3x4,C1781,HCPCS,278,RC,,both,7189.39,6470.45,Cigna,Default,Percent of Total Billed Charges,4241.74,,,,4241.74,5866.54
PHASIX MESH 3x4,C1781,HCPCS,278,RC,,both,7189.39,6470.45,United Healthcare,Default,Fee Schedule,5866.54,,,,4241.74,5866.54
SUTURE ETHILON 5-0 P-3 ETH 698-G,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
SUTURE ETHILON 5-0 P-3 ETH 698-G,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
SUTURE ETHILON 5-0 P-3 ETH 698-G,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
CATH FOGARTY ART EMB 4FR 80 LATEX FREE,C1757,HCPCS,278,RC,,both,195.71,176.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137,,,,115.47,159.7
CATH FOGARTY ART EMB 4FR 80 LATEX FREE,C1757,HCPCS,278,RC,,both,195.71,176.14,Cigna,Default,Percent of Total Billed Charges,115.47,,,,115.47,159.7
CATH FOGARTY ART EMB 4FR 80 LATEX FREE,C1757,HCPCS,278,RC,,both,195.71,176.14,United Healthcare,Default,Fee Schedule,159.7,,,,115.47,159.7
CATH FOGARTY ART EMB 3 FR LATEX FREE,C1757,HCPCS,278,RC,,both,196.75,177.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.72,,,,116.08,160.55
CATH FOGARTY ART EMB 3 FR LATEX FREE,C1757,HCPCS,278,RC,,both,196.75,177.08,Cigna,Default,Percent of Total Billed Charges,116.08,,,,116.08,160.55
CATH FOGARTY ART EMB 3 FR LATEX FREE,C1757,HCPCS,278,RC,,both,196.75,177.08,United Healthcare,Default,Fee Schedule,160.55,,,,116.08,160.55
CATH ART EMB 3 FR,C1757,HCPCS,278,RC,,both,207.99,187.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.59,,,,122.71,169.72
CATH ART EMB 3 FR,C1757,HCPCS,278,RC,,both,207.99,187.19,Cigna,Default,Percent of Total Billed Charges,122.71,,,,122.71,169.72
CATH ART EMB 3 FR,C1757,HCPCS,278,RC,,both,207.99,187.19,United Healthcare,Default,Fee Schedule,169.72,,,,122.71,169.72
CATH ANGIOGRAPHIC 4FR BERN 65CM,C1757,HCPCS,278,RC,,both,57.65,51.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.36,,,,34.01,47.04
CATH ANGIOGRAPHIC 4FR BERN 65CM,C1757,HCPCS,278,RC,,both,57.65,51.89,Cigna,Default,Percent of Total Billed Charges,34.01,,,,34.01,47.04
CATH ANGIOGRAPHIC 4FR BERN 65CM,C1757,HCPCS,278,RC,,both,57.65,51.89,United Healthcare,Default,Fee Schedule,47.04,,,,34.01,47.04
CATH ART EMB 4FR 80,C1757,HCPCS,278,RC,,both,222.61,200.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.83,,,,131.34,181.65
CATH ART EMB 4FR 80,C1757,HCPCS,278,RC,,both,222.61,200.35,Cigna,Default,Percent of Total Billed Charges,131.34,,,,131.34,181.65
CATH ART EMB 4FR 80,C1757,HCPCS,278,RC,,both,222.61,200.35,United Healthcare,Default,Fee Schedule,181.65,,,,131.34,181.65
PHASIX MESH 4x6,C1781,HCPCS,278,RC,,both,9632.72,8669.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6742.9,,,,5683.3,7860.3
PHASIX MESH 4x6,C1781,HCPCS,278,RC,,both,9632.72,8669.45,Cigna,Default,Percent of Total Billed Charges,5683.3,,,,5683.3,7860.3
PHASIX MESH 4x6,C1781,HCPCS,278,RC,,both,9632.72,8669.45,United Healthcare,Default,Fee Schedule,7860.3,,,,5683.3,7860.3
CATH ART EMBOLECTOMY 5FR,C1757,HCPCS,278,RC,,both,207.99,187.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.59,,,,122.71,169.72
CATH ART EMBOLECTOMY 5FR,C1757,HCPCS,278,RC,,both,207.99,187.19,Cigna,Default,Percent of Total Billed Charges,122.71,,,,122.71,169.72
CATH ART EMBOLECTOMY 5FR,C1757,HCPCS,278,RC,,both,207.99,187.19,United Healthcare,Default,Fee Schedule,169.72,,,,122.71,169.72
MESH PROLENE 3.0 X 6.,C1781,HCPCS,278,RC,,both,395.82,356.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,277.07,,,,233.53,322.99
MESH PROLENE 3.0 X 6.,C1781,HCPCS,278,RC,,both,395.82,356.24,Cigna,Default,Percent of Total Billed Charges,233.53,,,,233.53,322.99
MESH PROLENE 3.0 X 6.,C1781,HCPCS,278,RC,,both,395.82,356.24,United Healthcare,Default,Fee Schedule,322.99,,,,233.53,322.99
MESH PROLENE 12 X 12,C1781,HCPCS,278,RC,,both,412.91,371.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,289.04,,,,243.62,336.93
MESH PROLENE 12 X 12,C1781,HCPCS,278,RC,,both,412.91,371.62,Cigna,Default,Percent of Total Billed Charges,243.62,,,,243.62,336.93
MESH PROLENE 12 X 12,C1781,HCPCS,278,RC,,both,412.91,371.62,United Healthcare,Default,Fee Schedule,336.93,,,,243.62,336.93
MESH OVAL 4X6,C1781,HCPCS,278,RC,,both,1218.75,1096.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,853.12,,,,719.06,994.5
MESH OVAL 4X6,C1781,HCPCS,278,RC,,both,1218.75,1096.88,Cigna,Default,Percent of Total Billed Charges,719.06,,,,719.06,994.5
MESH OVAL 4X6,C1781,HCPCS,278,RC,,both,1218.75,1096.88,United Healthcare,Default,Fee Schedule,994.5,,,,719.06,994.5
PHASIX MESH 6X8,C1781,HCPCS,278,RC,,both,15820.17,14238.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11074.12,,,,9333.9,12909.26
PHASIX MESH 6X8,C1781,HCPCS,278,RC,,both,15820.17,14238.15,Cigna,Default,Percent of Total Billed Charges,9333.9,,,,9333.9,12909.26
PHASIX MESH 6X8,C1781,HCPCS,278,RC,,both,15820.17,14238.15,United Healthcare,Default,Fee Schedule,12909.26,,,,9333.9,12909.26
DRESSING  AQUACEL  AG 4  X 5,272,RC,,,,both,31.17,28.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.82,,,,18.39,25.43
DRESSING  AQUACEL  AG 4  X 5,272,RC,,,,both,31.17,28.05,Cigna,Default,Percent of Total Billed Charges,18.39,,,,18.39,25.43
DRESSING  AQUACEL  AG 4  X 5,272,RC,,,,both,31.17,28.05,United Healthcare,Default,Fee Schedule,25.43,,,,18.39,25.43
GRAFT PTFE BIFURCATED 18X9X40,C1768,HCPCS,278,RC,,both,3487.94,3139.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2441.56,,,,2057.88,2846.16
GRAFT PTFE BIFURCATED 18X9X40,C1768,HCPCS,278,RC,,both,3487.94,3139.15,Cigna,Default,Percent of Total Billed Charges,2057.88,,,,2057.88,2846.16
GRAFT PTFE BIFURCATED 18X9X40,C1768,HCPCS,278,RC,,both,3487.94,3139.15,United Healthcare,Default,Fee Schedule,2846.16,,,,2057.88,2846.16
GRAFT PTFE BIFURCATED 20X10X40,C1768,HCPCS,278,RC,,both,1765.3,1588.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1235.71,,,,1041.53,1440.48
GRAFT PTFE BIFURCATED 20X10X40,C1768,HCPCS,278,RC,,both,1765.3,1588.77,Cigna,Default,Percent of Total Billed Charges,1041.53,,,,1041.53,1440.48
GRAFT PTFE BIFURCATED 20X10X40,C1768,HCPCS,278,RC,,both,1765.3,1588.77,United Healthcare,Default,Fee Schedule,1440.48,,,,1041.53,1440.48
PHASIX MESH 8x10,C1781,HCPCS,278,RC,,both,26718.52,24046.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18702.96,,,,15763.93,21802.31
PHASIX MESH 8x10,C1781,HCPCS,278,RC,,both,26718.52,24046.67,Cigna,Default,Percent of Total Billed Charges,15763.93,,,,15763.93,21802.31
PHASIX MESH 8x10,C1781,HCPCS,278,RC,,both,26718.52,24046.67,United Healthcare,Default,Fee Schedule,21802.31,,,,15763.93,21802.31
GRAFT THIN WALL 8MMX60CM,C1768,HCPCS,278,RC,,both,4369.89,3932.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3058.92,,,,2578.24,3565.83
GRAFT THIN WALL 8MMX60CM,C1768,HCPCS,278,RC,,both,4369.89,3932.9,Cigna,Default,Percent of Total Billed Charges,2578.24,,,,2578.24,3565.83
GRAFT THIN WALL 8MMX60CM,C1768,HCPCS,278,RC,,both,4369.89,3932.9,United Healthcare,Default,Fee Schedule,3565.83,,,,2578.24,3565.83
T-ANCHORS HERNIA SET,272,RC,,,,both,217.8,196.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.46,,,,128.5,177.72
T-ANCHORS HERNIA SET,272,RC,,,,both,217.8,196.02,Cigna,Default,Percent of Total Billed Charges,128.5,,,,128.5,177.72
T-ANCHORS HERNIA SET,272,RC,,,,both,217.8,196.02,United Healthcare,Default,Fee Schedule,177.72,,,,128.5,177.72
*MESH PROLENE 3.0 X 6.0 PROLITE,C1781,HCPCS,278,RC,,both,238.93,215.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,167.25,,,,140.97,194.97
*MESH PROLENE 3.0 X 6.0 PROLITE,C1781,HCPCS,278,RC,,both,238.93,215.04,Cigna,Default,Percent of Total Billed Charges,140.97,,,,140.97,194.97
*MESH PROLENE 3.0 X 6.0 PROLITE,C1781,HCPCS,278,RC,,both,238.93,215.04,United Healthcare,Default,Fee Schedule,194.97,,,,140.97,194.97
SURGIMESH XB,C1781,HCPCS,278,RC,,both,5800.73,5220.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4060.51,,,,3422.43,4733.4
SURGIMESH XB,C1781,HCPCS,278,RC,,both,5800.73,5220.66,Cigna,Default,Percent of Total Billed Charges,3422.43,,,,3422.43,4733.4
SURGIMESH XB,C1781,HCPCS,278,RC,,both,5800.73,5220.66,United Healthcare,Default,Fee Schedule,4733.4,,,,3422.43,4733.4
CATH ART EMB,C1757,HCPCS,278,RC,,both,195.71,176.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137,,,,115.47,159.7
CATH ART EMB,C1757,HCPCS,278,RC,,both,195.71,176.14,Cigna,Default,Percent of Total Billed Charges,115.47,,,,115.47,159.7
CATH ART EMB,C1757,HCPCS,278,RC,,both,195.71,176.14,United Healthcare,Default,Fee Schedule,159.7,,,,115.47,159.7
GRAFT VASC 6MM 40CM,C1768,HCPCS,278,RC,,both,2594.51,2335.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1816.16,,,,1530.76,2117.12
GRAFT VASC 6MM 40CM,C1768,HCPCS,278,RC,,both,2594.51,2335.06,Cigna,Default,Percent of Total Billed Charges,1530.76,,,,1530.76,2117.12
GRAFT VASC 6MM 40CM,C1768,HCPCS,278,RC,,both,2594.51,2335.06,United Healthcare,Default,Fee Schedule,2117.12,,,,1530.76,2117.12
GRAFT VASC 4MM-7MM THIN-WALLED,C1768,HCPCS,278,RC,,both,5990.57,5391.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4193.4,,,,3534.44,4888.31
GRAFT VASC 4MM-7MM THIN-WALLED,C1768,HCPCS,278,RC,,both,5990.57,5391.51,Cigna,Default,Percent of Total Billed Charges,3534.44,,,,3534.44,4888.31
GRAFT VASC 4MM-7MM THIN-WALLED,C1768,HCPCS,278,RC,,both,5990.57,5391.51,United Healthcare,Default,Fee Schedule,4888.31,,,,3534.44,4888.31
GRAFT RINGED 6 X 90,C1768,HCPCS,278,RC,,both,4805.82,4325.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3364.07,,,,2835.43,3921.55
GRAFT RINGED 6 X 90,C1768,HCPCS,278,RC,,both,4805.82,4325.24,Cigna,Default,Percent of Total Billed Charges,2835.43,,,,2835.43,3921.55
GRAFT RINGED 6 X 90,C1768,HCPCS,278,RC,,both,4805.82,4325.24,United Healthcare,Default,Fee Schedule,3921.55,,,,2835.43,3921.55
HEMORRHOID LIGATOR 13-15MM STIEGMAN GOFF,278,RC,,,,both,217.13,195.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.99,,,,128.11,177.18
HEMORRHOID LIGATOR 13-15MM STIEGMAN GOFF,278,RC,,,,both,217.13,195.42,Cigna,Default,Percent of Total Billed Charges,128.11,,,,128.11,177.18
HEMORRHOID LIGATOR 13-15MM STIEGMAN GOFF,278,RC,,,,both,217.13,195.42,United Healthcare,Default,Fee Schedule,177.18,,,,128.11,177.18
PHASIX MESH 10x12,C1781,HCPCS,278,RC,,both,51749.55,46574.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36224.68,,,,30532.23,42227.63
PHASIX MESH 10x12,C1781,HCPCS,278,RC,,both,51749.55,46574.6,Cigna,Default,Percent of Total Billed Charges,30532.23,,,,30532.23,42227.63
PHASIX MESH 10x12,C1781,HCPCS,278,RC,,both,51749.55,46574.6,United Healthcare,Default,Fee Schedule,42227.63,,,,30532.23,42227.63
GRAFT VASC 14MMX7MM 40 CM,C1768,HCPCS,278,RC,,both,3282.41,2954.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2297.69,,,,1936.62,2678.45
GRAFT VASC 14MMX7MM 40 CM,C1768,HCPCS,278,RC,,both,3282.41,2954.17,Cigna,Default,Percent of Total Billed Charges,1936.62,,,,1936.62,2678.45
GRAFT VASC 14MMX7MM 40 CM,C1768,HCPCS,278,RC,,both,3282.41,2954.17,United Healthcare,Default,Fee Schedule,2678.45,,,,1936.62,2678.45
GRAFT VASC 12MMX6MM 40 CM,C1768,HCPCS,278,RC,,both,2524.19,2271.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1766.93,,,,1489.27,2059.74
GRAFT VASC 12MMX6MM 40 CM,C1768,HCPCS,278,RC,,both,2524.19,2271.77,Cigna,Default,Percent of Total Billed Charges,1489.27,,,,1489.27,2059.74
GRAFT VASC 12MMX6MM 40 CM,C1768,HCPCS,278,RC,,both,2524.19,2271.77,United Healthcare,Default,Fee Schedule,2059.74,,,,1489.27,2059.74
GRAFT HEMASHIELD GOLD 18X9X40,C1768,HCPCS,278,RC,,both,2360.9,2124.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1652.63,,,,1392.93,1926.49
GRAFT HEMASHIELD GOLD 18X9X40,C1768,HCPCS,278,RC,,both,2360.9,2124.81,Cigna,Default,Percent of Total Billed Charges,1392.93,,,,1392.93,1926.49
GRAFT HEMASHIELD GOLD 18X9X40,C1768,HCPCS,278,RC,,both,2360.9,2124.81,United Healthcare,Default,Fee Schedule,1926.49,,,,1392.93,1926.49
GRAFT HEMASHIELD GOLD,C1768,HCPCS,278,RC,,both,2812.48,2531.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1968.74,,,,1659.36,2294.98
GRAFT HEMASHIELD GOLD,C1768,HCPCS,278,RC,,both,2812.48,2531.23,Cigna,Default,Percent of Total Billed Charges,1659.36,,,,1659.36,2294.98
GRAFT HEMASHIELD GOLD,C1768,HCPCS,278,RC,,both,2812.48,2531.23,United Healthcare,Default,Fee Schedule,2294.98,,,,1659.36,2294.98
PHASIX MESH 15CMX20CM,C1781,HCPCS,278,RC,,both,27175.54,24457.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19022.88,,,,16033.57,22175.24
PHASIX MESH 15CMX20CM,C1781,HCPCS,278,RC,,both,27175.54,24457.99,Cigna,Default,Percent of Total Billed Charges,16033.57,,,,16033.57,22175.24
PHASIX MESH 15CMX20CM,C1781,HCPCS,278,RC,,both,27175.54,24457.99,United Healthcare,Default,Fee Schedule,22175.24,,,,16033.57,22175.24
GRAFT RINGED 6 X 40,C1768,HCPCS,278,RC,,both,2462.67,2216.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1723.87,,,,1452.98,2009.54
GRAFT RINGED 6 X 40,C1768,HCPCS,278,RC,,both,2462.67,2216.4,Cigna,Default,Percent of Total Billed Charges,1452.98,,,,1452.98,2009.54
GRAFT RINGED 6 X 40,C1768,HCPCS,278,RC,,both,2462.67,2216.4,United Healthcare,Default,Fee Schedule,2009.54,,,,1452.98,2009.54
GRAFT VASC 8MM 80CM,C1768,HCPCS,278,RC,,both,5494.87,4945.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3846.41,,,,3241.97,4483.81
GRAFT VASC 8MM 80CM,C1768,HCPCS,278,RC,,both,5494.87,4945.38,Cigna,Default,Percent of Total Billed Charges,3241.97,,,,3241.97,4483.81
GRAFT VASC 8MM 80CM,C1768,HCPCS,278,RC,,both,5494.87,4945.38,United Healthcare,Default,Fee Schedule,4483.81,,,,3241.97,4483.81
GRAFT VASC 6-4.5X80CM DISTAFLOW,C1768,HCPCS,278,RC,,both,8525.32,7672.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5967.72,,,,5029.94,6956.66
GRAFT VASC 6-4.5X80CM DISTAFLOW,C1768,HCPCS,278,RC,,both,8525.32,7672.79,Cigna,Default,Percent of Total Billed Charges,5029.94,,,,5029.94,6956.66
GRAFT VASC 6-4.5X80CM DISTAFLOW,C1768,HCPCS,278,RC,,both,8525.32,7672.79,United Healthcare,Default,Fee Schedule,6956.66,,,,5029.94,6956.66
GRAFT VASC 6MMX80CM FLEX SM W/STAND,C1768,HCPCS,278,RC,,both,6806.19,6125.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4764.33,,,,4015.65,5553.85
GRAFT VASC 6MMX80CM FLEX SM W/STAND,C1768,HCPCS,278,RC,,both,6806.19,6125.57,Cigna,Default,Percent of Total Billed Charges,4015.65,,,,4015.65,5553.85
GRAFT VASC 6MMX80CM FLEX SM W/STAND,C1768,HCPCS,278,RC,,both,6806.19,6125.57,United Healthcare,Default,Fee Schedule,5553.85,,,,4015.65,5553.85
GRAFT THIN WALL 6MMX60CM PTFE,C1768,HCPCS,278,RC,,both,4369.89,3932.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3058.92,,,,2578.24,3565.83
GRAFT THIN WALL 6MMX60CM PTFE,C1768,HCPCS,278,RC,,both,4369.89,3932.9,Cigna,Default,Percent of Total Billed Charges,2578.24,,,,2578.24,3565.83
GRAFT THIN WALL 6MMX60CM PTFE,C1768,HCPCS,278,RC,,both,4369.89,3932.9,United Healthcare,Default,Fee Schedule,3565.83,,,,2578.24,3565.83
GRAFT DERMAL & EPIDERMAL TISSUE,C1768,HCPCS,278,RC,,both,6855.4,6169.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4798.78,,,,4044.69,5594.01
GRAFT DERMAL & EPIDERMAL TISSUE,C1768,HCPCS,278,RC,,both,6855.4,6169.86,Cigna,Default,Percent of Total Billed Charges,4044.69,,,,4044.69,5594.01
GRAFT DERMAL & EPIDERMAL TISSUE,C1768,HCPCS,278,RC,,both,6855.4,6169.86,United Healthcare,Default,Fee Schedule,5594.01,,,,4044.69,5594.01
VASCULAR GRAFT 35 CM,C1768,HCPCS,278,RC,,both,5058.95,4553.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3541.26,,,,2984.78,4128.1
VASCULAR GRAFT 35 CM,C1768,HCPCS,278,RC,,both,5058.95,4553.06,Cigna,Default,Percent of Total Billed Charges,2984.78,,,,2984.78,4128.1
VASCULAR GRAFT 35 CM,C1768,HCPCS,278,RC,,both,5058.95,4553.06,United Healthcare,Default,Fee Schedule,4128.1,,,,2984.78,4128.1
DERMIS AXIS 6X8 CM,C1768,HCPCS,278,RC,,both,6011.67,5410.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4208.17,,,,3546.89,4905.52
DERMIS AXIS 6X8 CM,C1768,HCPCS,278,RC,,both,6011.67,5410.5,Cigna,Default,Percent of Total Billed Charges,3546.89,,,,3546.89,4905.52
DERMIS AXIS 6X8 CM,C1768,HCPCS,278,RC,,both,6011.67,5410.5,United Healthcare,Default,Fee Schedule,4905.52,,,,3546.89,4905.52
VASCULAR GRAFT,C1768,HCPCS,278,RC,,both,4682.77,4214.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3277.94,,,,2762.83,3821.14
VASCULAR GRAFT,C1768,HCPCS,278,RC,,both,4682.77,4214.49,Cigna,Default,Percent of Total Billed Charges,2762.83,,,,2762.83,3821.14
VASCULAR GRAFT,C1768,HCPCS,278,RC,,both,4682.77,4214.49,United Healthcare,Default,Fee Schedule,3821.14,,,,2762.83,3821.14
GRAFT VASC 6MMX40CM,C1768,HCPCS,278,RC,,both,3691.38,3322.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2583.97,,,,2177.91,3012.17
GRAFT VASC 6MMX40CM,C1768,HCPCS,278,RC,,both,3691.38,3322.24,Cigna,Default,Percent of Total Billed Charges,2177.91,,,,2177.91,3012.17
GRAFT VASC 6MMX40CM,C1768,HCPCS,278,RC,,both,3691.38,3322.24,United Healthcare,Default,Fee Schedule,3012.17,,,,2177.91,3012.17
GRAFT VASC 8MMX80CM,C1768,HCPCS,278,RC,,both,7031.19,6328.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4921.83,,,,4148.4,5737.45
GRAFT VASC 8MMX80CM,C1768,HCPCS,278,RC,,both,7031.19,6328.07,Cigna,Default,Percent of Total Billed Charges,4148.4,,,,4148.4,5737.45
GRAFT VASC 8MMX80CM,C1768,HCPCS,278,RC,,both,7031.19,6328.07,United Healthcare,Default,Fee Schedule,5737.45,,,,4148.4,5737.45
GRAFT VASC 6MMX80CM,C1768,HCPCS,278,RC,,both,8296.8,7467.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5807.76,,,,4895.11,6770.19
GRAFT VASC 6MMX80CM,C1768,HCPCS,278,RC,,both,8296.8,7467.12,Cigna,Default,Percent of Total Billed Charges,4895.11,,,,4895.11,6770.19
GRAFT VASC 6MMX80CM,C1768,HCPCS,278,RC,,both,8296.8,7467.12,United Healthcare,Default,Fee Schedule,6770.19,,,,4895.11,6770.19
GRAFT VASC 8MMX80CM,C1768,HCPCS,278,RC,,both,8384.69,7546.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5869.28,,,,4946.97,6841.91
GRAFT VASC 8MMX80CM,C1768,HCPCS,278,RC,,both,8384.69,7546.22,Cigna,Default,Percent of Total Billed Charges,4946.97,,,,4946.97,6841.91
GRAFT VASC 8MMX80CM,C1768,HCPCS,278,RC,,both,8384.69,7546.22,United Healthcare,Default,Fee Schedule,6841.91,,,,4946.97,6841.91
GRAFT VASC 4MMX7MMTAPEREDX45CM,C1768,HCPCS,278,RC,,both,4229.26,3806.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2960.48,,,,2495.26,3451.08
GRAFT VASC 4MMX7MMTAPEREDX45CM,C1768,HCPCS,278,RC,,both,4229.26,3806.33,Cigna,Default,Percent of Total Billed Charges,2495.26,,,,2495.26,3451.08
GRAFT VASC 4MMX7MMTAPEREDX45CM,C1768,HCPCS,278,RC,,both,4229.26,3806.33,United Healthcare,Default,Fee Schedule,3451.08,,,,2495.26,3451.08
GRAFT VASC 8MM-100CM THIN-WALLED,C1768,HCPCS,278,RC,,both,5789.67,5210.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4052.77,,,,3415.91,4724.37
GRAFT VASC 8MM-100CM THIN-WALLED,C1768,HCPCS,278,RC,,both,5789.67,5210.7,Cigna,Default,Percent of Total Billed Charges,3415.91,,,,3415.91,4724.37
GRAFT VASC 8MM-100CM THIN-WALLED,C1768,HCPCS,278,RC,,both,5789.67,5210.7,United Healthcare,Default,Fee Schedule,4724.37,,,,3415.91,4724.37
GRAFT 4.5MM-6.5MMX70CM THIN WALLED,C1768,HCPCS,278,RC,,both,3012.86,2711.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2109,,,,1777.59,2458.49
GRAFT 4.5MM-6.5MMX70CM THIN WALLED,C1768,HCPCS,278,RC,,both,3012.86,2711.57,Cigna,Default,Percent of Total Billed Charges,1777.59,,,,1777.59,2458.49
GRAFT 4.5MM-6.5MMX70CM THIN WALLED,C1768,HCPCS,278,RC,,both,3012.86,2711.57,United Healthcare,Default,Fee Schedule,2458.49,,,,1777.59,2458.49
STENT GUIDE LEMAITRE,C1874,HCPCS,278,RC,,both,205.28,184.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.7,,,,121.12,167.51
STENT GUIDE LEMAITRE,C1874,HCPCS,278,RC,,both,205.28,184.75,Cigna,Default,Percent of Total Billed Charges,121.12,,,,121.12,167.51
STENT GUIDE LEMAITRE,C1874,HCPCS,278,RC,,both,205.28,184.75,United Healthcare,Default,Fee Schedule,167.51,,,,121.12,167.51
GRAFT VASC 8MM-58CM THIN-WALLED,C1768,HCPCS,278,RC,,both,2870.97,2583.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2009.68,,,,1693.87,2342.71
GRAFT VASC 8MM-58CM THIN-WALLED,C1768,HCPCS,278,RC,,both,2870.97,2583.87,Cigna,Default,Percent of Total Billed Charges,1693.87,,,,1693.87,2342.71
GRAFT VASC 8MM-58CM THIN-WALLED,C1768,HCPCS,278,RC,,both,2870.97,2583.87,United Healthcare,Default,Fee Schedule,2342.71,,,,1693.87,2342.71
GRAFT VASC 8MM-42CM THIN-WALLED,C1768,HCPCS,278,RC,,both,2078.98,1871.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1455.29,,,,1226.6,1696.45
GRAFT VASC 8MM-42CM THIN-WALLED,C1768,HCPCS,278,RC,,both,2078.98,1871.08,Cigna,Default,Percent of Total Billed Charges,1226.6,,,,1226.6,1696.45
GRAFT VASC 8MM-42CM THIN-WALLED,C1768,HCPCS,278,RC,,both,2078.98,1871.08,United Healthcare,Default,Fee Schedule,1696.45,,,,1226.6,1696.45
STOCKING DONNER,271,RC,,,,both,125,112.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.5,,,,73.75,102
STOCKING DONNER,271,RC,,,,both,125,112.5,Cigna,Default,Percent of Total Billed Charges,73.75,,,,73.75,102
STOCKING DONNER,271,RC,,,,both,125,112.5,United Healthcare,Default,Fee Schedule,102,,,,73.75,102
STAPLER ROTCUL55-4.8,272,RC,,,,both,969.21,872.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,678.45,,,,571.83,790.88
STAPLER ROTCUL55-4.8,272,RC,,,,both,969.21,872.29,Cigna,Default,Percent of Total Billed Charges,571.83,,,,571.83,790.88
STAPLER ROTCUL55-4.8,272,RC,,,,both,969.21,872.29,United Healthcare,Default,Fee Schedule,790.88,,,,571.83,790.88
*STAPLER ROTCUL55-4.8,272,RC,,,,both,761.02,684.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,532.71,,,,449,620.99
*STAPLER ROTCUL55-4.8,272,RC,,,,both,761.02,684.92,Cigna,Default,Percent of Total Billed Charges,449,,,,449,620.99
*STAPLER ROTCUL55-4.8,272,RC,,,,both,761.02,684.92,United Healthcare,Default,Fee Schedule,620.99,,,,449,620.99
PAPILLOTOME COTTON DOUBLE LUMEN,272,RC,,,,both,564.96,508.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,395.47,,,,333.33,461.01
PAPILLOTOME COTTON DOUBLE LUMEN,272,RC,,,,both,564.96,508.46,Cigna,Default,Percent of Total Billed Charges,333.33,,,,333.33,461.01
PAPILLOTOME COTTON DOUBLE LUMEN,272,RC,,,,both,564.96,508.46,United Healthcare,Default,Fee Schedule,461.01,,,,333.33,461.01
GUIDE WIRE 7.5 35-480,C1769,HCPCS,278,RC,,both,365.62,329.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.93,,,,215.72,298.35
GUIDE WIRE 7.5 35-480,C1769,HCPCS,278,RC,,both,365.62,329.06,Cigna,Default,Percent of Total Billed Charges,215.72,,,,215.72,298.35
GUIDE WIRE 7.5 35-480,C1769,HCPCS,278,RC,,both,365.62,329.06,United Healthcare,Default,Fee Schedule,298.35,,,,215.72,298.35
NEEDLE SPINAL 20GX3.54MONO,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
NEEDLE SPINAL 20GX3.54MONO,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
NEEDLE SPINAL 20GX3.54MONO,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SUTURE DEXON PRE-1 ETH 9532-215-0,272,RC,,,,both,31.58,28.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.11,,,,18.63,25.77
SUTURE DEXON PRE-1 ETH 9532-215-0,272,RC,,,,both,31.58,28.42,Cigna,Default,Percent of Total Billed Charges,18.63,,,,18.63,25.77
SUTURE DEXON PRE-1 ETH 9532-215-0,272,RC,,,,both,31.58,28.42,United Healthcare,Default,Fee Schedule,25.77,,,,18.63,25.77
SUTURE SILK 3-0 PS-1 ETH 1684G,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE SILK 3-0 PS-1 ETH 1684G,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE SILK 3-0 PS-1 ETH 1684G,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
NEBULIZER VORTRAN PERCUSSIVE,271,RC,,,,both,427.53,384.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,299.27,,,,252.24,348.86
NEBULIZER VORTRAN PERCUSSIVE,271,RC,,,,both,427.53,384.78,Cigna,Default,Percent of Total Billed Charges,252.24,,,,252.24,348.86
NEBULIZER VORTRAN PERCUSSIVE,271,RC,,,,both,427.53,384.78,United Healthcare,Default,Fee Schedule,348.86,,,,252.24,348.86
EXERCISER VOLUMETRIC 4000ML,270,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
EXERCISER VOLUMETRIC 4000ML,270,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
EXERCISER VOLUMETRIC 4000ML,270,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
*AQUA-PACK,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*AQUA-PACK,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*AQUA-PACK,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
AQUA-PACK 1000 ML,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
AQUA-PACK 1000 ML,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
AQUA-PACK 1000 ML,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
LINE PRESSURE MONITOR,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
LINE PRESSURE MONITOR,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
LINE PRESSURE MONITOR,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SUTURE PDS 0 CT-1 ETH Z346H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE PDS 0 CT-1 ETH Z346H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE PDS 0 CT-1 ETH Z346H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
CATHETER -PTA DILATATION,272,RC,,,,both,710.75,639.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,497.52,,,,419.34,579.97
CATHETER -PTA DILATATION,272,RC,,,,both,710.75,639.68,Cigna,Default,Percent of Total Billed Charges,419.34,,,,419.34,579.97
CATHETER -PTA DILATATION,272,RC,,,,both,710.75,639.68,United Healthcare,Default,Fee Schedule,579.97,,,,419.34,579.97
S-CURVE URETHRAL DILATOR SET W/ AQ HYDRO,272,RC,,,,both,1219.78,1097.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,853.85,,,,719.67,995.34
S-CURVE URETHRAL DILATOR SET W/ AQ HYDRO,272,RC,,,,both,1219.78,1097.8,Cigna,Default,Percent of Total Billed Charges,719.67,,,,719.67,995.34
S-CURVE URETHRAL DILATOR SET W/ AQ HYDRO,272,RC,,,,both,1219.78,1097.8,United Healthcare,Default,Fee Schedule,995.34,,,,719.67,995.34
GUIDE WIRE PC ROADRUNNER,C1769,HCPCS,278,RC,,both,211.02,189.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.71,,,,124.5,172.19
GUIDE WIRE PC ROADRUNNER,C1769,HCPCS,278,RC,,both,211.02,189.92,Cigna,Default,Percent of Total Billed Charges,124.5,,,,124.5,172.19
GUIDE WIRE PC ROADRUNNER,C1769,HCPCS,278,RC,,both,211.02,189.92,United Healthcare,Default,Fee Schedule,172.19,,,,124.5,172.19
CYSTIC DUCT INTRODUCER,272,RC,,,,both,338.25,304.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.78,,,,199.57,276.01
CYSTIC DUCT INTRODUCER,272,RC,,,,both,338.25,304.43,Cigna,Default,Percent of Total Billed Charges,199.57,,,,199.57,276.01
CYSTIC DUCT INTRODUCER,272,RC,,,,both,338.25,304.43,United Healthcare,Default,Fee Schedule,276.01,,,,199.57,276.01
S-CURVE URETHRAL DILATOR 22 FR,272,RC,,,,both,172.42,155.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.69,,,,101.73,140.69
S-CURVE URETHRAL DILATOR 22 FR,272,RC,,,,both,172.42,155.18,Cigna,Default,Percent of Total Billed Charges,101.73,,,,101.73,140.69
S-CURVE URETHRAL DILATOR 22 FR,272,RC,,,,both,172.42,155.18,United Healthcare,Default,Fee Schedule,140.69,,,,101.73,140.69
SUTURE VICRYL 2-0 SH ETH J417H,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE VICRYL 2-0 SH ETH J417H,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE VICRYL 2-0 SH ETH J417H,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
GUIDE WIRE ROADRUNNER .018 300CM,C1769,HCPCS,278,RC,,both,580.08,522.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,406.06,,,,342.25,473.35
GUIDE WIRE ROADRUNNER .018 300CM,C1769,HCPCS,278,RC,,both,580.08,522.07,Cigna,Default,Percent of Total Billed Charges,342.25,,,,342.25,473.35
GUIDE WIRE ROADRUNNER .018 300CM,C1769,HCPCS,278,RC,,both,580.08,522.07,United Healthcare,Default,Fee Schedule,473.35,,,,342.25,473.35
GRAFT PRE SHAPED,278,RC,,,,both,3255.78,2930.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2279.05,,,,1920.91,2656.72
GRAFT PRE SHAPED,278,RC,,,,both,3255.78,2930.2,Cigna,Default,Percent of Total Billed Charges,1920.91,,,,1920.91,2656.72
GRAFT PRE SHAPED,278,RC,,,,both,3255.78,2930.2,United Healthcare,Default,Fee Schedule,2656.72,,,,1920.91,2656.72
GRAFT STRAIGHT 6MMX60CM REMV RING THIN W,C1768,HCPCS,278,RC,,both,4120.28,3708.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2884.2,,,,2430.97,3362.15
GRAFT STRAIGHT 6MMX60CM REMV RING THIN W,C1768,HCPCS,278,RC,,both,4120.28,3708.25,Cigna,Default,Percent of Total Billed Charges,2430.97,,,,2430.97,3362.15
GRAFT STRAIGHT 6MMX60CM REMV RING THIN W,C1768,HCPCS,278,RC,,both,4120.28,3708.25,United Healthcare,Default,Fee Schedule,3362.15,,,,2430.97,3362.15
GRAFT STRAIGHT 8MMX80CM PTFE REM RING TH,C1768,HCPCS,278,RC,,both,4630.04,4167.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3241.03,,,,2731.72,3778.11
GRAFT STRAIGHT 8MMX80CM PTFE REM RING TH,C1768,HCPCS,278,RC,,both,4630.04,4167.04,Cigna,Default,Percent of Total Billed Charges,2731.72,,,,2731.72,3778.11
GRAFT STRAIGHT 8MMX80CM PTFE REM RING TH,C1768,HCPCS,278,RC,,both,4630.04,4167.04,United Healthcare,Default,Fee Schedule,3778.11,,,,2731.72,3778.11
GRAFT DISTA FLOW SM CUFF 80CMX6M,C1768,HCPCS,278,RC,,both,6806.19,6125.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4764.33,,,,4015.65,5553.85
GRAFT DISTA FLOW SM CUFF 80CMX6M,C1768,HCPCS,278,RC,,both,6806.19,6125.57,Cigna,Default,Percent of Total Billed Charges,4015.65,,,,4015.65,5553.85
GRAFT DISTA FLOW SM CUFF 80CMX6M,C1768,HCPCS,278,RC,,both,6806.19,6125.57,United Healthcare,Default,Fee Schedule,5553.85,,,,4015.65,5553.85
STENT ICAST 8MMX38MMX80CM,C1874,HCPCS,278,RC,,both,8831.86,7948.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6182.3,,,,5210.8,7206.8
STENT ICAST 8MMX38MMX80CM,C1874,HCPCS,278,RC,,both,8831.86,7948.67,Cigna,Default,Percent of Total Billed Charges,5210.8,,,,5210.8,7206.8
STENT ICAST 8MMX38MMX80CM,C1874,HCPCS,278,RC,,both,8831.86,7948.67,United Healthcare,Default,Fee Schedule,7206.8,,,,5210.8,7206.8
STENT ICAST 6MMX59MMX80CM,C1874,HCPCS,278,RC,,both,9517.83,8566.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6662.48,,,,5615.52,7766.55
STENT ICAST 6MMX59MMX80CM,C1874,HCPCS,278,RC,,both,9517.83,8566.05,Cigna,Default,Percent of Total Billed Charges,5615.52,,,,5615.52,7766.55
STENT ICAST 6MMX59MMX80CM,C1874,HCPCS,278,RC,,both,9517.83,8566.05,United Healthcare,Default,Fee Schedule,7766.55,,,,5615.52,7766.55
STENT ICAST 10MMX38MMX80CM,C1874,HCPCS,278,RC,,both,8831.86,7948.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6182.3,,,,5210.8,7206.8
STENT ICAST 10MMX38MMX80CM,C1874,HCPCS,278,RC,,both,8831.86,7948.67,Cigna,Default,Percent of Total Billed Charges,5210.8,,,,5210.8,7206.8
STENT ICAST 10MMX38MMX80CM,C1874,HCPCS,278,RC,,both,8831.86,7948.67,United Healthcare,Default,Fee Schedule,7206.8,,,,5210.8,7206.8
STENT TACSHIELD 3X6,C1874,HCPCS,278,RC,,both,1680.63,1512.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1176.44,,,,991.57,1371.39
STENT TACSHIELD 3X6,C1874,HCPCS,278,RC,,both,1680.63,1512.57,Cigna,Default,Percent of Total Billed Charges,991.57,,,,991.57,1371.39
STENT TACSHIELD 3X6,C1874,HCPCS,278,RC,,both,1680.63,1512.57,United Healthcare,Default,Fee Schedule,1371.39,,,,991.57,1371.39
STENT TACSHIELD 4X6,C1874,HCPCS,278,RC,,both,1817.82,1636.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1272.47,,,,1072.51,1483.34
STENT TACSHIELD 4X6,C1874,HCPCS,278,RC,,both,1817.82,1636.04,Cigna,Default,Percent of Total Billed Charges,1072.51,,,,1072.51,1483.34
STENT TACSHIELD 4X6,C1874,HCPCS,278,RC,,both,1817.82,1636.04,United Healthcare,Default,Fee Schedule,1483.34,,,,1072.51,1483.34
STENT TACSHIELD 5X5,C1874,HCPCS,278,RC,,both,1817.82,1636.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1272.47,,,,1072.51,1483.34
STENT TACSHIELD 5X5,C1874,HCPCS,278,RC,,both,1817.82,1636.04,Cigna,Default,Percent of Total Billed Charges,1072.51,,,,1072.51,1483.34
STENT TACSHIELD 5X5,C1874,HCPCS,278,RC,,both,1817.82,1636.04,United Healthcare,Default,Fee Schedule,1483.34,,,,1072.51,1483.34
STENT TACSHIELD 6X8,C1874,HCPCS,278,RC,,both,2929.09,2636.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2050.36,,,,1728.16,2390.14
STENT TACSHIELD 6X8,C1874,HCPCS,278,RC,,both,2929.09,2636.18,Cigna,Default,Percent of Total Billed Charges,1728.16,,,,1728.16,2390.14
STENT TACSHIELD 6X8,C1874,HCPCS,278,RC,,both,2929.09,2636.18,United Healthcare,Default,Fee Schedule,2390.14,,,,1728.16,2390.14
STENT TACSHIELD 8X10,C1874,HCPCS,278,RC,,both,4784.64,4306.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3349.25,,,,2822.94,3904.27
STENT TACSHIELD 8X10,C1874,HCPCS,278,RC,,both,4784.64,4306.18,Cigna,Default,Percent of Total Billed Charges,2822.94,,,,2822.94,3904.27
STENT TACSHIELD 8X10,C1874,HCPCS,278,RC,,both,4784.64,4306.18,United Healthcare,Default,Fee Schedule,3904.27,,,,2822.94,3904.27
STENT TACSHIELD 8X12,C1874,HCPCS,278,RC,,both,5247.66,4722.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3673.36,,,,3096.12,4282.09
STENT TACSHIELD 8X12,C1874,HCPCS,278,RC,,both,5247.66,4722.89,Cigna,Default,Percent of Total Billed Charges,3096.12,,,,3096.12,4282.09
STENT TACSHIELD 8X12,C1874,HCPCS,278,RC,,both,5247.66,4722.89,United Healthcare,Default,Fee Schedule,4282.09,,,,3096.12,4282.09
US CBL EXTNS DISPOSABLE,272,RC,,,,both,102.9,92.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.03,,,,60.71,83.97
US CBL EXTNS DISPOSABLE,272,RC,,,,both,102.9,92.61,Cigna,Default,Percent of Total Billed Charges,60.71,,,,60.71,83.97
US CBL EXTNS DISPOSABLE,272,RC,,,,both,102.9,92.61,United Healthcare,Default,Fee Schedule,83.97,,,,60.71,83.97
WRENCH KIT ASSEM-BLY KIT,272,RC,,,,both,155.9,140.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.13,,,,91.98,127.21
WRENCH KIT ASSEM-BLY KIT,272,RC,,,,both,155.9,140.31,Cigna,Default,Percent of Total Billed Charges,91.98,,,,91.98,127.21
WRENCH KIT ASSEM-BLY KIT,272,RC,,,,both,155.9,140.31,United Healthcare,Default,Fee Schedule,127.21,,,,91.98,127.21
DNO VALVE-HEIMLICH,272,RC,,,,both,138.08,124.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.66,,,,81.47,112.67
DNO VALVE-HEIMLICH,272,RC,,,,both,138.08,124.27,Cigna,Default,Percent of Total Billed Charges,81.47,,,,81.47,112.67
DNO VALVE-HEIMLICH,272,RC,,,,both,138.08,124.27,United Healthcare,Default,Fee Schedule,112.67,,,,81.47,112.67
SUTURE VICRYL 5-0 TF ETH J433H,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SUTURE VICRYL 5-0 TF ETH J433H,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SUTURE VICRYL 5-0 TF ETH J433H,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
CATH ART EMB 7.5 FR,C1757,HCPCS,278,RC,,both,351.56,316.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,246.09,,,,207.42,286.87
CATH ART EMB 7.5 FR,C1757,HCPCS,278,RC,,both,351.56,316.4,Cigna,Default,Percent of Total Billed Charges,207.42,,,,207.42,286.87
CATH ART EMB 7.5 FR,C1757,HCPCS,278,RC,,both,351.56,316.4,United Healthcare,Default,Fee Schedule,286.87,,,,207.42,286.87
*CATH MUSHROOM 32FR,272,RC,,,,both,35.73,32.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.01,,,,21.08,29.16
*CATH MUSHROOM 32FR,272,RC,,,,both,35.73,32.16,Cigna,Default,Percent of Total Billed Charges,21.08,,,,21.08,29.16
*CATH MUSHROOM 32FR,272,RC,,,,both,35.73,32.16,United Healthcare,Default,Fee Schedule,29.16,,,,21.08,29.16
CATH BRONCHO 41FR L,272,RC,,,,both,230.46,207.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161.32,,,,135.97,188.06
CATH BRONCHO 41FR L,272,RC,,,,both,230.46,207.41,Cigna,Default,Percent of Total Billed Charges,135.97,,,,135.97,188.06
CATH BRONCHO 41FR L,272,RC,,,,both,230.46,207.41,United Healthcare,Default,Fee Schedule,188.06,,,,135.97,188.06
CATH BRONCHO 39F LEF,272,RC,,,,both,202.5,182.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.75,,,,119.48,165.24
CATH BRONCHO 39F LEF,272,RC,,,,both,202.5,182.25,Cigna,Default,Percent of Total Billed Charges,119.48,,,,119.48,165.24
CATH BRONCHO 39F LEF,272,RC,,,,both,202.5,182.25,United Healthcare,Default,Fee Schedule,165.24,,,,119.48,165.24
CATH BRONCHO 39FR RIG,272,RC,,,,both,193.73,174.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.61,,,,114.3,158.08
CATH BRONCHO 39FR RIG,272,RC,,,,both,193.73,174.36,Cigna,Default,Percent of Total Billed Charges,114.3,,,,114.3,158.08
CATH BRONCHO 39FR RIG,272,RC,,,,both,193.73,174.36,United Healthcare,Default,Fee Schedule,158.08,,,,114.3,158.08
BRONCHOSCOPE ASCOPE 4 SAMPLER 5MM/2.2MM,272,RC,,,,both,875.79,788.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,613.05,,,,516.72,714.64
BRONCHOSCOPE ASCOPE 4 SAMPLER 5MM/2.2MM,272,RC,,,,both,875.79,788.21,Cigna,Default,Percent of Total Billed Charges,516.72,,,,516.72,714.64
BRONCHOSCOPE ASCOPE 4 SAMPLER 5MM/2.2MM,272,RC,,,,both,875.79,788.21,United Healthcare,Default,Fee Schedule,714.64,,,,516.72,714.64
CATH BRONCHO 37FR RIGH,272,RC,,,,both,189.2,170.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.44,,,,111.63,154.39
CATH BRONCHO 37FR RIGH,272,RC,,,,both,189.2,170.28,Cigna,Default,Percent of Total Billed Charges,111.63,,,,111.63,154.39
CATH BRONCHO 37FR RIGH,272,RC,,,,both,189.2,170.28,United Healthcare,Default,Fee Schedule,154.39,,,,111.63,154.39
CATH BRONCHO 37FR LEF,272,RC,,,,both,169.4,152.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.58,,,,99.95,138.23
CATH BRONCHO 37FR LEF,272,RC,,,,both,169.4,152.46,Cigna,Default,Percent of Total Billed Charges,99.95,,,,99.95,138.23
CATH BRONCHO 37FR LEF,272,RC,,,,both,169.4,152.46,United Healthcare,Default,Fee Schedule,138.23,,,,99.95,138.23
CATH HEMO 20FR 30CC,C1757,HCPCS,278,RC,,both,21.11,19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.78,,,,12.45,17.23
CATH HEMO 20FR 30CC,C1757,HCPCS,278,RC,,both,21.11,19,Cigna,Default,Percent of Total Billed Charges,12.45,,,,12.45,17.23
CATH HEMO 20FR 30CC,C1757,HCPCS,278,RC,,both,21.11,19,United Healthcare,Default,Fee Schedule,17.23,,,,12.45,17.23
CATH SILICONE 20FR 30CC BALLOON,272,RC,,,,both,52.56,47.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.79,,,,31.01,42.89
CATH SILICONE 20FR 30CC BALLOON,272,RC,,,,both,52.56,47.3,Cigna,Default,Percent of Total Billed Charges,31.01,,,,31.01,42.89
CATH SILICONE 20FR 30CC BALLOON,272,RC,,,,both,52.56,47.3,United Healthcare,Default,Fee Schedule,42.89,,,,31.01,42.89
*CATH HEMO 22FR 30CC,C1757,HCPCS,278,RC,,both,20.5,18.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.35,,,,12.1,16.73
*CATH HEMO 22FR 30CC,C1757,HCPCS,278,RC,,both,20.5,18.45,Cigna,Default,Percent of Total Billed Charges,12.1,,,,12.1,16.73
*CATH HEMO 22FR 30CC,C1757,HCPCS,278,RC,,both,20.5,18.45,United Healthcare,Default,Fee Schedule,16.73,,,,12.1,16.73
*CATH SILICONE 22FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH SILICONE 22FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH SILICONE 22FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHILON 5-0 PC-5 ETH 1895G,272,RC,,,,both,23.56,21.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.49,,,,13.9,19.22
SUTURE ETHILON 5-0 PC-5 ETH 1895G,272,RC,,,,both,23.56,21.2,Cigna,Default,Percent of Total Billed Charges,13.9,,,,13.9,19.22
SUTURE ETHILON 5-0 PC-5 ETH 1895G,272,RC,,,,both,23.56,21.2,United Healthcare,Default,Fee Schedule,19.22,,,,13.9,19.22
*CATH SILICONE 24FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH SILICONE 24FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH SILICONE 24FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
*CATH HEMO 24FR 30CC,C1757,HCPCS,278,RC,,both,20.5,18.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.35,,,,12.1,16.73
*CATH HEMO 24FR 30CC,C1757,HCPCS,278,RC,,both,20.5,18.45,Cigna,Default,Percent of Total Billed Charges,12.1,,,,12.1,16.73
*CATH HEMO 24FR 30CC,C1757,HCPCS,278,RC,,both,20.5,18.45,United Healthcare,Default,Fee Schedule,16.73,,,,12.1,16.73
CATH THORACIC 24FR,272,RC,,,,both,35.62,32.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.93,,,,21.02,29.07
CATH THORACIC 24FR,272,RC,,,,both,35.62,32.06,Cigna,Default,Percent of Total Billed Charges,21.02,,,,21.02,29.07
CATH THORACIC 24FR,272,RC,,,,both,35.62,32.06,United Healthcare,Default,Fee Schedule,29.07,,,,21.02,29.07
CATH THORACIC STRAIGHT 28FR,272,RC,,,,both,23.97,21.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.78,,,,14.14,19.56
CATH THORACIC STRAIGHT 28FR,272,RC,,,,both,23.97,21.57,Cigna,Default,Percent of Total Billed Charges,14.14,,,,14.14,19.56
CATH THORACIC STRAIGHT 28FR,272,RC,,,,both,23.97,21.57,United Healthcare,Default,Fee Schedule,19.56,,,,14.14,19.56
CATH THORACIC 36FR,272,RC,,,,both,22.31,20.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.62,,,,13.16,18.2
CATH THORACIC 36FR,272,RC,,,,both,22.31,20.08,Cigna,Default,Percent of Total Billed Charges,13.16,,,,13.16,18.2
CATH THORACIC 36FR,272,RC,,,,both,22.31,20.08,United Healthcare,Default,Fee Schedule,18.2,,,,13.16,18.2
CATH THORACIC 32FR,272,RC,,,,both,39.59,35.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.71,,,,23.36,32.31
CATH THORACIC 32FR,272,RC,,,,both,39.59,35.63,Cigna,Default,Percent of Total Billed Charges,23.36,,,,23.36,32.31
CATH THORACIC 32FR,272,RC,,,,both,39.59,35.63,United Healthcare,Default,Fee Schedule,32.31,,,,23.36,32.31
CATH THORACIC 36FR RIGHT ANGLE,272,RC,,,,both,81.24,73.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.87,,,,47.93,66.29
CATH THORACIC 36FR RIGHT ANGLE,272,RC,,,,both,81.24,73.12,Cigna,Default,Percent of Total Billed Charges,47.93,,,,47.93,66.29
CATH THORACIC 36FR RIGHT ANGLE,272,RC,,,,both,81.24,73.12,United Healthcare,Default,Fee Schedule,66.29,,,,47.93,66.29
CATH SPIROFLEX 4F 135CM,C1725,HCPCS,278,RC,,both,5470.61,4923.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3829.43,,,,3227.66,4464.02
CATH SPIROFLEX 4F 135CM,C1725,HCPCS,278,RC,,both,5470.61,4923.55,Cigna,Default,Percent of Total Billed Charges,3227.66,,,,3227.66,4464.02
CATH SPIROFLEX 4F 135CM,C1725,HCPCS,278,RC,,both,5470.61,4923.55,United Healthcare,Default,Fee Schedule,4464.02,,,,3227.66,4464.02
CATH SPIROFLEX 5F 135CM,C1725,HCPCS,278,RC,,both,5470.61,4923.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3829.43,,,,3227.66,4464.02
CATH SPIROFLEX 5F 135CM,C1725,HCPCS,278,RC,,both,5470.61,4923.55,Cigna,Default,Percent of Total Billed Charges,3227.66,,,,3227.66,4464.02
CATH SPIROFLEX 5F 135CM,C1725,HCPCS,278,RC,,both,5470.61,4923.55,United Healthcare,Default,Fee Schedule,4464.02,,,,3227.66,4464.02
CATH SPIROFLEX 6F 120CM,C1725,HCPCS,278,RC,,both,6619.6,5957.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4633.72,,,,3905.56,5401.59
CATH SPIROFLEX 6F 120CM,C1725,HCPCS,278,RC,,both,6619.6,5957.64,Cigna,Default,Percent of Total Billed Charges,3905.56,,,,3905.56,5401.59
CATH SPIROFLEX 6F 120CM,C1725,HCPCS,278,RC,,both,6619.6,5957.64,United Healthcare,Default,Fee Schedule,5401.59,,,,3905.56,5401.59
CATH SPIROFLEX 6F 90CM,C1725,HCPCS,278,RC,,both,7991.54,7192.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5594.08,,,,4715.01,6521.1
CATH SPIROFLEX 6F 90CM,C1725,HCPCS,278,RC,,both,7991.54,7192.39,Cigna,Default,Percent of Total Billed Charges,4715.01,,,,4715.01,6521.1
CATH SPIROFLEX 6F 90CM,C1725,HCPCS,278,RC,,both,7991.54,7192.39,United Healthcare,Default,Fee Schedule,6521.1,,,,4715.01,6521.1
CATH SPIROFLEX 6F 50CM,C1725,HCPCS,278,RC,,both,3086.86,2778.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.8,,,,1821.25,2518.88
CATH SPIROFLEX 6F 50CM,C1725,HCPCS,278,RC,,both,3086.86,2778.17,Cigna,Default,Percent of Total Billed Charges,1821.25,,,,1821.25,2518.88
CATH SPIROFLEX 6F 50CM,C1725,HCPCS,278,RC,,both,3086.86,2778.17,United Healthcare,Default,Fee Schedule,2518.88,,,,1821.25,2518.88
*CATH COUNCIL 20FR 5CC TIP,A4330,HCPCS,272,RC,,both,52.84,47.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.99,,,,31.18,43.12
*CATH COUNCIL 20FR 5CC TIP,A4330,HCPCS,272,RC,,both,52.84,47.56,Cigna,Default,Percent of Total Billed Charges,31.18,,,,31.18,43.12
*CATH COUNCIL 20FR 5CC TIP,A4330,HCPCS,272,RC,,both,52.84,47.56,United Healthcare,Default,Fee Schedule,43.12,,,,31.18,43.12
*CATH 16FR 5CC LATEX,272,RC,,,,both,56.78,51.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.75,,,,33.5,46.33
*CATH 16FR 5CC LATEX,272,RC,,,,both,56.78,51.1,Cigna,Default,Percent of Total Billed Charges,33.5,,,,33.5,46.33
*CATH 16FR 5CC LATEX,272,RC,,,,both,56.78,51.1,United Healthcare,Default,Fee Schedule,46.33,,,,33.5,46.33
*CATH 18FR 5CC LATEX,272,RC,,,,both,56.78,51.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.75,,,,33.5,46.33
*CATH 18FR 5CC LATEX,272,RC,,,,both,56.78,51.1,Cigna,Default,Percent of Total Billed Charges,33.5,,,,33.5,46.33
*CATH 18FR 5CC LATEX,272,RC,,,,both,56.78,51.1,United Healthcare,Default,Fee Schedule,46.33,,,,33.5,46.33
"CATH, DUAL LUMEN URETHERAL",C1758,HCPCS,272,RC,,both,417.49,375.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.24,,,,246.32,340.67
"CATH, DUAL LUMEN URETHERAL",C1758,HCPCS,272,RC,,both,417.49,375.74,Cigna,Default,Percent of Total Billed Charges,246.32,,,,246.32,340.67
"CATH, DUAL LUMEN URETHERAL",C1758,HCPCS,272,RC,,both,417.49,375.74,United Healthcare,Default,Fee Schedule,340.67,,,,246.32,340.67
DILATOR 8/10 SHEATH SET,C1894,HCPCS,278,RC,,both,208.24,187.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.77,,,,122.86,169.92
DILATOR 8/10 SHEATH SET,C1894,HCPCS,278,RC,,both,208.24,187.42,Cigna,Default,Percent of Total Billed Charges,122.86,,,,122.86,169.92
DILATOR 8/10 SHEATH SET,C1894,HCPCS,278,RC,,both,208.24,187.42,United Healthcare,Default,Fee Schedule,169.92,,,,122.86,169.92
CATH COUNCIL 22FR 5CC,272,RC,,,,both,51.1,45.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.77,,,,30.15,41.7
CATH COUNCIL 22FR 5CC,272,RC,,,,both,51.1,45.99,Cigna,Default,Percent of Total Billed Charges,30.15,,,,30.15,41.7
CATH COUNCIL 22FR 5CC,272,RC,,,,both,51.1,45.99,United Healthcare,Default,Fee Schedule,41.7,,,,30.15,41.7
*CATH COUNCIL  TIP 16FR 5CC,A4330,HCPCS,272,RC,,both,84.1,75.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.87,,,,49.62,68.63
*CATH COUNCIL  TIP 16FR 5CC,A4330,HCPCS,272,RC,,both,84.1,75.69,Cigna,Default,Percent of Total Billed Charges,49.62,,,,49.62,68.63
*CATH COUNCIL  TIP 16FR 5CC,A4330,HCPCS,272,RC,,both,84.1,75.69,United Healthcare,Default,Fee Schedule,68.63,,,,49.62,68.63
CATH COUNCIL TIP 18FR 5CC,A4330,HCPCS,272,RC,,both,79.52,71.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.66,,,,46.92,64.89
CATH COUNCIL TIP 18FR 5CC,A4330,HCPCS,272,RC,,both,79.52,71.57,Cigna,Default,Percent of Total Billed Charges,46.92,,,,46.92,64.89
CATH COUNCIL TIP 18FR 5CC,A4330,HCPCS,272,RC,,both,79.52,71.57,United Healthcare,Default,Fee Schedule,64.89,,,,46.92,64.89
CATH COUNCIL TIP 20FR 5CC,A4330,HCPCS,272,RC,,both,49.61,44.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.73,,,,29.27,40.48
CATH COUNCIL TIP 20FR 5CC,A4330,HCPCS,272,RC,,both,49.61,44.65,Cigna,Default,Percent of Total Billed Charges,29.27,,,,29.27,40.48
CATH COUNCIL TIP 20FR 5CC,A4330,HCPCS,272,RC,,both,49.61,44.65,United Healthcare,Default,Fee Schedule,40.48,,,,29.27,40.48
DILATOR NAVIGATION 12/14FR,C1894,HCPCS,272,RC,,both,694.04,624.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,485.83,,,,409.48,566.34
DILATOR NAVIGATION 12/14FR,C1894,HCPCS,272,RC,,both,694.04,624.64,Cigna,Default,Percent of Total Billed Charges,409.48,,,,409.48,566.34
DILATOR NAVIGATION 12/14FR,C1894,HCPCS,272,RC,,both,694.04,624.64,United Healthcare,Default,Fee Schedule,566.34,,,,409.48,566.34
CATH FLEXIMA  ALL PURPOSE 6X20,272,RC,,,,both,209.09,188.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.36,,,,123.36,170.62
CATH FLEXIMA  ALL PURPOSE 6X20,272,RC,,,,both,209.09,188.18,Cigna,Default,Percent of Total Billed Charges,123.36,,,,123.36,170.62
CATH FLEXIMA  ALL PURPOSE 6X20,272,RC,,,,both,209.09,188.18,United Healthcare,Default,Fee Schedule,170.62,,,,123.36,170.62
CATH FLEXIMA  APD J TIP 8X20,272,RC,,,,both,209.09,188.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.36,,,,123.36,170.62
CATH FLEXIMA  APD J TIP 8X20,272,RC,,,,both,209.09,188.18,Cigna,Default,Percent of Total Billed Charges,123.36,,,,123.36,170.62
CATH FLEXIMA  APD J TIP 8X20,272,RC,,,,both,209.09,188.18,United Healthcare,Default,Fee Schedule,170.62,,,,123.36,170.62
*DNO DRAIN KIT PLEURX CATH,271,RC,,,,both,3067.68,2760.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2147.38,,,,1809.93,2503.23
*DNO DRAIN KIT PLEURX CATH,271,RC,,,,both,3067.68,2760.91,Cigna,Default,Percent of Total Billed Charges,1809.93,,,,1809.93,2503.23
*DNO DRAIN KIT PLEURX CATH,271,RC,,,,both,3067.68,2760.91,United Healthcare,Default,Fee Schedule,2503.23,,,,1809.93,2503.23
BRUSH CYTOLOGY 3.0/85,272,RC,,,,both,63.89,57.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.72,,,,37.7,52.13
BRUSH CYTOLOGY 3.0/85,272,RC,,,,both,63.89,57.5,Cigna,Default,Percent of Total Billed Charges,37.7,,,,37.7,52.13
BRUSH CYTOLOGY 3.0/85,272,RC,,,,both,63.89,57.5,United Healthcare,Default,Fee Schedule,52.13,,,,37.7,52.13
PLEURX PERITONEAL CATH KIT,271,RC,,,,both,2080.13,1872.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1456.09,,,,1227.28,1697.39
PLEURX PERITONEAL CATH KIT,271,RC,,,,both,2080.13,1872.12,Cigna,Default,Percent of Total Billed Charges,1227.28,,,,1227.28,1697.39
PLEURX PERITONEAL CATH KIT,271,RC,,,,both,2080.13,1872.12,United Healthcare,Default,Fee Schedule,1697.39,,,,1227.28,1697.39
PLEURX PERITONEAL CATHETER STARTER KIT,271,RC,,,,both,3067.68,2760.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2147.38,,,,1809.93,2503.23
PLEURX PERITONEAL CATHETER STARTER KIT,271,RC,,,,both,3067.68,2760.91,Cigna,Default,Percent of Total Billed Charges,1809.93,,,,1809.93,2503.23
PLEURX PERITONEAL CATHETER STARTER KIT,271,RC,,,,both,3067.68,2760.91,United Healthcare,Default,Fee Schedule,2503.23,,,,1809.93,2503.23
CATH ALL PURPOSE 16FR,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
CATH ALL PURPOSE 16FR,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
CATH ALL PURPOSE 16FR,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
CATH RED RUBBER COUDE TIP 16 FR,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
CATH RED RUBBER COUDE TIP 16 FR,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
CATH RED RUBBER COUDE TIP 16 FR,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNO CATH ALL PURPOSE 20FR,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
DNO CATH ALL PURPOSE 20FR,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
DNO CATH ALL PURPOSE 20FR,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
PLEURX DRAINAGE SYSTEM 1000ML,271,RC,,,,both,213.44,192.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.41,,,,125.93,174.17
PLEURX DRAINAGE SYSTEM 1000ML,271,RC,,,,both,213.44,192.1,Cigna,Default,Percent of Total Billed Charges,125.93,,,,125.93,174.17
PLEURX DRAINAGE SYSTEM 1000ML,271,RC,,,,both,213.44,192.1,United Healthcare,Default,Fee Schedule,174.17,,,,125.93,174.17
TUBE GASTRONOMY 16FR 20CC,272,RC,,,,both,341.28,307.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.9,,,,201.36,278.48
TUBE GASTRONOMY 16FR 20CC,272,RC,,,,both,341.28,307.15,Cigna,Default,Percent of Total Billed Charges,201.36,,,,201.36,278.48
TUBE GASTRONOMY 16FR 20CC,272,RC,,,,both,341.28,307.15,United Healthcare,Default,Fee Schedule,278.48,,,,201.36,278.48
MOSS G-TUBE PEG KIT 18FR,272,RC,,,,both,1853.24,1667.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1297.27,,,,1093.41,1512.24
MOSS G-TUBE PEG KIT 18FR,272,RC,,,,both,1853.24,1667.92,Cigna,Default,Percent of Total Billed Charges,1093.41,,,,1093.41,1512.24
MOSS G-TUBE PEG KIT 18FR,272,RC,,,,both,1853.24,1667.92,United Healthcare,Default,Fee Schedule,1512.24,,,,1093.41,1512.24
MOSS TUBE GASTROSTOMY 18FR,272,RC,,,,both,915.75,824.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,641.02,,,,540.29,747.25
MOSS TUBE GASTROSTOMY 18FR,272,RC,,,,both,915.75,824.18,Cigna,Default,Percent of Total Billed Charges,540.29,,,,540.29,747.25
MOSS TUBE GASTROSTOMY 18FR,272,RC,,,,both,915.75,824.18,United Healthcare,Default,Fee Schedule,747.25,,,,540.29,747.25
TUBE GASTRONOMY 18FR 20CC,272,RC,,,,both,341.28,307.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.9,,,,201.36,278.48
TUBE GASTRONOMY 18FR 20CC,272,RC,,,,both,341.28,307.15,Cigna,Default,Percent of Total Billed Charges,201.36,,,,201.36,278.48
TUBE GASTRONOMY 18FR 20CC,272,RC,,,,both,341.28,307.15,United Healthcare,Default,Fee Schedule,278.48,,,,201.36,278.48
TUBE GASTRONOMY 22FR 20CC,272,RC,,,,both,199.05,179.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.34,,,,117.44,162.42
TUBE GASTRONOMY 22FR 20CC,272,RC,,,,both,199.05,179.15,Cigna,Default,Percent of Total Billed Charges,117.44,,,,117.44,162.42
TUBE GASTRONOMY 22FR 20CC,272,RC,,,,both,199.05,179.15,United Healthcare,Default,Fee Schedule,162.42,,,,117.44,162.42
TUBE GASTROSTOMY 20FR 20CC,272,RC,,,,both,245.99,221.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.19,,,,145.13,200.73
TUBE GASTROSTOMY 20FR 20CC,272,RC,,,,both,245.99,221.39,Cigna,Default,Percent of Total Billed Charges,145.13,,,,145.13,200.73
TUBE GASTROSTOMY 20FR 20CC,272,RC,,,,both,245.99,221.39,United Healthcare,Default,Fee Schedule,200.73,,,,145.13,200.73
DNO MEASURING STOMA DEVICE,272,RC,,,,both,21.88,19.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.32,,,,12.91,17.85
DNO MEASURING STOMA DEVICE,272,RC,,,,both,21.88,19.69,Cigna,Default,Percent of Total Billed Charges,12.91,,,,12.91,17.85
DNO MEASURING STOMA DEVICE,272,RC,,,,both,21.88,19.69,United Healthcare,Default,Fee Schedule,17.85,,,,12.91,17.85
TRAY INTRODUCER 9 FR,272,RC,,,,both,143.74,129.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.62,,,,84.81,117.29
TRAY INTRODUCER 9 FR,272,RC,,,,both,143.74,129.37,Cigna,Default,Percent of Total Billed Charges,84.81,,,,84.81,117.29
TRAY INTRODUCER 9 FR,272,RC,,,,both,143.74,129.37,United Healthcare,Default,Fee Schedule,117.29,,,,84.81,117.29
KIT BUTTON REPLACEMENT 18FR,272,RC,,,,both,1014.25,912.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,709.98,,,,598.41,827.63
KIT BUTTON REPLACEMENT 18FR,272,RC,,,,both,1014.25,912.83,Cigna,Default,Percent of Total Billed Charges,598.41,,,,598.41,827.63
KIT BUTTON REPLACEMENT 18FR,272,RC,,,,both,1014.25,912.83,United Healthcare,Default,Fee Schedule,827.63,,,,598.41,827.63
KIT BUTTON REPLACEMENT 18FR X 2.4CM,272,RC,,,,both,1341.31,1207.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,938.92,,,,791.37,1094.51
KIT BUTTON REPLACEMENT 18FR X 2.4CM,272,RC,,,,both,1341.31,1207.18,Cigna,Default,Percent of Total Billed Charges,791.37,,,,791.37,1094.51
KIT BUTTON REPLACEMENT 18FR X 2.4CM,272,RC,,,,both,1341.31,1207.18,United Healthcare,Default,Fee Schedule,1094.51,,,,791.37,1094.51
KIT BUTTON REPLACEMENT 18FR,272,RC,,,,both,405.16,364.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,283.61,,,,239.04,330.61
KIT BUTTON REPLACEMENT 18FR,272,RC,,,,both,405.16,364.64,Cigna,Default,Percent of Total Billed Charges,239.04,,,,239.04,330.61
KIT BUTTON REPLACEMENT 18FR,272,RC,,,,both,405.16,364.64,United Healthcare,Default,Fee Schedule,330.61,,,,239.04,330.61
KIT BUTTON REPLACEMENT 28FR X 2,272,RC,,,,both,1595.36,1435.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1116.75,,,,941.26,1301.81
KIT BUTTON REPLACEMENT 28FR X 2,272,RC,,,,both,1595.36,1435.82,Cigna,Default,Percent of Total Billed Charges,941.26,,,,941.26,1301.81
KIT BUTTON REPLACEMENT 28FR X 2,272,RC,,,,both,1595.36,1435.82,United Healthcare,Default,Fee Schedule,1301.81,,,,941.26,1301.81
KIT BUTTON REPLACEMENT 28,272,RC,,,,both,1342.11,1207.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,939.48,,,,791.84,1095.16
KIT BUTTON REPLACEMENT 28,272,RC,,,,both,1342.11,1207.9,Cigna,Default,Percent of Total Billed Charges,791.84,,,,791.84,1095.16
KIT BUTTON REPLACEMENT 28,272,RC,,,,both,1342.11,1207.9,United Healthcare,Default,Fee Schedule,1095.16,,,,791.84,1095.16
KIT BUTTON REPLACEMENT 28,272,RC,,,,both,1229.95,1106.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,860.96,,,,725.67,1003.64
KIT BUTTON REPLACEMENT 28,272,RC,,,,both,1229.95,1106.96,Cigna,Default,Percent of Total Billed Charges,725.67,,,,725.67,1003.64
KIT BUTTON REPLACEMENT 28,272,RC,,,,both,1229.95,1106.96,United Healthcare,Default,Fee Schedule,1003.64,,,,725.67,1003.64
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,1595.36,1435.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1116.75,,,,941.26,1301.81
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,1595.36,1435.82,Cigna,Default,Percent of Total Billed Charges,941.26,,,,941.26,1301.81
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,1595.36,1435.82,United Healthcare,Default,Fee Schedule,1301.81,,,,941.26,1301.81
KIT BUTTON REPLACEMENT 24FR,272,RC,,,,both,1128.66,1015.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,790.06,,,,665.91,920.99
KIT BUTTON REPLACEMENT 24FR,272,RC,,,,both,1128.66,1015.79,Cigna,Default,Percent of Total Billed Charges,665.91,,,,665.91,920.99
KIT BUTTON REPLACEMENT 24FR,272,RC,,,,both,1128.66,1015.79,United Healthcare,Default,Fee Schedule,920.99,,,,665.91,920.99
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,969.11,872.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,678.38,,,,571.77,790.79
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,969.11,872.2,Cigna,Default,Percent of Total Billed Charges,571.77,,,,571.77,790.79
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,969.11,872.2,United Healthcare,Default,Fee Schedule,790.79,,,,571.77,790.79
"R ANGLE 12' BUTTON EXT SET ""Y""PORT W/CAP",272,RC,,,,both,95.89,86.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.12,,,,56.58,78.25
"R ANGLE 12' BUTTON EXT SET ""Y""PORT W/CAP",272,RC,,,,both,95.89,86.3,Cigna,Default,Percent of Total Billed Charges,56.58,,,,56.58,78.25
"R ANGLE 12' BUTTON EXT SET ""Y""PORT W/CAP",272,RC,,,,both,95.89,86.3,United Healthcare,Default,Fee Schedule,78.25,,,,56.58,78.25
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,919.69,827.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,643.78,,,,542.62,750.47
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,919.69,827.72,Cigna,Default,Percent of Total Billed Charges,542.62,,,,542.62,750.47
KIT BUTTON REPLACEMENT 24,272,RC,,,,both,919.69,827.72,United Healthcare,Default,Fee Schedule,750.47,,,,542.62,750.47
GRAFT BIFURCATED 16/,C1768,HCPCS,278,RC,,both,3294.1,2964.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2305.87,,,,1943.52,2687.99
GRAFT BIFURCATED 16/,C1768,HCPCS,278,RC,,both,3294.1,2964.69,Cigna,Default,Percent of Total Billed Charges,1943.52,,,,1943.52,2687.99
GRAFT BIFURCATED 16/,C1768,HCPCS,278,RC,,both,3294.1,2964.69,United Healthcare,Default,Fee Schedule,2687.99,,,,1943.52,2687.99
GRAFT BIFURCATED 18/9/,C1768,HCPCS,278,RC,,both,2742.16,2467.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1919.51,,,,1617.87,2237.6
GRAFT BIFURCATED 18/9/,C1768,HCPCS,278,RC,,both,2742.16,2467.94,Cigna,Default,Percent of Total Billed Charges,1617.87,,,,1617.87,2237.6
GRAFT BIFURCATED 18/9/,C1768,HCPCS,278,RC,,both,2742.16,2467.94,United Healthcare,Default,Fee Schedule,2237.6,,,,1617.87,2237.6
EXERCISER VOLUMETRIC 2500ML,270,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
EXERCISER VOLUMETRIC 2500ML,270,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
EXERCISER VOLUMETRIC 2500ML,270,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
GRAFT HEMOSHIELD GOLD TUBE 16MMX30CM,C1768,HCPCS,278,RC,,both,1968.73,1771.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1378.11,,,,1161.55,1606.48
GRAFT HEMOSHIELD GOLD TUBE 16MMX30CM,C1768,HCPCS,278,RC,,both,1968.73,1771.86,Cigna,Default,Percent of Total Billed Charges,1161.55,,,,1161.55,1606.48
GRAFT HEMOSHIELD GOLD TUBE 16MMX30CM,C1768,HCPCS,278,RC,,both,1968.73,1771.86,United Healthcare,Default,Fee Schedule,1606.48,,,,1161.55,1606.48
GRAFT SURGISIS BIODESIGN 20X20,C1768,HCPCS,278,RC,,both,24046.67,21642,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16832.67,,,,14187.54,19622.08
GRAFT SURGISIS BIODESIGN 20X20,C1768,HCPCS,278,RC,,both,24046.67,21642,Cigna,Default,Percent of Total Billed Charges,14187.54,,,,14187.54,19622.08
GRAFT SURGISIS BIODESIGN 20X20,C1768,HCPCS,278,RC,,both,24046.67,21642,United Healthcare,Default,Fee Schedule,19622.08,,,,14187.54,19622.08
GRAFT SURGISIS BIODESIGN 20X30,C1768,HCPCS,278,RC,,both,33064.16,29757.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23144.91,,,,19507.85,26980.35
GRAFT SURGISIS BIODESIGN 20X30,C1768,HCPCS,278,RC,,both,33064.16,29757.74,Cigna,Default,Percent of Total Billed Charges,19507.85,,,,19507.85,26980.35
GRAFT SURGISIS BIODESIGN 20X30,C1768,HCPCS,278,RC,,both,33064.16,29757.74,United Healthcare,Default,Fee Schedule,26980.35,,,,19507.85,26980.35
RETAINER GLASSMAN LARGE (FISH),272,RC,,,,both,163.85,147.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.7,,,,96.67,133.7
RETAINER GLASSMAN LARGE (FISH),272,RC,,,,both,163.85,147.47,Cigna,Default,Percent of Total Billed Charges,96.67,,,,96.67,133.7
RETAINER GLASSMAN LARGE (FISH),272,RC,,,,both,163.85,147.47,United Healthcare,Default,Fee Schedule,133.7,,,,96.67,133.7
CATH SILICONE 12FR 5CC,A4344,HCPCS,272,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH SILICONE 12FR 5CC,A4344,HCPCS,272,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH SILICONE 12FR 5CC,A4344,HCPCS,272,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO RETAINER GLASSMAN JUMBO,272,RC,,,,both,185.21,166.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.65,,,,109.27,151.13
DNO RETAINER GLASSMAN JUMBO,272,RC,,,,both,185.21,166.69,Cigna,Default,Percent of Total Billed Charges,109.27,,,,109.27,151.13
DNO RETAINER GLASSMAN JUMBO,272,RC,,,,both,185.21,166.69,United Healthcare,Default,Fee Schedule,151.13,,,,109.27,151.13
DEFOGGER FRED,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
DEFOGGER FRED,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
DEFOGGER FRED,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SET BLOOD/FLUID WARMI,272,RC,,,,both,44.27,39.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.99,,,,26.12,36.12
SET BLOOD/FLUID WARMI,272,RC,,,,both,44.27,39.84,Cigna,Default,Percent of Total Billed Charges,26.12,,,,26.12,36.12
SET BLOOD/FLUID WARMI,272,RC,,,,both,44.27,39.84,United Healthcare,Default,Fee Schedule,36.12,,,,26.12,36.12
CATH SILICONE 22FR 5CC,272,RC,,,,both,32.52,29.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.76,,,,19.19,26.54
CATH SILICONE 22FR 5CC,272,RC,,,,both,32.52,29.27,Cigna,Default,Percent of Total Billed Charges,19.19,,,,19.19,26.54
CATH SILICONE 22FR 5CC,272,RC,,,,both,32.52,29.27,United Healthcare,Default,Fee Schedule,26.54,,,,19.19,26.54
CATH GUIDING VISTA BRITE TIP 7FR H-STICK,278,RC,,,,both,284.68,256.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.28,,,,167.96,232.3
CATH GUIDING VISTA BRITE TIP 7FR H-STICK,278,RC,,,,both,284.68,256.21,Cigna,Default,Percent of Total Billed Charges,167.96,,,,167.96,232.3
CATH GUIDING VISTA BRITE TIP 7FR H-STICK,278,RC,,,,both,284.68,256.21,United Healthcare,Default,Fee Schedule,232.3,,,,167.96,232.3
CLEARIFY VISUALIZATION SYSTEM,272,RC,,,,both,175.11,157.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.58,,,,103.31,142.89
CLEARIFY VISUALIZATION SYSTEM,272,RC,,,,both,175.11,157.6,Cigna,Default,Percent of Total Billed Charges,103.31,,,,103.31,142.89
CLEARIFY VISUALIZATION SYSTEM,272,RC,,,,both,175.11,157.6,United Healthcare,Default,Fee Schedule,142.89,,,,103.31,142.89
*CATH SILICONE 24FR 5CC,A4344,HCPCS,272,RC,,both,23.44,21.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.41,,,,13.83,19.13
*CATH SILICONE 24FR 5CC,A4344,HCPCS,272,RC,,both,23.44,21.1,Cigna,Default,Percent of Total Billed Charges,13.83,,,,13.83,19.13
*CATH SILICONE 24FR 5CC,A4344,HCPCS,272,RC,,both,23.44,21.1,United Healthcare,Default,Fee Schedule,19.13,,,,13.83,19.13
CATH SILICONE 26FR 5CC RETENTION,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
CATH SILICONE 26FR 5CC RETENTION,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
CATH SILICONE 26FR 5CC RETENTION,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
SYSTEM CD-SET BAXTER,272,RC,,,,both,128.24,115.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.77,,,,75.66,104.64
SYSTEM CD-SET BAXTER,272,RC,,,,both,128.24,115.42,Cigna,Default,Percent of Total Billed Charges,75.66,,,,75.66,104.64
SYSTEM CD-SET BAXTER,272,RC,,,,both,128.24,115.42,United Healthcare,Default,Fee Schedule,104.64,,,,75.66,104.64
*CATH SILICONE 14FR 30CC,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH SILICONE 14FR 30CC,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH SILICONE 14FR 30CC,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH SILICONE 16FR 30CC,272,RC,,,,both,22.44,20.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.71,,,,13.24,18.31
CATH SILICONE 16FR 30CC,272,RC,,,,both,22.44,20.2,Cigna,Default,Percent of Total Billed Charges,13.24,,,,13.24,18.31
CATH SILICONE 16FR 30CC,272,RC,,,,both,22.44,20.2,United Healthcare,Default,Fee Schedule,18.31,,,,13.24,18.31
DNO CATH HEMO 16FR 30CC,C1752,HCPCS,278,RC,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
DNO CATH HEMO 16FR 30CC,C1752,HCPCS,278,RC,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
DNO CATH HEMO 16FR 30CC,C1752,HCPCS,278,RC,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
*CATH SILICONE 18FR 30CC,A4338,HCPCS,272,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH SILICONE 18FR 30CC,A4338,HCPCS,272,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH SILICONE 18FR 30CC,A4338,HCPCS,272,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
GRAFT VASC VENAFLO II 6MMX40CM STRAI,C1768,HCPCS,278,RC,,both,2239.44,2015.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1567.61,,,,1321.27,1827.38
GRAFT VASC VENAFLO II 6MMX40CM STRAI,C1768,HCPCS,278,RC,,both,2239.44,2015.5,Cigna,Default,Percent of Total Billed Charges,1321.27,,,,1321.27,1827.38
GRAFT VASC VENAFLO II 6MMX40CM STRAI,C1768,HCPCS,278,RC,,both,2239.44,2015.5,United Healthcare,Default,Fee Schedule,1827.38,,,,1321.27,1827.38
CATHETER 6FR FOLEY  PEDIATRIC,A4344,HCPCS,272,RC,,both,98.97,89.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.28,,,,58.39,80.76
CATHETER 6FR FOLEY  PEDIATRIC,A4344,HCPCS,272,RC,,both,98.97,89.07,Cigna,Default,Percent of Total Billed Charges,58.39,,,,58.39,80.76
CATHETER 6FR FOLEY  PEDIATRIC,A4344,HCPCS,272,RC,,both,98.97,89.07,United Healthcare,Default,Fee Schedule,80.76,,,,58.39,80.76
CATHETER 8FR FOLEY  PEDIATRIC,A4344,HCPCS,272,RC,,both,25.52,22.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.86,,,,15.06,20.82
CATHETER 8FR FOLEY  PEDIATRIC,A4344,HCPCS,272,RC,,both,25.52,22.97,Cigna,Default,Percent of Total Billed Charges,15.06,,,,15.06,20.82
CATHETER 8FR FOLEY  PEDIATRIC,A4344,HCPCS,272,RC,,both,25.52,22.97,United Healthcare,Default,Fee Schedule,20.82,,,,15.06,20.82
CATHETER - AINTREE INTUBATION,272,RC,,,,both,200.95,180.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.66,,,,118.56,163.98
CATHETER - AINTREE INTUBATION,272,RC,,,,both,200.95,180.86,Cigna,Default,Percent of Total Billed Charges,118.56,,,,118.56,163.98
CATHETER - AINTREE INTUBATION,272,RC,,,,both,200.95,180.86,United Healthcare,Default,Fee Schedule,163.98,,,,118.56,163.98
*SPECI-CATH KIT FEMALE,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*SPECI-CATH KIT FEMALE,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*SPECI-CATH KIT FEMALE,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH SILICONE 20FR 30CC,272,RC,,,,both,22.44,20.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.71,,,,13.24,18.31
CATH SILICONE 20FR 30CC,272,RC,,,,both,22.44,20.2,Cigna,Default,Percent of Total Billed Charges,13.24,,,,13.24,18.31
CATH SILICONE 20FR 30CC,272,RC,,,,both,22.44,20.2,United Healthcare,Default,Fee Schedule,18.31,,,,13.24,18.31
CATH SILICONE 16FR 30CC FOLEY 3-WAY,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
CATH SILICONE 16FR 30CC FOLEY 3-WAY,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
CATH SILICONE 16FR 30CC FOLEY 3-WAY,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
*CATH SILICONE 22FR 30CC,272,RC,,,,both,27.45,24.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.22,,,,16.2,22.4
*CATH SILICONE 22FR 30CC,272,RC,,,,both,27.45,24.71,Cigna,Default,Percent of Total Billed Charges,16.2,,,,16.2,22.4
*CATH SILICONE 22FR 30CC,272,RC,,,,both,27.45,24.71,United Healthcare,Default,Fee Schedule,22.4,,,,16.2,22.4
DNU CATH SILICONE 24FR 30CC,272,RC,,,,both,58,52.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.6,,,,34.22,47.33
DNU CATH SILICONE 24FR 30CC,272,RC,,,,both,58,52.2,Cigna,Default,Percent of Total Billed Charges,34.22,,,,34.22,47.33
DNU CATH SILICONE 24FR 30CC,272,RC,,,,both,58,52.2,United Healthcare,Default,Fee Schedule,47.33,,,,34.22,47.33
*CATH SILICONE 26FR 30CC,272,RC,,,,both,27.89,25.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.52,,,,16.46,22.76
*CATH SILICONE 26FR 30CC,272,RC,,,,both,27.89,25.1,Cigna,Default,Percent of Total Billed Charges,16.46,,,,16.46,22.76
*CATH SILICONE 26FR 30CC,272,RC,,,,both,27.89,25.1,United Healthcare,Default,Fee Schedule,22.76,,,,16.46,22.76
GRAFT THIN WALLED REMOVABLE RINGS,C1768,HCPCS,278,RC,,both,4314.29,3882.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3020,,,,2545.43,3520.46
GRAFT THIN WALLED REMOVABLE RINGS,C1768,HCPCS,278,RC,,both,4314.29,3882.86,Cigna,Default,Percent of Total Billed Charges,2545.43,,,,2545.43,3520.46
GRAFT THIN WALLED REMOVABLE RINGS,C1768,HCPCS,278,RC,,both,4314.29,3882.86,United Healthcare,Default,Fee Schedule,3520.46,,,,2545.43,3520.46
CATH SILICONE 28FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH SILICONE 28FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH SILICONE 28FR 5CC RETENTION,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
GRAFT RINGED 10 X 80,C1768,HCPCS,278,RC,,both,4693.22,4223.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3285.25,,,,2769,3829.67
GRAFT RINGED 10 X 80,C1768,HCPCS,278,RC,,both,4693.22,4223.9,Cigna,Default,Percent of Total Billed Charges,2769,,,,2769,3829.67
GRAFT RINGED 10 X 80,C1768,HCPCS,278,RC,,both,4693.22,4223.9,United Healthcare,Default,Fee Schedule,3829.67,,,,2769,3829.67
GRAFT STRETCH 6MMX40CM,C1768,HCPCS,278,RC,,both,1904.76,1714.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1333.33,,,,1123.81,1554.28
GRAFT STRETCH 6MMX40CM,C1768,HCPCS,278,RC,,both,1904.76,1714.28,Cigna,Default,Percent of Total Billed Charges,1123.81,,,,1123.81,1554.28
GRAFT STRETCH 6MMX40CM,C1768,HCPCS,278,RC,,both,1904.76,1714.28,United Healthcare,Default,Fee Schedule,1554.28,,,,1123.81,1554.28
GRAFT VASC 6 X 10,C1768,HCPCS,278,RC,,both,5495.25,4945.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3846.68,,,,3242.2,4484.12
GRAFT VASC 6 X 10,C1768,HCPCS,278,RC,,both,5495.25,4945.73,Cigna,Default,Percent of Total Billed Charges,3242.2,,,,3242.2,4484.12
GRAFT VASC 6 X 10,C1768,HCPCS,278,RC,,both,5495.25,4945.73,United Healthcare,Default,Fee Schedule,4484.12,,,,3242.2,4484.12
CATH SILICONE 10FR 3CC M/L PEDIATRIC,A4344,HCPCS,272,RC,,both,33.46,30.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.42,,,,19.74,27.3
CATH SILICONE 10FR 3CC M/L PEDIATRIC,A4344,HCPCS,272,RC,,both,33.46,30.11,Cigna,Default,Percent of Total Billed Charges,19.74,,,,19.74,27.3
CATH SILICONE 10FR 3CC M/L PEDIATRIC,A4344,HCPCS,272,RC,,both,33.46,30.11,United Healthcare,Default,Fee Schedule,27.3,,,,19.74,27.3
GRAFT BI-FURCATED 16X8,C1768,HCPCS,278,RC,,both,2382.79,2144.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1667.95,,,,1405.85,1944.36
GRAFT BI-FURCATED 16X8,C1768,HCPCS,278,RC,,both,2382.79,2144.51,Cigna,Default,Percent of Total Billed Charges,1405.85,,,,1405.85,1944.36
GRAFT BI-FURCATED 16X8,C1768,HCPCS,278,RC,,both,2382.79,2144.51,United Healthcare,Default,Fee Schedule,1944.36,,,,1405.85,1944.36
GRAFT STRAIGHT 8MMX80,C1768,HCPCS,278,RC,,both,3341.52,3007.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2339.06,,,,1971.5,2726.68
GRAFT STRAIGHT 8MMX80,C1768,HCPCS,278,RC,,both,3341.52,3007.37,Cigna,Default,Percent of Total Billed Charges,1971.5,,,,1971.5,2726.68
GRAFT STRAIGHT 8MMX80,C1768,HCPCS,278,RC,,both,3341.52,3007.37,United Healthcare,Default,Fee Schedule,2726.68,,,,1971.5,2726.68
GRAFT VASC 6MMX40CM,C1768,HCPCS,278,RC,,both,3310.8,2979.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2317.56,,,,1953.37,2701.61
GRAFT VASC 6MMX40CM,C1768,HCPCS,278,RC,,both,3310.8,2979.72,Cigna,Default,Percent of Total Billed Charges,1953.37,,,,1953.37,2701.61
GRAFT VASC 6MMX40CM,C1768,HCPCS,278,RC,,both,3310.8,2979.72,United Healthcare,Default,Fee Schedule,2701.61,,,,1953.37,2701.61
MESH ATRIUM CQUR 15X20CM,278,RC,,,,both,2552.48,2297.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1786.74,,,,1505.96,2082.82
MESH ATRIUM CQUR 15X20CM,278,RC,,,,both,2552.48,2297.23,Cigna,Default,Percent of Total Billed Charges,1505.96,,,,1505.96,2082.82
MESH ATRIUM CQUR 15X20CM,278,RC,,,,both,2552.48,2297.23,United Healthcare,Default,Fee Schedule,2082.82,,,,1505.96,2082.82
MESH PATCH DUAL 20X30,C1781,HCPCS,278,RC,,both,7543.17,6788.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5280.22,,,,4450.47,6155.23
MESH PATCH DUAL 20X30,C1781,HCPCS,278,RC,,both,7543.17,6788.85,Cigna,Default,Percent of Total Billed Charges,4450.47,,,,4450.47,6155.23
MESH PATCH DUAL 20X30,C1781,HCPCS,278,RC,,both,7543.17,6788.85,United Healthcare,Default,Fee Schedule,6155.23,,,,4450.47,6155.23
MESH PATCH DUAL 15X19,C1781,HCPCS,278,RC,,both,4010.51,3609.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2807.36,,,,2366.2,3272.58
MESH PATCH DUAL 15X19,C1781,HCPCS,278,RC,,both,4010.51,3609.46,Cigna,Default,Percent of Total Billed Charges,2366.2,,,,2366.2,3272.58
MESH PATCH DUAL 15X19,C1781,HCPCS,278,RC,,both,4010.51,3609.46,United Healthcare,Default,Fee Schedule,3272.58,,,,2366.2,3272.58
MESH PATCH DUAL10X15,C1781,HCPCS,278,RC,,both,2160.56,1944.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1512.39,,,,1274.73,1763.02
MESH PATCH DUAL10X15,C1781,HCPCS,278,RC,,both,2160.56,1944.5,Cigna,Default,Percent of Total Billed Charges,1274.73,,,,1274.73,1763.02
MESH PATCH DUAL10X15,C1781,HCPCS,278,RC,,both,2160.56,1944.5,United Healthcare,Default,Fee Schedule,1763.02,,,,1274.73,1763.02
MESH PATCH SOFT TISSUE 15X,C1781,HCPCS,278,RC,,both,5928.72,5335.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4150.1,,,,3497.94,4837.84
MESH PATCH SOFT TISSUE 15X,C1781,HCPCS,278,RC,,both,5928.72,5335.85,Cigna,Default,Percent of Total Billed Charges,3497.94,,,,3497.94,4837.84
MESH PATCH SOFT TISSUE 15X,C1781,HCPCS,278,RC,,both,5928.72,5335.85,United Healthcare,Default,Fee Schedule,4837.84,,,,3497.94,4837.84
GRAFT BIFURCATED KNITTED 12MMX6MM,C1768,HCPCS,278,RC,,both,2167.38,1950.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1517.17,,,,1278.75,1768.58
GRAFT BIFURCATED KNITTED 12MMX6MM,C1768,HCPCS,278,RC,,both,2167.38,1950.64,Cigna,Default,Percent of Total Billed Charges,1278.75,,,,1278.75,1768.58
GRAFT BIFURCATED KNITTED 12MMX6MM,C1768,HCPCS,278,RC,,both,2167.38,1950.64,United Healthcare,Default,Fee Schedule,1768.58,,,,1278.75,1768.58
GRAFT VASC PROPATEN 6MMX80CM,C1768,HCPCS,278,RC,,both,8055.15,7249.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5638.6,,,,4752.54,6573
GRAFT VASC PROPATEN 6MMX80CM,C1768,HCPCS,278,RC,,both,8055.15,7249.64,Cigna,Default,Percent of Total Billed Charges,4752.54,,,,4752.54,6573
GRAFT VASC PROPATEN 6MMX80CM,C1768,HCPCS,278,RC,,both,8055.15,7249.64,United Healthcare,Default,Fee Schedule,6573,,,,4752.54,6573
GRAFT VASC PROPATEN 6MMX50CM,C1768,HCPCS,278,RC,,both,5324.59,4792.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3727.21,,,,3141.51,4344.87
GRAFT VASC PROPATEN 6MMX50CM,C1768,HCPCS,278,RC,,both,5324.59,4792.13,Cigna,Default,Percent of Total Billed Charges,3141.51,,,,3141.51,4344.87
GRAFT VASC PROPATEN 6MMX50CM,C1768,HCPCS,278,RC,,both,5324.59,4792.13,United Healthcare,Default,Fee Schedule,4344.87,,,,3141.51,4344.87
GRAFT VASC PROPATEN 8MMX50CM,C1768,HCPCS,278,RC,,both,5324.59,4792.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3727.21,,,,3141.51,4344.87
GRAFT VASC PROPATEN 8MMX50CM,C1768,HCPCS,278,RC,,both,5324.59,4792.13,Cigna,Default,Percent of Total Billed Charges,3141.51,,,,3141.51,4344.87
GRAFT VASC PROPATEN 8MMX50CM,C1768,HCPCS,278,RC,,both,5324.59,4792.13,United Healthcare,Default,Fee Schedule,4344.87,,,,3141.51,4344.87
CATH 3WAY 18FR 5CC IRRIGATION,A4346,HCPCS,272,RC,,both,40.74,36.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.52,,,,24.04,33.24
CATH 3WAY 18FR 5CC IRRIGATION,A4346,HCPCS,272,RC,,both,40.74,36.67,Cigna,Default,Percent of Total Billed Charges,24.04,,,,24.04,33.24
CATH 3WAY 18FR 5CC IRRIGATION,A4346,HCPCS,272,RC,,both,40.74,36.67,United Healthcare,Default,Fee Schedule,33.24,,,,24.04,33.24
*CATH 3WAY 16FR 5CC IRRIGATION,A4340,HCPCS,272,RC,,both,36.28,32.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.4,,,,21.41,29.6
*CATH 3WAY 16FR 5CC IRRIGATION,A4340,HCPCS,272,RC,,both,36.28,32.65,Cigna,Default,Percent of Total Billed Charges,21.41,,,,21.41,29.6
*CATH 3WAY 16FR 5CC IRRIGATION,A4340,HCPCS,272,RC,,both,36.28,32.65,United Healthcare,Default,Fee Schedule,29.6,,,,21.41,29.6
CATH 3WAY 22FR 30CC IRRIGATION,A4346,HCPCS,272,RC,,both,13.41,12.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.39,,,,7.91,10.94
CATH 3WAY 22FR 30CC IRRIGATION,A4346,HCPCS,272,RC,,both,13.41,12.07,Cigna,Default,Percent of Total Billed Charges,7.91,,,,7.91,10.94
CATH 3WAY 22FR 30CC IRRIGATION,A4346,HCPCS,272,RC,,both,13.41,12.07,United Healthcare,Default,Fee Schedule,10.94,,,,7.91,10.94
WIRE - K,C1769,HCPCS,272,RC,,both,366,329.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.2,,,,215.94,298.66
WIRE - K,C1769,HCPCS,272,RC,,both,366,329.4,Cigna,Default,Percent of Total Billed Charges,215.94,,,,215.94,298.66
WIRE - K,C1769,HCPCS,272,RC,,both,366,329.4,United Healthcare,Default,Fee Schedule,298.66,,,,215.94,298.66
FIXION PF NAIL,278,RC,,,,both,2730.75,2457.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.52,,,,1611.14,2228.29
FIXION PF NAIL,278,RC,,,,both,2730.75,2457.68,Cigna,Default,Percent of Total Billed Charges,1611.14,,,,1611.14,2228.29
FIXION PF NAIL,278,RC,,,,both,2730.75,2457.68,United Healthcare,Default,Fee Schedule,2228.29,,,,1611.14,2228.29
FIXION PF PEG,278,RC,,,,both,795.75,716.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,557.02,,,,469.49,649.33
FIXION PF PEG,278,RC,,,,both,795.75,716.18,Cigna,Default,Percent of Total Billed Charges,469.49,,,,469.49,649.33
FIXION PF PEG,278,RC,,,,both,795.75,716.18,United Healthcare,Default,Fee Schedule,649.33,,,,469.49,649.33
CATH 3WAY 24FR 30CC,A4346,HCPCS,272,RC,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
CATH 3WAY 24FR 30CC,A4346,HCPCS,272,RC,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
CATH 3WAY 24FR 30CC,A4346,HCPCS,272,RC,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
CATH 3WAY 26FR 30CC IRRIGATION,A4346,HCPCS,272,RC,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
CATH 3WAY 26FR 30CC IRRIGATION,A4346,HCPCS,272,RC,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
CATH 3WAY 26FR 30CC IRRIGATION,A4346,HCPCS,272,RC,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
CATH ANGIO 4FR-.035-100CM-JB2,272,RC,,,,both,55.97,50.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.18,,,,33.02,45.67
CATH ANGIO 4FR-.035-100CM-JB2,272,RC,,,,both,55.97,50.37,Cigna,Default,Percent of Total Billed Charges,33.02,,,,33.02,45.67
CATH ANGIO 4FR-.035-100CM-JB2,272,RC,,,,both,55.97,50.37,United Healthcare,Default,Fee Schedule,45.67,,,,33.02,45.67
CATH ANGIO 4FR-.035-100CM-H1,272,RC,,,,both,53.3,47.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.31,,,,31.45,43.49
CATH ANGIO 4FR-.035-100CM-H1,272,RC,,,,both,53.3,47.97,Cigna,Default,Percent of Total Billed Charges,31.45,,,,31.45,43.49
CATH ANGIO 4FR-.035-100CM-H1,272,RC,,,,both,53.3,47.97,United Healthcare,Default,Fee Schedule,43.49,,,,31.45,43.49
*CATH URETHRAL 14F BAX,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH URETHRAL 14F BAX,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH URETHRAL 14F BAX,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
TROCAR ARGYLE 16FR,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TROCAR ARGYLE 16FR,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TROCAR ARGYLE 16FR,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
TROCAR ARGYLE 20FR,272,RC,,,,both,109.8,98.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.86,,,,64.78,89.6
TROCAR ARGYLE 20FR,272,RC,,,,both,109.8,98.82,Cigna,Default,Percent of Total Billed Charges,64.78,,,,64.78,89.6
TROCAR ARGYLE 20FR,272,RC,,,,both,109.8,98.82,United Healthcare,Default,Fee Schedule,89.6,,,,64.78,89.6
TRAY CATHETER 16 FR LF,272,RC,,,,both,29.18,26.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.43,,,,17.22,23.81
TRAY CATHETER 16 FR LF,272,RC,,,,both,29.18,26.26,Cigna,Default,Percent of Total Billed Charges,17.22,,,,17.22,23.81
TRAY CATHETER 16 FR LF,272,RC,,,,both,29.18,26.26,United Healthcare,Default,Fee Schedule,23.81,,,,17.22,23.81
CATH 8FR CONE TIP URETERAL,272,RC,,,,both,72.9,65.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.03,,,,43.01,59.49
CATH 8FR CONE TIP URETERAL,272,RC,,,,both,72.9,65.61,Cigna,Default,Percent of Total Billed Charges,43.01,,,,43.01,59.49
CATH 8FR CONE TIP URETERAL,272,RC,,,,both,72.9,65.61,United Healthcare,Default,Fee Schedule,59.49,,,,43.01,59.49
TRAY CATHETER W/D FDL,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TRAY CATHETER W/D FDL,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TRAY CATHETER W/D FDL,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH 5FR CONE TIP URETERAL,272,RC,,,,both,71.08,63.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.76,,,,41.94,58
CATH 5FR CONE TIP URETERAL,272,RC,,,,both,71.08,63.97,Cigna,Default,Percent of Total Billed Charges,41.94,,,,41.94,58
CATH 5FR CONE TIP URETERAL,272,RC,,,,both,71.08,63.97,United Healthcare,Default,Fee Schedule,58,,,,41.94,58
CATH ANGIO 4FR-.035-100CM,272,RC,,,,both,60.55,54.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.38,,,,35.72,49.41
CATH ANGIO 4FR-.035-100CM,272,RC,,,,both,60.55,54.5,Cigna,Default,Percent of Total Billed Charges,35.72,,,,35.72,49.41
CATH ANGIO 4FR-.035-100CM,272,RC,,,,both,60.55,54.5,United Healthcare,Default,Fee Schedule,49.41,,,,35.72,49.41
MESH SOFT TISUE 10 X,C1781,HCPCS,278,RC,,both,2058.16,1852.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1440.71,,,,1214.31,1679.46
MESH SOFT TISUE 10 X,C1781,HCPCS,278,RC,,both,2058.16,1852.34,Cigna,Default,Percent of Total Billed Charges,1214.31,,,,1214.31,1679.46
MESH SOFT TISUE 10 X,C1781,HCPCS,278,RC,,both,2058.16,1852.34,United Healthcare,Default,Fee Schedule,1679.46,,,,1214.31,1679.46
"CATH ANGIO 14G 5.25""",272,RC,,,,both,51.29,46.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.9,,,,30.26,41.85
"CATH ANGIO 14G 5.25""",272,RC,,,,both,51.29,46.16,Cigna,Default,Percent of Total Billed Charges,30.26,,,,30.26,41.85
"CATH ANGIO 14G 5.25""",272,RC,,,,both,51.29,46.16,United Healthcare,Default,Fee Schedule,41.85,,,,30.26,41.85
PRO PORT SYSTEM,272,RC,,,,both,983.42,885.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,688.39,,,,580.22,802.47
PRO PORT SYSTEM,272,RC,,,,both,983.42,885.08,Cigna,Default,Percent of Total Billed Charges,580.22,,,,580.22,802.47
PRO PORT SYSTEM,272,RC,,,,both,983.42,885.08,United Healthcare,Default,Fee Schedule,802.47,,,,580.22,802.47
PORT TITANIUM IMPLATED W/CATH,278,RC,,,,both,2328.58,2095.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1630.01,,,,1373.86,1900.12
PORT TITANIUM IMPLATED W/CATH,278,RC,,,,both,2328.58,2095.72,Cigna,Default,Percent of Total Billed Charges,1373.86,,,,1373.86,1900.12
PORT TITANIUM IMPLATED W/CATH,278,RC,,,,both,2328.58,2095.72,United Healthcare,Default,Fee Schedule,1900.12,,,,1373.86,1900.12
TRAY URETHRAL 14FR D,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
TRAY URETHRAL 14FR D,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
TRAY URETHRAL 14FR D,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SET NEPHROSTOMY ULTRATHANE,272,RC,,,,both,745.14,670.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,521.6,,,,439.63,608.03
SET NEPHROSTOMY ULTRATHANE,272,RC,,,,both,745.14,670.63,Cigna,Default,Percent of Total Billed Charges,439.63,,,,439.63,608.03
SET NEPHROSTOMY ULTRATHANE,272,RC,,,,both,745.14,670.63,United Healthcare,Default,Fee Schedule,608.03,,,,439.63,608.03
PERCUTANEOUS NEPHROSTOMY SET,272,RC,,,,both,762.14,685.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,533.5,,,,449.66,621.91
PERCUTANEOUS NEPHROSTOMY SET,272,RC,,,,both,762.14,685.93,Cigna,Default,Percent of Total Billed Charges,449.66,,,,449.66,621.91
PERCUTANEOUS NEPHROSTOMY SET,272,RC,,,,both,762.14,685.93,United Healthcare,Default,Fee Schedule,621.91,,,,449.66,621.91
SET NEPHROSTOMY ULTRATHANE 8.5FR,272,RC,,,,both,820.51,738.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,574.36,,,,484.1,669.54
SET NEPHROSTOMY ULTRATHANE 8.5FR,272,RC,,,,both,820.51,738.46,Cigna,Default,Percent of Total Billed Charges,484.1,,,,484.1,669.54
SET NEPHROSTOMY ULTRATHANE 8.5FR,272,RC,,,,both,820.51,738.46,United Healthcare,Default,Fee Schedule,669.54,,,,484.1,669.54
CATH NEPHROSTOMY 10FR PERCUFLEX,272,RC,,,,both,440.49,396.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,308.34,,,,259.89,359.44
CATH NEPHROSTOMY 10FR PERCUFLEX,272,RC,,,,both,440.49,396.44,Cigna,Default,Percent of Total Billed Charges,259.89,,,,259.89,359.44
CATH NEPHROSTOMY 10FR PERCUFLEX,272,RC,,,,both,440.49,396.44,United Healthcare,Default,Fee Schedule,359.44,,,,259.89,359.44
SUTURE VICRYL #1 CT-1 ETH J947H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL #1 CT-1 ETH J947H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL #1 CT-1 ETH J947H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DILATOR NAVAGATION HD 12/14 FR,C1894,HCPCS,278,RC,,both,673.83,606.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,471.68,,,,397.56,549.85
DILATOR NAVAGATION HD 12/14 FR,C1894,HCPCS,278,RC,,both,673.83,606.45,Cigna,Default,Percent of Total Billed Charges,397.56,,,,397.56,549.85
DILATOR NAVAGATION HD 12/14 FR,C1894,HCPCS,278,RC,,both,673.83,606.45,United Healthcare,Default,Fee Schedule,549.85,,,,397.56,549.85
REFURB MED SLEEVE COMPRESSION,271,RC,,,,both,42.56,38.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.79,,,,25.11,34.73
REFURB MED SLEEVE COMPRESSION,271,RC,,,,both,42.56,38.3,Cigna,Default,Percent of Total Billed Charges,25.11,,,,25.11,34.73
REFURB MED SLEEVE COMPRESSION,271,RC,,,,both,42.56,38.3,United Healthcare,Default,Fee Schedule,34.73,,,,25.11,34.73
SM SLEEVE COMPRESSION,271,RC,,,,both,90.24,81.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.17,,,,53.24,73.64
SM SLEEVE COMPRESSION,271,RC,,,,both,90.24,81.22,Cigna,Default,Percent of Total Billed Charges,53.24,,,,53.24,73.64
SM SLEEVE COMPRESSION,271,RC,,,,both,90.24,81.22,United Healthcare,Default,Fee Schedule,73.64,,,,53.24,73.64
MED SLEEVE COMPRESSION,271,RC,,,,both,56.53,50.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.57,,,,33.35,46.13
MED SLEEVE COMPRESSION,271,RC,,,,both,56.53,50.88,Cigna,Default,Percent of Total Billed Charges,33.35,,,,33.35,46.13
MED SLEEVE COMPRESSION,271,RC,,,,both,56.53,50.88,United Healthcare,Default,Fee Schedule,46.13,,,,33.35,46.13
LG SLEEVE COMPRESSION,271,RC,,,,both,96.5,86.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.55,,,,56.94,78.74
LG SLEEVE COMPRESSION,271,RC,,,,both,96.5,86.85,Cigna,Default,Percent of Total Billed Charges,56.94,,,,56.94,78.74
LG SLEEVE COMPRESSION,271,RC,,,,both,96.5,86.85,United Healthcare,Default,Fee Schedule,78.74,,,,56.94,78.74
SLEEVE SCD EXTRA LARGE BARIATRIC,271,RC,,,,both,198.82,178.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.17,,,,117.3,162.24
SLEEVE SCD EXTRA LARGE BARIATRIC,271,RC,,,,both,198.82,178.94,Cigna,Default,Percent of Total Billed Charges,117.3,,,,117.3,162.24
SLEEVE SCD EXTRA LARGE BARIATRIC,271,RC,,,,both,198.82,178.94,United Healthcare,Default,Fee Schedule,162.24,,,,117.3,162.24
DNO SLEEVE SCD MEDIUM KNEE,271,RC,,,,both,150.75,135.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.52,,,,88.94,123.01
DNO SLEEVE SCD MEDIUM KNEE,271,RC,,,,both,150.75,135.68,Cigna,Default,Percent of Total Billed Charges,88.94,,,,88.94,123.01
DNO SLEEVE SCD MEDIUM KNEE,271,RC,,,,both,150.75,135.68,United Healthcare,Default,Fee Schedule,123.01,,,,88.94,123.01
*EPIFIX 2.0X3.0,636,RC,,,,both,635.2,571.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,444.64,,,,374.77,518.32
*EPIFIX 2.0X3.0,636,RC,,,,both,635.2,571.68,Cigna,Default,Percent of Total Billed Charges,374.77,,,,374.77,518.32
*EPIFIX 2.0X3.0,636,RC,,,,both,635.2,571.68,United Healthcare,Default,Fee Schedule,518.32,,,,374.77,518.32
SNARE 4FR AMPLTZ 10/,272,RC,,,,both,860.49,774.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,602.34,,,,507.69,702.16
SNARE 4FR AMPLTZ 10/,272,RC,,,,both,860.49,774.44,Cigna,Default,Percent of Total Billed Charges,507.69,,,,507.69,702.16
SNARE 4FR AMPLTZ 10/,272,RC,,,,both,860.49,774.44,United Healthcare,Default,Fee Schedule,702.16,,,,507.69,702.16
CATH PERCUTANEOUS 10F 30CM,272,RC,,,,both,215.41,193.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,150.79,,,,127.09,175.77
CATH PERCUTANEOUS 10F 30CM,272,RC,,,,both,215.41,193.87,Cigna,Default,Percent of Total Billed Charges,127.09,,,,127.09,175.77
CATH PERCUTANEOUS 10F 30CM,272,RC,,,,both,215.41,193.87,United Healthcare,Default,Fee Schedule,175.77,,,,127.09,175.77
CATH PERCUTANEOUS 12FR,272,RC,,,,both,220.07,198.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.05,,,,129.84,179.58
CATH PERCUTANEOUS 12FR,272,RC,,,,both,220.07,198.06,Cigna,Default,Percent of Total Billed Charges,129.84,,,,129.84,179.58
CATH PERCUTANEOUS 12FR,272,RC,,,,both,220.07,198.06,United Healthcare,Default,Fee Schedule,179.58,,,,129.84,179.58
SET TRIPLE PRESSURE TRANSDUCER,272,RC,,,,both,291.19,262.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,203.83,,,,171.8,237.61
SET TRIPLE PRESSURE TRANSDUCER,272,RC,,,,both,291.19,262.07,Cigna,Default,Percent of Total Billed Charges,171.8,,,,171.8,237.61
SET TRIPLE PRESSURE TRANSDUCER,272,RC,,,,both,291.19,262.07,United Healthcare,Default,Fee Schedule,237.61,,,,171.8,237.61
TRANSDUCER KIT PRESSURE MONITOR,272,RC,,,,both,53.92,48.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.74,,,,31.81,44
TRANSDUCER KIT PRESSURE MONITOR,272,RC,,,,both,53.92,48.53,Cigna,Default,Percent of Total Billed Charges,31.81,,,,31.81,44
TRANSDUCER KIT PRESSURE MONITOR,272,RC,,,,both,53.92,48.53,United Healthcare,Default,Fee Schedule,44,,,,31.81,44
SALIVARY DUCT CATHETER,272,RC,,,,both,333.66,300.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.56,,,,196.86,272.27
SALIVARY DUCT CATHETER,272,RC,,,,both,333.66,300.29,Cigna,Default,Percent of Total Billed Charges,196.86,,,,196.86,272.27
SALIVARY DUCT CATHETER,272,RC,,,,both,333.66,300.29,United Healthcare,Default,Fee Schedule,272.27,,,,196.86,272.27
SLING TRANSVAGINAL MID-URETHRAL SYSTEM,278,RC,,,,both,3125.84,2813.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2188.09,,,,1844.25,2550.69
SLING TRANSVAGINAL MID-URETHRAL SYSTEM,278,RC,,,,both,3125.84,2813.26,Cigna,Default,Percent of Total Billed Charges,1844.25,,,,1844.25,2550.69
SLING TRANSVAGINAL MID-URETHRAL SYSTEM,278,RC,,,,both,3125.84,2813.26,United Healthcare,Default,Fee Schedule,2550.69,,,,1844.25,2550.69
T.V.T URINARY,C2631,HCPCS,278,RC,,both,2952.42,2657.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2066.69,,,,1741.93,2409.17
T.V.T URINARY,C2631,HCPCS,278,RC,,both,2952.42,2657.18,Cigna,Default,Percent of Total Billed Charges,1741.93,,,,1741.93,2409.17
T.V.T URINARY,C2631,HCPCS,278,RC,,both,2952.42,2657.18,United Healthcare,Default,Fee Schedule,2409.17,,,,1741.93,2409.17
TVT ADVANTAGE SYSTEM,C2631,HCPCS,278,RC,,both,4783.33,4305,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3348.33,,,,2822.16,3903.2
TVT ADVANTAGE SYSTEM,C2631,HCPCS,278,RC,,both,4783.33,4305,Cigna,Default,Percent of Total Billed Charges,2822.16,,,,2822.16,3903.2
TVT ADVANTAGE SYSTEM,C2631,HCPCS,278,RC,,both,4783.33,4305,United Healthcare,Default,Fee Schedule,3903.2,,,,2822.16,3903.2
SLING SYSTEM MID URETHRAL,278,RC,,,,both,4355.11,3919.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3048.58,,,,2569.51,3553.77
SLING SYSTEM MID URETHRAL,278,RC,,,,both,4355.11,3919.6,Cigna,Default,Percent of Total Billed Charges,2569.51,,,,2569.51,3553.77
SLING SYSTEM MID URETHRAL,278,RC,,,,both,4355.11,3919.6,United Healthcare,Default,Fee Schedule,3553.77,,,,2569.51,3553.77
RETRIVAL DEPLOYMENT DEVICE,278,RC,,,,both,1052.29,947.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,736.6,,,,620.85,858.67
RETRIVAL DEPLOYMENT DEVICE,278,RC,,,,both,1052.29,947.06,Cigna,Default,Percent of Total Billed Charges,620.85,,,,620.85,858.67
RETRIVAL DEPLOYMENT DEVICE,278,RC,,,,both,1052.29,947.06,United Healthcare,Default,Fee Schedule,858.67,,,,620.85,858.67
HEATED BREATHING CIRCUIT W/ CHAMBER,272,RC,,,,both,98,88.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.6,,,,57.82,79.97
HEATED BREATHING CIRCUIT W/ CHAMBER,272,RC,,,,both,98,88.2,Cigna,Default,Percent of Total Billed Charges,57.82,,,,57.82,79.97
HEATED BREATHING CIRCUIT W/ CHAMBER,272,RC,,,,both,98,88.2,United Healthcare,Default,Fee Schedule,79.97,,,,57.82,79.97
FLEX POINT ELECTRODE UNIV ROLLERBLL,272,RC,,,,both,428.33,385.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,299.83,,,,252.71,349.52
FLEX POINT ELECTRODE UNIV ROLLERBLL,272,RC,,,,both,428.33,385.5,Cigna,Default,Percent of Total Billed Charges,252.71,,,,252.71,349.52
FLEX POINT ELECTRODE UNIV ROLLERBLL,272,RC,,,,both,428.33,385.5,United Healthcare,Default,Fee Schedule,349.52,,,,252.71,349.52
ELECTRODE UNIV ROLLERBLL,272,RC,,,,both,495.46,445.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,346.82,,,,292.32,404.3
ELECTRODE UNIV ROLLERBLL,272,RC,,,,both,495.46,445.91,Cigna,Default,Percent of Total Billed Charges,292.32,,,,292.32,404.3
ELECTRODE UNIV ROLLERBLL,272,RC,,,,both,495.46,445.91,United Healthcare,Default,Fee Schedule,404.3,,,,292.32,404.3
ELECTRODE COLLINS KNIFE 22/24 FR,272,RC,,,,both,250.7,225.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,175.49,,,,147.91,204.57
ELECTRODE COLLINS KNIFE 22/24 FR,272,RC,,,,both,250.7,225.63,Cigna,Default,Percent of Total Billed Charges,147.91,,,,147.91,204.57
ELECTRODE COLLINS KNIFE 22/24 FR,272,RC,,,,both,250.7,225.63,United Healthcare,Default,Fee Schedule,204.57,,,,147.91,204.57
SHUNT 6 INCH CAROTID ARTERY,272,RC,,,,both,116.28,104.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.4,,,,68.61,94.88
SHUNT 6 INCH CAROTID ARTERY,272,RC,,,,both,116.28,104.65,Cigna,Default,Percent of Total Billed Charges,68.61,,,,68.61,94.88
SHUNT 6 INCH CAROTID ARTERY,272,RC,,,,both,116.28,104.65,United Healthcare,Default,Fee Schedule,94.88,,,,68.61,94.88
VASOSEAL ES,C1760,HCPCS,278,RC,,both,767.97,691.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,537.58,,,,453.1,626.66
VASOSEAL ES,C1760,HCPCS,278,RC,,both,767.97,691.17,Cigna,Default,Percent of Total Billed Charges,453.1,,,,453.1,626.66
VASOSEAL ES,C1760,HCPCS,278,RC,,both,767.97,691.17,United Healthcare,Default,Fee Schedule,626.66,,,,453.1,626.66
HET BIPOLAR FORCEPS,272,RC,,,,both,2102.9,1892.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1472.03,,,,1240.71,1715.97
HET BIPOLAR FORCEPS,272,RC,,,,both,2102.9,1892.61,Cigna,Default,Percent of Total Billed Charges,1240.71,,,,1240.71,1715.97
HET BIPOLAR FORCEPS,272,RC,,,,both,2102.9,1892.61,United Healthcare,Default,Fee Schedule,1715.97,,,,1240.71,1715.97
FORCEP ORANGE BIOPSY W/NEED,272,RC,,,,both,40.31,36.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.22,,,,23.78,32.89
FORCEP ORANGE BIOPSY W/NEED,272,RC,,,,both,40.31,36.28,Cigna,Default,Percent of Total Billed Charges,23.78,,,,23.78,32.89
FORCEP ORANGE BIOPSY W/NEED,272,RC,,,,both,40.31,36.28,United Healthcare,Default,Fee Schedule,32.89,,,,23.78,32.89
BIOPSY RADIAL JAW HOT,272,RC,,,,both,151.36,136.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.95,,,,89.3,123.51
BIOPSY RADIAL JAW HOT,272,RC,,,,both,151.36,136.22,Cigna,Default,Percent of Total Billed Charges,89.3,,,,89.3,123.51
BIOPSY RADIAL JAW HOT,272,RC,,,,both,151.36,136.22,United Healthcare,Default,Fee Schedule,123.51,,,,89.3,123.51
*STAPLER CURVED 29MM,272,RC,,,,both,1152.59,1037.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,806.81,,,,680.03,940.51
*STAPLER CURVED 29MM,272,RC,,,,both,1152.59,1037.33,Cigna,Default,Percent of Total Billed Charges,680.03,,,,680.03,940.51
*STAPLER CURVED 29MM,272,RC,,,,both,1152.59,1037.33,United Healthcare,Default,Fee Schedule,940.51,,,,680.03,940.51
STAPLER 35 REGULAR CONMED,272,RC,,,,both,46.86,42.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.8,,,,27.65,38.24
STAPLER 35 REGULAR CONMED,272,RC,,,,both,46.86,42.17,Cigna,Default,Percent of Total Billed Charges,27.65,,,,27.65,38.24
STAPLER 35 REGULAR CONMED,272,RC,,,,both,46.86,42.17,United Healthcare,Default,Fee Schedule,38.24,,,,27.65,38.24
STAPLER 35W,272,RC,,,,both,26.63,23.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.64,,,,15.71,21.73
STAPLER 35W,272,RC,,,,both,26.63,23.97,Cigna,Default,Percent of Total Billed Charges,15.71,,,,15.71,21.73
STAPLER 35W,272,RC,,,,both,26.63,23.97,United Healthcare,Default,Fee Schedule,21.73,,,,15.71,21.73
STAPLER 21 MM CURVED,272,RC,,,,both,1229.54,1106.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,860.68,,,,725.43,1003.3
STAPLER 21 MM CURVED,272,RC,,,,both,1229.54,1106.59,Cigna,Default,Percent of Total Billed Charges,725.43,,,,725.43,1003.3
STAPLER 21 MM CURVED,272,RC,,,,both,1229.54,1106.59,United Healthcare,Default,Fee Schedule,1003.3,,,,725.43,1003.3
STAPLER 35W 3M ORTH,272,RC,,,,both,35.56,32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.89,,,,20.98,29.02
STAPLER 35W 3M ORTH,272,RC,,,,both,35.56,32,Cigna,Default,Percent of Total Billed Charges,20.98,,,,20.98,29.02
STAPLER 35W 3M ORTH,272,RC,,,,both,35.56,32,United Healthcare,Default,Fee Schedule,29.02,,,,20.98,29.02
STAPLER 30MM TX30V LINEAR VASCULAR,272,RC,,,,both,262.08,235.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.46,,,,154.63,213.86
STAPLER 30MM TX30V LINEAR VASCULAR,272,RC,,,,both,262.08,235.87,Cigna,Default,Percent of Total Billed Charges,154.63,,,,154.63,213.86
STAPLER 30MM TX30V LINEAR VASCULAR,272,RC,,,,both,262.08,235.87,United Healthcare,Default,Fee Schedule,213.86,,,,154.63,213.86
LINEAR CUTTER 55MM,272,RC,,,,both,245.7,221.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.99,,,,144.96,200.49
LINEAR CUTTER 55MM,272,RC,,,,both,245.7,221.13,Cigna,Default,Percent of Total Billed Charges,144.96,,,,144.96,200.49
LINEAR CUTTER 55MM,272,RC,,,,both,245.7,221.13,United Healthcare,Default,Fee Schedule,200.49,,,,144.96,200.49
SHEARS 5 MM CURVED HARMONIC,272,RC,,,,both,1258.46,1132.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,880.92,,,,742.49,1026.9
SHEARS 5 MM CURVED HARMONIC,272,RC,,,,both,1258.46,1132.61,Cigna,Default,Percent of Total Billed Charges,742.49,,,,742.49,1026.9
SHEARS 5 MM CURVED HARMONIC,272,RC,,,,both,1258.46,1132.61,United Healthcare,Default,Fee Schedule,1026.9,,,,742.49,1026.9
PIRANHA URETEROSCOPIC BIOPSY FORCEP,272,RC,,,,both,1153.38,1038.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,807.37,,,,680.49,941.16
PIRANHA URETEROSCOPIC BIOPSY FORCEP,272,RC,,,,both,1153.38,1038.04,Cigna,Default,Percent of Total Billed Charges,680.49,,,,680.49,941.16
PIRANHA URETEROSCOPIC BIOPSY FORCEP,272,RC,,,,both,1153.38,1038.04,United Healthcare,Default,Fee Schedule,941.16,,,,680.49,941.16
HEMOCLIP 25 MED ENDOSCOPIC GRN,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
HEMOCLIP 25 MED ENDOSCOPIC GRN,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
HEMOCLIP 25 MED ENDOSCOPIC GRN,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
HEMOCLIP RELAY EMDPSCOPIC 16MMX230CM,272,RC,,,,both,239.76,215.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,167.83,,,,141.46,195.64
HEMOCLIP RELAY EMDPSCOPIC 16MMX230CM,272,RC,,,,both,239.76,215.78,Cigna,Default,Percent of Total Billed Charges,141.46,,,,141.46,195.64
HEMOCLIP RELAY EMDPSCOPIC 16MMX230CM,272,RC,,,,both,239.76,215.78,United Healthcare,Default,Fee Schedule,195.64,,,,141.46,195.64
CLIP HEMOLOK WECK LARGE,272,RC,,,,both,99.95,89.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.96,,,,58.97,81.56
CLIP HEMOLOK WECK LARGE,272,RC,,,,both,99.95,89.96,Cigna,Default,Percent of Total Billed Charges,58.97,,,,58.97,81.56
CLIP HEMOLOK WECK LARGE,272,RC,,,,both,99.95,89.96,United Healthcare,Default,Fee Schedule,81.56,,,,58.97,81.56
*STAPLER 33 MM CURVED,272,RC,,,,both,737.23,663.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,516.06,,,,434.97,601.58
*STAPLER 33 MM CURVED,272,RC,,,,both,737.23,663.51,Cigna,Default,Percent of Total Billed Charges,434.97,,,,434.97,601.58
*STAPLER 33 MM CURVED,272,RC,,,,both,737.23,663.51,United Healthcare,Default,Fee Schedule,601.58,,,,434.97,601.58
MICROFX OCD UNIVERSAL DRILL,272,RC,,,,both,1975.6,1778.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1382.92,,,,1165.6,1612.09
MICROFX OCD UNIVERSAL DRILL,272,RC,,,,both,1975.6,1778.04,Cigna,Default,Percent of Total Billed Charges,1165.6,,,,1165.6,1612.09
MICROFX OCD UNIVERSAL DRILL,272,RC,,,,both,1975.6,1778.04,United Healthcare,Default,Fee Schedule,1612.09,,,,1165.6,1612.09
HEMOSPRAY,272,RC,,,,both,5145.35,4630.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3601.74,,,,3035.76,4198.61
HEMOSPRAY,272,RC,,,,both,5145.35,4630.82,Cigna,Default,Percent of Total Billed Charges,3035.76,,,,3035.76,4198.61
HEMOSPRAY,272,RC,,,,both,5145.35,4630.82,United Healthcare,Default,Fee Schedule,4198.61,,,,3035.76,4198.61
DISC STAPLER CURVED 25MM,272,RC,,,,both,737.26,663.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,516.08,,,,434.98,601.6
DISC STAPLER CURVED 25MM,272,RC,,,,both,737.26,663.53,Cigna,Default,Percent of Total Billed Charges,434.98,,,,434.98,601.6
DISC STAPLER CURVED 25MM,272,RC,,,,both,737.26,663.53,United Healthcare,Default,Fee Schedule,601.6,,,,434.98,601.6
STAPLER ECS 21 MM ENDOSCOPIC,272,RC,,,,both,1306.14,1175.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,914.3,,,,770.62,1065.81
STAPLER ECS 21 MM ENDOSCOPIC,272,RC,,,,both,1306.14,1175.53,Cigna,Default,Percent of Total Billed Charges,770.62,,,,770.62,1065.81
STAPLER ECS 21 MM ENDOSCOPIC,272,RC,,,,both,1306.14,1175.53,United Healthcare,Default,Fee Schedule,1065.81,,,,770.62,1065.81
STAPLER PROXIMATE LINEAR TX30G,272,RC,,,,both,228.39,205.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.87,,,,134.75,186.37
STAPLER PROXIMATE LINEAR TX30G,272,RC,,,,both,228.39,205.55,Cigna,Default,Percent of Total Billed Charges,134.75,,,,134.75,186.37
STAPLER PROXIMATE LINEAR TX30G,272,RC,,,,both,228.39,205.55,United Healthcare,Default,Fee Schedule,186.37,,,,134.75,186.37
STAPLER 25MM CIRCULAR 370MM 28CM,272,RC,,,,both,797.79,718.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,558.45,,,,470.7,651
STAPLER 25MM CIRCULAR 370MM 28CM,272,RC,,,,both,797.79,718.01,Cigna,Default,Percent of Total Billed Charges,470.7,,,,470.7,651
STAPLER 25MM CIRCULAR 370MM 28CM,272,RC,,,,both,797.79,718.01,United Healthcare,Default,Fee Schedule,651,,,,470.7,651
STAPLER RELOAD 60MM WHITE,272,RC,,,,both,5268.05,4741.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3687.64,,,,3108.15,4298.73
STAPLER RELOAD 60MM WHITE,272,RC,,,,both,5268.05,4741.25,Cigna,Default,Percent of Total Billed Charges,3108.15,,,,3108.15,4298.73
STAPLER RELOAD 60MM WHITE,272,RC,,,,both,5268.05,4741.25,United Healthcare,Default,Fee Schedule,4298.73,,,,3108.15,4298.73
LINEAR CUTTER 75 MM,272,RC,,,,both,356.85,321.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,249.8,,,,210.54,291.19
LINEAR CUTTER 75 MM,272,RC,,,,both,356.85,321.17,Cigna,Default,Percent of Total Billed Charges,210.54,,,,210.54,291.19
LINEAR CUTTER 75 MM,272,RC,,,,both,356.85,321.17,United Healthcare,Default,Fee Schedule,291.19,,,,210.54,291.19
RELOAD 30MM TX30 LINEAR BLUE,272,RC,,,,both,140.11,126.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.08,,,,82.66,114.33
RELOAD 30MM TX30 LINEAR BLUE,272,RC,,,,both,140.11,126.1,Cigna,Default,Percent of Total Billed Charges,82.66,,,,82.66,114.33
RELOAD 30MM TX30 LINEAR BLUE,272,RC,,,,both,140.11,126.1,United Healthcare,Default,Fee Schedule,114.33,,,,82.66,114.33
RELOAD LINEAR CUTTER 75MM,272,RC,,,,both,190.3,171.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.21,,,,112.28,155.28
RELOAD LINEAR CUTTER 75MM,272,RC,,,,both,190.3,171.27,Cigna,Default,Percent of Total Billed Charges,112.28,,,,112.28,155.28
RELOAD LINEAR CUTTER 75MM,272,RC,,,,both,190.3,171.27,United Healthcare,Default,Fee Schedule,155.28,,,,112.28,155.28
RELOAD 30MM TX30 LINEAR GREEN,272,RC,,,,both,167.4,150.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.18,,,,98.77,136.6
RELOAD 30MM TX30 LINEAR GREEN,272,RC,,,,both,167.4,150.66,Cigna,Default,Percent of Total Billed Charges,98.77,,,,98.77,136.6
RELOAD 30MM TX30 LINEAR GREEN,272,RC,,,,both,167.4,150.66,United Healthcare,Default,Fee Schedule,136.6,,,,98.77,136.6
SCALPEL HARMONIC HAND HELD 36CM,272,RC,,,,both,1138.5,1024.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,796.95,,,,671.72,929.02
SCALPEL HARMONIC HAND HELD 36CM,272,RC,,,,both,1138.5,1024.65,Cigna,Default,Percent of Total Billed Charges,671.72,,,,671.72,929.02
SCALPEL HARMONIC HAND HELD 36CM,272,RC,,,,both,1138.5,1024.65,United Healthcare,Default,Fee Schedule,929.02,,,,671.72,929.02
DNU SCALPEL HARMONIC HAND HELD 14CM,272,RC,,,,both,785,706.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,549.5,,,,463.15,640.56
DNU SCALPEL HARMONIC HAND HELD 14CM,272,RC,,,,both,785,706.5,Cigna,Default,Percent of Total Billed Charges,463.15,,,,463.15,640.56
DNU SCALPEL HARMONIC HAND HELD 14CM,272,RC,,,,both,785,706.5,United Healthcare,Default,Fee Schedule,640.56,,,,463.15,640.56
CUTTER 4.0MM TOMCAT,272,RC,,,,both,221.85,199.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.3,,,,130.89,181.03
CUTTER 4.0MM TOMCAT,272,RC,,,,both,221.85,199.67,Cigna,Default,Percent of Total Billed Charges,130.89,,,,130.89,181.03
CUTTER 4.0MM TOMCAT,272,RC,,,,both,221.85,199.67,United Healthcare,Default,Fee Schedule,181.03,,,,130.89,181.03
CUTTER ANGLED AGGRESSIVE 5.0MM,272,RC,,,,both,179.86,161.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.9,,,,106.12,146.77
CUTTER ANGLED AGGRESSIVE 5.0MM,272,RC,,,,both,179.86,161.87,Cigna,Default,Percent of Total Billed Charges,106.12,,,,106.12,146.77
CUTTER ANGLED AGGRESSIVE 5.0MM,272,RC,,,,both,179.86,161.87,United Healthcare,Default,Fee Schedule,146.77,,,,106.12,146.77
BUR 5.5MM ROUND 12 FLUTE - HOLLOW,272,RC,,,,both,234.24,210.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.97,,,,138.2,191.14
BUR 5.5MM ROUND 12 FLUTE - HOLLOW,272,RC,,,,both,234.24,210.82,Cigna,Default,Percent of Total Billed Charges,138.2,,,,138.2,191.14
BUR 5.5MM ROUND 12 FLUTE - HOLLOW,272,RC,,,,both,234.24,210.82,United Healthcare,Default,Fee Schedule,191.14,,,,138.2,191.14
BUR 4.0MM BARREL 12 FLUTE HOLLOW,272,RC,,,,both,209.85,188.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.9,,,,123.81,171.24
BUR 4.0MM BARREL 12 FLUTE HOLLOW,272,RC,,,,both,209.85,188.87,Cigna,Default,Percent of Total Billed Charges,123.81,,,,123.81,171.24
BUR 4.0MM BARREL 12 FLUTE HOLLOW,272,RC,,,,both,209.85,188.87,United Healthcare,Default,Fee Schedule,171.24,,,,123.81,171.24
BUR 5.5MM BARREL 12 FLUTE HOLLOW,272,RC,,,,both,234.24,210.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.97,,,,138.2,191.14
BUR 5.5MM BARREL 12 FLUTE HOLLOW,272,RC,,,,both,234.24,210.82,Cigna,Default,Percent of Total Billed Charges,138.2,,,,138.2,191.14
BUR 5.5MM BARREL 12 FLUTE HOLLOW,272,RC,,,,both,234.24,210.82,United Healthcare,Default,Fee Schedule,191.14,,,,138.2,191.14
CUTTER 4.0 AGGRESSIVE PLUS,272,RC,,,,both,209.02,188.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.31,,,,123.32,170.56
CUTTER 4.0 AGGRESSIVE PLUS,272,RC,,,,both,209.02,188.12,Cigna,Default,Percent of Total Billed Charges,123.32,,,,123.32,170.56
CUTTER 4.0 AGGRESSIVE PLUS,272,RC,,,,both,209.02,188.12,United Healthcare,Default,Fee Schedule,170.56,,,,123.32,170.56
CUTTER 4.0MM RESECTOR,272,RC,,,,both,206.28,185.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.4,,,,121.71,168.32
CUTTER 4.0MM RESECTOR,272,RC,,,,both,206.28,185.65,Cigna,Default,Percent of Total Billed Charges,121.71,,,,121.71,168.32
CUTTER 4.0MM RESECTOR,272,RC,,,,both,206.28,185.65,United Healthcare,Default,Fee Schedule,168.32,,,,121.71,168.32
SERFAS ENERGY SUPER 90-S,272,RC,,,,both,640.92,576.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,448.64,,,,378.14,522.99
SERFAS ENERGY SUPER 90-S,272,RC,,,,both,640.92,576.83,Cigna,Default,Percent of Total Billed Charges,378.14,,,,378.14,522.99
SERFAS ENERGY SUPER 90-S,272,RC,,,,both,640.92,576.83,United Healthcare,Default,Fee Schedule,522.99,,,,378.14,522.99
PROBE 3.5MM HOOK SERFAS ENERGY,272,RC,,,,both,482.63,434.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,337.84,,,,284.75,393.83
PROBE 3.5MM HOOK SERFAS ENERGY,272,RC,,,,both,482.63,434.37,Cigna,Default,Percent of Total Billed Charges,284.75,,,,284.75,393.83
PROBE 3.5MM HOOK SERFAS ENERGY,272,RC,,,,both,482.63,434.37,United Healthcare,Default,Fee Schedule,393.83,,,,284.75,393.83
*TUBE SET FLOSTEADY,272,RC,,,,both,191.85,172.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.3,,,,113.19,156.55
*TUBE SET FLOSTEADY,272,RC,,,,both,191.85,172.67,Cigna,Default,Percent of Total Billed Charges,113.19,,,,113.19,156.55
*TUBE SET FLOSTEADY,272,RC,,,,both,191.85,172.67,United Healthcare,Default,Fee Schedule,156.55,,,,113.19,156.55
SCALPEL HARMONIC HAND HELD 36CM,272,RC,,,,both,1362.2,1225.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,953.54,,,,803.7,1111.56
SCALPEL HARMONIC HAND HELD 36CM,272,RC,,,,both,1362.2,1225.98,Cigna,Default,Percent of Total Billed Charges,803.7,,,,803.7,1111.56
SCALPEL HARMONIC HAND HELD 36CM,272,RC,,,,both,1362.2,1225.98,United Healthcare,Default,Fee Schedule,1111.56,,,,803.7,1111.56
TUBING INSUFFLATION HYSTEROSCOPIC CROSS/,272,RC,,,,both,224.86,202.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.4,,,,132.67,183.49
TUBING INSUFFLATION HYSTEROSCOPIC CROSS/,272,RC,,,,both,224.86,202.37,Cigna,Default,Percent of Total Billed Charges,132.67,,,,132.67,183.49
TUBING INSUFFLATION HYSTEROSCOPIC CROSS/,272,RC,,,,both,224.86,202.37,United Healthcare,Default,Fee Schedule,183.49,,,,132.67,183.49
TUBING INSUFFLATION ARTHROSCOPIC INFLOW,272,RC,,,,both,243.44,219.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.41,,,,143.63,198.65
TUBING INSUFFLATION ARTHROSCOPIC INFLOW,272,RC,,,,both,243.44,219.1,Cigna,Default,Percent of Total Billed Charges,143.63,,,,143.63,198.65
TUBING INSUFFLATION ARTHROSCOPIC INFLOW,272,RC,,,,both,243.44,219.1,United Healthcare,Default,Fee Schedule,198.65,,,,143.63,198.65
SERFAS ENERGY 90-S CRUISE,272,RC,,,,both,582.34,524.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,407.64,,,,343.58,475.19
SERFAS ENERGY 90-S CRUISE,272,RC,,,,both,582.34,524.11,Cigna,Default,Percent of Total Billed Charges,343.58,,,,343.58,475.19
SERFAS ENERGY 90-S CRUISE,272,RC,,,,both,582.34,524.11,United Healthcare,Default,Fee Schedule,475.19,,,,343.58,475.19
RESECTOR SHAVER BLADE F-SERIES-5.5MM,272,RC,,,,both,232.51,209.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.76,,,,137.18,189.73
RESECTOR SHAVER BLADE F-SERIES-5.5MM,272,RC,,,,both,232.51,209.26,Cigna,Default,Percent of Total Billed Charges,137.18,,,,137.18,189.73
RESECTOR SHAVER BLADE F-SERIES-5.5MM,272,RC,,,,both,232.51,209.26,United Healthcare,Default,Fee Schedule,189.73,,,,137.18,189.73
GRAFT VASC 22,C1768,HCPCS,278,RC,,both,1529.28,1376.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1070.5,,,,902.28,1247.89
GRAFT VASC 22,C1768,HCPCS,278,RC,,both,1529.28,1376.35,Cigna,Default,Percent of Total Billed Charges,902.28,,,,902.28,1247.89
GRAFT VASC 22,C1768,HCPCS,278,RC,,both,1529.28,1376.35,United Healthcare,Default,Fee Schedule,1247.89,,,,902.28,1247.89
GRAFT VASC 26,C1768,HCPCS,278,RC,,both,1669.91,1502.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1168.94,,,,985.25,1362.65
GRAFT VASC 26,C1768,HCPCS,278,RC,,both,1669.91,1502.92,Cigna,Default,Percent of Total Billed Charges,985.25,,,,985.25,1362.65
GRAFT VASC 26,C1768,HCPCS,278,RC,,both,1669.91,1502.92,United Healthcare,Default,Fee Schedule,1362.65,,,,985.25,1362.65
DRAIN SILICONE 10FR,272,RC,,,,both,27.39,24.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.17,,,,16.16,22.35
DRAIN SILICONE 10FR,272,RC,,,,both,27.39,24.65,Cigna,Default,Percent of Total Billed Charges,16.16,,,,16.16,22.35
DRAIN SILICONE 10FR,272,RC,,,,both,27.39,24.65,United Healthcare,Default,Fee Schedule,22.35,,,,16.16,22.35
DRAIN WOUND 19FR ROUND FLUTED W/O TROCAR,272,RC,,,,both,63.77,57.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.64,,,,37.62,52.04
DRAIN WOUND 19FR ROUND FLUTED W/O TROCAR,272,RC,,,,both,63.77,57.39,Cigna,Default,Percent of Total Billed Charges,37.62,,,,37.62,52.04
DRAIN WOUND 19FR ROUND FLUTED W/O TROCAR,272,RC,,,,both,63.77,57.39,United Healthcare,Default,Fee Schedule,52.04,,,,37.62,52.04
DRAIN SILICONE 7MM FLAT,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
DRAIN SILICONE 7MM FLAT,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
DRAIN SILICONE 7MM FLAT,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DRAIN JACKSON PRATT 10MM FLAT,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
DRAIN JACKSON PRATT 10MM FLAT,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
DRAIN JACKSON PRATT 10MM FLAT,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
RESERVOIR 100ML JACK/,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
RESERVOIR 100ML JACK/,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
RESERVOIR 100ML JACK/,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
DRAIN SILICONE 15FR,272,RC,,,,both,28.99,26.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.29,,,,17.1,23.66
DRAIN SILICONE 15FR,272,RC,,,,both,28.99,26.09,Cigna,Default,Percent of Total Billed Charges,17.1,,,,17.1,23.66
DRAIN SILICONE 15FR,272,RC,,,,both,28.99,26.09,United Healthcare,Default,Fee Schedule,23.66,,,,17.1,23.66
DRAIN JACKSON PRATT 19FR,272,RC,,,,both,27.12,24.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.98,,,,16,22.13
DRAIN JACKSON PRATT 19FR,272,RC,,,,both,27.12,24.41,Cigna,Default,Percent of Total Billed Charges,16,,,,16,22.13
DRAIN JACKSON PRATT 19FR,272,RC,,,,both,27.12,24.41,United Healthcare,Default,Fee Schedule,22.13,,,,16,22.13
"SURGICEL FIBRILLAR 2""X4""",272,RC,,,,both,295.14,265.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,206.6,,,,174.13,240.83
"SURGICEL FIBRILLAR 2""X4""",272,RC,,,,both,295.14,265.63,Cigna,Default,Percent of Total Billed Charges,174.13,,,,174.13,240.83
"SURGICEL FIBRILLAR 2""X4""",272,RC,,,,both,295.14,265.63,United Healthcare,Default,Fee Schedule,240.83,,,,174.13,240.83
6X24 URETERAL STENT,C1874,HCPCS,278,RC,,both,379.28,341.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.5,,,,223.78,309.49
6X24 URETERAL STENT,C1874,HCPCS,278,RC,,both,379.28,341.35,Cigna,Default,Percent of Total Billed Charges,223.78,,,,223.78,309.49
6X24 URETERAL STENT,C1874,HCPCS,278,RC,,both,379.28,341.35,United Healthcare,Default,Fee Schedule,309.49,,,,223.78,309.49
6X26 URETERAL STENT,C1874,HCPCS,278,RC,,both,371.93,334.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.35,,,,219.44,303.49
6X26 URETERAL STENT,C1874,HCPCS,278,RC,,both,371.93,334.74,Cigna,Default,Percent of Total Billed Charges,219.44,,,,219.44,303.49
6X26 URETERAL STENT,C1874,HCPCS,278,RC,,both,371.93,334.74,United Healthcare,Default,Fee Schedule,303.49,,,,219.44,303.49
6X28 URETERAL STENT,C1874,HCPCS,278,RC,,both,371.93,334.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.35,,,,219.44,303.49
6X28 URETERAL STENT,C1874,HCPCS,278,RC,,both,371.93,334.74,Cigna,Default,Percent of Total Billed Charges,219.44,,,,219.44,303.49
6X28 URETERAL STENT,C1874,HCPCS,278,RC,,both,371.93,334.74,United Healthcare,Default,Fee Schedule,303.49,,,,219.44,303.49
7X28 CONTOUR URETERAL STENT,C1874,HCPCS,278,RC,,both,368.23,331.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.76,,,,217.26,300.48
7X28 CONTOUR URETERAL STENT,C1874,HCPCS,278,RC,,both,368.23,331.41,Cigna,Default,Percent of Total Billed Charges,217.26,,,,217.26,300.48
7X28 CONTOUR URETERAL STENT,C1874,HCPCS,278,RC,,both,368.23,331.41,United Healthcare,Default,Fee Schedule,300.48,,,,217.26,300.48
TB-0009OF SET,272,RC,,,,both,1356.58,1220.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,949.61,,,,800.38,1106.97
TB-0009OF SET,272,RC,,,,both,1356.58,1220.92,Cigna,Default,Percent of Total Billed Charges,800.38,,,,800.38,1106.97
TB-0009OF SET,272,RC,,,,both,1356.58,1220.92,United Healthcare,Default,Fee Schedule,1106.97,,,,800.38,1106.97
*DRAIN  T  10FR BARD,272,RC,,,,both,30.29,27.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.2,,,,17.87,24.72
*DRAIN  T  10FR BARD,272,RC,,,,both,30.29,27.26,Cigna,Default,Percent of Total Billed Charges,17.87,,,,17.87,24.72
*DRAIN  T  10FR BARD,272,RC,,,,both,30.29,27.26,United Healthcare,Default,Fee Schedule,24.72,,,,17.87,24.72
*HANDPIECE THUNDERBEAT 20CM,272,RC,,,,both,1668.29,1501.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1167.8,,,,984.29,1361.32
*HANDPIECE THUNDERBEAT 20CM,272,RC,,,,both,1668.29,1501.46,Cigna,Default,Percent of Total Billed Charges,984.29,,,,984.29,1361.32
*HANDPIECE THUNDERBEAT 20CM,272,RC,,,,both,1668.29,1501.46,United Healthcare,Default,Fee Schedule,1361.32,,,,984.29,1361.32
DNO HANDPIECE THUNDERBEAT 35CM,272,RC,,,,both,3141.79,2827.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2199.25,,,,1853.66,2563.7
DNO HANDPIECE THUNDERBEAT 35CM,272,RC,,,,both,3141.79,2827.61,Cigna,Default,Percent of Total Billed Charges,1853.66,,,,1853.66,2563.7
DNO HANDPIECE THUNDERBEAT 35CM,272,RC,,,,both,3141.79,2827.61,United Healthcare,Default,Fee Schedule,2563.7,,,,1853.66,2563.7
"DRAIN ""T"" 12FR BARD",272,RC,,,,both,30.29,27.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.2,,,,17.87,24.72
"DRAIN ""T"" 12FR BARD",272,RC,,,,both,30.29,27.26,Cigna,Default,Percent of Total Billed Charges,17.87,,,,17.87,24.72
"DRAIN ""T"" 12FR BARD",272,RC,,,,both,30.29,27.26,United Healthcare,Default,Fee Schedule,24.72,,,,17.87,24.72
"*DRAIN ""T"" 14FR",272,RC,,,,both,57.08,51.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.96,,,,33.68,46.58
"*DRAIN ""T"" 14FR",272,RC,,,,both,57.08,51.37,Cigna,Default,Percent of Total Billed Charges,33.68,,,,33.68,46.58
"*DRAIN ""T"" 14FR",272,RC,,,,both,57.08,51.37,United Healthcare,Default,Fee Schedule,46.58,,,,33.68,46.58
"*DRAIN ""T"" 16FR 1001B",272,RC,,,,both,32.04,28.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.43,,,,18.9,26.14
"*DRAIN ""T"" 16FR 1001B",272,RC,,,,both,32.04,28.84,Cigna,Default,Percent of Total Billed Charges,18.9,,,,18.9,26.14
"*DRAIN ""T"" 16FR 1001B",272,RC,,,,both,32.04,28.84,United Healthcare,Default,Fee Schedule,26.14,,,,18.9,26.14
"*DRAIN ""T"" 18 FR",272,RC,,,,both,52.06,46.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.44,,,,30.72,42.48
"*DRAIN ""T"" 18 FR",272,RC,,,,both,52.06,46.85,Cigna,Default,Percent of Total Billed Charges,30.72,,,,30.72,42.48
"*DRAIN ""T"" 18 FR",272,RC,,,,both,52.06,46.85,United Healthcare,Default,Fee Schedule,42.48,,,,30.72,42.48
*DRAIN DEAVER T-TUBE 20 FR,272,RC,,,,both,30.29,27.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.2,,,,17.87,24.72
*DRAIN DEAVER T-TUBE 20 FR,272,RC,,,,both,30.29,27.26,Cigna,Default,Percent of Total Billed Charges,17.87,,,,17.87,24.72
*DRAIN DEAVER T-TUBE 20 FR,272,RC,,,,both,30.29,27.26,United Healthcare,Default,Fee Schedule,24.72,,,,17.87,24.72
DNO SNARE POLYPECTOMY X-SMALL,272,RC,,,,both,67.13,60.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.99,,,,39.61,54.78
DNO SNARE POLYPECTOMY X-SMALL,272,RC,,,,both,67.13,60.42,Cigna,Default,Percent of Total Billed Charges,39.61,,,,39.61,54.78
DNO SNARE POLYPECTOMY X-SMALL,272,RC,,,,both,67.13,60.42,United Healthcare,Default,Fee Schedule,54.78,,,,39.61,54.78
DNO SNARE POLYPECTOMY LARGE,272,RC,,,,both,82.65,74.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.86,,,,48.76,67.44
DNO SNARE POLYPECTOMY LARGE,272,RC,,,,both,82.65,74.39,Cigna,Default,Percent of Total Billed Charges,48.76,,,,48.76,67.44
DNO SNARE POLYPECTOMY LARGE,272,RC,,,,both,82.65,74.39,United Healthcare,Default,Fee Schedule,67.44,,,,48.76,67.44
SUTURE 6-0 VICRYL PS-3,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE 6-0 VICRYL PS-3,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE 6-0 VICRYL PS-3,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
DNO TUBE TRACH 4,A7521,HCPCS,272,RC,,both,222.84,200.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.99,,,,131.48,181.84
DNO TUBE TRACH 4,A7521,HCPCS,272,RC,,both,222.84,200.56,Cigna,Default,Percent of Total Billed Charges,131.48,,,,131.48,181.84
DNO TUBE TRACH 4,A7521,HCPCS,272,RC,,both,222.84,200.56,United Healthcare,Default,Fee Schedule,181.84,,,,131.48,181.84
DNO TUBE TRACH FENESTRATED 4,A7521,HCPCS,272,RC,,both,148.82,133.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.17,,,,87.8,121.44
DNO TUBE TRACH FENESTRATED 4,A7521,HCPCS,272,RC,,both,148.82,133.94,Cigna,Default,Percent of Total Billed Charges,87.8,,,,87.8,121.44
DNO TUBE TRACH FENESTRATED 4,A7521,HCPCS,272,RC,,both,148.82,133.94,United Healthcare,Default,Fee Schedule,121.44,,,,87.8,121.44
TRACHEOSTOMY TUBE 7.5MM ID CUFFED,A7521,HCPCS,272,RC,,both,148.53,133.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.97,,,,87.63,121.2
TRACHEOSTOMY TUBE 7.5MM ID CUFFED,A7521,HCPCS,272,RC,,both,148.53,133.68,Cigna,Default,Percent of Total Billed Charges,87.63,,,,87.63,121.2
TRACHEOSTOMY TUBE 7.5MM ID CUFFED,A7521,HCPCS,272,RC,,both,148.53,133.68,United Healthcare,Default,Fee Schedule,121.2,,,,87.63,121.2
DNO TUBE TRACH FENESTRATED 6,A7521,HCPCS,272,RC,,both,225.04,202.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.53,,,,132.77,183.63
DNO TUBE TRACH FENESTRATED 6,A7521,HCPCS,272,RC,,both,225.04,202.54,Cigna,Default,Percent of Total Billed Charges,132.77,,,,132.77,183.63
DNO TUBE TRACH FENESTRATED 6,A7521,HCPCS,272,RC,,both,225.04,202.54,United Healthcare,Default,Fee Schedule,183.63,,,,132.77,183.63
DNO TUBE TRACH 8,272,RC,,,,both,222.9,200.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,156.03,,,,131.51,181.89
DNO TUBE TRACH 8,272,RC,,,,both,222.9,200.61,Cigna,Default,Percent of Total Billed Charges,131.51,,,,131.51,181.89
DNO TUBE TRACH 8,272,RC,,,,both,222.9,200.61,United Healthcare,Default,Fee Schedule,181.89,,,,131.51,181.89
DNO TUBE TRACH FENESTRATED 8,272,RC,,,,both,220.76,198.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.53,,,,130.25,180.14
DNO TUBE TRACH FENESTRATED 8,272,RC,,,,both,220.76,198.68,Cigna,Default,Percent of Total Billed Charges,130.25,,,,130.25,180.14
DNO TUBE TRACH FENESTRATED 8,272,RC,,,,both,220.76,198.68,United Healthcare,Default,Fee Schedule,180.14,,,,130.25,180.14
TUBE TRACH CUFFED 8.0,A7521,HCPCS,272,RC,,both,216.41,194.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.49,,,,127.68,176.59
TUBE TRACH CUFFED 8.0,A7521,HCPCS,272,RC,,both,216.41,194.77,Cigna,Default,Percent of Total Billed Charges,127.68,,,,127.68,176.59
TUBE TRACH CUFFED 8.0,A7521,HCPCS,272,RC,,both,216.41,194.77,United Healthcare,Default,Fee Schedule,176.59,,,,127.68,176.59
TUBE TRACH 10,A7521,HCPCS,272,RC,,both,195.84,176.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.09,,,,115.55,159.81
TUBE TRACH 10,A7521,HCPCS,272,RC,,both,195.84,176.26,Cigna,Default,Percent of Total Billed Charges,115.55,,,,115.55,159.81
TUBE TRACH 10,A7521,HCPCS,272,RC,,both,195.84,176.26,United Healthcare,Default,Fee Schedule,159.81,,,,115.55,159.81
DNO TUBE TRACH 10 FEN,A7521,HCPCS,272,RC,,both,215.43,193.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,150.8,,,,127.1,175.79
DNO TUBE TRACH 10 FEN,A7521,HCPCS,272,RC,,both,215.43,193.89,Cigna,Default,Percent of Total Billed Charges,127.1,,,,127.1,175.79
DNO TUBE TRACH 10 FEN,A7521,HCPCS,272,RC,,both,215.43,193.89,United Healthcare,Default,Fee Schedule,175.79,,,,127.1,175.79
*TUBE SHILEY 8 DIC FENESTRATED,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
*TUBE SHILEY 8 DIC FENESTRATED,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
*TUBE SHILEY 8 DIC FENESTRATED,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
TUBE TRACH 8.5 SHILEY CUFFED W/ CANNULA,A7521,HCPCS,272,RC,,both,190.08,171.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.06,,,,112.15,155.11
TUBE TRACH 8.5 SHILEY CUFFED W/ CANNULA,A7521,HCPCS,272,RC,,both,190.08,171.07,Cigna,Default,Percent of Total Billed Charges,112.15,,,,112.15,155.11
TUBE TRACH 8.5 SHILEY CUFFED W/ CANNULA,A7521,HCPCS,272,RC,,both,190.08,171.07,United Healthcare,Default,Fee Schedule,155.11,,,,112.15,155.11
DNO TUBE TRACH 8 FEN DISPOSABLE,A7521,HCPCS,272,RC,,both,183.05,164.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.14,,,,108,149.37
DNO TUBE TRACH 8 FEN DISPOSABLE,A7521,HCPCS,272,RC,,both,183.05,164.75,Cigna,Default,Percent of Total Billed Charges,108,,,,108,149.37
DNO TUBE TRACH 8 FEN DISPOSABLE,A7521,HCPCS,272,RC,,both,183.05,164.75,United Healthcare,Default,Fee Schedule,149.37,,,,108,149.37
DNO TUBE TRACH 6 SHILEY DISPOSABLE,272,RC,,,,both,215.19,193.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,150.63,,,,126.96,175.6
DNO TUBE TRACH 6 SHILEY DISPOSABLE,272,RC,,,,both,215.19,193.67,Cigna,Default,Percent of Total Billed Charges,126.96,,,,126.96,175.6
DNO TUBE TRACH 6 SHILEY DISPOSABLE,272,RC,,,,both,215.19,193.67,United Healthcare,Default,Fee Schedule,175.6,,,,126.96,175.6
DNO TUBE TRACH 4 FEN CUFFLESS,A7520,HCPCS,272,RC,,both,130.46,117.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.32,,,,76.97,106.46
DNO TUBE TRACH 4 FEN CUFFLESS,A7520,HCPCS,272,RC,,both,130.46,117.41,Cigna,Default,Percent of Total Billed Charges,76.97,,,,76.97,106.46
DNO TUBE TRACH 4 FEN CUFFLESS,A7520,HCPCS,272,RC,,both,130.46,117.41,United Healthcare,Default,Fee Schedule,106.46,,,,76.97,106.46
TUBE TRACH 6 SHILEY CUFFLESS,A7520,HCPCS,272,RC,,both,165.27,148.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.69,,,,97.51,134.86
TUBE TRACH 6 SHILEY CUFFLESS,A7520,HCPCS,272,RC,,both,165.27,148.74,Cigna,Default,Percent of Total Billed Charges,97.51,,,,97.51,134.86
TUBE TRACH 6 SHILEY CUFFLESS,A7520,HCPCS,272,RC,,both,165.27,148.74,United Healthcare,Default,Fee Schedule,134.86,,,,97.51,134.86
DNO TUBE TRACH 4 SHILEY FEN CUFFLESS,A7520,HCPCS,272,RC,,both,181.27,163.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.89,,,,106.95,147.92
DNO TUBE TRACH 4 SHILEY FEN CUFFLESS,A7520,HCPCS,272,RC,,both,181.27,163.14,Cigna,Default,Percent of Total Billed Charges,106.95,,,,106.95,147.92
DNO TUBE TRACH 4 SHILEY FEN CUFFLESS,A7520,HCPCS,272,RC,,both,181.27,163.14,United Healthcare,Default,Fee Schedule,147.92,,,,106.95,147.92
TUBE TRACH 6 SHILEY FEN CUFFLESS,A7520,HCPCS,272,RC,,both,204.39,183.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.07,,,,120.59,166.78
TUBE TRACH 6 SHILEY FEN CUFFLESS,A7520,HCPCS,272,RC,,both,204.39,183.95,Cigna,Default,Percent of Total Billed Charges,120.59,,,,120.59,166.78
TUBE TRACH 6 SHILEY FEN CUFFLESS,A7520,HCPCS,272,RC,,both,204.39,183.95,United Healthcare,Default,Fee Schedule,166.78,,,,120.59,166.78
TUBE TRACH 7 SHILEY W/ CUFF,A7520,HCPCS,272,RC,,both,154.38,138.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.07,,,,91.08,125.97
TUBE TRACH 7 SHILEY W/ CUFF,A7520,HCPCS,272,RC,,both,154.38,138.94,Cigna,Default,Percent of Total Billed Charges,91.08,,,,91.08,125.97
TUBE TRACH 7 SHILEY W/ CUFF,A7520,HCPCS,272,RC,,both,154.38,138.94,United Healthcare,Default,Fee Schedule,125.97,,,,91.08,125.97
TUBE TRACH 6.5 SHILEY W/ CUFF,A7520,HCPCS,272,RC,,both,154.38,138.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.07,,,,91.08,125.97
TUBE TRACH 6.5 SHILEY W/ CUFF,A7520,HCPCS,272,RC,,both,154.38,138.94,Cigna,Default,Percent of Total Billed Charges,91.08,,,,91.08,125.97
TUBE TRACH 6.5 SHILEY W/ CUFF,A7520,HCPCS,272,RC,,both,154.38,138.94,United Healthcare,Default,Fee Schedule,125.97,,,,91.08,125.97
SET EXTENSION LUER LOCK 76CM 4.0ML.,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SET EXTENSION LUER LOCK 76CM 4.0ML.,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SET EXTENSION LUER LOCK 76CM 4.0ML.,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
"FILTERED EXTENSION SET 10"" 1.2 MICRON LL",272,RC,,,,both,21.63,19.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.14,,,,12.76,17.65
"FILTERED EXTENSION SET 10"" 1.2 MICRON LL",272,RC,,,,both,21.63,19.47,Cigna,Default,Percent of Total Billed Charges,12.76,,,,12.76,17.65
"FILTERED EXTENSION SET 10"" 1.2 MICRON LL",272,RC,,,,both,21.63,19.47,United Healthcare,Default,Fee Schedule,17.65,,,,12.76,17.65
MESH DEXON 25X15CM,C1781,HCPCS,278,RC,,both,929.39,836.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,650.57,,,,548.34,758.38
MESH DEXON 25X15CM,C1781,HCPCS,278,RC,,both,929.39,836.45,Cigna,Default,Percent of Total Billed Charges,548.34,,,,548.34,758.38
MESH DEXON 25X15CM,C1781,HCPCS,278,RC,,both,929.39,836.45,United Healthcare,Default,Fee Schedule,758.38,,,,548.34,758.38
MESH DEXON 20X10CM,C1781,HCPCS,278,RC,,both,902.28,812.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,631.6,,,,532.35,736.26
MESH DEXON 20X10CM,C1781,HCPCS,278,RC,,both,902.28,812.05,Cigna,Default,Percent of Total Billed Charges,532.35,,,,532.35,736.26
MESH DEXON 20X10CM,C1781,HCPCS,278,RC,,both,902.28,812.05,United Healthcare,Default,Fee Schedule,736.26,,,,532.35,736.26
"PORT, 19MM, STRAIGHT, 80MM",C1788,HCPCS,278,RC,,both,824.81,742.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,577.37,,,,486.64,673.04
"PORT, 19MM, STRAIGHT, 80MM",C1788,HCPCS,278,RC,,both,824.81,742.33,Cigna,Default,Percent of Total Billed Charges,486.64,,,,486.64,673.04
"PORT, 19MM, STRAIGHT, 80MM",C1788,HCPCS,278,RC,,both,824.81,742.33,United Healthcare,Default,Fee Schedule,673.04,,,,486.64,673.04
POWERPORT DUO MRI IMPLANTABLE 9.5 CF,278,RC,,,,both,2062,1855.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1443.4,,,,1216.58,1682.59
POWERPORT DUO MRI IMPLANTABLE 9.5 CF,278,RC,,,,both,2062,1855.8,Cigna,Default,Percent of Total Billed Charges,1216.58,,,,1216.58,1682.59
POWERPORT DUO MRI IMPLANTABLE 9.5 CF,278,RC,,,,both,2062,1855.8,United Healthcare,Default,Fee Schedule,1682.59,,,,1216.58,1682.59
PRO PORT SYSTEM SINGLE LUMEN 1.6MM 8.5FR,272,RC,,,,both,1063.5,957.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,744.45,,,,627.46,867.82
PRO PORT SYSTEM SINGLE LUMEN 1.6MM 8.5FR,272,RC,,,,both,1063.5,957.15,Cigna,Default,Percent of Total Billed Charges,627.46,,,,627.46,867.82
PRO PORT SYSTEM SINGLE LUMEN 1.6MM 8.5FR,272,RC,,,,both,1063.5,957.15,United Healthcare,Default,Fee Schedule,867.82,,,,627.46,867.82
PRO PORT SYSTEM LOW PROFILE 1.6MM 8.5FR,C1788,HCPCS,278,RC,,both,1126.74,1014.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.72,,,,664.78,919.42
PRO PORT SYSTEM LOW PROFILE 1.6MM 8.5FR,C1788,HCPCS,278,RC,,both,1126.74,1014.07,Cigna,Default,Percent of Total Billed Charges,664.78,,,,664.78,919.42
PRO PORT SYSTEM LOW PROFILE 1.6MM 8.5FR,C1788,HCPCS,278,RC,,both,1126.74,1014.07,United Healthcare,Default,Fee Schedule,919.42,,,,664.78,919.42
"MESH VICRYL KNITTED 12""X12""",C1781,HCPCS,278,RC,,both,4360.56,3924.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3052.39,,,,2572.73,3558.22
"MESH VICRYL KNITTED 12""X12""",C1781,HCPCS,278,RC,,both,4360.56,3924.5,Cigna,Default,Percent of Total Billed Charges,2572.73,,,,2572.73,3558.22
"MESH VICRYL KNITTED 12""X12""",C1781,HCPCS,278,RC,,both,4360.56,3924.5,United Healthcare,Default,Fee Schedule,3558.22,,,,2572.73,3558.22
"MESH VICRYL WOV 12""X12""",C1781,HCPCS,278,RC,,both,3194.41,2874.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2236.09,,,,1884.7,2606.64
"MESH VICRYL WOV 12""X12""",C1781,HCPCS,278,RC,,both,3194.41,2874.97,Cigna,Default,Percent of Total Billed Charges,1884.7,,,,1884.7,2606.64
"MESH VICRYL WOV 12""X12""",C1781,HCPCS,278,RC,,both,3194.41,2874.97,United Healthcare,Default,Fee Schedule,2606.64,,,,1884.7,2606.64
PORT MARS 19X60MM STRAIGHT DISPOSABLE,272,RC,,,,both,720.59,648.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.41,,,,425.15,588
PORT MARS 19X60MM STRAIGHT DISPOSABLE,272,RC,,,,both,720.59,648.53,Cigna,Default,Percent of Total Billed Charges,425.15,,,,425.15,588
PORT MARS 19X60MM STRAIGHT DISPOSABLE,272,RC,,,,both,720.59,648.53,United Healthcare,Default,Fee Schedule,588,,,,425.15,588
PORT MARS 19X40MM STRAIGHT DISPOSABLE,272,RC,,,,both,720.59,648.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.41,,,,425.15,588
PORT MARS 19X40MM STRAIGHT DISPOSABLE,272,RC,,,,both,720.59,648.53,Cigna,Default,Percent of Total Billed Charges,425.15,,,,425.15,588
PORT MARS 19X40MM STRAIGHT DISPOSABLE,272,RC,,,,both,720.59,648.53,United Healthcare,Default,Fee Schedule,588,,,,425.15,588
PORT MARS 19X70MM STRAIGHT DISPOSABLE,278,RC,,,,both,824.81,742.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,577.37,,,,486.64,673.04
PORT MARS 19X70MM STRAIGHT DISPOSABLE,278,RC,,,,both,824.81,742.33,Cigna,Default,Percent of Total Billed Charges,486.64,,,,486.64,673.04
PORT MARS 19X70MM STRAIGHT DISPOSABLE,278,RC,,,,both,824.81,742.33,United Healthcare,Default,Fee Schedule,673.04,,,,486.64,673.04
PORT MARS 19X40MM STRAIGHT DISPOSABLE,278,RC,,,,both,720.59,648.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.41,,,,425.15,588
PORT MARS 19X40MM STRAIGHT DISPOSABLE,278,RC,,,,both,720.59,648.53,Cigna,Default,Percent of Total Billed Charges,425.15,,,,425.15,588
PORT MARS 19X40MM STRAIGHT DISPOSABLE,278,RC,,,,both,720.59,648.53,United Healthcare,Default,Fee Schedule,588,,,,425.15,588
PORT MARS 19X90MM STRAIGHT DISPOSABLE,278,RC,,,,both,824.81,742.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,577.37,,,,486.64,673.04
PORT MARS 19X90MM STRAIGHT DISPOSABLE,278,RC,,,,both,824.81,742.33,Cigna,Default,Percent of Total Billed Charges,486.64,,,,486.64,673.04
PORT MARS 19X90MM STRAIGHT DISPOSABLE,278,RC,,,,both,824.81,742.33,United Healthcare,Default,Fee Schedule,673.04,,,,486.64,673.04
PORT MARS 19X 120MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,678.66,,,,572.02,791.13
PORT MARS 19X 120MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,Cigna,Default,Percent of Total Billed Charges,572.02,,,,572.02,791.13
PORT MARS 19X 120MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,United Healthcare,Default,Fee Schedule,791.13,,,,572.02,791.13
PORT MARS 19X100MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,678.66,,,,572.02,791.13
PORT MARS 19X100MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,Cigna,Default,Percent of Total Billed Charges,572.02,,,,572.02,791.13
PORT MARS 19X100MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,United Healthcare,Default,Fee Schedule,791.13,,,,572.02,791.13
PORT MARS 19X110MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,678.66,,,,572.02,791.13
PORT MARS 19X110MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,Cigna,Default,Percent of Total Billed Charges,572.02,,,,572.02,791.13
PORT MARS 19X110MM STRAIGHT DISPOSABLE,278,RC,,,,both,969.52,872.57,United Healthcare,Default,Fee Schedule,791.13,,,,572.02,791.13
CATH INFINITI 5FR JL-4,272,RC,,,,both,124.24,111.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.97,,,,73.3,101.38
CATH INFINITI 5FR JL-4,272,RC,,,,both,124.24,111.82,Cigna,Default,Percent of Total Billed Charges,73.3,,,,73.3,101.38
CATH INFINITI 5FR JL-4,272,RC,,,,both,124.24,111.82,United Healthcare,Default,Fee Schedule,101.38,,,,73.3,101.38
LIGATOR,272,RC,,,,both,240.09,216.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.06,,,,141.65,195.91
LIGATOR,272,RC,,,,both,240.09,216.08,Cigna,Default,Percent of Total Billed Charges,141.65,,,,141.65,195.91
LIGATOR,272,RC,,,,both,240.09,216.08,United Healthcare,Default,Fee Schedule,195.91,,,,141.65,195.91
STENT WALLFLEX ESOPHAGEAL 23MMX125MM,C1874,HCPCS,278,RC,,both,9265.58,8339.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6485.91,,,,5466.69,7560.71
STENT WALLFLEX ESOPHAGEAL 23MMX125MM,C1874,HCPCS,278,RC,,both,9265.58,8339.02,Cigna,Default,Percent of Total Billed Charges,5466.69,,,,5466.69,7560.71
STENT WALLFLEX ESOPHAGEAL 23MMX125MM,C1874,HCPCS,278,RC,,both,9265.58,8339.02,United Healthcare,Default,Fee Schedule,7560.71,,,,5466.69,7560.71
STENT POLYFLEX 18X90,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4895.02,,,,4125.81,5706.2
STENT POLYFLEX 18X90,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Cigna,Default,Percent of Total Billed Charges,4125.81,,,,4125.81,5706.2
STENT POLYFLEX 18X90,C1874,HCPCS,278,RC,,both,6992.89,6293.6,United Healthcare,Default,Fee Schedule,5706.2,,,,4125.81,5706.2
STENT POLYFLEX 18X120,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4895.02,,,,4125.81,5706.2
STENT POLYFLEX 18X120,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Cigna,Default,Percent of Total Billed Charges,4125.81,,,,4125.81,5706.2
STENT POLYFLEX 18X120,C1874,HCPCS,278,RC,,both,6992.89,6293.6,United Healthcare,Default,Fee Schedule,5706.2,,,,4125.81,5706.2
STENT POLYFLEX ESOPHAGEAL 16X20X90,C1874,HCPCS,278,RC,,both,6160.41,5544.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4312.29,,,,3634.64,5026.89
STENT POLYFLEX ESOPHAGEAL 16X20X90,C1874,HCPCS,278,RC,,both,6160.41,5544.37,Cigna,Default,Percent of Total Billed Charges,3634.64,,,,3634.64,5026.89
STENT POLYFLEX ESOPHAGEAL 16X20X90,C1874,HCPCS,278,RC,,both,6160.41,5544.37,United Healthcare,Default,Fee Schedule,5026.89,,,,3634.64,5026.89
STENT POLYFLEX ESOPHAGEAL 18X23X120,C1874,HCPCS,278,RC,,both,6160.41,5544.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4312.29,,,,3634.64,5026.89
STENT POLYFLEX ESOPHAGEAL 18X23X120,C1874,HCPCS,278,RC,,both,6160.41,5544.37,Cigna,Default,Percent of Total Billed Charges,3634.64,,,,3634.64,5026.89
STENT POLYFLEX ESOPHAGEAL 18X23X120,C1874,HCPCS,278,RC,,both,6160.41,5544.37,United Healthcare,Default,Fee Schedule,5026.89,,,,3634.64,5026.89
STENT POLYFLEX 21X120,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4895.02,,,,4125.81,5706.2
STENT POLYFLEX 21X120,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Cigna,Default,Percent of Total Billed Charges,4125.81,,,,4125.81,5706.2
STENT POLYFLEX 21X120,C1874,HCPCS,278,RC,,both,6992.89,6293.6,United Healthcare,Default,Fee Schedule,5706.2,,,,4125.81,5706.2
STENT WALLFLEX ESOPHAGEAL,C1874,HCPCS,278,RC,,both,8408.12,7567.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5885.68,,,,4960.79,6861.03
STENT WALLFLEX ESOPHAGEAL,C1874,HCPCS,278,RC,,both,8408.12,7567.31,Cigna,Default,Percent of Total Billed Charges,4960.79,,,,4960.79,6861.03
STENT WALLFLEX ESOPHAGEAL,C1874,HCPCS,278,RC,,both,8408.12,7567.31,United Healthcare,Default,Fee Schedule,6861.03,,,,4960.79,6861.03
MESH MARLEX 10 X 14,C1781,HCPCS,278,RC,,both,628.03,565.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,439.62,,,,370.54,512.47
MESH MARLEX 10 X 14,C1781,HCPCS,278,RC,,both,628.03,565.23,Cigna,Default,Percent of Total Billed Charges,370.54,,,,370.54,512.47
MESH MARLEX 10 X 14,C1781,HCPCS,278,RC,,both,628.03,565.23,United Healthcare,Default,Fee Schedule,512.47,,,,370.54,512.47
STENT WALLFLEX COLONIC,C1874,HCPCS,278,RC,,both,8741.12,7867.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.78,,,,5157.26,7132.75
STENT WALLFLEX COLONIC,C1874,HCPCS,278,RC,,both,8741.12,7867.01,Cigna,Default,Percent of Total Billed Charges,5157.26,,,,5157.26,7132.75
STENT WALLFLEX COLONIC,C1874,HCPCS,278,RC,,both,8741.12,7867.01,United Healthcare,Default,Fee Schedule,7132.75,,,,5157.26,7132.75
BREAST PROSTHESIS IMPLANTABLE,L8600,HCPCS,278,RC,,both,3071.87,2764.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2150.31,,,,1812.4,2506.65
BREAST PROSTHESIS IMPLANTABLE,L8600,HCPCS,278,RC,,both,3071.87,2764.68,Cigna,Default,Percent of Total Billed Charges,1812.4,,,,1812.4,2506.65
BREAST PROSTHESIS IMPLANTABLE,L8600,HCPCS,278,RC,,both,3071.87,2764.68,United Healthcare,Default,Fee Schedule,2506.65,,,,1812.4,2506.65
MESH MYCRO 6CM X 12CM,C1781,HCPCS,278,RC,,both,457.37,411.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,320.16,,,,269.85,373.21
MESH MYCRO 6CM X 12CM,C1781,HCPCS,278,RC,,both,457.37,411.63,Cigna,Default,Percent of Total Billed Charges,269.85,,,,269.85,373.21
MESH MYCRO 6CM X 12CM,C1781,HCPCS,278,RC,,both,457.37,411.63,United Healthcare,Default,Fee Schedule,373.21,,,,269.85,373.21
STENT WALLFLEX ESOPHAGEAL 23X155MM,C1874,HCPCS,278,RC,,both,8915.94,8024.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6241.16,,,,5260.4,7275.41
STENT WALLFLEX ESOPHAGEAL 23X155MM,C1874,HCPCS,278,RC,,both,8915.94,8024.35,Cigna,Default,Percent of Total Billed Charges,5260.4,,,,5260.4,7275.41
STENT WALLFLEX ESOPHAGEAL 23X155MM,C1874,HCPCS,278,RC,,both,8915.94,8024.35,United Healthcare,Default,Fee Schedule,7275.41,,,,5260.4,7275.41
STENT WALLFLEX ESOPHAGEAL 18MM X 153MM,C1874,HCPCS,278,RC,,both,7727.57,6954.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5409.3,,,,4559.27,6305.7
STENT WALLFLEX ESOPHAGEAL 18MM X 153MM,C1874,HCPCS,278,RC,,both,7727.57,6954.81,Cigna,Default,Percent of Total Billed Charges,4559.27,,,,4559.27,6305.7
STENT WALLFLEX ESOPHAGEAL 18MM X 153MM,C1874,HCPCS,278,RC,,both,7727.57,6954.81,United Healthcare,Default,Fee Schedule,6305.7,,,,4559.27,6305.7
WALLFLEX EXOPHAGEAL PARTIALLY COVERED 23,C1874,HCPCS,278,RC,,both,7727.57,6954.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5409.3,,,,4559.27,6305.7
WALLFLEX EXOPHAGEAL PARTIALLY COVERED 23,C1874,HCPCS,278,RC,,both,7727.57,6954.81,Cigna,Default,Percent of Total Billed Charges,4559.27,,,,4559.27,6305.7
WALLFLEX EXOPHAGEAL PARTIALLY COVERED 23,C1874,HCPCS,278,RC,,both,7727.57,6954.81,United Healthcare,Default,Fee Schedule,6305.7,,,,4559.27,6305.7
TUBE TRAC 6 SHILEY CUF FEN D,A7520,HCPCS,272,RC,,both,170.09,153.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,119.06,,,,100.35,138.79
TUBE TRAC 6 SHILEY CUF FEN D,A7520,HCPCS,272,RC,,both,170.09,153.08,Cigna,Default,Percent of Total Billed Charges,100.35,,,,100.35,138.79
TUBE TRAC 6 SHILEY CUF FEN D,A7520,HCPCS,272,RC,,both,170.09,153.08,United Healthcare,Default,Fee Schedule,138.79,,,,100.35,138.79
TUBE TRACH 6 SHILEY XL CUFFED,A7520,HCPCS,272,RC,,both,199.07,179.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.35,,,,117.45,162.44
TUBE TRACH 6 SHILEY XL CUFFED,A7520,HCPCS,272,RC,,both,199.07,179.16,Cigna,Default,Percent of Total Billed Charges,117.45,,,,117.45,162.44
TUBE TRACH 6 SHILEY XL CUFFED,A7520,HCPCS,272,RC,,both,199.07,179.16,United Healthcare,Default,Fee Schedule,162.44,,,,117.45,162.44
TUBE TRACH 8 XL SHILEY CUFFED,A7520,HCPCS,272,RC,,both,265.66,239.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,185.96,,,,156.74,216.78
TUBE TRACH 8 XL SHILEY CUFFED,A7520,HCPCS,272,RC,,both,265.66,239.09,Cigna,Default,Percent of Total Billed Charges,156.74,,,,156.74,216.78
TUBE TRACH 8 XL SHILEY CUFFED,A7520,HCPCS,272,RC,,both,265.66,239.09,United Healthcare,Default,Fee Schedule,216.78,,,,156.74,216.78
TUBE TRACH 5 SHILEY XL CUFFLED,A7520,HCPCS,272,RC,,both,265.66,239.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,185.96,,,,156.74,216.78
TUBE TRACH 5 SHILEY XL CUFFLED,A7520,HCPCS,272,RC,,both,265.66,239.09,Cigna,Default,Percent of Total Billed Charges,156.74,,,,156.74,216.78
TUBE TRACH 5 SHILEY XL CUFFLED,A7520,HCPCS,272,RC,,both,265.66,239.09,United Healthcare,Default,Fee Schedule,216.78,,,,156.74,216.78
SIZER 68HP 500CC,272,RC,,,,both,194.59,175.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.21,,,,114.81,158.79
SIZER 68HP 500CC,272,RC,,,,both,194.59,175.13,Cigna,Default,Percent of Total Billed Charges,114.81,,,,114.81,158.79
SIZER 68HP 500CC,272,RC,,,,both,194.59,175.13,United Healthcare,Default,Fee Schedule,158.79,,,,114.81,158.79
TUNNELER INSRT HICKMA,272,RC,,,,both,177.89,160.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.52,,,,104.96,145.16
TUNNELER INSRT HICKMA,272,RC,,,,both,177.89,160.1,Cigna,Default,Percent of Total Billed Charges,104.96,,,,104.96,145.16
TUNNELER INSRT HICKMA,272,RC,,,,both,177.89,160.1,United Healthcare,Default,Fee Schedule,145.16,,,,104.96,145.16
FLEX PORT 20 MM,272,RC,,,,both,203.6,183.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.52,,,,120.12,166.14
FLEX PORT 20 MM,272,RC,,,,both,203.6,183.24,Cigna,Default,Percent of Total Billed Charges,120.12,,,,120.12,166.14
FLEX PORT 20 MM,272,RC,,,,both,203.6,183.24,United Healthcare,Default,Fee Schedule,166.14,,,,120.12,166.14
SET PRIMARY GRAVITY WITH 2 PORTS,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SET PRIMARY GRAVITY WITH 2 PORTS,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SET PRIMARY GRAVITY WITH 2 PORTS,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
FLEXPATH 15 MM,272,RC,,,,both,484.06,435.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.84,,,,285.6,394.99
FLEXPATH 15 MM,272,RC,,,,both,484.06,435.65,Cigna,Default,Percent of Total Billed Charges,285.6,,,,285.6,394.99
FLEXPATH 15 MM,272,RC,,,,both,484.06,435.65,United Healthcare,Default,Fee Schedule,394.99,,,,285.6,394.99
SET SOLUSET,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SET SOLUSET,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SET SOLUSET,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH LUMEN 4FR 3,272,RC,,,,both,347.71,312.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.4,,,,205.15,283.73
CATH LUMEN 4FR 3,272,RC,,,,both,347.71,312.94,Cigna,Default,Percent of Total Billed Charges,205.15,,,,205.15,283.73
CATH LUMEN 4FR 3,272,RC,,,,both,347.71,312.94,United Healthcare,Default,Fee Schedule,283.73,,,,205.15,283.73
CATH LUMEN 3FR 3,272,RC,,,,both,393.07,353.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.15,,,,231.91,320.75
CATH LUMEN 3FR 3,272,RC,,,,both,393.07,353.76,Cigna,Default,Percent of Total Billed Charges,231.91,,,,231.91,320.75
CATH LUMEN 3FR 3,272,RC,,,,both,393.07,353.76,United Healthcare,Default,Fee Schedule,320.75,,,,231.91,320.75
CATH LUMEN 5FR 3,272,RC,,,,both,347.71,312.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.4,,,,205.15,283.73
CATH LUMEN 5FR 3,272,RC,,,,both,347.71,312.94,Cigna,Default,Percent of Total Billed Charges,205.15,,,,205.15,283.73
CATH LUMEN 5FR 3,272,RC,,,,both,347.71,312.94,United Healthcare,Default,Fee Schedule,283.73,,,,205.15,283.73
SECURFIT STEM,278,RC,,,,both,19835.01,17851.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13884.51,,,,11702.66,16185.37
SECURFIT STEM,278,RC,,,,both,19835.01,17851.51,Cigna,Default,Percent of Total Billed Charges,11702.66,,,,11702.66,16185.37
SECURFIT STEM,278,RC,,,,both,19835.01,17851.51,United Healthcare,Default,Fee Schedule,16185.37,,,,11702.66,16185.37
TRIDENT SHELL,272,RC,,,,both,7189.44,6470.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5032.61,,,,4241.77,5866.58
TRIDENT SHELL,272,RC,,,,both,7189.44,6470.5,Cigna,Default,Percent of Total Billed Charges,4241.77,,,,4241.77,5866.58
TRIDENT SHELL,272,RC,,,,both,7189.44,6470.5,United Healthcare,Default,Fee Schedule,5866.58,,,,4241.77,5866.58
TRIDENT LINER,272,RC,,,,both,6135.78,5522.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4295.05,,,,3620.11,5006.8
TRIDENT LINER,272,RC,,,,both,6135.78,5522.2,Cigna,Default,Percent of Total Billed Charges,3620.11,,,,3620.11,5006.8
TRIDENT LINER,272,RC,,,,both,6135.78,5522.2,United Healthcare,Default,Fee Schedule,5006.8,,,,3620.11,5006.8
SET BLOOD Y-TYPE B2 I,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SET BLOOD Y-TYPE B2 I,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SET BLOOD Y-TYPE B2 I,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SET OMNI-FLOW WITH 2 PORTS,271,RC,,,,both,98,88.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.6,,,,57.82,79.97
SET OMNI-FLOW WITH 2 PORTS,271,RC,,,,both,98,88.2,Cigna,Default,Percent of Total Billed Charges,57.82,,,,57.82,79.97
SET OMNI-FLOW WITH 2 PORTS,271,RC,,,,both,98,88.2,United Healthcare,Default,Fee Schedule,79.97,,,,57.82,79.97
STENT BALLOON CORINT 7MM/15MM,C1874,HCPCS,278,RC,,both,3812.79,3431.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2668.95,,,,2249.55,3111.24
STENT BALLOON CORINT 7MM/15MM,C1874,HCPCS,278,RC,,both,3812.79,3431.51,Cigna,Default,Percent of Total Billed Charges,2249.55,,,,2249.55,3111.24
STENT BALLOON CORINT 7MM/15MM,C1874,HCPCS,278,RC,,both,3812.79,3431.51,United Healthcare,Default,Fee Schedule,3111.24,,,,2249.55,3111.24
"WINGED INFUSION SET 20G X 1""",272,RC,,,,both,23.16,20.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.21,,,,13.66,18.9
"WINGED INFUSION SET 20G X 1""",272,RC,,,,both,23.16,20.84,Cigna,Default,Percent of Total Billed Charges,13.66,,,,13.66,18.9
"WINGED INFUSION SET 20G X 1""",272,RC,,,,both,23.16,20.84,United Healthcare,Default,Fee Schedule,18.9,,,,13.66,18.9
ADAPTER FIBER OPTIC S,272,RC,,,,both,41.08,36.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.76,,,,24.24,33.52
ADAPTER FIBER OPTIC S,272,RC,,,,both,41.08,36.97,Cigna,Default,Percent of Total Billed Charges,24.24,,,,24.24,33.52
ADAPTER FIBER OPTIC S,272,RC,,,,both,41.08,36.97,United Healthcare,Default,Fee Schedule,33.52,,,,24.24,33.52
GUIDE WIRE PLATINUM PLUS,C1769,HCPCS,278,RC,,both,523.82,471.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,366.67,,,,309.05,427.44
GUIDE WIRE PLATINUM PLUS,C1769,HCPCS,278,RC,,both,523.82,471.44,Cigna,Default,Percent of Total Billed Charges,309.05,,,,309.05,427.44
GUIDE WIRE PLATINUM PLUS,C1769,HCPCS,278,RC,,both,523.82,471.44,United Healthcare,Default,Fee Schedule,427.44,,,,309.05,427.44
SET BLOOD PUMP,271,RC,,,,both,44.86,40.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.4,,,,26.47,36.61
SET BLOOD PUMP,271,RC,,,,both,44.86,40.37,Cigna,Default,Percent of Total Billed Charges,26.47,,,,26.47,36.61
SET BLOOD PUMP,271,RC,,,,both,44.86,40.37,United Healthcare,Default,Fee Schedule,36.61,,,,26.47,36.61
DNU SET BLOOD PUMP,271,RC,,,,both,41.5,37.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.05,,,,24.48,33.86
DNU SET BLOOD PUMP,271,RC,,,,both,41.5,37.35,Cigna,Default,Percent of Total Billed Charges,24.48,,,,24.48,33.86
DNU SET BLOOD PUMP,271,RC,,,,both,41.5,37.35,United Healthcare,Default,Fee Schedule,33.86,,,,24.48,33.86
C TAPER 36 MM HEAD,278,RC,,,,both,4369.99,3932.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3058.99,,,,2578.29,3565.91
C TAPER 36 MM HEAD,278,RC,,,,both,4369.99,3932.99,Cigna,Default,Percent of Total Billed Charges,2578.29,,,,2578.29,3565.91
C TAPER 36 MM HEAD,278,RC,,,,both,4369.99,3932.99,United Healthcare,Default,Fee Schedule,3565.91,,,,2578.29,3565.91
SET PNEUMOTHORAX LANDERS,272,RC,,,,both,398.84,358.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.19,,,,235.32,325.45
SET PNEUMOTHORAX LANDERS,272,RC,,,,both,398.84,358.96,Cigna,Default,Percent of Total Billed Charges,235.32,,,,235.32,325.45
SET PNEUMOTHORAX LANDERS,272,RC,,,,both,398.84,358.96,United Healthcare,Default,Fee Schedule,325.45,,,,235.32,325.45
SET NITRO 40IN,271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
SET NITRO 40IN,271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
SET NITRO 40IN,271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
SET ANESTHESIA PUMP,271,RC,,,,both,30.05,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.73,24.52
SET ANESTHESIA PUMP,271,RC,,,,both,30.05,27.05,Cigna,Default,Percent of Total Billed Charges,17.73,,,,17.73,24.52
SET ANESTHESIA PUMP,271,RC,,,,both,30.05,27.05,United Healthcare,Default,Fee Schedule,24.52,,,,17.73,24.52
"SET BLOOD Y-TYPE 90""",271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SET BLOOD Y-TYPE 90""",271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SET BLOOD Y-TYPE 90""",271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
PROSTHESIS 20MM X 10MM,278,RC,,,,both,1787.69,1608.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1251.38,,,,1054.74,1458.76
PROSTHESIS 20MM X 10MM,278,RC,,,,both,1787.69,1608.92,Cigna,Default,Percent of Total Billed Charges,1054.74,,,,1054.74,1458.76
PROSTHESIS 20MM X 10MM,278,RC,,,,both,1787.69,1608.92,United Healthcare,Default,Fee Schedule,1458.76,,,,1054.74,1458.76
CATH AIR EX CHANGE 19FR 83 CM,272,RC,,,,both,218.78,196.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.15,,,,129.08,178.52
CATH AIR EX CHANGE 19FR 83 CM,272,RC,,,,both,218.78,196.9,Cigna,Default,Percent of Total Billed Charges,129.08,,,,129.08,178.52
CATH AIR EX CHANGE 19FR 83 CM,272,RC,,,,both,218.78,196.9,United Healthcare,Default,Fee Schedule,178.52,,,,129.08,178.52
CATH AIR EX CHANGE 14FR 83 CM,272,RC,,,,both,218.78,196.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.15,,,,129.08,178.52
CATH AIR EX CHANGE 14FR 83 CM,272,RC,,,,both,218.78,196.9,Cigna,Default,Percent of Total Billed Charges,129.08,,,,129.08,178.52
CATH AIR EX CHANGE 14FR 83 CM,272,RC,,,,both,218.78,196.9,United Healthcare,Default,Fee Schedule,178.52,,,,129.08,178.52
CATH AIR EXCHANGE 11FR 83 CM,272,RC,,,,both,218.78,196.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.15,,,,129.08,178.52
CATH AIR EXCHANGE 11FR 83 CM,272,RC,,,,both,218.78,196.9,Cigna,Default,Percent of Total Billed Charges,129.08,,,,129.08,178.52
CATH AIR EXCHANGE 11FR 83 CM,272,RC,,,,both,218.78,196.9,United Healthcare,Default,Fee Schedule,178.52,,,,129.08,178.52
KIT ARTERIAL LINE,272,RC,,,,both,63.57,57.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.5,,,,37.51,51.87
KIT ARTERIAL LINE,272,RC,,,,both,63.57,57.21,Cigna,Default,Percent of Total Billed Charges,37.51,,,,37.51,51.87
KIT ARTERIAL LINE,272,RC,,,,both,63.57,57.21,United Healthcare,Default,Fee Schedule,51.87,,,,37.51,51.87
CATH BRITE TIP 6FR-.070-90CM,272,RC,,,,both,297.5,267.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.25,,,,175.52,242.76
CATH BRITE TIP 6FR-.070-90CM,272,RC,,,,both,297.5,267.75,Cigna,Default,Percent of Total Billed Charges,175.52,,,,175.52,242.76
CATH BRITE TIP 6FR-.070-90CM,272,RC,,,,both,297.5,267.75,United Healthcare,Default,Fee Schedule,242.76,,,,175.52,242.76
CATH LUMEN MULTI KIT,C1751,HCPCS,272,RC,,both,184.5,166.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.15,,,,108.86,150.55
CATH LUMEN MULTI KIT,C1751,HCPCS,272,RC,,both,184.5,166.05,Cigna,Default,Percent of Total Billed Charges,108.86,,,,108.86,150.55
CATH LUMEN MULTI KIT,C1751,HCPCS,272,RC,,both,184.5,166.05,United Healthcare,Default,Fee Schedule,150.55,,,,108.86,150.55
CATH SET-CNTRL VEIN,272,RC,,,,both,66.3,59.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.41,,,,39.12,54.1
CATH SET-CNTRL VEIN,272,RC,,,,both,66.3,59.67,Cigna,Default,Percent of Total Billed Charges,39.12,,,,39.12,54.1
CATH SET-CNTRL VEIN,272,RC,,,,both,66.3,59.67,United Healthcare,Default,Fee Schedule,54.1,,,,39.12,54.1
CATH KIT RADIAL ART,272,RC,,,,both,73.39,66.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.37,,,,43.3,59.89
CATH KIT RADIAL ART,272,RC,,,,both,73.39,66.05,Cigna,Default,Percent of Total Billed Charges,43.3,,,,43.3,59.89
CATH KIT RADIAL ART,272,RC,,,,both,73.39,66.05,United Healthcare,Default,Fee Schedule,59.89,,,,43.3,59.89
LOOP CUTTING 24 FR,272,RC,,,,both,220.32,198.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.22,,,,129.99,179.78
LOOP CUTTING 24 FR,272,RC,,,,both,220.32,198.29,Cigna,Default,Percent of Total Billed Charges,129.99,,,,129.99,179.78
LOOP CUTTING 24 FR,272,RC,,,,both,220.32,198.29,United Healthcare,Default,Fee Schedule,179.78,,,,129.99,179.78
*NEEDLE EPIDURAL TUOHY 17GA,272,RC,,,,both,76.93,69.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.85,,,,45.39,62.77
*NEEDLE EPIDURAL TUOHY 17GA,272,RC,,,,both,76.93,69.24,Cigna,Default,Percent of Total Billed Charges,45.39,,,,45.39,62.77
*NEEDLE EPIDURAL TUOHY 17GA,272,RC,,,,both,76.93,69.24,United Healthcare,Default,Fee Schedule,62.77,,,,45.39,62.77
DNO NEEDLE TUOHY EPID,272,RC,,,,both,60.1,54.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.07,,,,35.46,49.04
DNO NEEDLE TUOHY EPID,272,RC,,,,both,60.1,54.09,Cigna,Default,Percent of Total Billed Charges,35.46,,,,35.46,49.04
DNO NEEDLE TUOHY EPID,272,RC,,,,both,60.1,54.09,United Healthcare,Default,Fee Schedule,49.04,,,,35.46,49.04
NEEDLE-TUOHY EPID,272,RC,,,,both,21.75,19.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.22,,,,12.83,17.75
NEEDLE-TUOHY EPID,272,RC,,,,both,21.75,19.58,Cigna,Default,Percent of Total Billed Charges,12.83,,,,12.83,17.75
NEEDLE-TUOHY EPID,272,RC,,,,both,21.75,19.58,United Healthcare,Default,Fee Schedule,17.75,,,,12.83,17.75
*STIMUCATH CONT NERVE BLK SET 17GX4CM,272,RC,,,,both,227.9,205.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.53,,,,134.46,185.97
*STIMUCATH CONT NERVE BLK SET 17GX4CM,272,RC,,,,both,227.9,205.11,Cigna,Default,Percent of Total Billed Charges,134.46,,,,134.46,185.97
*STIMUCATH CONT NERVE BLK SET 17GX4CM,272,RC,,,,both,227.9,205.11,United Healthcare,Default,Fee Schedule,185.97,,,,134.46,185.97
DNOSTIMUCATH CONT NERVE BLCK SET 17GX8CM,272,RC,,,,both,213.3,191.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.31,,,,125.85,174.05
DNOSTIMUCATH CONT NERVE BLCK SET 17GX8CM,272,RC,,,,both,213.3,191.97,Cigna,Default,Percent of Total Billed Charges,125.85,,,,125.85,174.05
DNOSTIMUCATH CONT NERVE BLCK SET 17GX8CM,272,RC,,,,both,213.3,191.97,United Healthcare,Default,Fee Schedule,174.05,,,,125.85,174.05
DNO NEEDLE NERVE BLOCK PROBLO,272,RC,,,,both,41.08,36.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.76,,,,24.24,33.52
DNO NEEDLE NERVE BLOCK PROBLO,272,RC,,,,both,41.08,36.97,Cigna,Default,Percent of Total Billed Charges,24.24,,,,24.24,33.52
DNO NEEDLE NERVE BLOCK PROBLO,272,RC,,,,both,41.08,36.97,United Healthcare,Default,Fee Schedule,33.52,,,,24.24,33.52
SET PNEUMOTHORAX TPT,272,RC,,,,both,337.17,303.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.02,,,,198.93,275.13
SET PNEUMOTHORAX TPT,272,RC,,,,both,337.17,303.45,Cigna,Default,Percent of Total Billed Charges,198.93,,,,198.93,275.13
SET PNEUMOTHORAX TPT,272,RC,,,,both,337.17,303.45,United Healthcare,Default,Fee Schedule,275.13,,,,198.93,275.13
"DNO TUBE EXTENSION 8""",272,RC,,,,both,30.63,27.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.44,,,,18.07,24.99
"DNO TUBE EXTENSION 8""",272,RC,,,,both,30.63,27.57,Cigna,Default,Percent of Total Billed Charges,18.07,,,,18.07,24.99
"DNO TUBE EXTENSION 8""",272,RC,,,,both,30.63,27.57,United Healthcare,Default,Fee Schedule,24.99,,,,18.07,24.99
TUBE NASOJEJUNOSTOMY 10FR 140CM,272,RC,,,,both,93.85,84.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.7,,,,55.37,76.58
TUBE NASOJEJUNOSTOMY 10FR 140CM,272,RC,,,,both,93.85,84.47,Cigna,Default,Percent of Total Billed Charges,55.37,,,,55.37,76.58
TUBE NASOJEJUNOSTOMY 10FR 140CM,272,RC,,,,both,93.85,84.47,United Healthcare,Default,Fee Schedule,76.58,,,,55.37,76.58
TUBING PCA MINI BORE,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TUBING PCA MINI BORE,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TUBING PCA MINI BORE,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DRAINAGE UNIT THORA SEAL,272,RC,,,,both,158.92,143.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.24,,,,93.76,129.68
DRAINAGE UNIT THORA SEAL,272,RC,,,,both,158.92,143.03,Cigna,Default,Percent of Total Billed Charges,93.76,,,,93.76,129.68
DRAINAGE UNIT THORA SEAL,272,RC,,,,both,158.92,143.03,United Healthcare,Default,Fee Schedule,129.68,,,,93.76,129.68
COLLECTION UNIT,272,RC,,,,both,130.6,117.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.42,,,,77.05,106.57
COLLECTION UNIT,272,RC,,,,both,130.6,117.54,Cigna,Default,Percent of Total Billed Charges,77.05,,,,77.05,106.57
COLLECTION UNIT,272,RC,,,,both,130.6,117.54,United Healthcare,Default,Fee Schedule,106.57,,,,77.05,106.57
*SET NITROGLYCERIN 107,271,RC,,,,both,28.75,25.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.12,,,,16.96,23.46
*SET NITROGLYCERIN 107,271,RC,,,,both,28.75,25.88,Cigna,Default,Percent of Total Billed Charges,16.96,,,,16.96,23.46
*SET NITROGLYCERIN 107,271,RC,,,,both,28.75,25.88,United Healthcare,Default,Fee Schedule,23.46,,,,16.96,23.46
SOLUTION POTASSIUM CHLORIDE,258,RC,,,,both,34.06,30.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.84,,,,20.1,27.79
SOLUTION POTASSIUM CHLORIDE,258,RC,,,,both,34.06,30.65,Cigna,Default,Percent of Total Billed Charges,20.1,,,,20.1,27.79
SOLUTION POTASSIUM CHLORIDE,258,RC,,,,both,34.06,30.65,United Healthcare,Default,Fee Schedule,27.79,,,,20.1,27.79
PLUG ANAL FISTULA,272,RC,,,,both,3319.01,2987.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2323.31,,,,1958.22,2708.31
PLUG ANAL FISTULA,272,RC,,,,both,3319.01,2987.11,Cigna,Default,Percent of Total Billed Charges,1958.22,,,,1958.22,2708.31
PLUG ANAL FISTULA,272,RC,,,,both,3319.01,2987.11,United Healthcare,Default,Fee Schedule,2708.31,,,,1958.22,2708.31
SENSOR BIS XP QUATRO,272,RC,,,,both,93.73,84.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.61,,,,55.3,76.48
SENSOR BIS XP QUATRO,272,RC,,,,both,93.73,84.36,Cigna,Default,Percent of Total Billed Charges,55.3,,,,55.3,76.48
SENSOR BIS XP QUATRO,272,RC,,,,both,93.73,84.36,United Healthcare,Default,Fee Schedule,76.48,,,,55.3,76.48
DNO SET CO 2 TUBING,271,RC,,,,both,45.1,40.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.57,,,,26.61,36.8
DNO SET CO 2 TUBING,271,RC,,,,both,45.1,40.59,Cigna,Default,Percent of Total Billed Charges,26.61,,,,26.61,36.8
DNO SET CO 2 TUBING,271,RC,,,,both,45.1,40.59,United Healthcare,Default,Fee Schedule,36.8,,,,26.61,36.8
SET CO 2 TUBING STRYKER HIGH FLOW,271,RC,,,,both,180.14,162.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.1,,,,106.28,146.99
SET CO 2 TUBING STRYKER HIGH FLOW,271,RC,,,,both,180.14,162.13,Cigna,Default,Percent of Total Billed Charges,106.28,,,,106.28,146.99
SET CO 2 TUBING STRYKER HIGH FLOW,271,RC,,,,both,180.14,162.13,United Healthcare,Default,Fee Schedule,146.99,,,,106.28,146.99
DNO SOLUTION DEXTROSE BAG 5% 100ML,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
DNO SOLUTION DEXTROSE BAG 5% 100ML,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
DNO SOLUTION DEXTROSE BAG 5% 100ML,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
SOLUTION DEXTROSE 5% ADVANTAGE,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
SOLUTION DEXTROSE 5% ADVANTAGE,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
SOLUTION DEXTROSE 5% ADVANTAGE,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
SOLUTION POTASSIUM CHLORIDE 1000ML,258,RC,,,,both,48.47,43.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.93,,,,28.6,39.55
SOLUTION POTASSIUM CHLORIDE 1000ML,258,RC,,,,both,48.47,43.62,Cigna,Default,Percent of Total Billed Charges,28.6,,,,28.6,39.55
SOLUTION POTASSIUM CHLORIDE 1000ML,258,RC,,,,both,48.47,43.62,United Healthcare,Default,Fee Schedule,39.55,,,,28.6,39.55
SOLUTION DEXTROSE 5% 250ML,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
SOLUTION DEXTROSE 5% 250ML,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
SOLUTION DEXTROSE 5% 250ML,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
SOLUTION DEXTROSE 10% (BAG) 1000ML,J7042,HCPCS,258,RC,,both,32.36,29.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.65,,,,19.09,26.41
SOLUTION DEXTROSE 10% (BAG) 1000ML,J7042,HCPCS,258,RC,,both,32.36,29.12,Cigna,Default,Percent of Total Billed Charges,19.09,,,,19.09,26.41
SOLUTION DEXTROSE 10% (BAG) 1000ML,J7042,HCPCS,258,RC,,both,32.36,29.12,United Healthcare,Default,Fee Schedule,26.41,,,,19.09,26.41
SOLUTION DEXTROSE 10%,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
SOLUTION DEXTROSE 10%,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
SOLUTION DEXTROSE 10%,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
SOLUTION DEXTROSE 5% 500ML,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
SOLUTION DEXTROSE 5% 500ML,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
SOLUTION DEXTROSE 5% 500ML,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
*SET INFUSION WING 20GA,272,RC,,,,both,34.2,30.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.94,,,,20.18,27.91
*SET INFUSION WING 20GA,272,RC,,,,both,34.2,30.78,Cigna,Default,Percent of Total Billed Charges,20.18,,,,20.18,27.91
*SET INFUSION WING 20GA,272,RC,,,,both,34.2,30.78,United Healthcare,Default,Fee Schedule,27.91,,,,20.18,27.91
SOLUTION DEXTROSE 5% 1000ML,258,RC,,,,both,23.21,20.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.25,,,,13.69,18.94
SOLUTION DEXTROSE 5% 1000ML,258,RC,,,,both,23.21,20.89,Cigna,Default,Percent of Total Billed Charges,13.69,,,,13.69,18.94
SOLUTION DEXTROSE 5% 1000ML,258,RC,,,,both,23.21,20.89,United Healthcare,Default,Fee Schedule,18.94,,,,13.69,18.94
SET ANESTHESIA 1.5ML,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SET ANESTHESIA 1.5ML,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SET ANESTHESIA 1.5ML,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SOLUTION DEXTROSE 5% SOD CHLORIDE .225,J7042,HCPCS,258,RC,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SOLUTION DEXTROSE 5% SOD CHLORIDE .225,J7042,HCPCS,258,RC,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SOLUTION DEXTROSE 5% SOD CHLORIDE .225,J7042,HCPCS,258,RC,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SOLUTION DEXTROSE 5% SOD CHLORIDE .45,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
SOLUTION DEXTROSE 5% SOD CHLORIDE .45,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
SOLUTION DEXTROSE 5% SOD CHLORIDE .45,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
SOLUTION DEXTROSE 5% SOD CHLORIDE .45,258,RC,,,,both,23.08,20.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.16,,,,13.62,18.83
SOLUTION DEXTROSE 5% SOD CHLORIDE .45,258,RC,,,,both,23.08,20.77,Cigna,Default,Percent of Total Billed Charges,13.62,,,,13.62,18.83
SOLUTION DEXTROSE 5% SOD CHLORIDE .45,258,RC,,,,both,23.08,20.77,United Healthcare,Default,Fee Schedule,18.83,,,,13.62,18.83
SOLUTION DEXTROSE 5% SODIUM CHLORIDE .9%,258,RC,,,,both,24.94,22.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.46,,,,14.71,20.35
SOLUTION DEXTROSE 5% SODIUM CHLORIDE .9%,258,RC,,,,both,24.94,22.45,Cigna,Default,Percent of Total Billed Charges,14.71,,,,14.71,20.35
SOLUTION DEXTROSE 5% SODIUM CHLORIDE .9%,258,RC,,,,both,24.94,22.45,United Healthcare,Default,Fee Schedule,20.35,,,,14.71,20.35
SOLUTION DEXTROSE 5% LAC/RINGER,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SOLUTION DEXTROSE 5% LAC/RINGER,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SOLUTION DEXTROSE 5% LAC/RINGER,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SOLUTION DEXTROSE 5% LAC/RINGER70,258,RC,,,,both,23.41,21.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.39,,,,13.81,19.1
SOLUTION DEXTROSE 5% LAC/RINGER70,258,RC,,,,both,23.41,21.07,Cigna,Default,Percent of Total Billed Charges,13.81,,,,13.81,19.1
SOLUTION DEXTROSE 5% LAC/RINGER70,258,RC,,,,both,23.41,21.07,United Healthcare,Default,Fee Schedule,19.1,,,,13.81,19.1
SOLUTION LACTATED RINGERS,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SOLUTION LACTATED RINGERS,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SOLUTION LACTATED RINGERS,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE 3%,J7042,HCPCS,258,RC,,both,24.3,21.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.01,,,,14.34,19.83
SOLUTION SODIUM CHLORIDE 3%,J7042,HCPCS,258,RC,,both,24.3,21.87,Cigna,Default,Percent of Total Billed Charges,14.34,,,,14.34,19.83
SOLUTION SODIUM CHLORIDE 3%,J7042,HCPCS,258,RC,,both,24.3,21.87,United Healthcare,Default,Fee Schedule,19.83,,,,14.34,19.83
LACTATED RINGERS 1000 ML,J7120,HCPCS,258,RC,,both,22.54,20.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.78,,,,13.3,18.39
LACTATED RINGERS 1000 ML,J7120,HCPCS,258,RC,,both,22.54,20.29,Cigna,Default,Percent of Total Billed Charges,13.3,,,,13.3,18.39
LACTATED RINGERS 1000 ML,J7120,HCPCS,258,RC,,both,22.54,20.29,United Healthcare,Default,Fee Schedule,18.39,,,,13.3,18.39
CLEARSIGHT FINGER CUFF LARGE,272,RC,,,,both,1229.28,1106.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,860.5,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF LARGE,272,RC,,,,both,1229.28,1106.35,Cigna,Default,Percent of Total Billed Charges,725.28,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF LARGE,272,RC,,,,both,1229.28,1106.35,United Healthcare,Default,Fee Schedule,1003.09,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF MEDIUM,272,RC,,,,both,1229.28,1106.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,860.5,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF MEDIUM,272,RC,,,,both,1229.28,1106.35,Cigna,Default,Percent of Total Billed Charges,725.28,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF MEDIUM,272,RC,,,,both,1229.28,1106.35,United Healthcare,Default,Fee Schedule,1003.09,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF SMALL,272,RC,,,,both,1229.28,1106.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,860.5,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF SMALL,272,RC,,,,both,1229.28,1106.35,Cigna,Default,Percent of Total Billed Charges,725.28,,,,725.28,1003.09
CLEARSIGHT FINGER CUFF SMALL,272,RC,,,,both,1229.28,1106.35,United Healthcare,Default,Fee Schedule,1003.09,,,,725.28,1003.09
FLOTRAC SENSOR,272,RC,,,,both,1229.28,1106.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,860.5,,,,725.28,1003.09
FLOTRAC SENSOR,272,RC,,,,both,1229.28,1106.35,Cigna,Default,Percent of Total Billed Charges,725.28,,,,725.28,1003.09
FLOTRAC SENSOR,272,RC,,,,both,1229.28,1106.35,United Healthcare,Default,Fee Schedule,1003.09,,,,725.28,1003.09
DRESSING EPIFIX 3X3 CM,Q4186,HCPCS,636,RC,,both,669.96,602.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,468.97,,,,395.28,546.69
DRESSING EPIFIX 3X3 CM,Q4186,HCPCS,636,RC,,both,669.96,602.96,Cigna,Default,Percent of Total Billed Charges,395.28,,,,395.28,546.69
DRESSING EPIFIX 3X3 CM,Q4186,HCPCS,636,RC,,both,669.96,602.96,United Healthcare,Default,Fee Schedule,546.69,,,,395.28,546.69
SOLUTION SODIUM CHLORIDE .9% 100ML,258,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SOLUTION SODIUM CHLORIDE .9% 100ML,258,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SOLUTION SODIUM CHLORIDE .9% 100ML,258,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SOLUTION SODIUM CHLORIDE .9%  50ML,258,RC,,,,both,22.07,19.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.45,,,,13.02,18.01
SOLUTION SODIUM CHLORIDE .9%  50ML,258,RC,,,,both,22.07,19.86,Cigna,Default,Percent of Total Billed Charges,13.02,,,,13.02,18.01
SOLUTION SODIUM CHLORIDE .9%  50ML,258,RC,,,,both,22.07,19.86,United Healthcare,Default,Fee Schedule,18.01,,,,13.02,18.01
SOLUTION SOD CHLORIDE .9% 250ML,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SOLUTION SOD CHLORIDE .9% 250ML,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SOLUTION SOD CHLORIDE .9% 250ML,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .9% AS,258,RC,,,,both,22.29,20.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.6,,,,13.15,18.19
SOLUTION SODIUM CHLORIDE .9% AS,258,RC,,,,both,22.29,20.06,Cigna,Default,Percent of Total Billed Charges,13.15,,,,13.15,18.19
SOLUTION SODIUM CHLORIDE .9% AS,258,RC,,,,both,22.29,20.06,United Healthcare,Default,Fee Schedule,18.19,,,,13.15,18.19
SUTURE TRICON 2 BLUE 30 T-56/HGS-21,272,RC,,,,both,25.98,23.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.19,,,,15.33,21.2
SUTURE TRICON 2 BLUE 30 T-56/HGS-21,272,RC,,,,both,25.98,23.38,Cigna,Default,Percent of Total Billed Charges,15.33,,,,15.33,21.2
SUTURE TRICON 2 BLUE 30 T-56/HGS-21,272,RC,,,,both,25.98,23.38,United Healthcare,Default,Fee Schedule,21.2,,,,15.33,21.2
*EPIFIX 2.0X2.0 CM,Q4186,HCPCS,636,RC,,both,908.36,817.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,635.85,,,,535.93,741.22
*EPIFIX 2.0X2.0 CM,Q4186,HCPCS,636,RC,,both,908.36,817.52,Cigna,Default,Percent of Total Billed Charges,535.93,,,,535.93,741.22
*EPIFIX 2.0X2.0 CM,Q4186,HCPCS,636,RC,,both,908.36,817.52,United Healthcare,Default,Fee Schedule,741.22,,,,535.93,741.22
SOLUTION SOD CLORIDE 0.9% 500ML BAG,258,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SOLUTION SOD CLORIDE 0.9% 500ML BAG,258,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SOLUTION SOD CLORIDE 0.9% 500ML BAG,258,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SODIUM CHLORIDE .9% 1000ML BAG,258,RC,,,,both,21.51,19.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.06,,,,12.69,17.55
SODIUM CHLORIDE .9% 1000ML BAG,258,RC,,,,both,21.51,19.36,Cigna,Default,Percent of Total Billed Charges,12.69,,,,12.69,17.55
SODIUM CHLORIDE .9% 1000ML BAG,258,RC,,,,both,21.51,19.36,United Healthcare,Default,Fee Schedule,17.55,,,,12.69,17.55
SOLUTION SODIUM CHLORIDE .9% IR 500ML BT,258,RC,,,,both,23.34,21.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.34,,,,13.77,19.05
SOLUTION SODIUM CHLORIDE .9% IR 500ML BT,258,RC,,,,both,23.34,21.01,Cigna,Default,Percent of Total Billed Charges,13.77,,,,13.77,19.05
SOLUTION SODIUM CHLORIDE .9% IR 500ML BT,258,RC,,,,both,23.34,21.01,United Healthcare,Default,Fee Schedule,19.05,,,,13.77,19.05
SODIUM CHLORIDE .9% 1000ML,258,RC,,,,both,23.29,20.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.3,,,,13.74,19
SODIUM CHLORIDE .9% 1000ML,258,RC,,,,both,23.29,20.96,Cigna,Default,Percent of Total Billed Charges,13.74,,,,13.74,19
SODIUM CHLORIDE .9% 1000ML,258,RC,,,,both,23.29,20.96,United Healthcare,Default,Fee Schedule,19,,,,13.74,19
SOLUTION SODIUM CL BAG .9% IRG 3000ML,258,RC,,,,both,30.83,27.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.58,,,,18.19,25.16
SOLUTION SODIUM CL BAG .9% IRG 3000ML,258,RC,,,,both,30.83,27.75,Cigna,Default,Percent of Total Billed Charges,18.19,,,,18.19,25.16
SOLUTION SODIUM CL BAG .9% IRG 3000ML,258,RC,,,,both,30.83,27.75,United Healthcare,Default,Fee Schedule,25.16,,,,18.19,25.16
SOLUTION SODIUM CHLORIDE .9% 1500ML,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .9% 1500ML,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .9% 1500ML,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
*EPIFIX 2.0X4.0 CM,636,RC,,,,both,575.99,518.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,403.19,,,,339.83,470.01
*EPIFIX 2.0X4.0 CM,636,RC,,,,both,575.99,518.39,Cigna,Default,Percent of Total Billed Charges,339.83,,,,339.83,470.01
*EPIFIX 2.0X4.0 CM,636,RC,,,,both,575.99,518.39,United Healthcare,Default,Fee Schedule,470.01,,,,339.83,470.01
WATER STERILE 500ML,J7060,HCPCS,258,RC,,both,22.33,20.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.63,,,,13.17,18.22
WATER STERILE 500ML,J7060,HCPCS,258,RC,,both,22.33,20.1,Cigna,Default,Percent of Total Billed Charges,13.17,,,,13.17,18.22
WATER STERILE 500ML,J7060,HCPCS,258,RC,,both,22.33,20.1,United Healthcare,Default,Fee Schedule,18.22,,,,13.17,18.22
WATER STERILE 1000ML,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
WATER STERILE 1000ML,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
WATER STERILE 1000ML,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SOLUTION WATER STERILE 3000ML,258,RC,,,,both,40.17,36.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.12,,,,23.7,32.78
SOLUTION WATER STERILE 3000ML,258,RC,,,,both,40.17,36.15,Cigna,Default,Percent of Total Billed Charges,23.7,,,,23.7,32.78
SOLUTION WATER STERILE 3000ML,258,RC,,,,both,40.17,36.15,United Healthcare,Default,Fee Schedule,32.78,,,,23.7,32.78
SOLUTION WATER STERILE BAG 1000ML,258,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SOLUTION WATER STERILE BAG 1000ML,258,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SOLUTION WATER STERILE BAG 1000ML,258,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SOLUTION WATER STERILE 1500ML BOTTLE,258,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SOLUTION WATER STERILE 1500ML BOTTLE,258,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SOLUTION WATER STERILE 1500ML BOTTLE,258,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SOLUTION GLYCINE 3000,258,RC,,,,both,51.97,46.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.38,,,,30.66,42.41
SOLUTION GLYCINE 3000,258,RC,,,,both,51.97,46.77,Cigna,Default,Percent of Total Billed Charges,30.66,,,,30.66,42.41
SOLUTION GLYCINE 3000,258,RC,,,,both,51.97,46.77,United Healthcare,Default,Fee Schedule,42.41,,,,30.66,42.41
DNU SOLUTION LACTATED RINGERS,J7042,HCPCS,258,RC,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
DNU SOLUTION LACTATED RINGERS,J7042,HCPCS,258,RC,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
DNU SOLUTION LACTATED RINGERS,J7042,HCPCS,258,RC,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
NEEDLE NERVE BLOCK,272,RC,,,,both,28.37,25.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.86,,,,16.74,23.15
NEEDLE NERVE BLOCK,272,RC,,,,both,28.37,25.53,Cigna,Default,Percent of Total Billed Charges,16.74,,,,16.74,23.15
NEEDLE NERVE BLOCK,272,RC,,,,both,28.37,25.53,United Healthcare,Default,Fee Schedule,23.15,,,,16.74,23.15
OCCLUDER VASCULAR 1.0,278,RC,,,,both,190.27,171.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.19,,,,112.26,155.26
OCCLUDER VASCULAR 1.0,278,RC,,,,both,190.27,171.24,Cigna,Default,Percent of Total Billed Charges,112.26,,,,112.26,155.26
OCCLUDER VASCULAR 1.0,278,RC,,,,both,190.27,171.24,United Healthcare,Default,Fee Schedule,155.26,,,,112.26,155.26
OCCLUDER VASCULAR 1.5,C1766,HCPCS,278,RC,,both,251.99,226.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.39,,,,148.67,205.62
OCCLUDER VASCULAR 1.5,C1766,HCPCS,278,RC,,both,251.99,226.79,Cigna,Default,Percent of Total Billed Charges,148.67,,,,148.67,205.62
OCCLUDER VASCULAR 1.5,C1766,HCPCS,278,RC,,both,251.99,226.79,United Healthcare,Default,Fee Schedule,205.62,,,,148.67,205.62
OCCLUDER VASCULAR 2.0,278,RC,,,,both,244.44,220,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.11,,,,144.22,199.46
OCCLUDER VASCULAR 2.0,278,RC,,,,both,244.44,220,Cigna,Default,Percent of Total Billed Charges,144.22,,,,144.22,199.46
OCCLUDER VASCULAR 2.0,278,RC,,,,both,244.44,220,United Healthcare,Default,Fee Schedule,199.46,,,,144.22,199.46
OCCLUDER VASCULAR 2.5,278,RC,,,,both,244.44,220,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.11,,,,144.22,199.46
OCCLUDER VASCULAR 2.5,278,RC,,,,both,244.44,220,Cigna,Default,Percent of Total Billed Charges,144.22,,,,144.22,199.46
OCCLUDER VASCULAR 2.5,278,RC,,,,both,244.44,220,United Healthcare,Default,Fee Schedule,199.46,,,,144.22,199.46
SOLUTION MANITOL 20%,258,RC,,,,both,71.46,64.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.02,,,,42.16,58.31
SOLUTION MANITOL 20%,258,RC,,,,both,71.46,64.31,Cigna,Default,Percent of Total Billed Charges,42.16,,,,42.16,58.31
SOLUTION MANITOL 20%,258,RC,,,,both,71.46,64.31,United Healthcare,Default,Fee Schedule,58.31,,,,42.16,58.31
SOLUTION SODIUM CHLORIDE .45% 1000ML,258,RC,,,,both,24.6,22.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.22,,,,14.51,20.07
SOLUTION SODIUM CHLORIDE .45% 1000ML,258,RC,,,,both,24.6,22.14,Cigna,Default,Percent of Total Billed Charges,14.51,,,,14.51,20.07
SOLUTION SODIUM CHLORIDE .45% 1000ML,258,RC,,,,both,24.6,22.14,United Healthcare,Default,Fee Schedule,20.07,,,,14.51,20.07
SOLUTION SODIUM CHLORIDE .45% 250ML,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .45% 250ML,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .45% 250ML,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .45% 500ML,258,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .45% 500ML,258,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SOLUTION SODIUM CHLORIDE .45% 500ML,258,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SOLUTION PREMIX POTASSIUM CHL 1000ML,258,RC,,,,both,27.49,24.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.24,,,,16.22,22.43
SOLUTION PREMIX POTASSIUM CHL 1000ML,258,RC,,,,both,27.49,24.74,Cigna,Default,Percent of Total Billed Charges,16.22,,,,16.22,22.43
SOLUTION PREMIX POTASSIUM CHL 1000ML,258,RC,,,,both,27.49,24.74,United Healthcare,Default,Fee Schedule,22.43,,,,16.22,22.43
DNO SET MANIFOLD EXT CAT 25CM,272,RC,,,,both,38.35,34.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.84,,,,22.63,31.29
DNO SET MANIFOLD EXT CAT 25CM,272,RC,,,,both,38.35,34.52,Cigna,Default,Percent of Total Billed Charges,22.63,,,,22.63,31.29
DNO SET MANIFOLD EXT CAT 25CM,272,RC,,,,both,38.35,34.52,United Healthcare,Default,Fee Schedule,31.29,,,,22.63,31.29
TUBE BLAKEMORE 20FR,272,RC,,,,both,1146.65,1031.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,802.66,,,,676.52,935.67
TUBE BLAKEMORE 20FR,272,RC,,,,both,1146.65,1031.99,Cigna,Default,Percent of Total Billed Charges,676.52,,,,676.52,935.67
TUBE BLAKEMORE 20FR,272,RC,,,,both,1146.65,1031.99,United Healthcare,Default,Fee Schedule,935.67,,,,676.52,935.67
SHUNT-DENVR VENS-SRG,278,RC,,,,both,3975.69,3578.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2782.98,,,,2345.66,3244.16
SHUNT-DENVR VENS-SRG,278,RC,,,,both,3975.69,3578.12,Cigna,Default,Percent of Total Billed Charges,2345.66,,,,2345.66,3244.16
SHUNT-DENVR VENS-SRG,278,RC,,,,both,3975.69,3578.12,United Healthcare,Default,Fee Schedule,3244.16,,,,2345.66,3244.16
STRATA 42866 FIXED PRESSURE VALVE,C1982,HCPCS,278,RC,,both,16082.57,14474.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11257.8,,,,9488.72,13123.38
STRATA 42866 FIXED PRESSURE VALVE,C1982,HCPCS,278,RC,,both,16082.57,14474.31,Cigna,Default,Percent of Total Billed Charges,9488.72,,,,9488.72,13123.38
STRATA 42866 FIXED PRESSURE VALVE,C1982,HCPCS,278,RC,,both,16082.57,14474.31,United Healthcare,Default,Fee Schedule,13123.38,,,,9488.72,13123.38
ARES CATHETER KIT 95001,272,RC,,,,both,2224.36,2001.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1557.05,,,,1312.37,1815.08
ARES CATHETER KIT 95001,272,RC,,,,both,2224.36,2001.92,Cigna,Default,Percent of Total Billed Charges,1312.37,,,,1312.37,1815.08
ARES CATHETER KIT 95001,272,RC,,,,both,2224.36,2001.92,United Healthcare,Default,Fee Schedule,1815.08,,,,1312.37,1815.08
STRATA PASSER 48409,272,RC,,,,both,514.49,463.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,360.14,,,,303.55,419.82
STRATA PASSER 48409,272,RC,,,,both,514.49,463.04,Cigna,Default,Percent of Total Billed Charges,303.55,,,,303.55,419.82
STRATA PASSER 48409,272,RC,,,,both,514.49,463.04,United Healthcare,Default,Fee Schedule,419.82,,,,303.55,419.82
"*SUTURE TAPE 18"" UMBILICAL SEE NOTES",272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"*SUTURE TAPE 18"" UMBILICAL SEE NOTES",272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"*SUTURE TAPE 18"" UMBILICAL SEE NOTES",272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
VASCU-GUARD W/APEX PROCESSING,271,RC,,,,both,779.35,701.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,545.54,,,,459.82,635.95
VASCU-GUARD W/APEX PROCESSING,271,RC,,,,both,779.35,701.42,Cigna,Default,Percent of Total Billed Charges,459.82,,,,459.82,635.95
VASCU-GUARD W/APEX PROCESSING,271,RC,,,,both,779.35,701.42,United Healthcare,Default,Fee Schedule,635.95,,,,459.82,635.95
LG LIGACLIP,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
LG LIGACLIP,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
LG LIGACLIP,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
LS100 LIGACLIP,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
LS100 LIGACLIP,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
LS100 LIGACLIP,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
LIGACLIP HORIZON,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
LIGACLIP HORIZON,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
LIGACLIP HORIZON,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
"DNO DRESSING AQUACEL  AG 4"" X 13.5""",272,RC,,,,both,156.26,140.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.38,,,,92.19,127.51
"DNO DRESSING AQUACEL  AG 4"" X 13.5""",272,RC,,,,both,156.26,140.63,Cigna,Default,Percent of Total Billed Charges,92.19,,,,92.19,127.51
"DNO DRESSING AQUACEL  AG 4"" X 13.5""",272,RC,,,,both,156.26,140.63,United Healthcare,Default,Fee Schedule,127.51,,,,92.19,127.51
SUTURE ETHILON #2 LR ETH 490T,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
SUTURE ETHILON #2 LR ETH 490T,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
SUTURE ETHILON #2 LR ETH 490T,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
KIT EDLICH GAS LAVGE,271,RC,,,,both,28.82,25.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.17,,,,17,23.52
KIT EDLICH GAS LAVGE,271,RC,,,,both,28.82,25.94,Cigna,Default,Percent of Total Billed Charges,17,,,,17,23.52
KIT EDLICH GAS LAVGE,271,RC,,,,both,28.82,25.94,United Healthcare,Default,Fee Schedule,23.52,,,,17,23.52
CATH FOLEY 18FR 10CC COUDE TIP 2-WAY,A4340,HCPCS,272,RC,,both,13.56,12.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.49,,,,8,11.06
CATH FOLEY 18FR 10CC COUDE TIP 2-WAY,A4340,HCPCS,272,RC,,both,13.56,12.2,Cigna,Default,Percent of Total Billed Charges,8,,,,8,11.06
CATH FOLEY 18FR 10CC COUDE TIP 2-WAY,A4340,HCPCS,272,RC,,both,13.56,12.2,United Healthcare,Default,Fee Schedule,11.06,,,,8,11.06
CATH COUDE 2-WAY 16FR 5CC,A4340,HCPCS,272,RC,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
CATH COUDE 2-WAY 16FR 5CC,A4340,HCPCS,272,RC,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
CATH COUDE 2-WAY 16FR 5CC,A4340,HCPCS,272,RC,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
CATH COUDE 20FR 5CC,A4340,HCPCS,272,RC,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
CATH COUDE 20FR 5CC,A4340,HCPCS,272,RC,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
CATH COUDE 20FR 5CC,A4340,HCPCS,272,RC,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
*CATH COUDE 22FR 30CC 3 WAY,272,RC,,,,both,81.34,73.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.94,,,,47.99,66.37
*CATH COUDE 22FR 30CC 3 WAY,272,RC,,,,both,81.34,73.21,Cigna,Default,Percent of Total Billed Charges,47.99,,,,47.99,66.37
*CATH COUDE 22FR 30CC 3 WAY,272,RC,,,,both,81.34,73.21,United Healthcare,Default,Fee Schedule,66.37,,,,47.99,66.37
*CATH COUDE 24FR 30CC 3 WAY,272,RC,,,,both,81.34,73.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.94,,,,47.99,66.37
*CATH COUDE 24FR 30CC 3 WAY,272,RC,,,,both,81.34,73.21,Cigna,Default,Percent of Total Billed Charges,47.99,,,,47.99,66.37
*CATH COUDE 24FR 30CC 3 WAY,272,RC,,,,both,81.34,73.21,United Healthcare,Default,Fee Schedule,66.37,,,,47.99,66.37
*CATH COUDE 12FR SILICONE,A4340,HCPCS,272,RC,,both,61.58,55.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.11,,,,36.33,50.25
*CATH COUDE 12FR SILICONE,A4340,HCPCS,272,RC,,both,61.58,55.42,Cigna,Default,Percent of Total Billed Charges,36.33,,,,36.33,50.25
*CATH COUDE 12FR SILICONE,A4340,HCPCS,272,RC,,both,61.58,55.42,United Healthcare,Default,Fee Schedule,50.25,,,,36.33,50.25
*CATH COUDE 14FR SILICONE,272,RC,,,,both,61.58,55.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.11,,,,36.33,50.25
*CATH COUDE 14FR SILICONE,272,RC,,,,both,61.58,55.42,Cigna,Default,Percent of Total Billed Charges,36.33,,,,36.33,50.25
*CATH COUDE 14FR SILICONE,272,RC,,,,both,61.58,55.42,United Healthcare,Default,Fee Schedule,50.25,,,,36.33,50.25
SHEATH INTRODUCER CP-,272,RC,,,,both,99.46,89.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.62,,,,58.68,81.16
SHEATH INTRODUCER CP-,272,RC,,,,both,99.46,89.51,Cigna,Default,Percent of Total Billed Charges,58.68,,,,58.68,81.16
SHEATH INTRODUCER CP-,272,RC,,,,both,99.46,89.51,United Healthcare,Default,Fee Schedule,81.16,,,,58.68,81.16
SHEATH INTRODUCER CL-,272,RC,,,,both,181.62,163.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.13,,,,107.16,148.2
SHEATH INTRODUCER CL-,272,RC,,,,both,181.62,163.46,Cigna,Default,Percent of Total Billed Charges,107.16,,,,107.16,148.2
SHEATH INTRODUCER CL-,272,RC,,,,both,181.62,163.46,United Healthcare,Default,Fee Schedule,148.2,,,,107.16,148.2
STAPLER TA90 4.8/D,272,RC,,,,both,1088.9,980.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,762.23,,,,642.45,888.54
STAPLER TA90 4.8/D,272,RC,,,,both,1088.9,980.01,Cigna,Default,Percent of Total Billed Charges,642.45,,,,642.45,888.54
STAPLER TA90 4.8/D,272,RC,,,,both,1088.9,980.01,United Healthcare,Default,Fee Schedule,888.54,,,,642.45,888.54
RELOAD TA 90 4.8,272,RC,,,,both,481.28,433.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,336.9,,,,283.96,392.72
RELOAD TA 90 4.8,272,RC,,,,both,481.28,433.15,Cigna,Default,Percent of Total Billed Charges,283.96,,,,283.96,392.72
RELOAD TA 90 4.8,272,RC,,,,both,481.28,433.15,United Healthcare,Default,Fee Schedule,392.72,,,,283.96,392.72
RELOAD TA 90 3.5,272,RC,,,,both,178.42,160.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.89,,,,105.27,145.59
RELOAD TA 90 3.5,272,RC,,,,both,178.42,160.58,Cigna,Default,Percent of Total Billed Charges,105.27,,,,105.27,145.59
RELOAD TA 90 3.5,272,RC,,,,both,178.42,160.58,United Healthcare,Default,Fee Schedule,145.59,,,,105.27,145.59
STENT PALMAZ UNMOUNTED XL 40C,C1874,HCPCS,278,RC,,both,5444.47,4900.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3811.13,,,,3212.24,4442.69
STENT PALMAZ UNMOUNTED XL 40C,C1874,HCPCS,278,RC,,both,5444.47,4900.02,Cigna,Default,Percent of Total Billed Charges,3212.24,,,,3212.24,4442.69
STENT PALMAZ UNMOUNTED XL 40C,C1874,HCPCS,278,RC,,both,5444.47,4900.02,United Healthcare,Default,Fee Schedule,4442.69,,,,3212.24,4442.69
STENT PALMAZ UNMOUNTED XL 50C,C1874,HCPCS,278,RC,,both,5827.41,5244.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.19,,,,3438.17,4755.17
STENT PALMAZ UNMOUNTED XL 50C,C1874,HCPCS,278,RC,,both,5827.41,5244.67,Cigna,Default,Percent of Total Billed Charges,3438.17,,,,3438.17,4755.17
STENT PALMAZ UNMOUNTED XL 50C,C1874,HCPCS,278,RC,,both,5827.41,5244.67,United Healthcare,Default,Fee Schedule,4755.17,,,,3438.17,4755.17
CATH PIGTAIL 5FR W/M,272,RC,,,,both,131.9,118.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.33,,,,77.82,107.63
CATH PIGTAIL 5FR W/M,272,RC,,,,both,131.9,118.71,Cigna,Default,Percent of Total Billed Charges,77.82,,,,77.82,107.63
CATH PIGTAIL 5FR W/M,272,RC,,,,both,131.9,118.71,United Healthcare,Default,Fee Schedule,107.63,,,,77.82,107.63
CATH SUPER TORQUE VERTEBRAL 5FR,272,RC,,,,both,64.64,58.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.25,,,,38.14,52.75
CATH SUPER TORQUE VERTEBRAL 5FR,272,RC,,,,both,64.64,58.18,Cigna,Default,Percent of Total Billed Charges,38.14,,,,38.14,52.75
CATH SUPER TORQUE VERTEBRAL 5FR,272,RC,,,,both,64.64,58.18,United Healthcare,Default,Fee Schedule,52.75,,,,38.14,52.75
STAPLER 60 MM TX60B LINER BLUE,272,RC,,,,both,245.15,220.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.6,,,,144.64,200.04
STAPLER 60 MM TX60B LINER BLUE,272,RC,,,,both,245.15,220.64,Cigna,Default,Percent of Total Billed Charges,144.64,,,,144.64,200.04
STAPLER 60 MM TX60B LINER BLUE,272,RC,,,,both,245.15,220.64,United Healthcare,Default,Fee Schedule,200.04,,,,144.64,200.04
STAPLER 60MM TX60 LINEAR GREEN,272,RC,,,,both,389.85,350.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,272.9,,,,230.01,318.12
STAPLER 60MM TX60 LINEAR GREEN,272,RC,,,,both,389.85,350.87,Cigna,Default,Percent of Total Billed Charges,230.01,,,,230.01,318.12
STAPLER 60MM TX60 LINEAR GREEN,272,RC,,,,both,389.85,350.87,United Healthcare,Default,Fee Schedule,318.12,,,,230.01,318.12
DNO RELOAD 60MM TX60 LINEAR GREEN,272,RC,,,,both,153.13,137.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.19,,,,90.35,124.95
DNO RELOAD 60MM TX60 LINEAR GREEN,272,RC,,,,both,153.13,137.82,Cigna,Default,Percent of Total Billed Charges,90.35,,,,90.35,124.95
DNO RELOAD 60MM TX60 LINEAR GREEN,272,RC,,,,both,153.13,137.82,United Healthcare,Default,Fee Schedule,124.95,,,,90.35,124.95
DNO RELOAD 60MM RX60B LINEAR BLUE,272,RC,,,,both,211.27,190.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.89,,,,124.65,172.4
DNO RELOAD 60MM RX60B LINEAR BLUE,272,RC,,,,both,211.27,190.14,Cigna,Default,Percent of Total Billed Charges,124.65,,,,124.65,172.4
DNO RELOAD 60MM RX60B LINEAR BLUE,272,RC,,,,both,211.27,190.14,United Healthcare,Default,Fee Schedule,172.4,,,,124.65,172.4
SET VASCULAR DIALATOR,272,RC,,,,both,203.17,182.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.22,,,,119.87,165.79
SET VASCULAR DIALATOR,272,RC,,,,both,203.17,182.85,Cigna,Default,Percent of Total Billed Charges,119.87,,,,119.87,165.79
SET VASCULAR DIALATOR,272,RC,,,,both,203.17,182.85,United Healthcare,Default,Fee Schedule,165.79,,,,119.87,165.79
6FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.15,,,,46.49,64.29
6FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Cigna,Default,Percent of Total Billed Charges,46.49,,,,46.49,64.29
6FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,United Healthcare,Default,Fee Schedule,64.29,,,,46.49,64.29
8FR 20CM  VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.15,,,,46.49,64.29
8FR 20CM  VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Cigna,Default,Percent of Total Billed Charges,46.49,,,,46.49,64.29
8FR 20CM  VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,United Healthcare,Default,Fee Schedule,64.29,,,,46.49,64.29
*10FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.15,,,,46.49,64.29
*10FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Cigna,Default,Percent of Total Billed Charges,46.49,,,,46.49,64.29
*10FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,United Healthcare,Default,Fee Schedule,64.29,,,,46.49,64.29
*12FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.15,,,,46.49,64.29
*12FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Cigna,Default,Percent of Total Billed Charges,46.49,,,,46.49,64.29
*12FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,United Healthcare,Default,Fee Schedule,64.29,,,,46.49,64.29
*14FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.15,,,,46.49,64.29
*14FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,Cigna,Default,Percent of Total Billed Charges,46.49,,,,46.49,64.29
*14FR 20CM VASCULAR DIALATOR,272,RC,,,,both,78.79,70.91,United Healthcare,Default,Fee Schedule,64.29,,,,46.49,64.29
"NEEDLE STIMULATOR 21G X 1.5"" (40MM)",272,RC,,,,both,40.43,36.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.3,,,,23.85,32.99
"NEEDLE STIMULATOR 21G X 1.5"" (40MM)",272,RC,,,,both,40.43,36.39,Cigna,Default,Percent of Total Billed Charges,23.85,,,,23.85,32.99
"NEEDLE STIMULATOR 21G X 1.5"" (40MM)",272,RC,,,,both,40.43,36.39,United Healthcare,Default,Fee Schedule,32.99,,,,23.85,32.99
NEEDLE STIMULATOR 21G X 3 1/8 (80MM),272,RC,,,,both,47.56,42.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.29,,,,28.06,38.81
NEEDLE STIMULATOR 21G X 3 1/8 (80MM),272,RC,,,,both,47.56,42.8,Cigna,Default,Percent of Total Billed Charges,28.06,,,,28.06,38.81
NEEDLE STIMULATOR 21G X 3 1/8 (80MM),272,RC,,,,both,47.56,42.8,United Healthcare,Default,Fee Schedule,38.81,,,,28.06,38.81
STIMUPLEX ULTRA INSULATED ECHOGENIC22GX2,272,RC,,,,both,44.4,39.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.08,,,,26.2,36.23
STIMUPLEX ULTRA INSULATED ECHOGENIC22GX2,272,RC,,,,both,44.4,39.96,Cigna,Default,Percent of Total Billed Charges,26.2,,,,26.2,36.23
STIMUPLEX ULTRA INSULATED ECHOGENIC22GX2,272,RC,,,,both,44.4,39.96,United Healthcare,Default,Fee Schedule,36.23,,,,26.2,36.23
STIMUPLEX ULTRA 360 INSULATED ECHOGENIC,272,RC,,,,both,50.8,45.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.56,,,,29.97,41.45
STIMUPLEX ULTRA 360 INSULATED ECHOGENIC,272,RC,,,,both,50.8,45.72,Cigna,Default,Percent of Total Billed Charges,29.97,,,,29.97,41.45
STIMUPLEX ULTRA 360 INSULATED ECHOGENIC,272,RC,,,,both,50.8,45.72,United Healthcare,Default,Fee Schedule,41.45,,,,29.97,41.45
"*21G 6"" ECHOBLOCK ECHOGENIC NON-INSULTE",272,RC,,,,both,43.02,38.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.11,,,,25.38,35.1
"*21G 6"" ECHOBLOCK ECHOGENIC NON-INSULTE",272,RC,,,,both,43.02,38.72,Cigna,Default,Percent of Total Billed Charges,25.38,,,,25.38,35.1
"*21G 6"" ECHOBLOCK ECHOGENIC NON-INSULTE",272,RC,,,,both,43.02,38.72,United Healthcare,Default,Fee Schedule,35.1,,,,25.38,35.1
"*20G 6"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.06,,,,20.28,28.05
"*20G 6"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,Cigna,Default,Percent of Total Billed Charges,20.28,,,,20.28,28.05
"*20G 6"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,United Healthcare,Default,Fee Schedule,28.05,,,,20.28,28.05
"22G 2"" ECHOBLOCK PTC ECHOGENIC NEEDLE",272,RC,,,,both,28.11,25.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.68,,,,16.58,22.94
"22G 2"" ECHOBLOCK PTC ECHOGENIC NEEDLE",272,RC,,,,both,28.11,25.3,Cigna,Default,Percent of Total Billed Charges,16.58,,,,16.58,22.94
"22G 2"" ECHOBLOCK PTC ECHOGENIC NEEDLE",272,RC,,,,both,28.11,25.3,United Healthcare,Default,Fee Schedule,22.94,,,,16.58,22.94
"17G 6"" ECHOTUOHY EPIDURAL NEEDLES",272,RC,,,,both,51.23,46.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.86,,,,30.23,41.8
"17G 6"" ECHOTUOHY EPIDURAL NEEDLES",272,RC,,,,both,51.23,46.11,Cigna,Default,Percent of Total Billed Charges,30.23,,,,30.23,41.8
"17G 6"" ECHOTUOHY EPIDURAL NEEDLES",272,RC,,,,both,51.23,46.11,United Healthcare,Default,Fee Schedule,41.8,,,,30.23,41.8
"DNO 18G X 8"" TUOHY NEEDLES",272,RC,,,,both,46.91,42.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.84,,,,27.68,38.28
"DNO 18G X 8"" TUOHY NEEDLES",272,RC,,,,both,46.91,42.22,Cigna,Default,Percent of Total Billed Charges,27.68,,,,27.68,38.28
"DNO 18G X 8"" TUOHY NEEDLES",272,RC,,,,both,46.91,42.22,United Healthcare,Default,Fee Schedule,38.28,,,,27.68,38.28
"DNO 22G 6"" TUOHY NEEDLES",272,RC,,,,both,46.91,42.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.84,,,,27.68,38.28
"DNO 22G 6"" TUOHY NEEDLES",272,RC,,,,both,46.91,42.22,Cigna,Default,Percent of Total Billed Charges,27.68,,,,27.68,38.28
"DNO 22G 6"" TUOHY NEEDLES",272,RC,,,,both,46.91,42.22,United Healthcare,Default,Fee Schedule,38.28,,,,27.68,38.28
"Y22G 3.5"" TUOHY NEEDLES",272,RC,,,,both,38.7,34.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.09,,,,22.83,31.58
"Y22G 3.5"" TUOHY NEEDLES",272,RC,,,,both,38.7,34.83,Cigna,Default,Percent of Total Billed Charges,22.83,,,,22.83,31.58
"Y22G 3.5"" TUOHY NEEDLES",272,RC,,,,both,38.7,34.83,United Healthcare,Default,Fee Schedule,31.58,,,,22.83,31.58
"*22G 6"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.06,,,,20.28,28.05
"*22G 6"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,Cigna,Default,Percent of Total Billed Charges,20.28,,,,20.28,28.05
"*22G 6"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,United Healthcare,Default,Fee Schedule,28.05,,,,20.28,28.05
"20G 8"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.06,,,,20.28,28.05
"20G 8"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,Cigna,Default,Percent of Total Billed Charges,20.28,,,,20.28,28.05
"20G 8"" ECHOBLOCK PTC30 ECHOGENIC NON-IN",272,RC,,,,both,34.37,30.93,United Healthcare,Default,Fee Schedule,28.05,,,,20.28,28.05
"*22G 8"" ECHOBLOCK PTC30 ECHGENIC NON-INS",272,RC,,,,both,34.37,30.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.06,,,,20.28,28.05
"*22G 8"" ECHOBLOCK PTC30 ECHGENIC NON-INS",272,RC,,,,both,34.37,30.93,Cigna,Default,Percent of Total Billed Charges,20.28,,,,20.28,28.05
"*22G 8"" ECHOBLOCK PTC30 ECHGENIC NON-INS",272,RC,,,,both,34.37,30.93,United Healthcare,Default,Fee Schedule,28.05,,,,20.28,28.05
DNO COLD SNARE  EXACTO 2.4MM 230CM,272,RC,,,,both,102.5,92.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.75,,,,60.48,83.64
DNO COLD SNARE  EXACTO 2.4MM 230CM,272,RC,,,,both,102.5,92.25,Cigna,Default,Percent of Total Billed Charges,60.48,,,,60.48,83.64
DNO COLD SNARE  EXACTO 2.4MM 230CM,272,RC,,,,both,102.5,92.25,United Healthcare,Default,Fee Schedule,83.64,,,,60.48,83.64
SNARE 15MM 120MM,272,RC,,,,both,1159.01,1043.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,811.31,,,,683.82,945.75
SNARE 15MM 120MM,272,RC,,,,both,1159.01,1043.11,Cigna,Default,Percent of Total Billed Charges,683.82,,,,683.82,945.75
SNARE 15MM 120MM,272,RC,,,,both,1159.01,1043.11,United Healthcare,Default,Fee Schedule,945.75,,,,683.82,945.75
SNARE STANDARD 9-15DX120CML CATH,272,RC,,,,both,1071.21,964.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,749.85,,,,632.01,874.11
SNARE STANDARD 9-15DX120CML CATH,272,RC,,,,both,1071.21,964.09,Cigna,Default,Percent of Total Billed Charges,632.01,,,,632.01,874.11
SNARE STANDARD 9-15DX120CML CATH,272,RC,,,,both,1071.21,964.09,United Healthcare,Default,Fee Schedule,874.11,,,,632.01,874.11
FELT PTFE TEFLON,272,RC,,,,both,720.28,648.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.2,,,,424.97,587.75
FELT PTFE TEFLON,272,RC,,,,both,720.28,648.25,Cigna,Default,Percent of Total Billed Charges,424.97,,,,424.97,587.75
FELT PTFE TEFLON,272,RC,,,,both,720.28,648.25,United Healthcare,Default,Fee Schedule,587.75,,,,424.97,587.75
STENT PALMAZ 5FR X 80CM,C1874,HCPCS,278,RC,,both,3812.79,3431.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2668.95,,,,2249.55,3111.24
STENT PALMAZ 5FR X 80CM,C1874,HCPCS,278,RC,,both,3812.79,3431.51,Cigna,Default,Percent of Total Billed Charges,2249.55,,,,2249.55,3111.24
STENT PALMAZ 5FR X 80CM,C1874,HCPCS,278,RC,,both,3812.79,3431.51,United Healthcare,Default,Fee Schedule,3111.24,,,,2249.55,3111.24
*ADHESIVE DERMABOND,272,RC,,,,both,87.66,78.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.36,,,,51.72,71.53
*ADHESIVE DERMABOND,272,RC,,,,both,87.66,78.89,Cigna,Default,Percent of Total Billed Charges,51.72,,,,51.72,71.53
*ADHESIVE DERMABOND,272,RC,,,,both,87.66,78.89,United Healthcare,Default,Fee Schedule,71.53,,,,51.72,71.53
EXOFUSION SKIN CLOSURE SYSTEM 22CM,272,RC,,,,both,206.19,185.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.33,,,,121.65,168.25
EXOFUSION SKIN CLOSURE SYSTEM 22CM,272,RC,,,,both,206.19,185.57,Cigna,Default,Percent of Total Billed Charges,121.65,,,,121.65,168.25
EXOFUSION SKIN CLOSURE SYSTEM 22CM,272,RC,,,,both,206.19,185.57,United Healthcare,Default,Fee Schedule,168.25,,,,121.65,168.25
EXOFUSION SKIN CLOSURE SYSTEM 30 CM,272,RC,,,,both,226.46,203.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.52,,,,133.61,184.79
EXOFUSION SKIN CLOSURE SYSTEM 30 CM,272,RC,,,,both,226.46,203.81,Cigna,Default,Percent of Total Billed Charges,133.61,,,,133.61,184.79
EXOFUSION SKIN CLOSURE SYSTEM 30 CM,272,RC,,,,both,226.46,203.81,United Healthcare,Default,Fee Schedule,184.79,,,,133.61,184.79
EXOFIN SURGICAL SKIN ADHESIVE 1ML,272,RC,,,,both,49.73,44.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.81,,,,29.34,40.58
EXOFIN SURGICAL SKIN ADHESIVE 1ML,272,RC,,,,both,49.73,44.76,Cigna,Default,Percent of Total Billed Charges,29.34,,,,29.34,40.58
EXOFIN SURGICAL SKIN ADHESIVE 1ML,272,RC,,,,both,49.73,44.76,United Healthcare,Default,Fee Schedule,40.58,,,,29.34,40.58
ADHESIVE SURE&CLOSE WOUND CLOSURE SYS,272,RC,,,,both,81.82,73.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.27,,,,48.27,66.77
ADHESIVE SURE&CLOSE WOUND CLOSURE SYS,272,RC,,,,both,81.82,73.64,Cigna,Default,Percent of Total Billed Charges,48.27,,,,48.27,66.77
ADHESIVE SURE&CLOSE WOUND CLOSURE SYS,272,RC,,,,both,81.82,73.64,United Healthcare,Default,Fee Schedule,66.77,,,,48.27,66.77
ADHESIVE BIO-GLUE,272,RC,,,,both,2757.06,2481.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1929.94,,,,1626.67,2249.76
ADHESIVE BIO-GLUE,272,RC,,,,both,2757.06,2481.35,Cigna,Default,Percent of Total Billed Charges,1626.67,,,,1626.67,2249.76
ADHESIVE BIO-GLUE,272,RC,,,,both,2757.06,2481.35,United Healthcare,Default,Fee Schedule,2249.76,,,,1626.67,2249.76
SURGICAL SEALANT 4ML COSEAL,272,RC,,,,both,2109.45,1898.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1476.62,,,,1244.58,1721.31
SURGICAL SEALANT 4ML COSEAL,272,RC,,,,both,2109.45,1898.51,Cigna,Default,Percent of Total Billed Charges,1244.58,,,,1244.58,1721.31
SURGICAL SEALANT 4ML COSEAL,272,RC,,,,both,2109.45,1898.51,United Healthcare,Default,Fee Schedule,1721.31,,,,1244.58,1721.31
HEMOSTATIC MATRIX FLOSEAL 5ML,C1713,HCPCS,272,RC,,both,817.21,735.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,572.05,,,,482.15,666.84
HEMOSTATIC MATRIX FLOSEAL 5ML,C1713,HCPCS,272,RC,,both,817.21,735.49,Cigna,Default,Percent of Total Billed Charges,482.15,,,,482.15,666.84
HEMOSTATIC MATRIX FLOSEAL 5ML,C1713,HCPCS,272,RC,,both,817.21,735.49,United Healthcare,Default,Fee Schedule,666.84,,,,482.15,666.84
TACHOSIL SEALANT PATCH,272,RC,,,,both,2283.56,2055.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1598.49,,,,1347.3,1863.38
TACHOSIL SEALANT PATCH,272,RC,,,,both,2283.56,2055.2,Cigna,Default,Percent of Total Billed Charges,1347.3,,,,1347.3,1863.38
TACHOSIL SEALANT PATCH,272,RC,,,,both,2283.56,2055.2,United Healthcare,Default,Fee Schedule,1863.38,,,,1347.3,1863.38
*DURASEAL EXACT 5ML,272,RC,,,,both,4414.11,3972.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3089.88,,,,2604.32,3601.91
*DURASEAL EXACT 5ML,272,RC,,,,both,4414.11,3972.7,Cigna,Default,Percent of Total Billed Charges,2604.32,,,,2604.32,3601.91
*DURASEAL EXACT 5ML,272,RC,,,,both,4414.11,3972.7,United Healthcare,Default,Fee Schedule,3601.91,,,,2604.32,3601.91
DURAGEN SECURE 3X3,272,RC,,,,both,3505.61,3155.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2453.93,,,,2068.31,2860.58
DURAGEN SECURE 3X3,272,RC,,,,both,3505.61,3155.05,Cigna,Default,Percent of Total Billed Charges,2068.31,,,,2068.31,2860.58
DURAGEN SECURE 3X3,272,RC,,,,both,3505.61,3155.05,United Healthcare,Default,Fee Schedule,2860.58,,,,2068.31,2860.58
DURASEAL 8CM APPLICATOR,272,RC,,,,both,873.83,786.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,611.68,,,,515.56,713.05
DURASEAL 8CM APPLICATOR,272,RC,,,,both,873.83,786.45,Cigna,Default,Percent of Total Billed Charges,515.56,,,,515.56,713.05
DURASEAL 8CM APPLICATOR,272,RC,,,,both,873.83,786.45,United Healthcare,Default,Fee Schedule,713.05,,,,515.56,713.05
ENDOSCOPIC APPLICATOR FLOSEAL,272,RC,,,,both,242.1,217.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.47,,,,142.84,197.55
ENDOSCOPIC APPLICATOR FLOSEAL,272,RC,,,,both,242.1,217.89,Cigna,Default,Percent of Total Billed Charges,142.84,,,,142.84,197.55
ENDOSCOPIC APPLICATOR FLOSEAL,272,RC,,,,both,242.1,217.89,United Healthcare,Default,Fee Schedule,197.55,,,,142.84,197.55
FIBRIN SEALANT 4ML TISSEEL,272,RC,,,,both,928.97,836.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,650.28,,,,548.09,758.04
FIBRIN SEALANT 4ML TISSEEL,272,RC,,,,both,928.97,836.07,Cigna,Default,Percent of Total Billed Charges,548.09,,,,548.09,758.04
FIBRIN SEALANT 4ML TISSEEL,272,RC,,,,both,928.97,836.07,United Healthcare,Default,Fee Schedule,758.04,,,,548.09,758.04
ENDOSCOPIC APPLICATOR TISSEEL SPRAY SET,272,RC,,,,both,491.45,442.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.02,,,,289.96,401.02
ENDOSCOPIC APPLICATOR TISSEEL SPRAY SET,272,RC,,,,both,491.45,442.31,Cigna,Default,Percent of Total Billed Charges,289.96,,,,289.96,401.02
ENDOSCOPIC APPLICATOR TISSEEL SPRAY SET,272,RC,,,,both,491.45,442.31,United Healthcare,Default,Fee Schedule,401.02,,,,289.96,401.02
TISSEEL EASY SPRAY SET W/PRESSURE REGULA,272,RC,,,,both,227.37,204.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.16,,,,134.15,185.53
TISSEEL EASY SPRAY SET W/PRESSURE REGULA,272,RC,,,,both,227.37,204.63,Cigna,Default,Percent of Total Billed Charges,134.15,,,,134.15,185.53
TISSEEL EASY SPRAY SET W/PRESSURE REGULA,272,RC,,,,both,227.37,204.63,United Healthcare,Default,Fee Schedule,185.53,,,,134.15,185.53
"BAG OSTOMY 2"" DRAINABLE",271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"BAG OSTOMY 2"" DRAINABLE",271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"DNU BAG OSTOMY 1 3/4"" DRAINABLE",271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" DRAINABLE",271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" DRAINABLE",271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"SUTURE HI-FI 1X40""",272,RC,,,,both,104.43,93.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.1,,,,61.61,85.21
"SUTURE HI-FI 1X40""",272,RC,,,,both,104.43,93.99,Cigna,Default,Percent of Total Billed Charges,61.61,,,,61.61,85.21
"SUTURE HI-FI 1X40""",272,RC,,,,both,104.43,93.99,United Healthcare,Default,Fee Schedule,85.21,,,,61.61,85.21
"SUTURE HI-FI 1X40"" 2 QTY TELFLEX",272,RC,,,,both,177.3,159.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.11,,,,104.61,144.68
"SUTURE HI-FI 1X40"" 2 QTY TELFLEX",272,RC,,,,both,177.3,159.57,Cigna,Default,Percent of Total Billed Charges,104.61,,,,104.61,144.68
"SUTURE HI-FI 1X40"" 2 QTY TELFLEX",272,RC,,,,both,177.3,159.57,United Healthcare,Default,Fee Schedule,144.68,,,,104.61,144.68
SUTURE VICRYL 3-0 SH ETH J415H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 3-0 SH ETH J415H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 3-0 SH ETH J415H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNU SUTURE CAPIO NONABSORBABLE,272,RC,,,,both,146.67,132,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.67,,,,86.54,119.68
DNU SUTURE CAPIO NONABSORBABLE,272,RC,,,,both,146.67,132,Cigna,Default,Percent of Total Billed Charges,86.54,,,,86.54,119.68
DNU SUTURE CAPIO NONABSORBABLE,272,RC,,,,both,146.67,132,United Healthcare,Default,Fee Schedule,119.68,,,,86.54,119.68
SUTURE SILK 2-0 CT-1 ETH 423H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 2-0 CT-1 ETH 423H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 2-0 CT-1 ETH 423H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE MONOCRYL 5-0 PS-2 ETH Y495G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE MONOCRYL 5-0 PS-2 ETH Y495G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE MONOCRYL 5-0 PS-2 ETH Y495G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SUTURE VICRYL 3-0 SH 18"" J864D",272,RC,,,,both,38.34,34.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.84,,,,22.62,31.29
"SUTURE VICRYL 3-0 SH 18"" J864D",272,RC,,,,both,38.34,34.51,Cigna,Default,Percent of Total Billed Charges,22.62,,,,22.62,31.29
"SUTURE VICRYL 3-0 SH 18"" J864D",272,RC,,,,both,38.34,34.51,United Healthcare,Default,Fee Schedule,31.29,,,,22.62,31.29
TUBE CONNECTOR SHUNT,278,RC,,,,both,199.5,179.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.65,,,,117.7,162.79
TUBE CONNECTOR SHUNT,278,RC,,,,both,199.5,179.55,Cigna,Default,Percent of Total Billed Charges,117.7,,,,117.7,162.79
TUBE CONNECTOR SHUNT,278,RC,,,,both,199.5,179.55,United Healthcare,Default,Fee Schedule,162.79,,,,117.7,162.79
SUTURE CAPIO ABSORBABLE,272,RC,,,,both,146.67,132,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.67,,,,86.54,119.68
SUTURE CAPIO ABSORBABLE,272,RC,,,,both,146.67,132,Cigna,Default,Percent of Total Billed Charges,86.54,,,,86.54,119.68
SUTURE CAPIO ABSORBABLE,272,RC,,,,both,146.67,132,United Healthcare,Default,Fee Schedule,119.68,,,,86.54,119.68
CATH VENOUS SHUNT,272,RC,,,,both,222.75,200.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.92,,,,131.42,181.76
CATH VENOUS SHUNT,272,RC,,,,both,222.75,200.48,Cigna,Default,Percent of Total Billed Charges,131.42,,,,131.42,181.76
CATH VENOUS SHUNT,272,RC,,,,both,222.75,200.48,United Healthcare,Default,Fee Schedule,181.76,,,,131.42,181.76
"SUTURE PROLENE 7-0 BV-1 30"" ETH 8703H",272,RC,,,,both,62.19,55.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.53,,,,36.69,50.75
"SUTURE PROLENE 7-0 BV-1 30"" ETH 8703H",272,RC,,,,both,62.19,55.97,Cigna,Default,Percent of Total Billed Charges,36.69,,,,36.69,50.75
"SUTURE PROLENE 7-0 BV-1 30"" ETH 8703H",272,RC,,,,both,62.19,55.97,United Healthcare,Default,Fee Schedule,50.75,,,,36.69,50.75
"SUTURE PROLENE 2-0 SH 48"" ETH 8533H",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SUTURE PROLENE 2-0 SH 48"" ETH 8533H",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SUTURE PROLENE 2-0 SH 48"" ETH 8533H",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SUTURE PROLENE 3-0 SH 48"" ETH 8534H",272,RC,,,,both,29.8,26.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.86,,,,17.58,24.32
"SUTURE PROLENE 3-0 SH 48"" ETH 8534H",272,RC,,,,both,29.8,26.82,Cigna,Default,Percent of Total Billed Charges,17.58,,,,17.58,24.32
"SUTURE PROLENE 3-0 SH 48"" ETH 8534H",272,RC,,,,both,29.8,26.82,United Healthcare,Default,Fee Schedule,24.32,,,,17.58,24.32
"SUTURE SILK 2-0 SH 30""  ETH C016D",272,RC,,,,both,47.74,42.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.42,,,,28.17,38.96
"SUTURE SILK 2-0 SH 30""  ETH C016D",272,RC,,,,both,47.74,42.97,Cigna,Default,Percent of Total Billed Charges,28.17,,,,28.17,38.96
"SUTURE SILK 2-0 SH 30""  ETH C016D",272,RC,,,,both,47.74,42.97,United Healthcare,Default,Fee Schedule,38.96,,,,28.17,38.96
SUTURE SILK 2-0 CT-1 ETH C022D,272,RC,,,,both,35.19,31.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.63,,,,20.76,28.72
SUTURE SILK 2-0 CT-1 ETH C022D,272,RC,,,,both,35.19,31.67,Cigna,Default,Percent of Total Billed Charges,20.76,,,,20.76,28.72
SUTURE SILK 2-0 CT-1 ETH C022D,272,RC,,,,both,35.19,31.67,United Healthcare,Default,Fee Schedule,28.72,,,,20.76,28.72
SUTURE SILK 3-0 REEL ETH LA-54-G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 3-0 REEL ETH LA-54-G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 3-0 REEL ETH LA-54-G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 2-0 REEL ETH LA55G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 2-0 REEL ETH LA55G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 2-0 REEL ETH LA55G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SUTURE SILK 2-0 30"" TIES ETH SA-85H",272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
"SUTURE SILK 2-0 30"" TIES ETH SA-85H",272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
"SUTURE SILK 2-0 30"" TIES ETH SA-85H",272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SUTURE CHROMIC #1 CT-1 ETH 925H,272,RC,,,,both,22.62,20.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.83,,,,13.35,18.46
SUTURE CHROMIC #1 CT-1 ETH 925H,272,RC,,,,both,22.62,20.36,Cigna,Default,Percent of Total Billed Charges,13.35,,,,13.35,18.46
SUTURE CHROMIC #1 CT-1 ETH 925H,272,RC,,,,both,22.62,20.36,United Healthcare,Default,Fee Schedule,18.46,,,,13.35,18.46
DNU SUTURE MONOCRYL 4-0 P-3 ETH Y494G,272,RC,,,,both,31.5,28.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.05,,,,18.58,25.7
DNU SUTURE MONOCRYL 4-0 P-3 ETH Y494G,272,RC,,,,both,31.5,28.35,Cigna,Default,Percent of Total Billed Charges,18.58,,,,18.58,25.7
DNU SUTURE MONOCRYL 4-0 P-3 ETH Y494G,272,RC,,,,both,31.5,28.35,United Healthcare,Default,Fee Schedule,25.7,,,,18.58,25.7
SUTURE MONOCRYL 5-0 P-3 ETH Y493G,272,RC,,,,both,20.64,18.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.45,,,,12.18,16.84
SUTURE MONOCRYL 5-0 P-3 ETH Y493G,272,RC,,,,both,20.64,18.58,Cigna,Default,Percent of Total Billed Charges,12.18,,,,12.18,16.84
SUTURE MONOCRYL 5-0 P-3 ETH Y493G,272,RC,,,,both,20.64,18.58,United Healthcare,Default,Fee Schedule,16.84,,,,12.18,16.84
DNU SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,272,RC,,,,both,31.5,28.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.05,,,,18.58,25.7
DNU SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,272,RC,,,,both,31.5,28.35,Cigna,Default,Percent of Total Billed Charges,18.58,,,,18.58,25.7
DNU SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,272,RC,,,,both,31.5,28.35,United Healthcare,Default,Fee Schedule,25.7,,,,18.58,25.7
SUTURE STAINLESS STEEL M682G,272,RC,,,,both,80,72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56,,,,47.2,65.28
SUTURE STAINLESS STEEL M682G,272,RC,,,,both,80,72,Cigna,Default,Percent of Total Billed Charges,47.2,,,,47.2,65.28
SUTURE STAINLESS STEEL M682G,272,RC,,,,both,80,72,United Healthcare,Default,Fee Schedule,65.28,,,,47.2,65.28
SUTURE VICRYL 3-0 SH ETH J416H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 3-0 SH ETH J416H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 3-0 SH ETH J416H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 5-0 P-3 ETH J493G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 5-0 P-3 ETH J493G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 5-0 P-3 ETH J493G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 2-0 CT-1 ETH J945H,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SUTURE VICRYL 2-0 CT-1 ETH J945H,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SUTURE VICRYL 2-0 CT-1 ETH J945H,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SUTURE VICRYL 2-0 UR-5 ETH J375H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 2-0 UR-5 ETH J375H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 2-0 UR-5 ETH J375H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 4-0 TIES ETH J643H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 4-0 TIES ETH J643H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 4-0 TIES ETH J643H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 0 CT-1 ETH J946H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 0 CT-1 ETH J946H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 0 CT-1 ETH J946H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SUTURE ETHILON 7-0 P-6 18"" ETH 1647G",272,RC,,,,both,21.98,19.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.39,,,,12.97,17.94
"SUTURE ETHILON 7-0 P-6 18"" ETH 1647G",272,RC,,,,both,21.98,19.78,Cigna,Default,Percent of Total Billed Charges,12.97,,,,12.97,17.94
"SUTURE ETHILON 7-0 P-6 18"" ETH 1647G",272,RC,,,,both,21.98,19.78,United Healthcare,Default,Fee Schedule,17.94,,,,12.97,17.94
SUTURE ETHILON P-3 ETH699G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHILON P-3 ETH699G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHILON P-3 ETH699G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PLAIN 6-0 (FAST ACTING)ETH 1916G,272,RC,,,,both,34.29,30.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24,,,,20.23,27.98
SUTURE PLAIN 6-0 (FAST ACTING)ETH 1916G,272,RC,,,,both,34.29,30.86,Cigna,Default,Percent of Total Billed Charges,20.23,,,,20.23,27.98
SUTURE PLAIN 6-0 (FAST ACTING)ETH 1916G,272,RC,,,,both,34.29,30.86,United Healthcare,Default,Fee Schedule,27.98,,,,20.23,27.98
SUTURE ETHIBOND #2 LR ETH X496T,272,RC,,,,both,23.87,21.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.71,,,,14.08,19.48
SUTURE ETHIBOND #2 LR ETH X496T,272,RC,,,,both,23.87,21.48,Cigna,Default,Percent of Total Billed Charges,14.08,,,,14.08,19.48
SUTURE ETHIBOND #2 LR ETH X496T,272,RC,,,,both,23.87,21.48,United Healthcare,Default,Fee Schedule,19.48,,,,14.08,19.48
SUTURE PROLENE 4-0 PS-2 ETH 8682G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 4-0 PS-2 ETH 8682G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 4-0 PS-2 ETH 8682G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PDS 6-0 II P-1 ETH Z489G,272,RC,,,,both,23.78,21.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.65,,,,14.03,19.4
SUTURE PDS 6-0 II P-1 ETH Z489G,272,RC,,,,both,23.78,21.4,Cigna,Default,Percent of Total Billed Charges,14.03,,,,14.03,19.4
SUTURE PDS 6-0 II P-1 ETH Z489G,272,RC,,,,both,23.78,21.4,United Healthcare,Default,Fee Schedule,19.4,,,,14.03,19.4
"SUTURE PROLENE 2-0 SH 36"" ETH 8523H",272,RC,,,,both,29.6,26.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.72,,,,17.46,24.15
"SUTURE PROLENE 2-0 SH 36"" ETH 8523H",272,RC,,,,both,29.6,26.64,Cigna,Default,Percent of Total Billed Charges,17.46,,,,17.46,24.15
"SUTURE PROLENE 2-0 SH 36"" ETH 8523H",272,RC,,,,both,29.6,26.64,United Healthcare,Default,Fee Schedule,24.15,,,,17.46,24.15
SUTURE VICRYL ETH J232,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL ETH J232,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL ETH J232,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 6-0 P-3 ETH 1639G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 6-0 P-3 ETH 1639G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 6-0 P-3 ETH 1639G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 4-0 SH ETH K831H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 4-0 SH ETH K831H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 4-0 SH ETH K831H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 0 CT-1 ETH J346H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 0 CT-1 ETH J346H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 0 CT-1 ETH J346H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CONV SUTURE VICRYL 0 UR-5 ETH J376H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CONV SUTURE VICRYL 0 UR-5 ETH J376H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CONV SUTURE VICRYL 0 UR-5 ETH J376H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 0 8-18 J740D,272,RC,,,,both,37.79,34.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.45,,,,22.3,30.84
SUTURE VICRYL 0 8-18 J740D,272,RC,,,,both,37.79,34.01,Cigna,Default,Percent of Total Billed Charges,22.3,,,,22.3,30.84
SUTURE VICRYL 0 8-18 J740D,272,RC,,,,both,37.79,34.01,United Healthcare,Default,Fee Schedule,30.84,,,,22.3,30.84
SUTURE VICRYL 4-0 PS-2 ETH J496H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 4-0 PS-2 ETH J496H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 4-0 PS-2 ETH J496H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PLAIN 3-0 CT' ETH 842H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PLAIN 3-0 CT' ETH 842H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PLAIN 3-0 CT' ETH 842H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 4-0 SH ETH G121H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 4-0 SH ETH G121H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 4-0 SH ETH G121H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 0 CT' ETH 924H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 0 CT' ETH 924H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 0 CT' ETH 924H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 2-0 CT' ETH 923H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 2-0 CT' ETH 923H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 2-0 CT' ETH 923H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 6-0 BV-1 ETH 8805H,272,RC,,,,both,109.1,98.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.37,,,,64.37,89.03
SUTURE PROLENE 6-0 BV-1 ETH 8805H,272,RC,,,,both,109.1,98.19,Cigna,Default,Percent of Total Billed Charges,64.37,,,,64.37,89.03
SUTURE PROLENE 6-0 BV-1 ETH 8805H,272,RC,,,,both,109.1,98.19,United Healthcare,Default,Fee Schedule,89.03,,,,64.37,89.03
SUTURE MERSILENE 2-0 SH ETH R833H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE MERSILENE 2-0 SH ETH R833H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE MERSILENE 2-0 SH ETH R833H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHIBOND 1 EXCEL OS-4 ETH X518H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHIBOND 1 EXCEL OS-4 ETH X518H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHIBOND 1 EXCEL OS-4 ETH X518H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE GZM 7-776 TEVDEK II 2 C-2,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE GZM 7-776 TEVDEK II 2 C-2,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE GZM 7-776 TEVDEK II 2 C-2,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE MONOCRYL 4-0 PC-3 ETH Y845G,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SUTURE MONOCRYL 4-0 PC-3 ETH Y845G,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SUTURE MONOCRYL 4-0 PC-3 ETH Y845G,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SUTURE VICRYL 1 CTX ETH J977H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 1 CTX ETH J977H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 1 CTX ETH J977H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNU SUTURE ETH J549H,272,RC,,,,both,24.25,21.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.98,,,,14.31,19.79
DNU SUTURE ETH J549H,272,RC,,,,both,24.25,21.83,Cigna,Default,Percent of Total Billed Charges,14.31,,,,14.31,19.79
DNU SUTURE ETH J549H,272,RC,,,,both,24.25,21.83,United Healthcare,Default,Fee Schedule,19.79,,,,14.31,19.79
SUTURE ETHIBOND 0 CT-1 ETH X424H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHIBOND 0 CT-1 ETH X424H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHIBOND 0 CT-1 ETH X424H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHIBOND 4-0 X871H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHIBOND 4-0 X871H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHIBOND 4-0 X871H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
*CATH SILICONE 14FR 5CC,A4338,HCPCS,272,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*CATH SILICONE 14FR 5CC,A4338,HCPCS,272,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*CATH SILICONE 14FR 5CC,A4338,HCPCS,272,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"DNU ENDO STITCH W/SURG 2-0 GRN 48"" ES-9",272,RC,,,,both,194,174.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.8,,,,114.46,158.3
"DNU ENDO STITCH W/SURG 2-0 GRN 48"" ES-9",272,RC,,,,both,194,174.6,Cigna,Default,Percent of Total Billed Charges,114.46,,,,114.46,158.3
"DNU ENDO STITCH W/SURG 2-0 GRN 48"" ES-9",272,RC,,,,both,194,174.6,United Healthcare,Default,Fee Schedule,158.3,,,,114.46,158.3
DNU ENDO STITCH 10MM SUTURING DEVICE,272,RC,,,,both,503.75,453.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.62,,,,297.21,411.06
DNU ENDO STITCH 10MM SUTURING DEVICE,272,RC,,,,both,503.75,453.38,Cigna,Default,Percent of Total Billed Charges,297.21,,,,297.21,411.06
DNU ENDO STITCH 10MM SUTURING DEVICE,272,RC,,,,both,503.75,453.38,United Healthcare,Default,Fee Schedule,411.06,,,,297.21,411.06
DNU PROTACK 5 MM,272,RC,,,,both,982.5,884.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,687.75,,,,579.68,801.72
DNU PROTACK 5 MM,272,RC,,,,both,982.5,884.25,Cigna,Default,Percent of Total Billed Charges,579.68,,,,579.68,801.72
DNU PROTACK 5 MM,272,RC,,,,both,982.5,884.25,United Healthcare,Default,Fee Schedule,801.72,,,,579.68,801.72
SUTURE TI-CON COATED BRAIDED 5,272,RC,,,,both,47.93,43.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.55,,,,28.28,39.11
SUTURE TI-CON COATED BRAIDED 5,272,RC,,,,both,47.93,43.14,Cigna,Default,Percent of Total Billed Charges,28.28,,,,28.28,39.11
SUTURE TI-CON COATED BRAIDED 5,272,RC,,,,both,47.93,43.14,United Healthcare,Default,Fee Schedule,39.11,,,,28.28,39.11
SUTURE ETHIBOND EXCEL X833H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHIBOND EXCEL X833H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHIBOND EXCEL X833H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHIBOND 0 V-34 X444H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHIBOND 0 V-34 X444H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHIBOND 0 V-34 X444H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHIBOND 0 OS-2 CX74T,272,RC,,,,both,35.72,32.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25,,,,21.07,29.15
SUTURE ETHIBOND 0 OS-2 CX74T,272,RC,,,,both,35.72,32.15,Cigna,Default,Percent of Total Billed Charges,21.07,,,,21.07,29.15
SUTURE ETHIBOND 0 OS-2 CX74T,272,RC,,,,both,35.72,32.15,United Healthcare,Default,Fee Schedule,29.15,,,,21.07,29.15
SUTURE VICRYL 70CM CP-2 J870H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 70CM CP-2 J870H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 70CM CP-2 J870H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHIBOND 0 CX45D,272,RC,,,,both,68.09,61.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.66,,,,40.17,55.56
SUTURE ETHIBOND 0 CX45D,272,RC,,,,both,68.09,61.28,Cigna,Default,Percent of Total Billed Charges,40.17,,,,40.17,55.56
SUTURE ETHIBOND 0 CX45D,272,RC,,,,both,68.09,61.28,United Healthcare,Default,Fee Schedule,55.56,,,,40.17,55.56
SUTURE VICRYL 2-0 ETH J269H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 2-0 ETH J269H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 2-0 ETH J269H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL CT-1 J260H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL CT-1 J260H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL CT-1 J260H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
GEL-ONE PER DOSE,J7326,HCPCS,636,RC,,both,1631.7,1468.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1142.19,,,,962.7,1331.47
GEL-ONE PER DOSE,J7326,HCPCS,636,RC,,both,1631.7,1468.53,Cigna,Default,Percent of Total Billed Charges,962.7,,,,962.7,1331.47
GEL-ONE PER DOSE,J7326,HCPCS,636,RC,,both,1631.7,1468.53,United Healthcare,Default,Fee Schedule,1331.47,,,,962.7,1331.47
"SUTURE SILK 0 30"" TIES ETH SA86G 0",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SUTURE SILK 0 30"" TIES ETH SA86G 0",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SUTURE SILK 0 30"" TIES ETH SA86G 0",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 3-0 FS-1 ETH 684H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 3-0 FS-1 ETH 684H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 3-0 FS-1 ETH 684H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 3-0 K-S ETH 622H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 3-0 K-S ETH 622H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 3-0 K-S ETH 622H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 4-0 KS ETH 621H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 4-0 KS ETH 621H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 4-0 KS ETH 621H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 5-0 FS-2 ETH 682G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 5-0 FS-2 ETH 682G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 5-0 FS-2 ETH 682G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 5-0 P-3 ETH 640G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 5-0 P-3 ETH 640G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 5-0 P-3 ETH 640G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 6-0 C-3 ETH 711G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 6-0 C-3 ETH 711G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 6-0 C-3 ETH 711G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SILK 0 CT-1 ETH 424H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 0 CT-1 ETH 424H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 0 CT-1 ETH 424H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SUTURE SILK 3-0 SH 30"" ETH K832H",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SUTURE SILK 3-0 SH 30"" ETH K832H",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SUTURE SILK 3-0 SH 30"" ETH K832H",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CONV SUTURE VICRYL 0 TIES ETH J616H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CONV SUTURE VICRYL 0 TIES ETH J616H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CONV SUTURE VICRYL 0 TIES ETH J616H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE VICRYL 4-0 P-3 ETH J494H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE VICRYL 4-0 P-3 ETH J494H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE VICRYL 4-0 P-3 ETH J494H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CONV SUTURE VICRYL 2-0 UR-6 ETH J602H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CONV SUTURE VICRYL 2-0 UR-6 ETH J602H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CONV SUTURE VICRYL 2-0 UR-6 ETH J602H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 2-0 KS ETH 8623H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 2-0 KS ETH 8623H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 2-0 KS ETH 8623H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 2-0 FS-1 ETH 8685H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 2-0 FS-1 ETH 8685H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 2-0 FS-1 ETH 8685H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 3-0 KS ETH 8622H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 3-0 KS ETH 8622H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 3-0 KS ETH 8622H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 4-0 KS ETH 8621H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 4-0 KS ETH 8621H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 4-0 KS ETH 8621H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 4-0 FS-2 ETH 8683G,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SUTURE PROLENE 4-0 FS-2 ETH 8683G,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SUTURE PROLENE 4-0 FS-2 ETH 8683G,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SUTURE PROLENE 5-0 FS-2 ETH 8661G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 5-0 FS-2 ETH 8661G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 5-0 FS-2 ETH 8661G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 5-0 PS-5 ETH 8655G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE 5-0 PS-5 ETH 8655G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE 5-0 PS-5 ETH 8655G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE #1 CT-1 ETH 8425H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PROLENE #1 CT-1 ETH 8425H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PROLENE #1 CT-1 ETH 8425H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 0 MO-7 CR/8 ETH C841G,272,RC,,,,both,73.95,66.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.76,,,,43.63,60.34
SUTURE PROLENE 0 MO-7 CR/8 ETH C841G,272,RC,,,,both,73.95,66.56,Cigna,Default,Percent of Total Billed Charges,43.63,,,,43.63,60.34
SUTURE PROLENE 0 MO-7 CR/8 ETH C841G,272,RC,,,,both,73.95,66.56,United Healthcare,Default,Fee Schedule,60.34,,,,43.63,60.34
"SUTURE PROLENE 3-0 SH 36"" ETH 8522H",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SUTURE PROLENE 3-0 SH 36"" ETH 8522H",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SUTURE PROLENE 3-0 SH 36"" ETH 8522H",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 3-0 V-7 ETH 8976H,272,RC,,,,both,27.41,24.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.19,,,,16.17,22.37
SUTURE PROLENE 3-0 V-7 ETH 8976H,272,RC,,,,both,27.41,24.67,Cigna,Default,Percent of Total Billed Charges,16.17,,,,16.17,22.37
SUTURE PROLENE 3-0 V-7 ETH 8976H,272,RC,,,,both,27.41,24.67,United Healthcare,Default,Fee Schedule,22.37,,,,16.17,22.37
"SUTURE PROLENE 4-0 SH 36"" ETH 8521H",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SUTURE PROLENE 4-0 SH 36"" ETH 8521H",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SUTURE PROLENE 4-0 SH 36"" ETH 8521H",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PROLENE 5-0 BV-1 ETH 9702H,272,RC,,,,both,109.63,98.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.74,,,,64.68,89.46
SUTURE PROLENE 5-0 BV-1 ETH 9702H,272,RC,,,,both,109.63,98.67,Cigna,Default,Percent of Total Billed Charges,64.68,,,,64.68,89.46
SUTURE PROLENE 5-0 BV-1 ETH 9702H,272,RC,,,,both,109.63,98.67,United Healthcare,Default,Fee Schedule,89.46,,,,64.68,89.46
SUTURE PDS 4-0 SH ETH 9706H,272,RC,,,,both,34,30.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.8,,,,20.06,27.74
SUTURE PDS 4-0 SH ETH 9706H,272,RC,,,,both,34,30.6,Cigna,Default,Percent of Total Billed Charges,20.06,,,,20.06,27.74
SUTURE PDS 4-0 SH ETH 9706H,272,RC,,,,both,34,30.6,United Healthcare,Default,Fee Schedule,27.74,,,,20.06,27.74
SUTURE PDS 4-0 II FS-1 ETH Z441H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PDS 4-0 II FS-1 ETH Z441H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PDS 4-0 II FS-1 ETH Z441H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PDS #1 CT-1 ETH Z347H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PDS #1 CT-1 ETH Z347H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PDS #1 CT-1 ETH Z347H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PDS 4-0 SH ETH Z315H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PDS 4-0 SH ETH Z315H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PDS 4-0 SH ETH Z315H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC #1 TIES ETH S115H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC #1 TIES ETH S115H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC #1 TIES ETH S115H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 0 TIES ETH S114H,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SUTURE CHROMIC 0 TIES ETH S114H,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SUTURE CHROMIC 0 TIES ETH S114H,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SUTURE CHROMIC #2 TP-1 ETH GL31G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC #2 TP-1 ETH GL31G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC #2 TP-1 ETH GL31G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC #1 TP-1 ETH GL30G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC #1 TP-1 ETH GL30G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC #1 TP-1 ETH GL30G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 0 BP-1 ETH 47T,272,RC,,,,both,23.87,21.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.71,,,,14.08,19.48
SUTURE CHROMIC 0 BP-1 ETH 47T,272,RC,,,,both,23.87,21.48,Cigna,Default,Percent of Total Billed Charges,14.08,,,,14.08,19.48
SUTURE CHROMIC 0 BP-1 ETH 47T,272,RC,,,,both,23.87,21.48,United Healthcare,Default,Fee Schedule,19.48,,,,14.08,19.48
SUTURE CHROMIC 2-0 SH ETH G123H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 2-0 SH ETH G123H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 2-0 SH ETH G123H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 3-0 CT-3 ETH 892H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 3-0 CT-3 ETH 892H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 3-0 CT-3 ETH 892H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 4-0 RB-1 ETH U203H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 4-0 RB-1 ETH U203H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 4-0 RB-1 ETH U203H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE PLAIN 2-0 CT-1 ETH 843H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE PLAIN 2-0 CT-1 ETH 843H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE PLAIN 2-0 CT-1 ETH 843H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHILON 2-0 FS ETH 664H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHILON 2-0 FS ETH 664H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHILON 2-0 FS ETH 664H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHILON 5-0 FS-2 ETH 661G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE ETHILON 5-0 FS-2 ETH 661G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE ETHILON 5-0 FS-2 ETH 661G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHILON 6-0 FS-3 DNR,272,RC,,,,both,48.48,43.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.94,,,,28.6,39.56
SUTURE ETHILON 6-0 FS-3 DNR,272,RC,,,,both,48.48,43.63,Cigna,Default,Percent of Total Billed Charges,28.6,,,,28.6,39.56
SUTURE ETHILON 6-0 FS-3 DNR,272,RC,,,,both,48.48,43.63,United Healthcare,Default,Fee Schedule,39.56,,,,28.6,39.56
SUTURE CHROMIC 2-0 SH ETH 883H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 2-0 SH ETH 883H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 2-0 SH ETH 883H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"*SUTURE TAPE 36""UMBILICAL SEE NOTES",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"*SUTURE TAPE 36""UMBILICAL SEE NOTES",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"*SUTURE TAPE 36""UMBILICAL SEE NOTES",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE CHROMIC 3-0 CT-2 ETH 882H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE CHROMIC 3-0 CT-2 ETH 882H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE CHROMIC 3-0 CT-2 ETH 882H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE SURGICAL STEEL #7 CCS ETH M655G,272,RC,,,,both,79.31,71.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.52,,,,46.79,64.72
SUTURE SURGICAL STEEL #7 CCS ETH M655G,272,RC,,,,both,79.31,71.38,Cigna,Default,Percent of Total Billed Charges,46.79,,,,46.79,64.72
SUTURE SURGICAL STEEL #7 CCS ETH M655G,272,RC,,,,both,79.31,71.38,United Healthcare,Default,Fee Schedule,64.72,,,,46.79,64.72
SUTURE SURGICAL STEEL #5 CCS ETH M653G,272,RC,,,,both,75.59,68.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.91,,,,44.6,61.68
SUTURE SURGICAL STEEL #5 CCS ETH M653G,272,RC,,,,both,75.59,68.03,Cigna,Default,Percent of Total Billed Charges,44.6,,,,44.6,61.68
SUTURE SURGICAL STEEL #5 CCS ETH M653G,272,RC,,,,both,75.59,68.03,United Healthcare,Default,Fee Schedule,61.68,,,,44.6,61.68
SUTURE GORE 3N10B 3-0 GORTEX CV3,272,RC,,,,both,118.9,107.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.23,,,,70.15,97.02
SUTURE GORE 3N10B 3-0 GORTEX CV3,272,RC,,,,both,118.9,107.01,Cigna,Default,Percent of Total Billed Charges,70.15,,,,70.15,97.02
SUTURE GORE 3N10B 3-0 GORTEX CV3,272,RC,,,,both,118.9,107.01,United Healthcare,Default,Fee Schedule,97.02,,,,70.15,97.02
SUTURE GORE 4N02A 4-0 GORTEX CV4,272,RC,,,,both,118.56,106.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.99,,,,69.95,96.74
SUTURE GORE 4N02A 4-0 GORTEX CV4,272,RC,,,,both,118.56,106.7,Cigna,Default,Percent of Total Billed Charges,69.95,,,,69.95,96.74
SUTURE GORE 4N02A 4-0 GORTEX CV4,272,RC,,,,both,118.56,106.7,United Healthcare,Default,Fee Schedule,96.74,,,,69.95,96.74
SUTURE GORE 5N02A 5-0 GORTEX CV5,272,RC,,,,both,143.16,128.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.21,,,,84.46,116.82
SUTURE GORE 5N02A 5-0 GORTEX CV5,272,RC,,,,both,143.16,128.84,Cigna,Default,Percent of Total Billed Charges,84.46,,,,84.46,116.82
SUTURE GORE 5N02A 5-0 GORTEX CV5,272,RC,,,,both,143.16,128.84,United Healthcare,Default,Fee Schedule,116.82,,,,84.46,116.82
SUTURE PROLENE #2 MS/3 ETH 3846T,272,RC,,,,both,51.07,45.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.75,,,,30.13,41.67
SUTURE PROLENE #2 MS/3 ETH 3846T,272,RC,,,,both,51.07,45.96,Cigna,Default,Percent of Total Billed Charges,30.13,,,,30.13,41.67
SUTURE PROLENE #2 MS/3 ETH 3846T,272,RC,,,,both,51.07,45.96,United Healthcare,Default,Fee Schedule,41.67,,,,30.13,41.67
SUTURE SILK 4-0 FS-2 ETH 683G,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE SILK 4-0 FS-2 ETH 683G,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE SILK 4-0 FS-2 ETH 683G,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE GORE 6M02A 6-0 GORTEX CV6,272,RC,,,,both,147.94,133.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.56,,,,87.28,120.72
SUTURE GORE 6M02A 6-0 GORTEX CV6,272,RC,,,,both,147.94,133.15,Cigna,Default,Percent of Total Billed Charges,87.28,,,,87.28,120.72
SUTURE GORE 6M02A 6-0 GORTEX CV6,272,RC,,,,both,147.94,133.15,United Healthcare,Default,Fee Schedule,120.72,,,,87.28,120.72
SUTURE 3-0 VICRYL CT-1 J258H,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE 3-0 VICRYL CT-1 J258H,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE 3-0 VICRYL CT-1 J258H,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE 5-0 NUROLON,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE 5-0 NUROLON,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE 5-0 NUROLON,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE 6-0 NUROLON,272,RC,,,,both,23.18,20.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.23,,,,13.68,18.91
SUTURE 6-0 NUROLON,272,RC,,,,both,23.18,20.86,Cigna,Default,Percent of Total Billed Charges,13.68,,,,13.68,18.91
SUTURE 6-0 NUROLON,272,RC,,,,both,23.18,20.86,United Healthcare,Default,Fee Schedule,18.91,,,,13.68,18.91
SUTURE 4-0 PDS II PS-2 NEEDLE 18,272,RC,,,,both,27.11,24.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.98,,,,15.99,22.12
SUTURE 4-0 PDS II PS-2 NEEDLE 18,272,RC,,,,both,27.11,24.4,Cigna,Default,Percent of Total Billed Charges,15.99,,,,15.99,22.12
SUTURE 4-0 PDS II PS-2 NEEDLE 18,272,RC,,,,both,27.11,24.4,United Healthcare,Default,Fee Schedule,22.12,,,,15.99,22.12
SUTURE 2-0 VICRYL CDT-2 NEEDLE 2,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE 2-0 VICRYL CDT-2 NEEDLE 2,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE 2-0 VICRYL CDT-2 NEEDLE 2,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE 5-0 PDS RB-1 NEEDLE,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE 5-0 PDS RB-1 NEEDLE,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE 5-0 PDS RB-1 NEEDLE,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SUTURE ETHICON ENDOLOOPS,272,RC,,,,both,122.37,110.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.66,,,,72.2,99.85
SUTURE ETHICON ENDOLOOPS,272,RC,,,,both,122.37,110.13,Cigna,Default,Percent of Total Billed Charges,72.2,,,,72.2,99.85
SUTURE ETHICON ENDOLOOPS,272,RC,,,,both,122.37,110.13,United Healthcare,Default,Fee Schedule,99.85,,,,72.2,99.85
SUTURE EHTIBOND EXCEL 1 CT,272,RC,,,,both,20.58,18.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.41,,,,12.14,16.79
SUTURE EHTIBOND EXCEL 1 CT,272,RC,,,,both,20.58,18.52,Cigna,Default,Percent of Total Billed Charges,12.14,,,,12.14,16.79
SUTURE EHTIBOND EXCEL 1 CT,272,RC,,,,both,20.58,18.52,United Healthcare,Default,Fee Schedule,16.79,,,,12.14,16.79
SUTURE EHTBOND EXCEL 5CCS,272,RC,,,,both,63.2,56.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.24,,,,37.29,51.57
SUTURE EHTBOND EXCEL 5CCS,272,RC,,,,both,63.2,56.88,Cigna,Default,Percent of Total Billed Charges,37.29,,,,37.29,51.57
SUTURE EHTBOND EXCEL 5CCS,272,RC,,,,both,63.2,56.88,United Healthcare,Default,Fee Schedule,51.57,,,,37.29,51.57
CONV SUTURE VICRYL 27,272,RC,,,,both,38.81,34.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.17,,,,22.9,31.67
CONV SUTURE VICRYL 27,272,RC,,,,both,38.81,34.93,Cigna,Default,Percent of Total Billed Charges,22.9,,,,22.9,31.67
CONV SUTURE VICRYL 27,272,RC,,,,both,38.81,34.93,United Healthcare,Default,Fee Schedule,31.67,,,,22.9,31.67
PACK SHOULDER SPLIT,272,RC,,,,both,142.56,128.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.79,,,,84.11,116.33
PACK SHOULDER SPLIT,272,RC,,,,both,142.56,128.3,Cigna,Default,Percent of Total Billed Charges,84.11,,,,84.11,116.33
PACK SHOULDER SPLIT,272,RC,,,,both,142.56,128.3,United Healthcare,Default,Fee Schedule,116.33,,,,84.11,116.33
SUTURE BONE WAX,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SUTURE BONE WAX,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SUTURE BONE WAX,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH GROSHONG SINGLE LUMEN 7FR,C1751,HCPCS,272,RC,,both,1781.52,1603.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1247.06,,,,1051.1,1453.72
CATH GROSHONG SINGLE LUMEN 7FR,C1751,HCPCS,272,RC,,both,1781.52,1603.37,Cigna,Default,Percent of Total Billed Charges,1051.1,,,,1051.1,1453.72
CATH GROSHONG SINGLE LUMEN 7FR,C1751,HCPCS,272,RC,,both,1781.52,1603.37,United Healthcare,Default,Fee Schedule,1453.72,,,,1051.1,1453.72
CATH GROSHONG DUAL LUMEN 9.5FR,272,RC,,,,both,1148.64,1033.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,804.05,,,,677.7,937.29
CATH GROSHONG DUAL LUMEN 9.5FR,272,RC,,,,both,1148.64,1033.78,Cigna,Default,Percent of Total Billed Charges,677.7,,,,677.7,937.29
CATH GROSHONG DUAL LUMEN 9.5FR,272,RC,,,,both,1148.64,1033.78,United Healthcare,Default,Fee Schedule,937.29,,,,677.7,937.29
*MASK LMA DISPOSABLE SZ 3,272,RC,,,,both,158.92,143.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.24,,,,93.76,129.68
*MASK LMA DISPOSABLE SZ 3,272,RC,,,,both,158.92,143.03,Cigna,Default,Percent of Total Billed Charges,93.76,,,,93.76,129.68
*MASK LMA DISPOSABLE SZ 3,272,RC,,,,both,158.92,143.03,United Healthcare,Default,Fee Schedule,129.68,,,,93.76,129.68
*MASK LMA DISPOSABLE SZ 4 DNU,272,RC,,,,both,95.13,85.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.59,,,,56.13,77.63
*MASK LMA DISPOSABLE SZ 4 DNU,272,RC,,,,both,95.13,85.62,Cigna,Default,Percent of Total Billed Charges,56.13,,,,56.13,77.63
*MASK LMA DISPOSABLE SZ 4 DNU,272,RC,,,,both,95.13,85.62,United Healthcare,Default,Fee Schedule,77.63,,,,56.13,77.63
*MASK LMA DISPOSABLE SZ 5,272,RC,,,,both,95.13,85.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.59,,,,56.13,77.63
*MASK LMA DISPOSABLE SZ 5,272,RC,,,,both,95.13,85.62,Cigna,Default,Percent of Total Billed Charges,56.13,,,,56.13,77.63
*MASK LMA DISPOSABLE SZ 5,272,RC,,,,both,95.13,85.62,United Healthcare,Default,Fee Schedule,77.63,,,,56.13,77.63
PACK ORTHO UPPER EXTREMITY,272,RC,,,,both,76.06,68.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.24,,,,44.88,62.06
PACK ORTHO UPPER EXTREMITY,272,RC,,,,both,76.06,68.45,Cigna,Default,Percent of Total Billed Charges,44.88,,,,44.88,62.06
PACK ORTHO UPPER EXTREMITY,272,RC,,,,both,76.06,68.45,United Healthcare,Default,Fee Schedule,62.06,,,,44.88,62.06
PACK ORTHO LOWER EXTREMITY,272,RC,,,,both,163.13,146.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.19,,,,96.25,133.11
PACK ORTHO LOWER EXTREMITY,272,RC,,,,both,163.13,146.82,Cigna,Default,Percent of Total Billed Charges,96.25,,,,96.25,133.11
PACK ORTHO LOWER EXTREMITY,272,RC,,,,both,163.13,146.82,United Healthcare,Default,Fee Schedule,133.11,,,,96.25,133.11
PACK CYSTO,272,RC,,,,both,24.09,21.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.86,,,,14.21,19.66
PACK CYSTO,272,RC,,,,both,24.09,21.68,Cigna,Default,Percent of Total Billed Charges,14.21,,,,14.21,19.66
PACK CYSTO,272,RC,,,,both,24.09,21.68,United Healthcare,Default,Fee Schedule,19.66,,,,14.21,19.66
CYSTOSCOPE DISPOSABLE SCOPE,272,RC,,,,both,582.75,524.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,407.92,,,,343.82,475.52
CYSTOSCOPE DISPOSABLE SCOPE,272,RC,,,,both,582.75,524.48,Cigna,Default,Percent of Total Billed Charges,343.82,,,,343.82,475.52
CYSTOSCOPE DISPOSABLE SCOPE,272,RC,,,,both,582.75,524.48,United Healthcare,Default,Fee Schedule,475.52,,,,343.82,475.52
HEMOSTASIS VALVE LARGE BORE,272,RC,,,,both,47.89,43.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.52,,,,28.26,39.08
HEMOSTASIS VALVE LARGE BORE,272,RC,,,,both,47.89,43.1,Cigna,Default,Percent of Total Billed Charges,28.26,,,,28.26,39.08
HEMOSTASIS VALVE LARGE BORE,272,RC,,,,both,47.89,43.1,United Healthcare,Default,Fee Schedule,39.08,,,,28.26,39.08
PACK ORTHO MAJOR,272,RC,,,,both,73.37,66.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.36,,,,43.29,59.87
PACK ORTHO MAJOR,272,RC,,,,both,73.37,66.03,Cigna,Default,Percent of Total Billed Charges,43.29,,,,43.29,59.87
PACK ORTHO MAJOR,272,RC,,,,both,73.37,66.03,United Healthcare,Default,Fee Schedule,59.87,,,,43.29,59.87
PACK ORTHOARTS HIP W/ POCKET,272,RC,,,,both,182.86,164.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128,,,,107.89,149.21
PACK ORTHOARTS HIP W/ POCKET,272,RC,,,,both,182.86,164.57,Cigna,Default,Percent of Total Billed Charges,107.89,,,,107.89,149.21
PACK ORTHOARTS HIP W/ POCKET,272,RC,,,,both,182.86,164.57,United Healthcare,Default,Fee Schedule,149.21,,,,107.89,149.21
PACK BASIC II W/ UTILITY COVER,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
PACK BASIC II W/ UTILITY COVER,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
PACK BASIC II W/ UTILITY COVER,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
PACK KNEE ARTHROSCOPY/FLUID CONTROL,272,RC,,,,both,158.12,142.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.68,,,,93.29,129.03
PACK KNEE ARTHROSCOPY/FLUID CONTROL,272,RC,,,,both,158.12,142.31,Cigna,Default,Percent of Total Billed Charges,93.29,,,,93.29,129.03
PACK KNEE ARTHROSCOPY/FLUID CONTROL,272,RC,,,,both,158.12,142.31,United Healthcare,Default,Fee Schedule,129.03,,,,93.29,129.03
PACK UNIVERSAL,272,RC,,,,both,65.76,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.03,,,,38.8,53.66
PACK UNIVERSAL,272,RC,,,,both,65.76,59.18,Cigna,Default,Percent of Total Billed Charges,38.8,,,,38.8,53.66
PACK UNIVERSAL,272,RC,,,,both,65.76,59.18,United Healthcare,Default,Fee Schedule,53.66,,,,38.8,53.66
PACK SHOULDER ARTHROSCOPY ORTHOARTS,272,RC,,,,both,192.32,173.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.62,,,,113.47,156.93
PACK SHOULDER ARTHROSCOPY ORTHOARTS,272,RC,,,,both,192.32,173.09,Cigna,Default,Percent of Total Billed Charges,113.47,,,,113.47,156.93
PACK SHOULDER ARTHROSCOPY ORTHOARTS,272,RC,,,,both,192.32,173.09,United Healthcare,Default,Fee Schedule,156.93,,,,113.47,156.93
PACK UNIVERSAL SPLIT SURGICAL AURORA,272,RC,,,,both,54.16,48.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.91,,,,31.95,44.19
PACK UNIVERSAL SPLIT SURGICAL AURORA,272,RC,,,,both,54.16,48.74,Cigna,Default,Percent of Total Billed Charges,31.95,,,,31.95,44.19
PACK UNIVERSAL SPLIT SURGICAL AURORA,272,RC,,,,both,54.16,48.74,United Healthcare,Default,Fee Schedule,44.19,,,,31.95,44.19
DNO PACK OB III,272,RC,,,,both,46.49,41.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.54,,,,27.43,37.94
DNO PACK OB III,272,RC,,,,both,46.49,41.84,Cigna,Default,Percent of Total Billed Charges,27.43,,,,27.43,37.94
DNO PACK OB III,272,RC,,,,both,46.49,41.84,United Healthcare,Default,Fee Schedule,37.94,,,,27.43,37.94
DNO PACK EENT I,272,RC,,,,both,40.91,36.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.64,,,,24.14,33.38
DNO PACK EENT I,272,RC,,,,both,40.91,36.82,Cigna,Default,Percent of Total Billed Charges,24.14,,,,24.14,33.38
DNO PACK EENT I,272,RC,,,,both,40.91,36.82,United Healthcare,Default,Fee Schedule,33.38,,,,24.14,33.38
PACK LAP 111,272,RC,,,,both,34.65,31.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.26,,,,20.44,28.27
PACK LAP 111,272,RC,,,,both,34.65,31.19,Cigna,Default,Percent of Total Billed Charges,20.44,,,,20.44,28.27
PACK LAP 111,272,RC,,,,both,34.65,31.19,United Healthcare,Default,Fee Schedule,28.27,,,,20.44,28.27
CATH PERCUTANEOUS 14 FR,272,RC,,,,both,250.75,225.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,175.52,,,,147.94,204.61
CATH PERCUTANEOUS 14 FR,272,RC,,,,both,250.75,225.68,Cigna,Default,Percent of Total Billed Charges,147.94,,,,147.94,204.61
CATH PERCUTANEOUS 14 FR,272,RC,,,,both,250.75,225.68,United Healthcare,Default,Fee Schedule,204.61,,,,147.94,204.61
CATH BENTSON WIRE .035X180 CM TSFB 35,C1769,HCPCS,272,RC,,both,82,73.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.4,,,,48.38,66.91
CATH BENTSON WIRE .035X180 CM TSFB 35,C1769,HCPCS,272,RC,,both,82,73.8,Cigna,Default,Percent of Total Billed Charges,48.38,,,,48.38,66.91
CATH BENTSON WIRE .035X180 CM TSFB 35,C1769,HCPCS,272,RC,,both,82,73.8,United Healthcare,Default,Fee Schedule,66.91,,,,48.38,66.91
TUBE ENDOTRACHEAL 8.5,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
TUBE ENDOTRACHEAL 8.5,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
TUBE ENDOTRACHEAL 8.5,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
TUBE NASOPHARYNGEAL 28,272,RC,,,,both,49.6,44.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.72,,,,29.26,40.47
TUBE NASOPHARYNGEAL 28,272,RC,,,,both,49.6,44.64,Cigna,Default,Percent of Total Billed Charges,29.26,,,,29.26,40.47
TUBE NASOPHARYNGEAL 28,272,RC,,,,both,49.6,44.64,United Healthcare,Default,Fee Schedule,40.47,,,,29.26,40.47
DNO TUBE COMBITUBE 41FR.,272,RC,,,,both,183.11,164.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.18,,,,108.03,149.42
DNO TUBE COMBITUBE 41FR.,272,RC,,,,both,183.11,164.8,Cigna,Default,Percent of Total Billed Charges,108.03,,,,108.03,149.42
DNO TUBE COMBITUBE 41FR.,272,RC,,,,both,183.11,164.8,United Healthcare,Default,Fee Schedule,149.42,,,,108.03,149.42
DNO TUBE TRACH MLT 6.0,272,RC,,,,both,43.33,39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.33,,,,25.56,35.36
DNO TUBE TRACH MLT 6.0,272,RC,,,,both,43.33,39,Cigna,Default,Percent of Total Billed Charges,25.56,,,,25.56,35.36
DNO TUBE TRACH MLT 6.0,272,RC,,,,both,43.33,39,United Healthcare,Default,Fee Schedule,35.36,,,,25.56,35.36
DNO TUBE TRACH MLT 4.0,272,RC,,,,both,27.92,25.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.54,,,,16.47,22.78
DNO TUBE TRACH MLT 4.0,272,RC,,,,both,27.92,25.13,Cigna,Default,Percent of Total Billed Charges,16.47,,,,16.47,22.78
DNO TUBE TRACH MLT 4.0,272,RC,,,,both,27.92,25.13,United Healthcare,Default,Fee Schedule,22.78,,,,16.47,22.78
ENDO TUBE 6.5MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 6.5MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 6.5MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
TUBE NASOPHARYNGEAL 26  FR,272,RC,,,,both,22.75,20.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.92,,,,13.42,18.56
TUBE NASOPHARYNGEAL 26  FR,272,RC,,,,both,22.75,20.48,Cigna,Default,Percent of Total Billed Charges,13.42,,,,13.42,18.56
TUBE NASOPHARYNGEAL 26  FR,272,RC,,,,both,22.75,20.48,United Healthcare,Default,Fee Schedule,18.56,,,,13.42,18.56
ENDO TUBE NASAL RAE-FLEX 7.0,272,RC,,,,both,24,21.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.8,,,,14.16,19.58
ENDO TUBE NASAL RAE-FLEX 7.0,272,RC,,,,both,24,21.6,Cigna,Default,Percent of Total Billed Charges,14.16,,,,14.16,19.58
ENDO TUBE NASAL RAE-FLEX 7.0,272,RC,,,,both,24,21.6,United Healthcare,Default,Fee Schedule,19.58,,,,14.16,19.58
ENDO TUBE NASAL RAE-FLEX 7.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE NASAL RAE-FLEX 7.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE NASAL RAE-FLEX 7.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE ORAL RAE FLEX CUFFED 7.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE ORAL RAE FLEX CUFFED 7.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE ORAL RAE FLEX CUFFED 7.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
TUBE NASOPHARYNGEAL 24FR,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
TUBE NASOPHARYNGEAL 24FR,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
TUBE NASOPHARYNGEAL 24FR,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNO TUBE TRACH ORAL RAE FLEX CUFFED 8.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE TRACH ORAL RAE FLEX CUFFED 8.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE TRACH ORAL RAE FLEX CUFFED 8.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE TRACH CUFFED 4.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE TRACH CUFFED 4.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE TRACH CUFFED 4.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 4.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 4.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 4.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 4.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 4.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 4.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 5.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 5.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 5.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 5.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 5.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE NASAL RAE NR W/O CUFF 5.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO ENDO TUBE 3.5 REIN O/N W/ CUFF,272,RC,,,,both,98.51,88.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.96,,,,58.12,80.38
DNO ENDO TUBE 3.5 REIN O/N W/ CUFF,272,RC,,,,both,98.51,88.66,Cigna,Default,Percent of Total Billed Charges,58.12,,,,58.12,80.38
DNO ENDO TUBE 3.5 REIN O/N W/ CUFF,272,RC,,,,both,98.51,88.66,United Healthcare,Default,Fee Schedule,80.38,,,,58.12,80.38
DNO ENDO TUBE 4.0 REIN O/N W/ CUFF,272,RC,,,,both,92.89,83.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.02,,,,54.81,75.8
DNO ENDO TUBE 4.0 REIN O/N W/ CUFF,272,RC,,,,both,92.89,83.6,Cigna,Default,Percent of Total Billed Charges,54.81,,,,54.81,75.8
DNO ENDO TUBE 4.0 REIN O/N W/ CUFF,272,RC,,,,both,92.89,83.6,United Healthcare,Default,Fee Schedule,75.8,,,,54.81,75.8
ENDO TUBE 4.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
ENDO TUBE 4.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
ENDO TUBE 4.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNO ENDO TUBE 5.0 REIN O/N  W/ CUFF,272,RC,,,,both,98.53,88.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.97,,,,58.13,80.4
DNO ENDO TUBE 5.0 REIN O/N  W/ CUFF,272,RC,,,,both,98.53,88.68,Cigna,Default,Percent of Total Billed Charges,58.13,,,,58.13,80.4
DNO ENDO TUBE 5.0 REIN O/N  W/ CUFF,272,RC,,,,both,98.53,88.68,United Healthcare,Default,Fee Schedule,80.4,,,,58.13,80.4
NEEDLE BIOPSY TRU-CUT,272,RC,,,,both,51.63,46.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.14,,,,30.46,42.13
NEEDLE BIOPSY TRU-CUT,272,RC,,,,both,51.63,46.47,Cigna,Default,Percent of Total Billed Charges,30.46,,,,30.46,42.13
NEEDLE BIOPSY TRU-CUT,272,RC,,,,both,51.63,46.47,United Healthcare,Default,Fee Schedule,42.13,,,,30.46,42.13
NEEDLE CO-AX INTRODUCER 15G X11.8,272,RC,,,,both,112.34,101.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.64,,,,66.28,91.67
NEEDLE CO-AX INTRODUCER 15G X11.8,272,RC,,,,both,112.34,101.11,Cigna,Default,Percent of Total Billed Charges,66.28,,,,66.28,91.67
NEEDLE CO-AX INTRODUCER 15G X11.8,272,RC,,,,both,112.34,101.11,United Healthcare,Default,Fee Schedule,91.67,,,,66.28,91.67
NEEDLE TIP SINGLE USE,272,RC,,,,both,234.03,210.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.82,,,,138.08,190.97
NEEDLE TIP SINGLE USE,272,RC,,,,both,234.03,210.63,Cigna,Default,Percent of Total Billed Charges,138.08,,,,138.08,190.97
NEEDLE TIP SINGLE USE,272,RC,,,,both,234.03,210.63,United Healthcare,Default,Fee Schedule,190.97,,,,138.08,190.97
ADHESIVE MASTISOL LIQUID 2/3 CC VIAL,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
ADHESIVE MASTISOL LIQUID 2/3 CC VIAL,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
ADHESIVE MASTISOL LIQUID 2/3 CC VIAL,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
MASK AEROSOL ADULT,71,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
MASK AEROSOL ADULT,71,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
MASK AEROSOL ADULT,71,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
TLAB TRANSJUGULAR LIVER BIOPSY KIT,272,RC,,,,both,1843.9,1659.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1290.73,,,,1087.9,1504.62
TLAB TRANSJUGULAR LIVER BIOPSY KIT,272,RC,,,,both,1843.9,1659.51,Cigna,Default,Percent of Total Billed Charges,1087.9,,,,1087.9,1504.62
TLAB TRANSJUGULAR LIVER BIOPSY KIT,272,RC,,,,both,1843.9,1659.51,United Healthcare,Default,Fee Schedule,1504.62,,,,1087.9,1504.62
*AMPLATZER VASCULAR PLUG II 22MM,272,RC,,,,both,2922.13,2629.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2045.49,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 22MM,272,RC,,,,both,2922.13,2629.92,Cigna,Default,Percent of Total Billed Charges,1724.06,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 22MM,272,RC,,,,both,2922.13,2629.92,United Healthcare,Default,Fee Schedule,2384.46,,,,1724.06,2384.46
NEEDLE CHIBA 22GX20CM TENMO,272,RC,,,,both,22.35,20.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.64,,,,13.19,18.24
NEEDLE CHIBA 22GX20CM TENMO,272,RC,,,,both,22.35,20.12,Cigna,Default,Percent of Total Billed Charges,13.19,,,,13.19,18.24
NEEDLE CHIBA 22GX20CM TENMO,272,RC,,,,both,22.35,20.12,United Healthcare,Default,Fee Schedule,18.24,,,,13.19,18.24
CATH 4 FR SIM1  NON-HYDROPHILLIC,272,RC,,,,both,55.97,50.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.18,,,,33.02,45.67
CATH 4 FR SIM1  NON-HYDROPHILLIC,272,RC,,,,both,55.97,50.37,Cigna,Default,Percent of Total Billed Charges,33.02,,,,33.02,45.67
CATH 4 FR SIM1  NON-HYDROPHILLIC,272,RC,,,,both,55.97,50.37,United Healthcare,Default,Fee Schedule,45.67,,,,33.02,45.67
*CATH 4 FR BERENSTEIN 65 CM,272,RC,,,,both,72.65,65.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.86,,,,42.86,59.28
*CATH 4 FR BERENSTEIN 65 CM,272,RC,,,,both,72.65,65.39,Cigna,Default,Percent of Total Billed Charges,42.86,,,,42.86,59.28
*CATH 4 FR BERENSTEIN 65 CM,272,RC,,,,both,72.65,65.39,United Healthcare,Default,Fee Schedule,59.28,,,,42.86,59.28
NEEDLE COAXIAL INTRO 19X10,272,RC,,,,both,80.99,72.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.69,,,,47.78,66.09
NEEDLE COAXIAL INTRO 19X10,272,RC,,,,both,80.99,72.89,Cigna,Default,Percent of Total Billed Charges,47.78,,,,47.78,66.09
NEEDLE COAXIAL INTRO 19X10,272,RC,,,,both,80.99,72.89,United Healthcare,Default,Fee Schedule,66.09,,,,47.78,66.09
NEEDLE COAXIAL INTRO 19X15,272,RC,,,,both,80.99,72.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.69,,,,47.78,66.09
NEEDLE COAXIAL INTRO 19X15,272,RC,,,,both,80.99,72.89,Cigna,Default,Percent of Total Billed Charges,47.78,,,,47.78,66.09
NEEDLE COAXIAL INTRO 19X15,272,RC,,,,both,80.99,72.89,United Healthcare,Default,Fee Schedule,66.09,,,,47.78,66.09
BIOPSY DEVICE 18G X 15CM,272,RC,,,,both,303.03,272.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,212.12,,,,178.79,247.27
BIOPSY DEVICE 18G X 15CM,272,RC,,,,both,303.03,272.73,Cigna,Default,Percent of Total Billed Charges,178.79,,,,178.79,247.27
BIOPSY DEVICE 18G X 15CM,272,RC,,,,both,303.03,272.73,United Healthcare,Default,Fee Schedule,247.27,,,,178.79,247.27
BIOPSY NEEDLE CO-AX INTRO 17G X 11.8CM,272,RC,,,,both,112.34,101.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.64,,,,66.28,91.67
BIOPSY NEEDLE CO-AX INTRO 17G X 11.8CM,272,RC,,,,both,112.34,101.11,Cigna,Default,Percent of Total Billed Charges,66.28,,,,66.28,91.67
BIOPSY NEEDLE CO-AX INTRO 17G X 11.8CM,272,RC,,,,both,112.34,101.11,United Healthcare,Default,Fee Schedule,91.67,,,,66.28,91.67
*PUNCH BIOPSY 1MM,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
*PUNCH BIOPSY 1MM,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
*PUNCH BIOPSY 1MM,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
PUNCH BIOPSY 3MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
PUNCH BIOPSY 3MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
PUNCH BIOPSY 3MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
*TRAY BONE MARROW BIOPSY MONOJECT,272,RC,,,,both,204.69,184.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.28,,,,120.77,167.03
*TRAY BONE MARROW BIOPSY MONOJECT,272,RC,,,,both,204.69,184.22,Cigna,Default,Percent of Total Billed Charges,120.77,,,,120.77,167.03
*TRAY BONE MARROW BIOPSY MONOJECT,272,RC,,,,both,204.69,184.22,United Healthcare,Default,Fee Schedule,167.03,,,,120.77,167.03
TRAY BONE MARROW BIOPSY JAMSHIDI,272,RC,,,,both,79.08,71.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.36,,,,46.66,64.53
TRAY BONE MARROW BIOPSY JAMSHIDI,272,RC,,,,both,79.08,71.17,Cigna,Default,Percent of Total Billed Charges,46.66,,,,46.66,64.53
TRAY BONE MARROW BIOPSY JAMSHIDI,272,RC,,,,both,79.08,71.17,United Healthcare,Default,Fee Schedule,64.53,,,,46.66,64.53
COAXIAL SETS WITH CHIBA NEEDLE 14CM,272,RC,,,,both,160.22,144.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.15,,,,94.53,130.74
COAXIAL SETS WITH CHIBA NEEDLE 14CM,272,RC,,,,both,160.22,144.2,Cigna,Default,Percent of Total Billed Charges,94.53,,,,94.53,130.74
COAXIAL SETS WITH CHIBA NEEDLE 14CM,272,RC,,,,both,160.22,144.2,United Healthcare,Default,Fee Schedule,130.74,,,,94.53,130.74
PLUG FISTULA ANAL,272,RC,,,,both,3968.76,3571.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2778.13,,,,2341.57,3238.51
PLUG FISTULA ANAL,272,RC,,,,both,3968.76,3571.88,Cigna,Default,Percent of Total Billed Charges,2341.57,,,,2341.57,3238.51
PLUG FISTULA ANAL,272,RC,,,,both,3968.76,3571.88,United Healthcare,Default,Fee Schedule,3238.51,,,,2341.57,3238.51
*AMPLATZER VASCULAR PLUG II 20MM,272,RC,,,,both,2922.13,2629.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2045.49,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 20MM,272,RC,,,,both,2922.13,2629.92,Cigna,Default,Percent of Total Billed Charges,1724.06,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 20MM,272,RC,,,,both,2922.13,2629.92,United Healthcare,Default,Fee Schedule,2384.46,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 14MM,272,RC,,,,both,2922.13,2629.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2045.49,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 14MM,272,RC,,,,both,2922.13,2629.92,Cigna,Default,Percent of Total Billed Charges,1724.06,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 14MM,272,RC,,,,both,2922.13,2629.92,United Healthcare,Default,Fee Schedule,2384.46,,,,1724.06,2384.46
*NEEDLE BIOPSY 20GX3.5,272,RC,,,,both,44.55,40.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.18,,,,26.28,36.35
*NEEDLE BIOPSY 20GX3.5,272,RC,,,,both,44.55,40.1,Cigna,Default,Percent of Total Billed Charges,26.28,,,,26.28,36.35
*NEEDLE BIOPSY 20GX3.5,272,RC,,,,both,44.55,40.1,United Healthcare,Default,Fee Schedule,36.35,,,,26.28,36.35
BIOPSY DEVICE 16G X 15CM,272,RC,,,,both,273.9,246.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.73,,,,161.6,223.5
BIOPSY DEVICE 16G X 15CM,272,RC,,,,both,273.9,246.51,Cigna,Default,Percent of Total Billed Charges,161.6,,,,161.6,223.5
BIOPSY DEVICE 16G X 15CM,272,RC,,,,both,273.9,246.51,United Healthcare,Default,Fee Schedule,223.5,,,,161.6,223.5
*BIOPSY TEMNO EVOL 20X20,272,RC,,,,both,198.92,179.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.24,,,,117.36,162.32
*BIOPSY TEMNO EVOL 20X20,272,RC,,,,both,198.92,179.03,Cigna,Default,Percent of Total Billed Charges,117.36,,,,117.36,162.32
*BIOPSY TEMNO EVOL 20X20,272,RC,,,,both,198.92,179.03,United Healthcare,Default,Fee Schedule,162.32,,,,117.36,162.32
BIOPSY ACHIEVE 20X15,272,RC,,,,both,117.57,105.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.3,,,,69.37,95.94
BIOPSY ACHIEVE 20X15,272,RC,,,,both,117.57,105.81,Cigna,Default,Percent of Total Billed Charges,69.37,,,,69.37,95.94
BIOPSY ACHIEVE 20X15,272,RC,,,,both,117.57,105.81,United Healthcare,Default,Fee Schedule,95.94,,,,69.37,95.94
PUNCH AORTIC CLEANCUT 3.5MM,272,RC,,,,both,80.17,72.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.12,,,,47.3,65.42
PUNCH AORTIC CLEANCUT 3.5MM,272,RC,,,,both,80.17,72.15,Cigna,Default,Percent of Total Billed Charges,47.3,,,,47.3,65.42
PUNCH AORTIC CLEANCUT 3.5MM,272,RC,,,,both,80.17,72.15,United Healthcare,Default,Fee Schedule,65.42,,,,47.3,65.42
PUNCH AORTIC CLEANCUT 5.0MM,272,RC,,,,both,94.44,85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.11,,,,55.72,77.06
PUNCH AORTIC CLEANCUT 5.0MM,272,RC,,,,both,94.44,85,Cigna,Default,Percent of Total Billed Charges,55.72,,,,55.72,77.06
PUNCH AORTIC CLEANCUT 5.0MM,272,RC,,,,both,94.44,85,United Healthcare,Default,Fee Schedule,77.06,,,,55.72,77.06
AMPLATZER VASCULAR PLUG II 10MM,272,RC,,,,both,2922.13,2629.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2045.49,,,,1724.06,2384.46
AMPLATZER VASCULAR PLUG II 10MM,272,RC,,,,both,2922.13,2629.92,Cigna,Default,Percent of Total Billed Charges,1724.06,,,,1724.06,2384.46
AMPLATZER VASCULAR PLUG II 10MM,272,RC,,,,both,2922.13,2629.92,United Healthcare,Default,Fee Schedule,2384.46,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 12MM,272,RC,,,,both,2922.13,2629.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2045.49,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 12MM,272,RC,,,,both,2922.13,2629.92,Cigna,Default,Percent of Total Billed Charges,1724.06,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 12MM,272,RC,,,,both,2922.13,2629.92,United Healthcare,Default,Fee Schedule,2384.46,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 16MM,272,RC,,,,both,2922.13,2629.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2045.49,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 16MM,272,RC,,,,both,2922.13,2629.92,Cigna,Default,Percent of Total Billed Charges,1724.06,,,,1724.06,2384.46
*AMPLATZER VASCULAR PLUG II 16MM,272,RC,,,,both,2922.13,2629.92,United Healthcare,Default,Fee Schedule,2384.46,,,,1724.06,2384.46
AMPLATZER VASCULAR PLUG 4 4MM,272,RC,,,,both,3163.5,2847.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2214.45,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 4MM,272,RC,,,,both,3163.5,2847.15,Cigna,Default,Percent of Total Billed Charges,1866.46,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 4MM,272,RC,,,,both,3163.5,2847.15,United Healthcare,Default,Fee Schedule,2581.42,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 6MM,272,RC,,,,both,3336.57,3002.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2335.6,,,,1968.58,2722.64
AMPLATZER VASCULAR PLUG 4 6MM,272,RC,,,,both,3336.57,3002.91,Cigna,Default,Percent of Total Billed Charges,1968.58,,,,1968.58,2722.64
AMPLATZER VASCULAR PLUG 4 6MM,272,RC,,,,both,3336.57,3002.91,United Healthcare,Default,Fee Schedule,2722.64,,,,1968.58,2722.64
AMPLATZER VASCULAR PLUG 4 8MM,272,RC,,,,both,3336.57,3002.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2335.6,,,,1968.58,2722.64
AMPLATZER VASCULAR PLUG 4 8MM,272,RC,,,,both,3336.57,3002.91,Cigna,Default,Percent of Total Billed Charges,1968.58,,,,1968.58,2722.64
AMPLATZER VASCULAR PLUG 4 8MM,272,RC,,,,both,3336.57,3002.91,United Healthcare,Default,Fee Schedule,2722.64,,,,1968.58,2722.64
CATH W/GLOVE 14 SCTN,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH W/GLOVE 14 SCTN,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH W/GLOVE 14 SCTN,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
AMPLATZER VASCULAR PLUG 4 5MM,272,RC,,,,both,3163.5,2847.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2214.45,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 5MM,272,RC,,,,both,3163.5,2847.15,Cigna,Default,Percent of Total Billed Charges,1866.46,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 5MM,272,RC,,,,both,3163.5,2847.15,United Healthcare,Default,Fee Schedule,2581.42,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 7MM,272,RC,,,,both,3163.5,2847.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2214.45,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 7MM,272,RC,,,,both,3163.5,2847.15,Cigna,Default,Percent of Total Billed Charges,1866.46,,,,1866.46,2581.42
AMPLATZER VASCULAR PLUG 4 7MM,272,RC,,,,both,3163.5,2847.15,United Healthcare,Default,Fee Schedule,2581.42,,,,1866.46,2581.42
CATH SUCTION #10,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH SUCTION #10,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH SUCTION #10,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH SUCTION 6 FR,A4624,HCPCS,272,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH SUCTION 6 FR,A4624,HCPCS,272,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH SUCTION 6 FR,A4624,HCPCS,272,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH 4 FR JB 1 TEMP OPEN END,272,RC,,,,both,69.03,62.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.32,,,,40.73,56.33
CATH 4 FR JB 1 TEMP OPEN END,272,RC,,,,both,69.03,62.13,Cigna,Default,Percent of Total Billed Charges,40.73,,,,40.73,56.33
CATH 4 FR JB 1 TEMP OPEN END,272,RC,,,,both,69.03,62.13,United Healthcare,Default,Fee Schedule,56.33,,,,40.73,56.33
CATH VERSI 18FR,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH VERSI 18FR,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH VERSI 18FR,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH COUDE 14FR 10CC - 5CC PACKAGE,A4340,HCPCS,272,RC,,both,39.66,35.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.76,,,,23.4,32.36
CATH COUDE 14FR 10CC - 5CC PACKAGE,A4340,HCPCS,272,RC,,both,39.66,35.69,Cigna,Default,Percent of Total Billed Charges,23.4,,,,23.4,32.36
CATH COUDE 14FR 10CC - 5CC PACKAGE,A4340,HCPCS,272,RC,,both,39.66,35.69,United Healthcare,Default,Fee Schedule,32.36,,,,23.4,32.36
CATH MALECOT 22FR,272,RC,,,,both,108.54,97.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.98,,,,64.04,88.57
CATH MALECOT 22FR,272,RC,,,,both,108.54,97.69,Cigna,Default,Percent of Total Billed Charges,64.04,,,,64.04,88.57
CATH MALECOT 22FR,272,RC,,,,both,108.54,97.69,United Healthcare,Default,Fee Schedule,88.57,,,,64.04,88.57
CATH MALECOT 24FR,272,RC,,,,both,82.61,74.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.83,,,,48.74,67.41
CATH MALECOT 24FR,272,RC,,,,both,82.61,74.35,Cigna,Default,Percent of Total Billed Charges,48.74,,,,48.74,67.41
CATH MALECOT 24FR,272,RC,,,,both,82.61,74.35,United Healthcare,Default,Fee Schedule,67.41,,,,48.74,67.41
CATH MALECOT 24FR LATEX FREE,C1729,HCPCS,272,RC,,both,167.44,150.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.21,,,,98.79,136.63
CATH MALECOT 24FR LATEX FREE,C1729,HCPCS,272,RC,,both,167.44,150.7,Cigna,Default,Percent of Total Billed Charges,98.79,,,,98.79,136.63
CATH MALECOT 24FR LATEX FREE,C1729,HCPCS,272,RC,,both,167.44,150.7,United Healthcare,Default,Fee Schedule,136.63,,,,98.79,136.63
*TUBE ET REINFORCED NO CUFF 2.5,272,RC,,,,both,127.44,114.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.21,,,,75.19,103.99
*TUBE ET REINFORCED NO CUFF 2.5,272,RC,,,,both,127.44,114.7,Cigna,Default,Percent of Total Billed Charges,75.19,,,,75.19,103.99
*TUBE ET REINFORCED NO CUFF 2.5,272,RC,,,,both,127.44,114.7,United Healthcare,Default,Fee Schedule,103.99,,,,75.19,103.99
DNO TUBE ET REINFORCED NO CUFF 3.0,272,RC,,,,both,127.44,114.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.21,,,,75.19,103.99
DNO TUBE ET REINFORCED NO CUFF 3.0,272,RC,,,,both,127.44,114.7,Cigna,Default,Percent of Total Billed Charges,75.19,,,,75.19,103.99
DNO TUBE ET REINFORCED NO CUFF 3.0,272,RC,,,,both,127.44,114.7,United Healthcare,Default,Fee Schedule,103.99,,,,75.19,103.99
*TUBE ET REINFORCED NO CUFF 3.5,272,RC,,,,both,123.72,111.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.6,,,,72.99,100.96
*TUBE ET REINFORCED NO CUFF 3.5,272,RC,,,,both,123.72,111.35,Cigna,Default,Percent of Total Billed Charges,72.99,,,,72.99,100.96
*TUBE ET REINFORCED NO CUFF 3.5,272,RC,,,,both,123.72,111.35,United Healthcare,Default,Fee Schedule,100.96,,,,72.99,100.96
DNO TUBE ET REINFORCED NO CUFF 4.0,272,RC,,,,both,127.44,114.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.21,,,,75.19,103.99
DNO TUBE ET REINFORCED NO CUFF 4.0,272,RC,,,,both,127.44,114.7,Cigna,Default,Percent of Total Billed Charges,75.19,,,,75.19,103.99
DNO TUBE ET REINFORCED NO CUFF 4.0,272,RC,,,,both,127.44,114.7,United Healthcare,Default,Fee Schedule,103.99,,,,75.19,103.99
DNO TUBE ET REINFORCED NO CUFF 4.5,272,RC,,,,both,125.15,112.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.6,,,,73.84,102.12
DNO TUBE ET REINFORCED NO CUFF 4.5,272,RC,,,,both,125.15,112.64,Cigna,Default,Percent of Total Billed Charges,73.84,,,,73.84,102.12
DNO TUBE ET REINFORCED NO CUFF 4.5,272,RC,,,,both,125.15,112.64,United Healthcare,Default,Fee Schedule,102.12,,,,73.84,102.12
*CATH MALECOT 28FR,272,RC,,,,both,108.58,97.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.01,,,,64.06,88.6
*CATH MALECOT 28FR,272,RC,,,,both,108.58,97.72,Cigna,Default,Percent of Total Billed Charges,64.06,,,,64.06,88.6
*CATH MALECOT 28FR,272,RC,,,,both,108.58,97.72,United Healthcare,Default,Fee Schedule,88.6,,,,64.06,88.6
*CATH MALECOT 30FR,272,RC,,,,both,108.58,97.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.01,,,,64.06,88.6
*CATH MALECOT 30FR,272,RC,,,,both,108.58,97.72,Cigna,Default,Percent of Total Billed Charges,64.06,,,,64.06,88.6
*CATH MALECOT 30FR,272,RC,,,,both,108.58,97.72,United Healthcare,Default,Fee Schedule,88.6,,,,64.06,88.6
*CATH MUSHROOM 20FR,272,RC,,,,both,75.12,67.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.58,,,,44.32,61.3
*CATH MUSHROOM 20FR,272,RC,,,,both,75.12,67.61,Cigna,Default,Percent of Total Billed Charges,44.32,,,,44.32,61.3
*CATH MUSHROOM 20FR,272,RC,,,,both,75.12,67.61,United Healthcare,Default,Fee Schedule,61.3,,,,44.32,61.3
*CATH MUSHROOM 22FR,272,RC,,,,both,75.12,67.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.58,,,,44.32,61.3
*CATH MUSHROOM 22FR,272,RC,,,,both,75.12,67.61,Cigna,Default,Percent of Total Billed Charges,44.32,,,,44.32,61.3
*CATH MUSHROOM 22FR,272,RC,,,,both,75.12,67.61,United Healthcare,Default,Fee Schedule,61.3,,,,44.32,61.3
ENDO TUBE 8.0 ORAL RAE W/ CUFF,272,RC,,,,both,96.48,86.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.54,,,,56.92,78.73
ENDO TUBE 8.0 ORAL RAE W/ CUFF,272,RC,,,,both,96.48,86.83,Cigna,Default,Percent of Total Billed Charges,56.92,,,,56.92,78.73
ENDO TUBE 8.0 ORAL RAE W/ CUFF,272,RC,,,,both,96.48,86.83,United Healthcare,Default,Fee Schedule,78.73,,,,56.92,78.73
ENDO TUBE NASAL RAE W/CUFF 8.0,272,RC,,,,both,96.48,86.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.54,,,,56.92,78.73
ENDO TUBE NASAL RAE W/CUFF 8.0,272,RC,,,,both,96.48,86.83,Cigna,Default,Percent of Total Billed Charges,56.92,,,,56.92,78.73
ENDO TUBE NASAL RAE W/CUFF 8.0,272,RC,,,,both,96.48,86.83,United Healthcare,Default,Fee Schedule,78.73,,,,56.92,78.73
TUBE ET REINFORCED W/CUFF 6.0,272,RC,,,,both,162,145.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.4,,,,95.58,132.19
TUBE ET REINFORCED W/CUFF 6.0,272,RC,,,,both,162,145.8,Cigna,Default,Percent of Total Billed Charges,95.58,,,,95.58,132.19
TUBE ET REINFORCED W/CUFF 6.0,272,RC,,,,both,162,145.8,United Healthcare,Default,Fee Schedule,132.19,,,,95.58,132.19
*TUBE ET REINFORCED W/CUFF 6.5,272,RC,,,,both,106.12,95.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.28,,,,62.61,86.59
*TUBE ET REINFORCED W/CUFF 6.5,272,RC,,,,both,106.12,95.51,Cigna,Default,Percent of Total Billed Charges,62.61,,,,62.61,86.59
*TUBE ET REINFORCED W/CUFF 6.5,272,RC,,,,both,106.12,95.51,United Healthcare,Default,Fee Schedule,86.59,,,,62.61,86.59
DNO CATH BAKER JEJUNOSTOMY 16 F,272,RC,,,,both,1219.85,1097.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,853.9,,,,719.71,995.4
DNO CATH BAKER JEJUNOSTOMY 16 F,272,RC,,,,both,1219.85,1097.87,Cigna,Default,Percent of Total Billed Charges,719.71,,,,719.71,995.4
DNO CATH BAKER JEJUNOSTOMY 16 F,272,RC,,,,both,1219.85,1097.87,United Healthcare,Default,Fee Schedule,995.4,,,,719.71,995.4
KIT GASTROJEJUNOSTOMY SET,272,RC,,,,both,1423.2,1280.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,996.24,,,,839.69,1161.33
KIT GASTROJEJUNOSTOMY SET,272,RC,,,,both,1423.2,1280.88,Cigna,Default,Percent of Total Billed Charges,839.69,,,,839.69,1161.33
KIT GASTROJEJUNOSTOMY SET,272,RC,,,,both,1423.2,1280.88,United Healthcare,Default,Fee Schedule,1161.33,,,,839.69,1161.33
CATH GASTROJEJUNOSTOMY REPLAC CATH,272,RC,,,,both,303.25,272.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,212.28,,,,178.92,247.45
CATH GASTROJEJUNOSTOMY REPLAC CATH,272,RC,,,,both,303.25,272.93,Cigna,Default,Percent of Total Billed Charges,178.92,,,,178.92,247.45
CATH GASTROJEJUNOSTOMY REPLAC CATH,272,RC,,,,both,303.25,272.93,United Healthcare,Default,Fee Schedule,247.45,,,,178.92,247.45
"DNU BAG OSTOMY 1 1/2"" DRAINABLE",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/2"" DRAINABLE",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/2"" DRAINABLE",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNO CAUTERY TIP SURGICAL,272,RC,,,,both,26.24,23.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.37,,,,15.48,21.41
DNO CAUTERY TIP SURGICAL,272,RC,,,,both,26.24,23.62,Cigna,Default,Percent of Total Billed Charges,15.48,,,,15.48,21.41
DNO CAUTERY TIP SURGICAL,272,RC,,,,both,26.24,23.62,United Healthcare,Default,Fee Schedule,21.41,,,,15.48,21.41
MARKER BREAST BIOPSY 17G. 10CM ULTRA CLI,A4648,HCPCS,278,RC,,both,245.08,220.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.56,,,,144.6,199.99
MARKER BREAST BIOPSY 17G. 10CM ULTRA CLI,A4648,HCPCS,278,RC,,both,245.08,220.57,Cigna,Default,Percent of Total Billed Charges,144.6,,,,144.6,199.99
MARKER BREAST BIOPSY 17G. 10CM ULTRA CLI,A4648,HCPCS,278,RC,,both,245.08,220.57,United Healthcare,Default,Fee Schedule,199.99,,,,144.6,199.99
TIP SCISSOR METZENBAUM,272,RC,,,,both,224.3,201.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.01,,,,132.34,183.03
TIP SCISSOR METZENBAUM,272,RC,,,,both,224.3,201.87,Cigna,Default,Percent of Total Billed Charges,132.34,,,,132.34,183.03
TIP SCISSOR METZENBAUM,272,RC,,,,both,224.3,201.87,United Healthcare,Default,Fee Schedule,183.03,,,,132.34,183.03
"DNU BAG OSTOMY 1"" SEALED",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1"" SEALED",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1"" SEALED",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/4"" SEALED   0",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/4"" SEALED   0",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/4"" SEALED   0",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNU BAG OSTOMY 1 1/2 SEALED,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU BAG OSTOMY 1 1/2 SEALED,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU BAG OSTOMY 1 1/2 SEALED,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" SEALED",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" SEALED",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1 3/4"" SEALED",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"DNU BAG OSTOMY 3"" SEALED",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 3"" SEALED",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 3"" SEALED",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
BAG COLOSTOMY FLANGE 2 3/4 70MM,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
BAG COLOSTOMY FLANGE 2 3/4 70MM,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
BAG COLOSTOMY FLANGE 2 3/4 70MM,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
PASTE KARAYA 7910,A4405,HCPCS,270,RC,,both,22.62,20.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.83,,,,13.35,18.46
PASTE KARAYA 7910,A4405,HCPCS,270,RC,,both,22.62,20.36,Cigna,Default,Percent of Total Billed Charges,13.35,,,,13.35,18.46
PASTE KARAYA 7910,A4405,HCPCS,270,RC,,both,22.62,20.36,United Healthcare,Default,Fee Schedule,18.46,,,,13.35,18.46
FLANGE FLEX 2.25 INCH,271,RC,,,,both,107.37,96.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.16,,,,63.35,87.61
FLANGE FLEX 2.25 INCH,271,RC,,,,both,107.37,96.63,Cigna,Default,Percent of Total Billed Charges,63.35,,,,63.35,87.61
FLANGE FLEX 2.25 INCH,271,RC,,,,both,107.37,96.63,United Healthcare,Default,Fee Schedule,87.61,,,,63.35,87.61
"DNU BAG OSTOMY 2 1/2"" DRAINABLE",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 2 1/2"" DRAINABLE",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 2 1/2"" DRAINABLE",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"BAG OSTOMY 2"" DRAINABLE",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"BAG OSTOMY 2"" DRAINABLE",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"BAG OSTOMY 2"" DRAINABLE",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNU FLANGE CLOSED END,271,RC,,,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
DNU FLANGE CLOSED END,271,RC,,,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
DNU FLANGE CLOSED END,271,RC,,,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
"BAG UROSTOMY 1""",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"BAG UROSTOMY 1""",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"BAG UROSTOMY 1""",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNU DRAIN TUBE UROSTOMY,272,RC,,,,both,38.25,34.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.78,,,,22.57,31.21
DNU DRAIN TUBE UROSTOMY,272,RC,,,,both,38.25,34.43,Cigna,Default,Percent of Total Billed Charges,22.57,,,,22.57,31.21
DNU DRAIN TUBE UROSTOMY,272,RC,,,,both,38.25,34.43,United Healthcare,Default,Fee Schedule,31.21,,,,22.57,31.21
"DNU BAG OSTOMY 2 1/2"" SEALED",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 2 1/2"" SEALED",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 2 1/2"" SEALED",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"DNU BAG OSTOMY 3"" DEODORIZER FILTER",A4456,HCPCS,272,RC,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 3"" DEODORIZER FILTER",A4456,HCPCS,272,RC,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 3"" DEODORIZER FILTER",A4456,HCPCS,272,RC,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/8"" DRAINABLE",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/8"" DRAINABLE",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 1 1/8"" DRAINABLE",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"DNU BAG OSTOMY 64MM (2 1/2"")",A4456,HCPCS,272,RC,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 64MM (2 1/2"")",A4456,HCPCS,272,RC,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 64MM (2 1/2"")",A4456,HCPCS,272,RC,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNU DRAIN STOMA IRRIGATOR,A4421,HCPCS,272,RC,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
DNU DRAIN STOMA IRRIGATOR,A4421,HCPCS,272,RC,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
DNU DRAIN STOMA IRRIGATOR,A4421,HCPCS,272,RC,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
FLANGE FLEXWARE 2 3/4X 2 1/4,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
FLANGE FLEXWARE 2 3/4X 2 1/4,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
FLANGE FLEXWARE 2 3/4X 2 1/4,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNU KIT STOMA IRRIGATOR,A4421,HCPCS,272,RC,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU KIT STOMA IRRIGATOR,A4421,HCPCS,272,RC,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU KIT STOMA IRRIGATOR,A4421,HCPCS,272,RC,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
BARRIER POST OP CUT TO FIT,272,RC,,,,both,35.5,31.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.85,,,,20.94,28.97
BARRIER POST OP CUT TO FIT,272,RC,,,,both,35.5,31.95,Cigna,Default,Percent of Total Billed Charges,20.94,,,,20.94,28.97
BARRIER POST OP CUT TO FIT,272,RC,,,,both,35.5,31.95,United Healthcare,Default,Fee Schedule,28.97,,,,20.94,28.97
BARRIER POST OP CUT TO FIT,A6154,HCPCS,272,RC,,both,54.43,48.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.1,,,,32.11,44.41
BARRIER POST OP CUT TO FIT,A6154,HCPCS,272,RC,,both,54.43,48.99,Cigna,Default,Percent of Total Billed Charges,32.11,,,,32.11,44.41
BARRIER POST OP CUT TO FIT,A6154,HCPCS,272,RC,,both,54.43,48.99,United Healthcare,Default,Fee Schedule,44.41,,,,32.11,44.41
"DNU BAG OSTOMY 2"" SEALED",272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"DNU BAG OSTOMY 2"" SEALED",272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"DNU BAG OSTOMY 2"" SEALED",272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DX-PH PROBE,A4338,HCPCS,272,RC,,both,439.02,395.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.31,,,,259.02,358.24
DX-PH PROBE,A4338,HCPCS,272,RC,,both,439.02,395.12,Cigna,Default,Percent of Total Billed Charges,259.02,,,,259.02,358.24
DX-PH PROBE,A4338,HCPCS,272,RC,,both,439.02,395.12,United Healthcare,Default,Fee Schedule,358.24,,,,259.02,358.24
DNU OSTOMY LOOP STARTER SET 3 1/2,272,RC,,,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
DNU OSTOMY LOOP STARTER SET 3 1/2,272,RC,,,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
DNU OSTOMY LOOP STARTER SET 3 1/2,272,RC,,,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
DNU OSTOMY LOOP DRAINABLE,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU OSTOMY LOOP DRAINABLE,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU OSTOMY LOOP DRAINABLE,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
"POUCH CLOSED W/FILTER 1 3/16""",271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
"POUCH CLOSED W/FILTER 1 3/16""",271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
"POUCH CLOSED W/FILTER 1 3/16""",271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
POUCH POST OP,271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
POUCH POST OP,271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
POUCH POST OP,271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
*DRESSING EZ DERM  (MEDISKIN),272,RC,,,,both,223.87,201.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,156.71,,,,132.08,182.68
*DRESSING EZ DERM  (MEDISKIN),272,RC,,,,both,223.87,201.48,Cigna,Default,Percent of Total Billed Charges,132.08,,,,132.08,182.68
*DRESSING EZ DERM  (MEDISKIN),272,RC,,,,both,223.87,201.48,United Healthcare,Default,Fee Schedule,182.68,,,,132.08,182.68
THERASKIN 2X3,272,RC,,,,both,4143.75,3729.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2900.62,,,,2444.81,3381.3
THERASKIN 2X3,272,RC,,,,both,4143.75,3729.38,Cigna,Default,Percent of Total Billed Charges,2444.81,,,,2444.81,3381.3
THERASKIN 2X3,272,RC,,,,both,4143.75,3729.38,United Healthcare,Default,Fee Schedule,3381.3,,,,2444.81,3381.3
DRESSING EZ DERM 3X4 (MEDISKIN),272,RC,,,,both,206.31,185.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.42,,,,121.72,168.35
DRESSING EZ DERM 3X4 (MEDISKIN),272,RC,,,,both,206.31,185.68,Cigna,Default,Percent of Total Billed Charges,121.72,,,,121.72,168.35
DRESSING EZ DERM 3X4 (MEDISKIN),272,RC,,,,both,206.31,185.68,United Healthcare,Default,Fee Schedule,168.35,,,,121.72,168.35
CONV TUBE ENDOTRACHEAL 6.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CONV TUBE ENDOTRACHEAL 6.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CONV TUBE ENDOTRACHEAL 6.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNU TUBE ET ORAL RAE NO CUFF 3.0,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU TUBE ET ORAL RAE NO CUFF 3.0,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU TUBE ET ORAL RAE NO CUFF 3.0,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNO TUBE ET ORAL RAE NO CUFF 3.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ET ORAL RAE NO CUFF 3.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ET ORAL RAE NO CUFF 3.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE ET ORAL RAE NO CUFF 4.0,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNO TUBE ET ORAL RAE NO CUFF 4.0,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNO TUBE ET ORAL RAE NO CUFF 4.0,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNO TUBE ET NO CUFF 2.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ET NO CUFF 2.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ET NO CUFF 2.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE ET NO CUFF 3.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ET NO CUFF 3.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ET NO CUFF 3.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 3.5MM HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 3.5MM HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 3.5MM HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE ET NO CUFF 4.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ET NO CUFF 4.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ET NO CUFF 4.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SET T-U-R ""Y"" TYPE IR",272,RC,,,,both,46.23,41.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.36,,,,27.28,37.72
"SET T-U-R ""Y"" TYPE IR",272,RC,,,,both,46.23,41.61,Cigna,Default,Percent of Total Billed Charges,27.28,,,,27.28,37.72
"SET T-U-R ""Y"" TYPE IR",272,RC,,,,both,46.23,41.61,United Healthcare,Default,Fee Schedule,37.72,,,,27.28,37.72
"36"" ARGYLE SALEM SUMP TUBE 10FR",272,RC,,,,both,43.94,39.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.76,,,,25.92,35.86
"36"" ARGYLE SALEM SUMP TUBE 10FR",272,RC,,,,both,43.94,39.55,Cigna,Default,Percent of Total Billed Charges,25.92,,,,25.92,35.86
"36"" ARGYLE SALEM SUMP TUBE 10FR",272,RC,,,,both,43.94,39.55,United Healthcare,Default,Fee Schedule,35.86,,,,25.92,35.86
SYSTEM FILTER G2 FOR PERMANENT PLACEMENT,278,RC,,,,both,2770.5,2493.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1939.35,,,,1634.6,2260.73
SYSTEM FILTER G2 FOR PERMANENT PLACEMENT,278,RC,,,,both,2770.5,2493.45,Cigna,Default,Percent of Total Billed Charges,1634.6,,,,1634.6,2260.73
SYSTEM FILTER G2 FOR PERMANENT PLACEMENT,278,RC,,,,both,2770.5,2493.45,United Healthcare,Default,Fee Schedule,2260.73,,,,1634.6,2260.73
*KIT TRAPEASE INTRODUCER,C1880,HCPCS,278,RC,,both,2780.03,2502.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1946.02,,,,1640.22,2268.5
*KIT TRAPEASE INTRODUCER,C1880,HCPCS,278,RC,,both,2780.03,2502.03,Cigna,Default,Percent of Total Billed Charges,1640.22,,,,1640.22,2268.5
*KIT TRAPEASE INTRODUCER,C1880,HCPCS,278,RC,,both,2780.03,2502.03,United Healthcare,Default,Fee Schedule,2268.5,,,,1640.22,2268.5
CATH SAVVY BALLOON 3X6X80,272,RC,,,,both,668.5,601.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.95,,,,394.42,545.5
CATH SAVVY BALLOON 3X6X80,272,RC,,,,both,668.5,601.65,Cigna,Default,Percent of Total Billed Charges,394.42,,,,394.42,545.5
CATH SAVVY BALLOON 3X6X80,272,RC,,,,both,668.5,601.65,United Healthcare,Default,Fee Schedule,545.5,,,,394.42,545.5
CATH SAVVY BALLOON 3X10X80,272,RC,,,,both,668.5,601.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.95,,,,394.42,545.5
CATH SAVVY BALLOON 3X10X80,272,RC,,,,both,668.5,601.65,Cigna,Default,Percent of Total Billed Charges,394.42,,,,394.42,545.5
CATH SAVVY BALLOON 3X10X80,272,RC,,,,both,668.5,601.65,United Healthcare,Default,Fee Schedule,545.5,,,,394.42,545.5
*NEEDLE BIOPSY 18GA X,272,RC,,,,both,73.51,66.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.46,,,,43.37,59.98
*NEEDLE BIOPSY 18GA X,272,RC,,,,both,73.51,66.16,Cigna,Default,Percent of Total Billed Charges,43.37,,,,43.37,59.98
*NEEDLE BIOPSY 18GA X,272,RC,,,,both,73.51,66.16,United Healthcare,Default,Fee Schedule,59.98,,,,43.37,59.98
MAXCORE BIOPSY 18GX25CM,272,RC,,,,both,146.02,131.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.21,,,,86.15,119.15
MAXCORE BIOPSY 18GX25CM,272,RC,,,,both,146.02,131.42,Cigna,Default,Percent of Total Billed Charges,86.15,,,,86.15,119.15
MAXCORE BIOPSY 18GX25CM,272,RC,,,,both,146.02,131.42,United Healthcare,Default,Fee Schedule,119.15,,,,86.15,119.15
*ENDO GIA II 60-4.8,272,RC,,,,both,559.7,503.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.79,,,,330.22,456.72
*ENDO GIA II 60-4.8,272,RC,,,,both,559.7,503.73,Cigna,Default,Percent of Total Billed Charges,330.22,,,,330.22,456.72
*ENDO GIA II 60-4.8,272,RC,,,,both,559.7,503.73,United Healthcare,Default,Fee Schedule,456.72,,,,330.22,456.72
*ENDO GIA PURPLE 60MM MED/THICK RELOAD,272,RC,,,,both,1558.07,1402.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1090.65,,,,919.26,1271.39
*ENDO GIA PURPLE 60MM MED/THICK RELOAD,272,RC,,,,both,1558.07,1402.26,Cigna,Default,Percent of Total Billed Charges,919.26,,,,919.26,1271.39
*ENDO GIA PURPLE 60MM MED/THICK RELOAD,272,RC,,,,both,1558.07,1402.26,United Healthcare,Default,Fee Schedule,1271.39,,,,919.26,1271.39
*ENDO GIA BLCK 60MM ARTICULATING EXTRA-T,272,RC,,,,both,1898.14,1708.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1328.7,,,,1119.9,1548.88
*ENDO GIA BLCK 60MM ARTICULATING EXTRA-T,272,RC,,,,both,1898.14,1708.33,Cigna,Default,Percent of Total Billed Charges,1119.9,,,,1119.9,1548.88
*ENDO GIA BLCK 60MM ARTICULATING EXTRA-T,272,RC,,,,both,1898.14,1708.33,United Healthcare,Default,Fee Schedule,1548.88,,,,1119.9,1548.88
NEEDLE KOPANS BREAST 20G/9CM,272,RC,,,,both,101.9,91.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.33,,,,60.12,83.15
NEEDLE KOPANS BREAST 20G/9CM,272,RC,,,,both,101.9,91.71,Cigna,Default,Percent of Total Billed Charges,60.12,,,,60.12,83.15
NEEDLE KOPANS BREAST 20G/9CM,272,RC,,,,both,101.9,91.71,United Healthcare,Default,Fee Schedule,83.15,,,,60.12,83.15
NEEDLE BREAST KOPANS 20GA/9CM,272,RC,,,,both,75.35,67.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.74,,,,44.46,61.49
NEEDLE BREAST KOPANS 20GA/9CM,272,RC,,,,both,75.35,67.82,Cigna,Default,Percent of Total Billed Charges,44.46,,,,44.46,61.49
NEEDLE BREAST KOPANS 20GA/9CM,272,RC,,,,both,75.35,67.82,United Healthcare,Default,Fee Schedule,61.49,,,,44.46,61.49
DNO CAUTERY PENCIL MEDLINE DISPOSABLE,272,RC,,,,both,24.3,21.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.01,,,,14.34,19.83
DNO CAUTERY PENCIL MEDLINE DISPOSABLE,272,RC,,,,both,24.3,21.87,Cigna,Default,Percent of Total Billed Charges,14.34,,,,14.34,19.83
DNO CAUTERY PENCIL MEDLINE DISPOSABLE,272,RC,,,,both,24.3,21.87,United Healthcare,Default,Fee Schedule,19.83,,,,14.34,19.83
*STAPLER ENDO GIA UNIVERSAL,272,RC,,,,both,1166.83,1050.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,816.78,,,,688.43,952.13
*STAPLER ENDO GIA UNIVERSAL,272,RC,,,,both,1166.83,1050.15,Cigna,Default,Percent of Total Billed Charges,688.43,,,,688.43,952.13
*STAPLER ENDO GIA UNIVERSAL,272,RC,,,,both,1166.83,1050.15,United Healthcare,Default,Fee Schedule,952.13,,,,688.43,952.13
*DNU RELOAD ENDO GIA ROTICULATING 60-4.8,272,RC,,,,both,867.66,780.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,607.36,,,,511.92,708.01
*DNU RELOAD ENDO GIA ROTICULATING 60-4.8,272,RC,,,,both,867.66,780.89,Cigna,Default,Percent of Total Billed Charges,511.92,,,,511.92,708.01
*DNU RELOAD ENDO GIA ROTICULATING 60-4.8,272,RC,,,,both,867.66,780.89,United Healthcare,Default,Fee Schedule,708.01,,,,511.92,708.01
*RELOAD ENDO GIA ROTICULATING 60-3.5,272,RC,,,,both,1608.37,1447.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1125.86,,,,948.94,1312.43
*RELOAD ENDO GIA ROTICULATING 60-3.5,272,RC,,,,both,1608.37,1447.53,Cigna,Default,Percent of Total Billed Charges,948.94,,,,948.94,1312.43
*RELOAD ENDO GIA ROTICULATING 60-3.5,272,RC,,,,both,1608.37,1447.53,United Healthcare,Default,Fee Schedule,1312.43,,,,948.94,1312.43
TUBE ET 7.5MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TUBE ET 7.5MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TUBE ET 7.5MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE NASAL RAE W/CUFF 6.0,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
ENDO TUBE NASAL RAE W/CUFF 6.0,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
ENDO TUBE NASAL RAE W/CUFF 6.0,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
ENDO TUBE NASAL RAE W/CUFF 6.5,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
ENDO TUBE NASAL RAE W/CUFF 6.5,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
ENDO TUBE NASAL RAE W/CUFF 6.5,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNO ENDO TUBE 7.0 REINFORCED W/CUFF,272,RC,,,,both,97.51,87.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.26,,,,57.53,79.57
DNO ENDO TUBE 7.0 REINFORCED W/CUFF,272,RC,,,,both,97.51,87.76,Cigna,Default,Percent of Total Billed Charges,57.53,,,,57.53,79.57
DNO ENDO TUBE 7.0 REINFORCED W/CUFF,272,RC,,,,both,97.51,87.76,United Healthcare,Default,Fee Schedule,79.57,,,,57.53,79.57
DNO TUBE TRACH LARYNGOFLEX SZ 8,272,RC,,,,both,266.84,240.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.79,,,,157.44,217.74
DNO TUBE TRACH LARYNGOFLEX SZ 8,272,RC,,,,both,266.84,240.16,Cigna,Default,Percent of Total Billed Charges,157.44,,,,157.44,217.74
DNO TUBE TRACH LARYNGOFLEX SZ 8,272,RC,,,,both,266.84,240.16,United Healthcare,Default,Fee Schedule,217.74,,,,157.44,217.74
TUBE TRACH LARYNGOFLEX SZ 9,272,RC,,,,both,271.78,244.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,190.25,,,,160.35,221.77
TUBE TRACH LARYNGOFLEX SZ 9,272,RC,,,,both,271.78,244.6,Cigna,Default,Percent of Total Billed Charges,160.35,,,,160.35,221.77
TUBE TRACH LARYNGOFLEX SZ 9,272,RC,,,,both,271.78,244.6,United Healthcare,Default,Fee Schedule,221.77,,,,160.35,221.77
TUBE TRACH LARYNGOFLEX SZ 10,272,RC,,,,both,271.78,244.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,190.25,,,,160.35,221.77
TUBE TRACH LARYNGOFLEX SZ 10,272,RC,,,,both,271.78,244.6,Cigna,Default,Percent of Total Billed Charges,160.35,,,,160.35,221.77
TUBE TRACH LARYNGOFLEX SZ 10,272,RC,,,,both,271.78,244.6,United Healthcare,Default,Fee Schedule,221.77,,,,160.35,221.77
*TUBE TRACH LARYNGOFLEX SZ 7,272,RC,,,,both,299.62,269.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209.73,,,,176.78,244.49
*TUBE TRACH LARYNGOFLEX SZ 7,272,RC,,,,both,299.62,269.66,Cigna,Default,Percent of Total Billed Charges,176.78,,,,176.78,244.49
*TUBE TRACH LARYNGOFLEX SZ 7,272,RC,,,,both,299.62,269.66,United Healthcare,Default,Fee Schedule,244.49,,,,176.78,244.49
DNU TUBE TRACH 4.5FR 8646,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU TUBE TRACH 4.5FR 8646,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU TUBE TRACH 4.5FR 8646,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
ENDO TUBE 6.5 HI-LO CUFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 6.5 HI-LO CUFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 6.5 HI-LO CUFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 7.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 7.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 7.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 7.5MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 7.5MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 7.5MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 8.0MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 8.0MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 8.0MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 9.0MM HI-LO CUFFED,272,RC,,,,both,4.35,3.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.04,,,,2.57,3.55
ENDO TUBE 9.0MM HI-LO CUFFED,272,RC,,,,both,4.35,3.92,Cigna,Default,Percent of Total Billed Charges,2.57,,,,2.57,3.55
ENDO TUBE 9.0MM HI-LO CUFFED,272,RC,,,,both,4.35,3.92,United Healthcare,Default,Fee Schedule,3.55,,,,2.57,3.55
DNO TUBE ENDOTRACHEAL 9.5MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 9.5MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE ENDOTRACHEAL 9.5MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 7.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
ENDO TUBE 7.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
ENDO TUBE 7.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
TUBE TRACH 7.0 HI-LO CUFFED,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TUBE TRACH 7.0 HI-LO CUFFED,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TUBE TRACH 7.0 HI-LO CUFFED,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 8.0 HI-LO CUFFED,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 8.0 HI-LO CUFFED,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 8.0 HI-LO CUFFED,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 5.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 5.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 5.5 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNU TUBE TRACH CUFFED 5.0,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU TUBE TRACH CUFFED 5.0,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU TUBE TRACH CUFFED 5.0,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNO TUBE TRACH LO-PRO CUFFED 6.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE TRACH LO-PRO CUFFED 6.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE TRACH LO-PRO CUFFED 6.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE TRACH CUFFED 8.0,272,RC,,,,both,38.83,34.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.18,,,,22.91,31.69
DNO TUBE TRACH CUFFED 8.0,272,RC,,,,both,38.83,34.95,Cigna,Default,Percent of Total Billed Charges,22.91,,,,22.91,31.69
DNO TUBE TRACH CUFFED 8.0,272,RC,,,,both,38.83,34.95,United Healthcare,Default,Fee Schedule,31.69,,,,22.91,31.69
DNO TUBE TRACH CUFFED 8.5,272,RC,,,,both,38.79,34.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.15,,,,22.89,31.65
DNO TUBE TRACH CUFFED 8.5,272,RC,,,,both,38.79,34.91,Cigna,Default,Percent of Total Billed Charges,22.89,,,,22.89,31.65
DNO TUBE TRACH CUFFED 8.5,272,RC,,,,both,38.79,34.91,United Healthcare,Default,Fee Schedule,31.65,,,,22.89,31.65
DNO TUBE TRACH CUFFED,272,RC,,,,both,27.16,24.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.01,,,,16.02,22.16
DNO TUBE TRACH CUFFED,272,RC,,,,both,27.16,24.44,Cigna,Default,Percent of Total Billed Charges,16.02,,,,16.02,22.16
DNO TUBE TRACH CUFFED,272,RC,,,,both,27.16,24.44,United Healthcare,Default,Fee Schedule,22.16,,,,16.02,22.16
DNO ENDO TUBE 7.5 REINFORCED W/ CUFF,272,RC,,,,both,98.5,88.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.95,,,,58.12,80.38
DNO ENDO TUBE 7.5 REINFORCED W/ CUFF,272,RC,,,,both,98.5,88.65,Cigna,Default,Percent of Total Billed Charges,58.12,,,,58.12,80.38
DNO ENDO TUBE 7.5 REINFORCED W/ CUFF,272,RC,,,,both,98.5,88.65,United Healthcare,Default,Fee Schedule,80.38,,,,58.12,80.38
DNO ENDO TUBE 8.0 REINFORCED W/ CUFF,272,RC,,,,both,95.74,86.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.02,,,,56.49,78.12
DNO ENDO TUBE 8.0 REINFORCED W/ CUFF,272,RC,,,,both,95.74,86.17,Cigna,Default,Percent of Total Billed Charges,56.49,,,,56.49,78.12
DNO ENDO TUBE 8.0 REINFORCED W/ CUFF,272,RC,,,,both,95.74,86.17,United Healthcare,Default,Fee Schedule,78.12,,,,56.49,78.12
ENDO TUBE ORAL RAE CUFFED 5.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 5.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 5.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 5.0MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 5.0MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 5.0MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 6.0MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 6.0MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 6.0MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE TRACH ORAL RAE CUFFED 4.5,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE TRACH ORAL RAE CUFFED 4.5,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE TRACH ORAL RAE CUFFED 4.5,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 5.0 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,24.4,21.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.08,,,,14.4,19.91
ENDO TUBE 5.0 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,24.4,21.96,Cigna,Default,Percent of Total Billed Charges,14.4,,,,14.4,19.91
ENDO TUBE 5.0 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,24.4,21.96,United Healthcare,Default,Fee Schedule,19.91,,,,14.4,19.91
CATH VISTA BRIGHT TIP 6FX55CM H-STICK,C1887,HCPCS,278,RC,,both,279.25,251.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.48,,,,164.76,227.87
CATH VISTA BRIGHT TIP 6FX55CM H-STICK,C1887,HCPCS,278,RC,,both,279.25,251.33,Cigna,Default,Percent of Total Billed Charges,164.76,,,,164.76,227.87
CATH VISTA BRIGHT TIP 6FX55CM H-STICK,C1887,HCPCS,278,RC,,both,279.25,251.33,United Healthcare,Default,Fee Schedule,227.87,,,,164.76,227.87
CATH VISTA BRITE TIP 6F INTERNAL MAMMARY,C1887,HCPCS,278,RC,,both,678.2,610.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,474.74,,,,400.14,553.41
CATH VISTA BRITE TIP 6F INTERNAL MAMMARY,C1887,HCPCS,278,RC,,both,678.2,610.38,Cigna,Default,Percent of Total Billed Charges,400.14,,,,400.14,553.41
CATH VISTA BRITE TIP 6F INTERNAL MAMMARY,C1887,HCPCS,278,RC,,both,678.2,610.38,United Healthcare,Default,Fee Schedule,553.41,,,,400.14,553.41
CATH VISTA BRIGHT TIP 6FX55CM RDC(1),272,RC,,,,both,262.75,236.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.92,,,,155.02,214.4
CATH VISTA BRIGHT TIP 6FX55CM RDC(1),272,RC,,,,both,262.75,236.48,Cigna,Default,Percent of Total Billed Charges,155.02,,,,155.02,214.4
CATH VISTA BRIGHT TIP 6FX55CM RDC(1),272,RC,,,,both,262.75,236.48,United Healthcare,Default,Fee Schedule,214.4,,,,155.02,214.4
ENDO TUBE 7.0MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 7.0MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 7.0MM ORAL RAE CUFFED,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO ENDO TUBE 5.5 LO-MAGILL CUFF,272,RC,,,,both,102.41,92.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.69,,,,60.42,83.57
DNO ENDO TUBE 5.5 LO-MAGILL CUFF,272,RC,,,,both,102.41,92.17,Cigna,Default,Percent of Total Billed Charges,60.42,,,,60.42,83.57
DNO ENDO TUBE 5.5 LO-MAGILL CUFF,272,RC,,,,both,102.41,92.17,United Healthcare,Default,Fee Schedule,83.57,,,,60.42,83.57
"CAST STOCKINETTE 3"" X25YD",71,RC,,,,both,29.18,26.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.43,,,,17.22,23.81
"CAST STOCKINETTE 3"" X25YD",71,RC,,,,both,29.18,26.26,Cigna,Default,Percent of Total Billed Charges,17.22,,,,17.22,23.81
"CAST STOCKINETTE 3"" X25YD",71,RC,,,,both,29.18,26.26,United Healthcare,Default,Fee Schedule,23.81,,,,17.22,23.81
DNO USE 16004470 CATH BAKER JEJUNSOTOMY,272,RC,,,,both,692,622.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,484.4,,,,408.28,564.67
DNO USE 16004470 CATH BAKER JEJUNSOTOMY,272,RC,,,,both,692,622.8,Cigna,Default,Percent of Total Billed Charges,408.28,,,,408.28,564.67
DNO USE 16004470 CATH BAKER JEJUNSOTOMY,272,RC,,,,both,692,622.8,United Healthcare,Default,Fee Schedule,564.67,,,,408.28,564.67
*SHOULDER SUSPENSION KIT,272,RC,,,,both,340.96,306.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.67,,,,201.17,278.22
*SHOULDER SUSPENSION KIT,272,RC,,,,both,340.96,306.86,Cigna,Default,Percent of Total Billed Charges,201.17,,,,201.17,278.22
*SHOULDER SUSPENSION KIT,272,RC,,,,both,340.96,306.86,United Healthcare,Default,Fee Schedule,278.22,,,,201.17,278.22
DNO TUBE ET NO CUFF 4.0,C1725,HCPCS,272,RC,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
DNO TUBE ET NO CUFF 4.0,C1725,HCPCS,272,RC,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
DNO TUBE ET NO CUFF 4.0,C1725,HCPCS,272,RC,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNO TUBE ET W/CUFF 5.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE ET W/CUFF 5.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SET CYSTO IRRIGATION,272,RC,,,,both,39.76,35.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.83,,,,23.46,32.44
SET CYSTO IRRIGATION,272,RC,,,,both,39.76,35.78,Cigna,Default,Percent of Total Billed Charges,23.46,,,,23.46,32.44
SET CYSTO IRRIGATION,272,RC,,,,both,39.76,35.78,United Healthcare,Default,Fee Schedule,32.44,,,,23.46,32.44
TUBE LEVINE 14FR,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
TUBE LEVINE 14FR,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
TUBE LEVINE 14FR,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
TUBE SALEM SILICONE 16FRX48,B4082,HCPCS,274,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TUBE SALEM SILICONE 16FRX48,B4082,HCPCS,274,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TUBE SALEM SILICONE 16FRX48,B4082,HCPCS,274,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
TUBE SALEM SUMP 18FR,272,RC,,,,both,49.38,44.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.57,,,,29.13,40.29
TUBE SALEM SUMP 18FR,272,RC,,,,both,49.38,44.44,Cigna,Default,Percent of Total Billed Charges,29.13,,,,29.13,40.29
TUBE SALEM SUMP 18FR,272,RC,,,,both,49.38,44.44,United Healthcare,Default,Fee Schedule,40.29,,,,29.13,40.29
TUBE LEVINE 18FR,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
TUBE LEVINE 18FR,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
TUBE LEVINE 18FR,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
PVC TUBE SALEM SUMP 16FRX48 DBL LUMEN,272,RC,,,,both,57.89,52.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.52,,,,34.16,47.24
PVC TUBE SALEM SUMP 16FRX48 DBL LUMEN,272,RC,,,,both,57.89,52.1,Cigna,Default,Percent of Total Billed Charges,34.16,,,,34.16,47.24
PVC TUBE SALEM SUMP 16FRX48 DBL LUMEN,272,RC,,,,both,57.89,52.1,United Healthcare,Default,Fee Schedule,47.24,,,,34.16,47.24
TUBE SALEM SUMP 14FR,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TUBE SALEM SUMP 14FR,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TUBE SALEM SUMP 14FR,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
TUBE SALEM SUMP 12FR,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
TUBE SALEM SUMP 12FR,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
TUBE SALEM SUMP 12FR,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DRYSEAL SHEATH DSL1628,C1894,HCPCS,278,RC,,both,915.74,824.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,641.02,,,,540.29,747.24
DRYSEAL SHEATH DSL1628,C1894,HCPCS,278,RC,,both,915.74,824.17,Cigna,Default,Percent of Total Billed Charges,540.29,,,,540.29,747.24
DRYSEAL SHEATH DSL1628,C1894,HCPCS,278,RC,,both,915.74,824.17,United Healthcare,Default,Fee Schedule,747.24,,,,540.29,747.24
EXCLUDER RLT261418,C1874,HCPCS,278,RC,,both,37728.33,33955.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26409.83,,,,22259.71,30786.32
EXCLUDER RLT261418,C1874,HCPCS,278,RC,,both,37728.33,33955.5,Cigna,Default,Percent of Total Billed Charges,22259.71,,,,22259.71,30786.32
EXCLUDER RLT261418,C1874,HCPCS,278,RC,,both,37728.33,33955.5,United Healthcare,Default,Fee Schedule,30786.32,,,,22259.71,30786.32
EXCLUDER PLC181400,C1874,HCPCS,278,RC,,both,15018.07,13516.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10512.65,,,,8860.66,12254.75
EXCLUDER PLC181400,C1874,HCPCS,278,RC,,both,15018.07,13516.26,Cigna,Default,Percent of Total Billed Charges,8860.66,,,,8860.66,12254.75
EXCLUDER PLC181400,C1874,HCPCS,278,RC,,both,15018.07,13516.26,United Healthcare,Default,Fee Schedule,12254.75,,,,8860.66,12254.75
DRYSEAL SHEATH DSL1828,C1894,HCPCS,278,RC,,both,1098.88,988.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,769.22,,,,648.34,896.69
DRYSEAL SHEATH DSL1828,C1894,HCPCS,278,RC,,both,1098.88,988.99,Cigna,Default,Percent of Total Billed Charges,648.34,,,,648.34,896.69
DRYSEAL SHEATH DSL1828,C1894,HCPCS,278,RC,,both,1098.88,988.99,United Healthcare,Default,Fee Schedule,896.69,,,,648.34,896.69
Q50 PLUS STENT GRAFT BALLOON CATH,C1725,HCPCS,278,RC,,both,1615.03,1453.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1130.52,,,,952.87,1317.86
Q50 PLUS STENT GRAFT BALLOON CATH,C1725,HCPCS,278,RC,,both,1615.03,1453.53,Cigna,Default,Percent of Total Billed Charges,952.87,,,,952.87,1317.86
Q50 PLUS STENT GRAFT BALLOON CATH,C1725,HCPCS,278,RC,,both,1615.03,1453.53,United Healthcare,Default,Fee Schedule,1317.86,,,,952.87,1317.86
DRYSEAL SHEATH DSL1228,C1894,HCPCS,278,RC,,both,915.74,824.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,641.02,,,,540.29,747.24
DRYSEAL SHEATH DSL1228,C1894,HCPCS,278,RC,,both,915.74,824.17,Cigna,Default,Percent of Total Billed Charges,540.29,,,,540.29,747.24
DRYSEAL SHEATH DSL1228,C1894,HCPCS,278,RC,,both,915.74,824.17,United Healthcare,Default,Fee Schedule,747.24,,,,540.29,747.24
EXCLUDER RLT281418,C1874,HCPCS,278,RC,,both,37728.33,33955.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26409.83,,,,22259.71,30786.32
EXCLUDER RLT281418,C1874,HCPCS,278,RC,,both,37728.33,33955.5,Cigna,Default,Percent of Total Billed Charges,22259.71,,,,22259.71,30786.32
EXCLUDER RLT281418,C1874,HCPCS,278,RC,,both,37728.33,33955.5,United Healthcare,Default,Fee Schedule,30786.32,,,,22259.71,30786.32
SHEATH 5FR BRITE TIP,272,RC,,,,both,151.36,136.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.95,,,,89.3,123.51
SHEATH 5FR BRITE TIP,272,RC,,,,both,151.36,136.22,Cigna,Default,Percent of Total Billed Charges,89.3,,,,89.3,123.51
SHEATH 5FR BRITE TIP,272,RC,,,,both,151.36,136.22,United Healthcare,Default,Fee Schedule,123.51,,,,89.3,123.51
8 FR DESTINATION SHEATH,C1887,HCPCS,278,RC,,both,586.08,527.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,410.26,,,,345.79,478.24
8 FR DESTINATION SHEATH,C1887,HCPCS,278,RC,,both,586.08,527.47,Cigna,Default,Percent of Total Billed Charges,345.79,,,,345.79,478.24
8 FR DESTINATION SHEATH,C1887,HCPCS,278,RC,,both,586.08,527.47,United Healthcare,Default,Fee Schedule,478.24,,,,345.79,478.24
SHEATH,272,RC,,,,both,456.58,410.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,319.61,,,,269.38,372.57
SHEATH,272,RC,,,,both,456.58,410.92,Cigna,Default,Percent of Total Billed Charges,269.38,,,,269.38,372.57
SHEATH,272,RC,,,,both,456.58,410.92,United Healthcare,Default,Fee Schedule,372.57,,,,269.38,372.57
SHEATH,272,RC,,,,both,456.58,410.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,319.61,,,,269.38,372.57
SHEATH,272,RC,,,,both,456.58,410.92,Cigna,Default,Percent of Total Billed Charges,269.38,,,,269.38,372.57
SHEATH,272,RC,,,,both,456.58,410.92,United Healthcare,Default,Fee Schedule,372.57,,,,269.38,372.57
SHEATH INTRODUCER 6FR SHUTTLE,272,RC,,,,both,828.88,745.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,580.22,,,,489.04,676.37
SHEATH INTRODUCER 6FR SHUTTLE,272,RC,,,,both,828.88,745.99,Cigna,Default,Percent of Total Billed Charges,489.04,,,,489.04,676.37
SHEATH INTRODUCER 6FR SHUTTLE,272,RC,,,,both,828.88,745.99,United Healthcare,Default,Fee Schedule,676.37,,,,489.04,676.37
SHEATH DESTINATION 90CM,272,RC,,,,both,579.51,521.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,405.66,,,,341.91,472.88
SHEATH DESTINATION 90CM,272,RC,,,,both,579.51,521.56,Cigna,Default,Percent of Total Billed Charges,341.91,,,,341.91,472.88
SHEATH DESTINATION 90CM,272,RC,,,,both,579.51,521.56,United Healthcare,Default,Fee Schedule,472.88,,,,341.91,472.88
HEMOSTATIC ABSORBABLE PARTICLES,258,RC,,,,both,473.19,425.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,331.23,,,,279.18,386.12
HEMOSTATIC ABSORBABLE PARTICLES,258,RC,,,,both,473.19,425.87,Cigna,Default,Percent of Total Billed Charges,279.18,,,,279.18,386.12
HEMOSTATIC ABSORBABLE PARTICLES,258,RC,,,,both,473.19,425.87,United Healthcare,Default,Fee Schedule,386.12,,,,279.18,386.12
SHEATH DESTINATION 45CM,272,RC,,,,both,541.26,487.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,378.88,,,,319.34,441.67
SHEATH DESTINATION 45CM,272,RC,,,,both,541.26,487.13,Cigna,Default,Percent of Total Billed Charges,319.34,,,,319.34,441.67
SHEATH DESTINATION 45CM,272,RC,,,,both,541.26,487.13,United Healthcare,Default,Fee Schedule,441.67,,,,319.34,441.67
GRAFT MAIN BODY,C1768,HCPCS,278,RC,,both,28004.71,25204.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19603.3,,,,16522.78,22851.84
GRAFT MAIN BODY,C1768,HCPCS,278,RC,,both,28004.71,25204.24,Cigna,Default,Percent of Total Billed Charges,16522.78,,,,16522.78,22851.84
GRAFT MAIN BODY,C1768,HCPCS,278,RC,,both,28004.71,25204.24,United Healthcare,Default,Fee Schedule,22851.84,,,,16522.78,22851.84
GRAFT LEG CONTROL,C1768,HCPCS,278,RC,,both,12553.91,11298.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8787.74,,,,7406.81,10243.99
GRAFT LEG CONTROL,C1768,HCPCS,278,RC,,both,12553.91,11298.52,Cigna,Default,Percent of Total Billed Charges,7406.81,,,,7406.81,10243.99
GRAFT LEG CONTROL,C1768,HCPCS,278,RC,,both,12553.91,11298.52,United Healthcare,Default,Fee Schedule,10243.99,,,,7406.81,10243.99
DNU ENDO RETRACT 5MM,272,RC,,,,both,347.78,313,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.45,,,,205.19,283.79
DNU ENDO RETRACT 5MM,272,RC,,,,both,347.78,313,Cigna,Default,Percent of Total Billed Charges,205.19,,,,205.19,283.79
DNU ENDO RETRACT 5MM,272,RC,,,,both,347.78,313,United Healthcare,Default,Fee Schedule,283.79,,,,205.19,283.79
ENDO RETRACT 10MM,272,RC,,,,both,761.12,685.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,532.78,,,,449.06,621.07
ENDO RETRACT 10MM,272,RC,,,,both,761.12,685.01,Cigna,Default,Percent of Total Billed Charges,449.06,,,,449.06,621.07
ENDO RETRACT 10MM,272,RC,,,,both,761.12,685.01,United Healthcare,Default,Fee Schedule,621.07,,,,449.06,621.07
DISC GRASPER ROTICULATOR 5MM,272,RC,,,,both,919.64,827.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,643.75,,,,542.59,750.43
DISC GRASPER ROTICULATOR 5MM,272,RC,,,,both,919.64,827.68,Cigna,Default,Percent of Total Billed Charges,542.59,,,,542.59,750.43
DISC GRASPER ROTICULATOR 5MM,272,RC,,,,both,919.64,827.68,United Healthcare,Default,Fee Schedule,750.43,,,,542.59,750.43
RELOAD 30MM TX30V WHITE VASCULAR,272,RC,,,,both,204.68,184.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.28,,,,120.76,167.02
RELOAD 30MM TX30V WHITE VASCULAR,272,RC,,,,both,204.68,184.21,Cigna,Default,Percent of Total Billed Charges,120.76,,,,120.76,167.02
RELOAD 30MM TX30V WHITE VASCULAR,272,RC,,,,both,204.68,184.21,United Healthcare,Default,Fee Schedule,167.02,,,,120.76,167.02
SILS DISSECTOR 5MM,272,RC,,,,both,1131.62,1018.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,792.13,,,,667.66,923.4
SILS DISSECTOR 5MM,272,RC,,,,both,1131.62,1018.46,Cigna,Default,Percent of Total Billed Charges,667.66,,,,667.66,923.4
SILS DISSECTOR 5MM,272,RC,,,,both,1131.62,1018.46,United Healthcare,Default,Fee Schedule,923.4,,,,667.66,923.4
SHEATH DESTINATION RDC RENAL CATH 6FR 45,272,RC,,,,both,502.23,452.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,351.56,,,,296.32,409.82
SHEATH DESTINATION RDC RENAL CATH 6FR 45,272,RC,,,,both,502.23,452.01,Cigna,Default,Percent of Total Billed Charges,296.32,,,,296.32,409.82
SHEATH DESTINATION RDC RENAL CATH 6FR 45,272,RC,,,,both,502.23,452.01,United Healthcare,Default,Fee Schedule,409.82,,,,296.32,409.82
MARGINMARKER WITH CLIPS,272,RC,,,,both,592.22,533,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,414.55,,,,349.41,483.25
MARGINMARKER WITH CLIPS,272,RC,,,,both,592.22,533,Cigna,Default,Percent of Total Billed Charges,349.41,,,,349.41,483.25
MARGINMARKER WITH CLIPS,272,RC,,,,both,592.22,533,United Healthcare,Default,Fee Schedule,483.25,,,,349.41,483.25
SHEATH DESTINATION RDC RENAL 5FR 45CM,272,RC,,,,both,541.26,487.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,378.88,,,,319.34,441.67
SHEATH DESTINATION RDC RENAL 5FR 45CM,272,RC,,,,both,541.26,487.13,Cigna,Default,Percent of Total Billed Charges,319.34,,,,319.34,441.67
SHEATH DESTINATION RDC RENAL 5FR 45CM,272,RC,,,,both,541.26,487.13,United Healthcare,Default,Fee Schedule,441.67,,,,319.34,441.67
*ENDOPATH 5MM GRASPER,272,RC,,,,both,144.13,129.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.89,,,,85.04,117.61
*ENDOPATH 5MM GRASPER,272,RC,,,,both,144.13,129.72,Cigna,Default,Percent of Total Billed Charges,85.04,,,,85.04,117.61
*ENDOPATH 5MM GRASPER,272,RC,,,,both,144.13,129.72,United Healthcare,Default,Fee Schedule,117.61,,,,85.04,117.61
SUB GRASPER DISSECTING 5MM,272,RC,,,,both,919.65,827.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,643.76,,,,542.59,750.43
SUB GRASPER DISSECTING 5MM,272,RC,,,,both,919.65,827.69,Cigna,Default,Percent of Total Billed Charges,542.59,,,,542.59,750.43
SUB GRASPER DISSECTING 5MM,272,RC,,,,both,919.65,827.69,United Healthcare,Default,Fee Schedule,750.43,,,,542.59,750.43
*CATH EPIDURAL,272,RC,,,,both,52.24,47.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.57,,,,30.82,42.63
*CATH EPIDURAL,272,RC,,,,both,52.24,47.02,Cigna,Default,Percent of Total Billed Charges,30.82,,,,30.82,42.63
*CATH EPIDURAL,272,RC,,,,both,52.24,47.02,United Healthcare,Default,Fee Schedule,42.63,,,,30.82,42.63
TROCAR THORACIC 12MM,272,RC,,,,both,276.76,249.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,193.73,,,,163.29,225.84
TROCAR THORACIC 12MM,272,RC,,,,both,276.76,249.08,Cigna,Default,Percent of Total Billed Charges,163.29,,,,163.29,225.84
TROCAR THORACIC 12MM,272,RC,,,,both,276.76,249.08,United Healthcare,Default,Fee Schedule,225.84,,,,163.29,225.84
EXCLUDER RLT231218,C1874,HCPCS,278,RC,,both,36151.15,32536.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25305.8,,,,21329.18,29499.34
EXCLUDER RLT231218,C1874,HCPCS,278,RC,,both,36151.15,32536.04,Cigna,Default,Percent of Total Billed Charges,21329.18,,,,21329.18,29499.34
EXCLUDER RLT231218,C1874,HCPCS,278,RC,,both,36151.15,32536.04,United Healthcare,Default,Fee Schedule,29499.34,,,,21329.18,29499.34
EXCLUDER PLC141200,C1874,HCPCS,278,RC,,both,14335.65,12902.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10034.96,,,,8458.03,11697.89
EXCLUDER PLC141200,C1874,HCPCS,278,RC,,both,14335.65,12902.09,Cigna,Default,Percent of Total Billed Charges,8458.03,,,,8458.03,11697.89
EXCLUDER PLC141200,C1874,HCPCS,278,RC,,both,14335.65,12902.09,United Healthcare,Default,Fee Schedule,11697.89,,,,8458.03,11697.89
EXCLUDER PLL161207,C1874,HCPCS,278,RC,,both,10069.92,9062.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7048.94,,,,5941.25,8217.05
EXCLUDER PLL161207,C1874,HCPCS,278,RC,,both,10069.92,9062.93,Cigna,Default,Percent of Total Billed Charges,5941.25,,,,5941.25,8217.05
EXCLUDER PLL161207,C1874,HCPCS,278,RC,,both,10069.92,9062.93,United Healthcare,Default,Fee Schedule,8217.05,,,,5941.25,8217.05
DRYSEAL SHEATH DSF1233,C1894,HCPCS,278,RC,,both,1471.86,1324.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1030.3,,,,868.4,1201.04
DRYSEAL SHEATH DSF1233,C1894,HCPCS,278,RC,,both,1471.86,1324.67,Cigna,Default,Percent of Total Billed Charges,868.4,,,,868.4,1201.04
DRYSEAL SHEATH DSF1233,C1894,HCPCS,278,RC,,both,1471.86,1324.67,United Healthcare,Default,Fee Schedule,1201.04,,,,868.4,1201.04
DRYSEAL SHEATH DSF1633,C1894,HCPCS,278,RC,,both,1415.25,1273.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,990.68,,,,835,1154.84
DRYSEAL SHEATH DSF1633,C1894,HCPCS,278,RC,,both,1415.25,1273.73,Cigna,Default,Percent of Total Billed Charges,835,,,,835,1154.84
DRYSEAL SHEATH DSF1633,C1894,HCPCS,278,RC,,both,1415.25,1273.73,United Healthcare,Default,Fee Schedule,1154.84,,,,835,1154.84
CATH OCCULDER OCCULSION MOLDING MOB37,C1725,HCPCS,272,RC,,both,1655.01,1489.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1158.51,,,,976.46,1350.49
CATH OCCULDER OCCULSION MOLDING MOB37,C1725,HCPCS,272,RC,,both,1655.01,1489.51,Cigna,Default,Percent of Total Billed Charges,976.46,,,,976.46,1350.49
CATH OCCULDER OCCULSION MOLDING MOB37,C1725,HCPCS,272,RC,,both,1655.01,1489.51,United Healthcare,Default,Fee Schedule,1350.49,,,,976.46,1350.49
EXCLUDER PLL161407,C1874,HCPCS,278,RC,,both,10572.75,9515.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7400.92,,,,6237.92,8627.36
EXCLUDER PLL161407,C1874,HCPCS,278,RC,,both,10572.75,9515.48,Cigna,Default,Percent of Total Billed Charges,6237.92,,,,6237.92,8627.36
EXCLUDER PLL161407,C1874,HCPCS,278,RC,,both,10572.75,9515.48,United Healthcare,Default,Fee Schedule,8627.36,,,,6237.92,8627.36
TRAY PONSKY PULL PEG,272,RC,,,,both,208.61,187.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.03,,,,123.08,170.23
TRAY PONSKY PULL PEG,272,RC,,,,both,208.61,187.75,Cigna,Default,Percent of Total Billed Charges,123.08,,,,123.08,170.23
TRAY PONSKY PULL PEG,272,RC,,,,both,208.61,187.75,United Healthcare,Default,Fee Schedule,170.23,,,,123.08,170.23
TISSUE EXPANDERS,278,RC,,,,both,4829.25,4346.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3380.48,,,,2849.26,3940.67
TISSUE EXPANDERS,278,RC,,,,both,4829.25,4346.33,Cigna,Default,Percent of Total Billed Charges,2849.26,,,,2849.26,3940.67
TISSUE EXPANDERS,278,RC,,,,both,4829.25,4346.33,United Healthcare,Default,Fee Schedule,3940.67,,,,2849.26,3940.67
LIGASURE EXACT DISSECTOR,272,RC,,,,both,2190.58,1971.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1533.41,,,,1292.44,1787.51
LIGASURE EXACT DISSECTOR,272,RC,,,,both,2190.58,1971.52,Cigna,Default,Percent of Total Billed Charges,1292.44,,,,1292.44,1787.51
LIGASURE EXACT DISSECTOR,272,RC,,,,both,2190.58,1971.52,United Healthcare,Default,Fee Schedule,1787.51,,,,1292.44,1787.51
DNU CLIP APPLIER 10MM EN,272,RC,,,,both,250.5,225.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,175.35,,,,147.8,204.41
DNU CLIP APPLIER 10MM EN,272,RC,,,,both,250.5,225.45,Cigna,Default,Percent of Total Billed Charges,147.8,,,,147.8,204.41
DNU CLIP APPLIER 10MM EN,272,RC,,,,both,250.5,225.45,United Healthcare,Default,Fee Schedule,204.41,,,,147.8,204.41
LIGASURE IMPACT,272,RC,,,,both,2251.49,2026.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1576.04,,,,1328.38,1837.22
LIGASURE IMPACT,272,RC,,,,both,2251.49,2026.34,Cigna,Default,Percent of Total Billed Charges,1328.38,,,,1328.38,1837.22
LIGASURE IMPACT,272,RC,,,,both,2251.49,2026.34,United Healthcare,Default,Fee Schedule,1837.22,,,,1328.38,1837.22
LIGASURE SMALL JAW,272,RC,,,,both,1390.01,1251.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,973.01,,,,820.11,1134.25
LIGASURE SMALL JAW,272,RC,,,,both,1390.01,1251.01,Cigna,Default,Percent of Total Billed Charges,820.11,,,,820.11,1134.25
LIGASURE SMALL JAW,272,RC,,,,both,1390.01,1251.01,United Healthcare,Default,Fee Schedule,1134.25,,,,820.11,1134.25
LIGASURE BLUNT TIP 5 MM,272,RC,,,,both,1896.57,1706.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1327.6,,,,1118.98,1547.6
LIGASURE BLUNT TIP 5 MM,272,RC,,,,both,1896.57,1706.91,Cigna,Default,Percent of Total Billed Charges,1118.98,,,,1118.98,1547.6
LIGASURE BLUNT TIP 5 MM,272,RC,,,,both,1896.57,1706.91,United Healthcare,Default,Fee Schedule,1547.6,,,,1118.98,1547.6
DNU CLIP APPLIER LIGAMAX 5,272,RC,,,,both,419.25,377.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,293.48,,,,247.36,342.11
DNU CLIP APPLIER LIGAMAX 5,272,RC,,,,both,419.25,377.33,Cigna,Default,Percent of Total Billed Charges,247.36,,,,247.36,342.11
DNU CLIP APPLIER LIGAMAX 5,272,RC,,,,both,419.25,377.33,United Healthcare,Default,Fee Schedule,342.11,,,,247.36,342.11
DNO PENCIL FORCE TRIVERSE BOVIE,272,RC,,,,both,172.97,155.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.08,,,,102.05,141.14
DNO PENCIL FORCE TRIVERSE BOVIE,272,RC,,,,both,172.97,155.67,Cigna,Default,Percent of Total Billed Charges,102.05,,,,102.05,141.14
DNO PENCIL FORCE TRIVERSE BOVIE,272,RC,,,,both,172.97,155.67,United Healthcare,Default,Fee Schedule,141.14,,,,102.05,141.14
LIGASURE ATLAS 10MM 37CM HAND SWITCHING,272,RC,,,,both,1633.24,1469.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1143.27,,,,963.61,1332.72
LIGASURE ATLAS 10MM 37CM HAND SWITCHING,272,RC,,,,both,1633.24,1469.92,Cigna,Default,Percent of Total Billed Charges,963.61,,,,963.61,1332.72
LIGASURE ATLAS 10MM 37CM HAND SWITCHING,272,RC,,,,both,1633.24,1469.92,United Healthcare,Default,Fee Schedule,1332.72,,,,963.61,1332.72
LIGASURE CURVED MARYLAND 5MM 23CM,272,RC,,,,both,2184.47,1966.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1529.13,,,,1288.84,1782.53
LIGASURE CURVED MARYLAND 5MM 23CM,272,RC,,,,both,2184.47,1966.02,Cigna,Default,Percent of Total Billed Charges,1288.84,,,,1288.84,1782.53
LIGASURE CURVED MARYLAND 5MM 23CM,272,RC,,,,both,2184.47,1966.02,United Healthcare,Default,Fee Schedule,1782.53,,,,1288.84,1782.53
LIGASURE CURVED MARYLAND 5MM 37CM,272,RC,,,,both,1947.09,1752.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1362.96,,,,1148.78,1588.83
LIGASURE CURVED MARYLAND 5MM 37CM,272,RC,,,,both,1947.09,1752.38,Cigna,Default,Percent of Total Billed Charges,1148.78,,,,1148.78,1588.83
LIGASURE CURVED MARYLAND 5MM 37CM,272,RC,,,,both,1947.09,1752.38,United Healthcare,Default,Fee Schedule,1588.83,,,,1148.78,1588.83
VISIPORT PLUS OPTICAL TROCAR 5-12MM,272,RC,,,,both,542.23,488.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,379.56,,,,319.92,442.46
VISIPORT PLUS OPTICAL TROCAR 5-12MM,272,RC,,,,both,542.23,488.01,Cigna,Default,Percent of Total Billed Charges,319.92,,,,319.92,442.46
VISIPORT PLUS OPTICAL TROCAR 5-12MM,272,RC,,,,both,542.23,488.01,United Healthcare,Default,Fee Schedule,442.46,,,,319.92,442.46
REPROC LIGASURE CURVED MARYLAND 5MM 37CM,272,RC,,,,both,1315.35,1183.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,920.74,,,,776.06,1073.33
REPROC LIGASURE CURVED MARYLAND 5MM 37CM,272,RC,,,,both,1315.35,1183.82,Cigna,Default,Percent of Total Billed Charges,776.06,,,,776.06,1073.33
REPROC LIGASURE CURVED MARYLAND 5MM 37CM,272,RC,,,,both,1315.35,1183.82,United Healthcare,Default,Fee Schedule,1073.33,,,,776.06,1073.33
"MEGADYNE ELECTRO BLADE 2.75"" PTFE-COATED",272,RC,,,,both,23.36,21.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.35,,,,13.78,19.06
"MEGADYNE ELECTRO BLADE 2.75"" PTFE-COATED",272,RC,,,,both,23.36,21.02,Cigna,Default,Percent of Total Billed Charges,13.78,,,,13.78,19.06
"MEGADYNE ELECTRO BLADE 2.75"" PTFE-COATED",272,RC,,,,both,23.36,21.02,United Healthcare,Default,Fee Schedule,19.06,,,,13.78,19.06
ELECTRODE BLADE 6.5 E-Z CLEAN INSULATED,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
ELECTRODE BLADE 6.5 E-Z CLEAN INSULATED,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
ELECTRODE BLADE 6.5 E-Z CLEAN INSULATED,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
*L-HOOK ELECTRODE 33CM,272,RC,,,,both,192.86,173.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135,,,,113.79,157.37
*L-HOOK ELECTRODE 33CM,272,RC,,,,both,192.86,173.57,Cigna,Default,Percent of Total Billed Charges,113.79,,,,113.79,157.37
*L-HOOK ELECTRODE 33CM,272,RC,,,,both,192.86,173.57,United Healthcare,Default,Fee Schedule,157.37,,,,113.79,157.37
*L-HOOK ELECTRODE 45CM,272,RC,,,,both,180.44,162.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.31,,,,106.46,147.24
*L-HOOK ELECTRODE 45CM,272,RC,,,,both,180.44,162.4,Cigna,Default,Percent of Total Billed Charges,106.46,,,,106.46,147.24
*L-HOOK ELECTRODE 45CM,272,RC,,,,both,180.44,162.4,United Healthcare,Default,Fee Schedule,147.24,,,,106.46,147.24
CATH BERENSTEIN II .038 X 100 CM,272,RC,,,,both,52.02,46.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.41,,,,30.69,42.45
CATH BERENSTEIN II .038 X 100 CM,272,RC,,,,both,52.02,46.82,Cigna,Default,Percent of Total Billed Charges,30.69,,,,30.69,42.45
CATH BERENSTEIN II .038 X 100 CM,272,RC,,,,both,52.02,46.82,United Healthcare,Default,Fee Schedule,42.45,,,,30.69,42.45
"MEGADYNE EZ CLEAN BLADE ELECTRODES 4""",272,RC,,,,both,20.25,18.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.18,,,,11.95,16.52
"MEGADYNE EZ CLEAN BLADE ELECTRODES 4""",272,RC,,,,both,20.25,18.23,Cigna,Default,Percent of Total Billed Charges,11.95,,,,11.95,16.52
"MEGADYNE EZ CLEAN BLADE ELECTRODES 4""",272,RC,,,,both,20.25,18.23,United Healthcare,Default,Fee Schedule,16.52,,,,11.95,16.52
SCISSOR 5MMX35CM,272,RC,,,,both,164.32,147.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.02,,,,96.95,134.09
SCISSOR 5MMX35CM,272,RC,,,,both,164.32,147.89,Cigna,Default,Percent of Total Billed Charges,96.95,,,,96.95,134.09
SCISSOR 5MMX35CM,272,RC,,,,both,164.32,147.89,United Healthcare,Default,Fee Schedule,134.09,,,,96.95,134.09
BAG SPECIMEN RETRIEVAL SYSTEM,272,RC,,,,both,119.88,107.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.92,,,,70.73,97.82
BAG SPECIMEN RETRIEVAL SYSTEM,272,RC,,,,both,119.88,107.89,Cigna,Default,Percent of Total Billed Charges,70.73,,,,70.73,97.82
BAG SPECIMEN RETRIEVAL SYSTEM,272,RC,,,,both,119.88,107.89,United Healthcare,Default,Fee Schedule,97.82,,,,70.73,97.82
TROCAR BALLOON 12X100MM,272,RC,,,,both,88.68,79.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.08,,,,52.32,72.36
TROCAR BALLOON 12X100MM,272,RC,,,,both,88.68,79.81,Cigna,Default,Percent of Total Billed Charges,52.32,,,,52.32,72.36
TROCAR BALLOON 12X100MM,272,RC,,,,both,88.68,79.81,United Healthcare,Default,Fee Schedule,72.36,,,,52.32,72.36
TROCAR 5X100 OPT SEP SYS,272,RC,,,,both,76.01,68.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.21,,,,44.85,62.02
TROCAR 5X100 OPT SEP SYS,272,RC,,,,both,76.01,68.41,Cigna,Default,Percent of Total Billed Charges,44.85,,,,44.85,62.02
TROCAR 5X100 OPT SEP SYS,272,RC,,,,both,76.01,68.41,United Healthcare,Default,Fee Schedule,62.02,,,,44.85,62.02
SLEEVE CANN/SEAL,272,RC,,,,both,28.95,26.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.26,,,,17.08,23.62
SLEEVE CANN/SEAL,272,RC,,,,both,28.95,26.06,Cigna,Default,Percent of Total Billed Charges,17.08,,,,17.08,23.62
SLEEVE CANN/SEAL,272,RC,,,,both,28.95,26.06,United Healthcare,Default,Fee Schedule,23.62,,,,17.08,23.62
DNU SLEEVE ADV FIX  CANN/SEAL,272,RC,,,,both,31.25,28.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.88,,,,18.44,25.5
DNU SLEEVE ADV FIX  CANN/SEAL,272,RC,,,,both,31.25,28.13,Cigna,Default,Percent of Total Billed Charges,18.44,,,,18.44,25.5
DNU SLEEVE ADV FIX  CANN/SEAL,272,RC,,,,both,31.25,28.13,United Healthcare,Default,Fee Schedule,25.5,,,,18.44,25.5
*TROCAR 11x100 THR OPT SEP SYS,272,RC,,,,both,118.92,107.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.24,,,,70.16,97.04
*TROCAR 11x100 THR OPT SEP SYS,272,RC,,,,both,118.92,107.03,Cigna,Default,Percent of Total Billed Charges,70.16,,,,70.16,97.04
*TROCAR 11x100 THR OPT SEP SYS,272,RC,,,,both,118.92,107.03,United Healthcare,Default,Fee Schedule,97.04,,,,70.16,97.04
SLEEVE 11X100MM THR CAN/SEAL,272,RC,,,,both,61.24,55.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.87,,,,36.13,49.97
SLEEVE 11X100MM THR CAN/SEAL,272,RC,,,,both,61.24,55.12,Cigna,Default,Percent of Total Billed Charges,36.13,,,,36.13,49.97
SLEEVE 11X100MM THR CAN/SEAL,272,RC,,,,both,61.24,55.12,United Healthcare,Default,Fee Schedule,49.97,,,,36.13,49.97
DNU SLEEVE 11X100MM ADVFIX CAN/SEAL,272,RC,,,,both,72.5,65.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.75,,,,42.78,59.16
DNU SLEEVE 11X100MM ADVFIX CAN/SEAL,272,RC,,,,both,72.5,65.25,Cigna,Default,Percent of Total Billed Charges,42.78,,,,42.78,59.16
DNU SLEEVE 11X100MM ADVFIX CAN/SEAL,272,RC,,,,both,72.5,65.25,United Healthcare,Default,Fee Schedule,59.16,,,,42.78,59.16
DNO TROCAR 15X150 NON BLADED,272,RC,,,,both,200.59,180.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.41,,,,118.35,163.68
DNO TROCAR 15X150 NON BLADED,272,RC,,,,both,200.59,180.53,Cigna,Default,Percent of Total Billed Charges,118.35,,,,118.35,163.68
DNO TROCAR 15X150 NON BLADED,272,RC,,,,both,200.59,180.53,United Healthcare,Default,Fee Schedule,163.68,,,,118.35,163.68
DNU TROCAR 15X100 NON BLADED,272,RC,,,,both,200.5,180.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.35,,,,118.3,163.61
DNU TROCAR 15X100 NON BLADED,272,RC,,,,both,200.5,180.45,Cigna,Default,Percent of Total Billed Charges,118.3,,,,118.3,163.61
DNU TROCAR 15X100 NON BLADED,272,RC,,,,both,200.5,180.45,United Healthcare,Default,Fee Schedule,163.61,,,,118.3,163.61
DNO CAUTERY PENCIL,271,RC,,,,both,53.45,48.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.42,,,,31.54,43.62
DNO CAUTERY PENCIL,271,RC,,,,both,53.45,48.11,Cigna,Default,Percent of Total Billed Charges,31.54,,,,31.54,43.62
DNO CAUTERY PENCIL,271,RC,,,,both,53.45,48.11,United Healthcare,Default,Fee Schedule,43.62,,,,31.54,43.62
BLADE ELECTRODE,272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
BLADE ELECTRODE,272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
BLADE ELECTRODE,272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
"NEEDLE MEGADYNE NEEDLE ELECTRODE 2.75""",272,RC,,,,both,23.65,21.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.56,,,,13.95,19.3
"NEEDLE MEGADYNE NEEDLE ELECTRODE 2.75""",272,RC,,,,both,23.65,21.29,Cigna,Default,Percent of Total Billed Charges,13.95,,,,13.95,19.3
"NEEDLE MEGADYNE NEEDLE ELECTRODE 2.75""",272,RC,,,,both,23.65,21.29,United Healthcare,Default,Fee Schedule,19.3,,,,13.95,19.3
"E-Z CLEAN BLADE ELECTRODE 6""",272,RC,,,,both,29.26,26.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.48,,,,17.26,23.88
"E-Z CLEAN BLADE ELECTRODE 6""",272,RC,,,,both,29.26,26.33,Cigna,Default,Percent of Total Billed Charges,17.26,,,,17.26,23.88
"E-Z CLEAN BLADE ELECTRODE 6""",272,RC,,,,both,29.26,26.33,United Healthcare,Default,Fee Schedule,23.88,,,,17.26,23.88
DNU BALLOON 5MM ORIGIN PORT,272,RC,,,,both,72,64.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.4,,,,42.48,58.75
DNU BALLOON 5MM ORIGIN PORT,272,RC,,,,both,72,64.8,Cigna,Default,Percent of Total Billed Charges,42.48,,,,42.48,58.75
DNU BALLOON 5MM ORIGIN PORT,272,RC,,,,both,72,64.8,United Healthcare,Default,Fee Schedule,58.75,,,,42.48,58.75
*CLIP APPLIER 5MM,272,RC,,,,both,379.83,341.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.88,,,,224.1,309.94
*CLIP APPLIER 5MM,272,RC,,,,both,379.83,341.85,Cigna,Default,Percent of Total Billed Charges,224.1,,,,224.1,309.94
*CLIP APPLIER 5MM,272,RC,,,,both,379.83,341.85,United Healthcare,Default,Fee Schedule,309.94,,,,224.1,309.94
*CLIP APPLIER 10MM,272,RC,,,,both,253.24,227.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,177.27,,,,149.41,206.64
*CLIP APPLIER 10MM,272,RC,,,,both,253.24,227.92,Cigna,Default,Percent of Total Billed Charges,149.41,,,,149.41,206.64
*CLIP APPLIER 10MM,272,RC,,,,both,253.24,227.92,United Healthcare,Default,Fee Schedule,206.64,,,,149.41,206.64
*KII FIOS FIRST ENTRY 11MM X 150M,272,RC,,,,both,142.53,128.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.77,,,,84.09,116.3
*KII FIOS FIRST ENTRY 11MM X 150M,272,RC,,,,both,142.53,128.28,Cigna,Default,Percent of Total Billed Charges,84.09,,,,84.09,116.3
*KII FIOS FIRST ENTRY 11MM X 150M,272,RC,,,,both,142.53,128.28,United Healthcare,Default,Fee Schedule,116.3,,,,84.09,116.3
KII FIOS FIRST ENTRY 5MM X 150MM,272,RC,,,,both,73.49,66.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.44,,,,43.36,59.97
KII FIOS FIRST ENTRY 5MM X 150MM,272,RC,,,,both,73.49,66.14,Cigna,Default,Percent of Total Billed Charges,43.36,,,,43.36,59.97
KII FIOS FIRST ENTRY 5MM X 150MM,272,RC,,,,both,73.49,66.14,United Healthcare,Default,Fee Schedule,59.97,,,,43.36,59.97
*KII SLEEVE 5 X 150,272,RC,,,,both,33.4,30.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.38,,,,19.71,27.25
*KII SLEEVE 5 X 150,272,RC,,,,both,33.4,30.06,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.25
*KII SLEEVE 5 X 150,272,RC,,,,both,33.4,30.06,United Healthcare,Default,Fee Schedule,27.25,,,,19.71,27.25
KII SLEEVE 11 X 150,272,RC,,,,both,55.67,50.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.97,,,,32.85,45.43
KII SLEEVE 11 X 150,272,RC,,,,both,55.67,50.1,Cigna,Default,Percent of Total Billed Charges,32.85,,,,32.85,45.43
KII SLEEVE 11 X 150,272,RC,,,,both,55.67,50.1,United Healthcare,Default,Fee Schedule,45.43,,,,32.85,45.43
TROCAR 15X100MM OPTICAL ACCESS,272,RC,,,,both,162.93,146.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.05,,,,96.13,132.95
TROCAR 15X100MM OPTICAL ACCESS,272,RC,,,,both,162.93,146.64,Cigna,Default,Percent of Total Billed Charges,96.13,,,,96.13,132.95
TROCAR 15X100MM OPTICAL ACCESS,272,RC,,,,both,162.93,146.64,United Healthcare,Default,Fee Schedule,132.95,,,,96.13,132.95
TROCAR 5X100MM OPTIC ACCESS,272,RC,,,,both,76.01,68.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.21,,,,44.85,62.02
TROCAR 5X100MM OPTIC ACCESS,272,RC,,,,both,76.01,68.41,Cigna,Default,Percent of Total Billed Charges,44.85,,,,44.85,62.02
TROCAR 5X100MM OPTIC ACCESS,272,RC,,,,both,76.01,68.41,United Healthcare,Default,Fee Schedule,62.02,,,,44.85,62.02
CLIP APPLIER AUTO ENDO 5MM,272,RC,,,,both,470.28,423.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,329.2,,,,277.47,383.75
CLIP APPLIER AUTO ENDO 5MM,272,RC,,,,both,470.28,423.25,Cigna,Default,Percent of Total Billed Charges,277.47,,,,277.47,383.75
CLIP APPLIER AUTO ENDO 5MM,272,RC,,,,both,470.28,423.25,United Healthcare,Default,Fee Schedule,383.75,,,,277.47,383.75
TROCAR 5x100 NO BALLOON,272,RC,,,,both,77.94,70.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.56,,,,45.98,63.6
TROCAR 5x100 NO BALLOON,272,RC,,,,both,77.94,70.15,Cigna,Default,Percent of Total Billed Charges,45.98,,,,45.98,63.6
TROCAR 5x100 NO BALLOON,272,RC,,,,both,77.94,70.15,United Healthcare,Default,Fee Schedule,63.6,,,,45.98,63.6
TROCAR 5x150,272,RC,,,,both,76.01,68.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.21,,,,44.85,62.02
TROCAR 5x150,272,RC,,,,both,76.01,68.41,Cigna,Default,Percent of Total Billed Charges,44.85,,,,44.85,62.02
TROCAR 5x150,272,RC,,,,both,76.01,68.41,United Healthcare,Default,Fee Schedule,62.02,,,,44.85,62.02
TROCAR SLEEVE 5 X 100MM,272,RC,,,,both,33.78,30.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.65,,,,19.93,27.56
TROCAR SLEEVE 5 X 100MM,272,RC,,,,both,33.78,30.4,Cigna,Default,Percent of Total Billed Charges,19.93,,,,19.93,27.56
TROCAR SLEEVE 5 X 100MM,272,RC,,,,both,33.78,30.4,United Healthcare,Default,Fee Schedule,27.56,,,,19.93,27.56
ACCESS NEEDLE STEP INSUFFLATION,272,RC,,,,both,165.39,148.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.77,,,,97.58,134.96
ACCESS NEEDLE STEP INSUFFLATION,272,RC,,,,both,165.39,148.85,Cigna,Default,Percent of Total Billed Charges,97.58,,,,97.58,134.96
ACCESS NEEDLE STEP INSUFFLATION,272,RC,,,,both,165.39,148.85,United Healthcare,Default,Fee Schedule,134.96,,,,97.58,134.96
"NEEDLE, SURGINEEDLE 150MM LONG PNEUMOPER",272,RC,,,,both,88.33,79.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.83,,,,52.11,72.08
"NEEDLE, SURGINEEDLE 150MM LONG PNEUMOPER",272,RC,,,,both,88.33,79.5,Cigna,Default,Percent of Total Billed Charges,52.11,,,,52.11,72.08
"NEEDLE, SURGINEEDLE 150MM LONG PNEUMOPER",272,RC,,,,both,88.33,79.5,United Healthcare,Default,Fee Schedule,72.08,,,,52.11,72.08
DNO SPECIMEN RETRIEVAL SYSTEM 3X6,272,RC,,,,both,191.4,172.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.98,,,,112.93,156.18
DNO SPECIMEN RETRIEVAL SYSTEM 3X6,272,RC,,,,both,191.4,172.26,Cigna,Default,Percent of Total Billed Charges,112.93,,,,112.93,156.18
DNO SPECIMEN RETRIEVAL SYSTEM 3X6,272,RC,,,,both,191.4,172.26,United Healthcare,Default,Fee Schedule,156.18,,,,112.93,156.18
DNO ENDOSCOPIC PEANUT DEVICE 5MM,272,RC,,,,both,213.67,192.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.57,,,,126.07,174.35
DNO ENDOSCOPIC PEANUT DEVICE 5MM,272,RC,,,,both,213.67,192.3,Cigna,Default,Percent of Total Billed Charges,126.07,,,,126.07,174.35
DNO ENDOSCOPIC PEANUT DEVICE 5MM,272,RC,,,,both,213.67,192.3,United Healthcare,Default,Fee Schedule,174.35,,,,126.07,174.35
TROCAR OPTIC PORT 11x100MM,272,RC,,,,both,118.24,106.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.77,,,,69.76,96.48
TROCAR OPTIC PORT 11x100MM,272,RC,,,,both,118.24,106.42,Cigna,Default,Percent of Total Billed Charges,69.76,,,,69.76,96.48
TROCAR OPTIC PORT 11x100MM,272,RC,,,,both,118.24,106.42,United Healthcare,Default,Fee Schedule,96.48,,,,69.76,96.48
OPTICAL PORT SLEEVE 11 X 100,272,RC,,,,both,58.07,52.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.65,,,,34.26,47.39
OPTICAL PORT SLEEVE 11 X 100,272,RC,,,,both,58.07,52.26,Cigna,Default,Percent of Total Billed Charges,34.26,,,,34.26,47.39
OPTICAL PORT SLEEVE 11 X 100,272,RC,,,,both,58.07,52.26,United Healthcare,Default,Fee Schedule,47.39,,,,34.26,47.39
CLIP APPLIER 5MM ENDOCLIP III,272,RC,,,,both,1367.02,1230.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,956.91,,,,806.54,1115.49
CLIP APPLIER 5MM ENDOCLIP III,272,RC,,,,both,1367.02,1230.32,Cigna,Default,Percent of Total Billed Charges,806.54,,,,806.54,1115.49
CLIP APPLIER 5MM ENDOCLIP III,272,RC,,,,both,1367.02,1230.32,United Healthcare,Default,Fee Schedule,1115.49,,,,806.54,1115.49
CLIP APPLIER 10MM ENDOCLIP II,272,RC,,,,both,1136.67,1023,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,795.67,,,,670.64,927.52
CLIP APPLIER 10MM ENDOCLIP II,272,RC,,,,both,1136.67,1023,Cigna,Default,Percent of Total Billed Charges,670.64,,,,670.64,927.52
CLIP APPLIER 10MM ENDOCLIP II,272,RC,,,,both,1136.67,1023,United Healthcare,Default,Fee Schedule,927.52,,,,670.64,927.52
DRAIN ROUND WOUND W/ TROCAR 10FR,272,RC,,,,both,39.99,35.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.99,,,,23.59,32.63
DRAIN ROUND WOUND W/ TROCAR 10FR,272,RC,,,,both,39.99,35.99,Cigna,Default,Percent of Total Billed Charges,23.59,,,,23.59,32.63
DRAIN ROUND WOUND W/ TROCAR 10FR,272,RC,,,,both,39.99,35.99,United Healthcare,Default,Fee Schedule,32.63,,,,23.59,32.63
12X150 KII OPTICAL ACCESS SYSTEM,272,RC,,,,both,118.24,106.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.77,,,,69.76,96.48
12X150 KII OPTICAL ACCESS SYSTEM,272,RC,,,,both,118.24,106.42,Cigna,Default,Percent of Total Billed Charges,69.76,,,,69.76,96.48
12X150 KII OPTICAL ACCESS SYSTEM,272,RC,,,,both,118.24,106.42,United Healthcare,Default,Fee Schedule,96.48,,,,69.76,96.48
CATH OCCULDER OCCULISION 26FRX100CM,C1725,HCPCS,272,RC,,both,847.19,762.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,593.03,,,,499.84,691.31
CATH OCCULDER OCCULISION 26FRX100CM,C1725,HCPCS,272,RC,,both,847.19,762.47,Cigna,Default,Percent of Total Billed Charges,499.84,,,,499.84,691.31
CATH OCCULDER OCCULISION 26FRX100CM,C1725,HCPCS,272,RC,,both,847.19,762.47,United Healthcare,Default,Fee Schedule,691.31,,,,499.84,691.31
CATH OCCULDER OCCULSION 34FRX100CM,C1725,HCPCS,272,RC,,both,847.19,762.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,593.03,,,,499.84,691.31
CATH OCCULDER OCCULSION 34FRX100CM,C1725,HCPCS,272,RC,,both,847.19,762.47,Cigna,Default,Percent of Total Billed Charges,499.84,,,,499.84,691.31
CATH OCCULDER OCCULSION 34FRX100CM,C1725,HCPCS,272,RC,,both,847.19,762.47,United Healthcare,Default,Fee Schedule,691.31,,,,499.84,691.31
LINEAR RELOAD 60MM GREEN,272,RC,,,,both,550.76,495.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,385.53,,,,324.95,449.42
LINEAR RELOAD 60MM GREEN,272,RC,,,,both,550.76,495.68,Cigna,Default,Percent of Total Billed Charges,324.95,,,,324.95,449.42
LINEAR RELOAD 60MM GREEN,272,RC,,,,both,550.76,495.68,United Healthcare,Default,Fee Schedule,449.42,,,,324.95,449.42
STAPLER ETHELON POWERED 60MM,272,RC,,,,both,1344.03,1209.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,940.82,,,,792.98,1096.73
STAPLER ETHELON POWERED 60MM,272,RC,,,,both,1344.03,1209.63,Cigna,Default,Percent of Total Billed Charges,792.98,,,,792.98,1096.73
STAPLER ETHELON POWERED 60MM,272,RC,,,,both,1344.03,1209.63,United Healthcare,Default,Fee Schedule,1096.73,,,,792.98,1096.73
REINFORCEMENT ECHELON 60MM,272,RC,,,,both,757.54,681.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,530.28,,,,446.95,618.15
REINFORCEMENT ECHELON 60MM,272,RC,,,,both,757.54,681.79,Cigna,Default,Percent of Total Billed Charges,446.95,,,,446.95,618.15
REINFORCEMENT ECHELON 60MM,272,RC,,,,both,757.54,681.79,United Healthcare,Default,Fee Schedule,618.15,,,,446.95,618.15
"PUSH-BUTTON SMOKE EVAC PENCIL, COATED",272,RC,,,,both,97.13,87.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.99,,,,57.31,79.26
"PUSH-BUTTON SMOKE EVAC PENCIL, COATED",272,RC,,,,both,97.13,87.42,Cigna,Default,Percent of Total Billed Charges,57.31,,,,57.31,79.26
"PUSH-BUTTON SMOKE EVAC PENCIL, COATED",272,RC,,,,both,97.13,87.42,United Healthcare,Default,Fee Schedule,79.26,,,,57.31,79.26
CATH ART EMB 2FR,272,RC,,,,both,332.77,299.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,232.94,,,,196.33,271.54
CATH ART EMB 2FR,272,RC,,,,both,332.77,299.49,Cigna,Default,Percent of Total Billed Charges,196.33,,,,196.33,271.54
CATH ART EMB 2FR,272,RC,,,,both,332.77,299.49,United Healthcare,Default,Fee Schedule,271.54,,,,196.33,271.54
TRAY SPINAL PENCIL PO W/O LIDOCAINE,272,RC,,,,both,44.86,40.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.4,,,,26.47,36.61
TRAY SPINAL PENCIL PO W/O LIDOCAINE,272,RC,,,,both,44.86,40.37,Cigna,Default,Percent of Total Billed Charges,26.47,,,,26.47,36.61
TRAY SPINAL PENCIL PO W/O LIDOCAINE,272,RC,,,,both,44.86,40.37,United Healthcare,Default,Fee Schedule,36.61,,,,26.47,36.61
TRAY LUMBAR PUNCTURE PED,272,RC,,,,both,93.45,84.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.42,,,,55.14,76.26
TRAY LUMBAR PUNCTURE PED,272,RC,,,,both,93.45,84.11,Cigna,Default,Percent of Total Billed Charges,55.14,,,,55.14,76.26
TRAY LUMBAR PUNCTURE PED,272,RC,,,,both,93.45,84.11,United Healthcare,Default,Fee Schedule,76.26,,,,55.14,76.26
RELOAD LINEAR CUTTER 55MM,272,RC,,,,both,158.36,142.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.85,,,,93.43,129.22
RELOAD LINEAR CUTTER 55MM,272,RC,,,,both,158.36,142.52,Cigna,Default,Percent of Total Billed Charges,93.43,,,,93.43,129.22
RELOAD LINEAR CUTTER 55MM,272,RC,,,,both,158.36,142.52,United Healthcare,Default,Fee Schedule,129.22,,,,93.43,129.22
TRAY EPIDURAL PAINPAK,272,RC,,,,both,56.26,50.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.38,,,,33.19,45.91
TRAY EPIDURAL PAINPAK,272,RC,,,,both,56.26,50.63,Cigna,Default,Percent of Total Billed Charges,33.19,,,,33.19,45.91
TRAY EPIDURAL PAINPAK,272,RC,,,,both,56.26,50.63,United Healthcare,Default,Fee Schedule,45.91,,,,33.19,45.91
TRAY SPINAL PENCIL LIDOCAINE,272,RC,,,,both,64.35,57.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.04,,,,37.97,52.51
TRAY SPINAL PENCIL LIDOCAINE,272,RC,,,,both,64.35,57.92,Cigna,Default,Percent of Total Billed Charges,37.97,,,,37.97,52.51
TRAY SPINAL PENCIL LIDOCAINE,272,RC,,,,both,64.35,57.92,United Healthcare,Default,Fee Schedule,52.51,,,,37.97,52.51
*TRAY CONTINOUS EPIDURAL,272,RC,,,,both,88.64,79.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.05,,,,52.3,72.33
*TRAY CONTINOUS EPIDURAL,272,RC,,,,both,88.64,79.78,Cigna,Default,Percent of Total Billed Charges,52.3,,,,52.3,72.33
*TRAY CONTINOUS EPIDURAL,272,RC,,,,both,88.64,79.78,United Healthcare,Default,Fee Schedule,72.33,,,,52.3,72.33
TRAY LUMBAR PUNCTURE,272,RC,,,,both,70.93,63.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.65,,,,41.85,57.88
TRAY LUMBAR PUNCTURE,272,RC,,,,both,70.93,63.84,Cigna,Default,Percent of Total Billed Charges,41.85,,,,41.85,57.88
TRAY LUMBAR PUNCTURE,272,RC,,,,both,70.93,63.84,United Healthcare,Default,Fee Schedule,57.88,,,,41.85,57.88
TRAY CONTINOUS CONTINUOUS EPIDURAL TRAY,272,RC,,,,both,128.91,116.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.24,,,,76.06,105.19
TRAY CONTINOUS CONTINUOUS EPIDURAL TRAY,272,RC,,,,both,128.91,116.02,Cigna,Default,Percent of Total Billed Charges,76.06,,,,76.06,105.19
TRAY CONTINOUS CONTINUOUS EPIDURAL TRAY,272,RC,,,,both,128.91,116.02,United Healthcare,Default,Fee Schedule,105.19,,,,76.06,105.19
DNO TRAY THORACENTISIS,272,RC,,,,both,142.86,128.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100,,,,84.29,116.57
DNO TRAY THORACENTISIS,272,RC,,,,both,142.86,128.57,Cigna,Default,Percent of Total Billed Charges,84.29,,,,84.29,116.57
DNO TRAY THORACENTISIS,272,RC,,,,both,142.86,128.57,United Healthcare,Default,Fee Schedule,116.57,,,,84.29,116.57
*TRAY NERVE BLOCK CONT STIM,272,RC,,,,both,483.76,435.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.63,,,,285.42,394.75
*TRAY NERVE BLOCK CONT STIM,272,RC,,,,both,483.76,435.38,Cigna,Default,Percent of Total Billed Charges,285.42,,,,285.42,394.75
*TRAY NERVE BLOCK CONT STIM,272,RC,,,,both,483.76,435.38,United Healthcare,Default,Fee Schedule,394.75,,,,285.42,394.75
TRAY SPINAL NEEDLE PEACAN,272,RC,,,,both,78.17,70.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.72,,,,46.12,63.79
TRAY SPINAL NEEDLE PEACAN,272,RC,,,,both,78.17,70.35,Cigna,Default,Percent of Total Billed Charges,46.12,,,,46.12,63.79
TRAY SPINAL NEEDLE PEACAN,272,RC,,,,both,78.17,70.35,United Healthcare,Default,Fee Schedule,63.79,,,,46.12,63.79
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,127.39,114.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.17,,,,75.16,103.95
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,127.39,114.65,Cigna,Default,Percent of Total Billed Charges,75.16,,,,75.16,103.95
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,127.39,114.65,United Healthcare,Default,Fee Schedule,103.95,,,,75.16,103.95
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,111.93,100.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.35,,,,66.04,91.33
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,111.93,100.74,Cigna,Default,Percent of Total Billed Charges,66.04,,,,66.04,91.33
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,111.93,100.74,United Healthcare,Default,Fee Schedule,91.33,,,,66.04,91.33
TRAY NERVE BLOCK CONT STIM,272,RC,,,,both,326.65,293.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.66,,,,192.72,266.55
TRAY NERVE BLOCK CONT STIM,272,RC,,,,both,326.65,293.99,Cigna,Default,Percent of Total Billed Charges,192.72,,,,192.72,266.55
TRAY NERVE BLOCK CONT STIM,272,RC,,,,both,326.65,293.99,United Healthcare,Default,Fee Schedule,266.55,,,,192.72,266.55
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,111.97,100.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.38,,,,66.06,91.37
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,111.97,100.77,Cigna,Default,Percent of Total Billed Charges,66.06,,,,66.06,91.37
SET NERVE BLOCK CONT TUOHY,272,RC,,,,both,111.97,100.77,United Healthcare,Default,Fee Schedule,91.37,,,,66.06,91.37
SHEATH SUPER R/O  8FR 11CM,272,RC,,,,both,160.35,144.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.24,,,,94.61,130.85
SHEATH SUPER R/O  8FR 11CM,272,RC,,,,both,160.35,144.32,Cigna,Default,Percent of Total Billed Charges,94.61,,,,94.61,130.85
SHEATH SUPER R/O  8FR 11CM,272,RC,,,,both,160.35,144.32,United Healthcare,Default,Fee Schedule,130.85,,,,94.61,130.85
TIPLESS STONE EXTRACTOR,272,RC,,,,both,1202.13,1081.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,841.49,,,,709.26,980.94
TIPLESS STONE EXTRACTOR,272,RC,,,,both,1202.13,1081.92,Cigna,Default,Percent of Total Billed Charges,709.26,,,,709.26,980.94
TIPLESS STONE EXTRACTOR,272,RC,,,,both,1202.13,1081.92,United Healthcare,Default,Fee Schedule,980.94,,,,709.26,980.94
EXTRACTOR EBL 8.5-20,272,RC,,,,both,621.65,559.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,435.16,,,,366.77,507.27
EXTRACTOR EBL 8.5-20,272,RC,,,,both,621.65,559.49,Cigna,Default,Percent of Total Billed Charges,366.77,,,,366.77,507.27
EXTRACTOR EBL 8.5-20,272,RC,,,,both,621.65,559.49,United Healthcare,Default,Fee Schedule,507.27,,,,366.77,507.27
EXTRACTOR STONE EBL,272,RC,,,,both,511.02,459.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,357.71,,,,301.5,416.99
EXTRACTOR STONE EBL,272,RC,,,,both,511.02,459.92,Cigna,Default,Percent of Total Billed Charges,301.5,,,,301.5,416.99
EXTRACTOR STONE EBL,272,RC,,,,both,511.02,459.92,United Healthcare,Default,Fee Schedule,416.99,,,,301.5,416.99
WIRE BASKET MWB-2X4,272,RC,,,,both,1450.53,1305.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1015.37,,,,855.81,1183.63
WIRE BASKET MWB-2X4,272,RC,,,,both,1450.53,1305.48,Cigna,Default,Percent of Total Billed Charges,855.81,,,,855.81,1183.63
WIRE BASKET MWB-2X4,272,RC,,,,both,1450.53,1305.48,United Healthcare,Default,Fee Schedule,1183.63,,,,855.81,1183.63
BASKET MEMORY POLYP RETRIEVER 7FR,272,RC,,,,both,636.03,572.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,445.22,,,,375.26,519
BASKET MEMORY POLYP RETRIEVER 7FR,272,RC,,,,both,636.03,572.43,Cigna,Default,Percent of Total Billed Charges,375.26,,,,375.26,519
BASKET MEMORY POLYP RETRIEVER 7FR,272,RC,,,,both,636.03,572.43,United Healthcare,Default,Fee Schedule,519,,,,375.26,519
BLADE BEAVER 3M,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
BLADE BEAVER 3M,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
BLADE BEAVER 3M,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
BLADE BEAVER 5MM,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
BLADE BEAVER 5MM,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
BLADE BEAVER 5MM,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDOPATH ENDOSCOPIC DISSECTOR 5MM,272,RC,,,,both,46.9,42.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.83,,,,27.67,38.27
ENDOPATH ENDOSCOPIC DISSECTOR 5MM,272,RC,,,,both,46.9,42.21,Cigna,Default,Percent of Total Billed Charges,27.67,,,,27.67,38.27
ENDOPATH ENDOSCOPIC DISSECTOR 5MM,272,RC,,,,both,46.9,42.21,United Healthcare,Default,Fee Schedule,38.27,,,,27.67,38.27
STYLET INTUBATING 14FR,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
STYLET INTUBATING 14FR,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
STYLET INTUBATING 14FR,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
STYLET INTUBATING 10FR,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
STYLET INTUBATING 10FR,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
STYLET INTUBATING 10FR,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
BASKET RETRIEVER ZERO TIP,272,RC,,,,both,729.97,656.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,510.98,,,,430.68,595.66
BASKET RETRIEVER ZERO TIP,272,RC,,,,both,729.97,656.97,Cigna,Default,Percent of Total Billed Charges,430.68,,,,430.68,595.66
BASKET RETRIEVER ZERO TIP,272,RC,,,,both,729.97,656.97,United Healthcare,Default,Fee Schedule,595.66,,,,430.68,595.66
BASKET STONE RETRACTOR TIPLESS 1.5FR,272,RC,,,,both,1018.34,916.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,712.84,,,,600.82,830.97
BASKET STONE RETRACTOR TIPLESS 1.5FR,272,RC,,,,both,1018.34,916.51,Cigna,Default,Percent of Total Billed Charges,600.82,,,,600.82,830.97
BASKET STONE RETRACTOR TIPLESS 1.5FR,272,RC,,,,both,1018.34,916.51,United Healthcare,Default,Fee Schedule,830.97,,,,600.82,830.97
BASKET STONE SKYLITE TIPLESS 1.9FR,272,RC,,,,both,822.38,740.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,575.67,,,,485.2,671.06
BASKET STONE SKYLITE TIPLESS 1.9FR,272,RC,,,,both,822.38,740.14,Cigna,Default,Percent of Total Billed Charges,485.2,,,,485.2,671.06
BASKET STONE SKYLITE TIPLESS 1.9FR,272,RC,,,,both,822.38,740.14,United Healthcare,Default,Fee Schedule,671.06,,,,485.2,671.06
STAPLER ETHELON POWERED 340MM,272,RC,,,,both,1120.02,1008.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,784.01,,,,660.81,913.94
STAPLER ETHELON POWERED 340MM,272,RC,,,,both,1120.02,1008.02,Cigna,Default,Percent of Total Billed Charges,660.81,,,,660.81,913.94
STAPLER ETHELON POWERED 340MM,272,RC,,,,both,1120.02,1008.02,United Healthcare,Default,Fee Schedule,913.94,,,,660.81,913.94
STAPLER ETHELON POWERED 440MM,272,RC,,,,both,1122.92,1010.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,786.04,,,,662.52,916.3
STAPLER ETHELON POWERED 440MM,272,RC,,,,both,1122.92,1010.63,Cigna,Default,Percent of Total Billed Charges,662.52,,,,662.52,916.3
STAPLER ETHELON POWERED 440MM,272,RC,,,,both,1122.92,1010.63,United Healthcare,Default,Fee Schedule,916.3,,,,662.52,916.3
LINEAR RELOAD 60MM BLUE,272,RC,,,,both,538.68,484.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,377.08,,,,317.82,439.56
LINEAR RELOAD 60MM BLUE,272,RC,,,,both,538.68,484.81,Cigna,Default,Percent of Total Billed Charges,317.82,,,,317.82,439.56
LINEAR RELOAD 60MM BLUE,272,RC,,,,both,538.68,484.81,United Healthcare,Default,Fee Schedule,439.56,,,,317.82,439.56
LINEAR RELOAD 60MM BLACK,272,RC,,,,both,534.72,481.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,374.3,,,,315.48,436.33
LINEAR RELOAD 60MM BLACK,272,RC,,,,both,534.72,481.25,Cigna,Default,Percent of Total Billed Charges,315.48,,,,315.48,436.33
LINEAR RELOAD 60MM BLACK,272,RC,,,,both,534.72,481.25,United Healthcare,Default,Fee Schedule,436.33,,,,315.48,436.33
"ULTRABLATOR 30 DEGREE, THREE RIB",272,RC,,,,both,285.12,256.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.58,,,,168.22,232.66
"ULTRABLATOR 30 DEGREE, THREE RIB",272,RC,,,,both,285.12,256.61,Cigna,Default,Percent of Total Billed Charges,168.22,,,,168.22,232.66
"ULTRABLATOR 30 DEGREE, THREE RIB",272,RC,,,,both,285.12,256.61,United Healthcare,Default,Fee Schedule,232.66,,,,168.22,232.66
"ULTRABLATOR 90 DEGREE, THREE RIB",272,RC,,,,both,285.12,256.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.58,,,,168.22,232.66
"ULTRABLATOR 90 DEGREE, THREE RIB",272,RC,,,,both,285.12,256.61,Cigna,Default,Percent of Total Billed Charges,168.22,,,,168.22,232.66
"ULTRABLATOR 90 DEGREE, THREE RIB",272,RC,,,,both,285.12,256.61,United Healthcare,Default,Fee Schedule,232.66,,,,168.22,232.66
STENT 4.8FRX24CM URET,C1874,HCPCS,278,RC,,both,695.96,626.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,487.17,,,,410.62,567.9
STENT 4.8FRX24CM URET,C1874,HCPCS,278,RC,,both,695.96,626.36,Cigna,Default,Percent of Total Billed Charges,410.62,,,,410.62,567.9
STENT 4.8FRX24CM URET,C1874,HCPCS,278,RC,,both,695.96,626.36,United Healthcare,Default,Fee Schedule,567.9,,,,410.62,567.9
STENT 4.BFR 26 CM URET,C1874,HCPCS,278,RC,,both,695.96,626.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,487.17,,,,410.62,567.9
STENT 4.BFR 26 CM URET,C1874,HCPCS,278,RC,,both,695.96,626.36,Cigna,Default,Percent of Total Billed Charges,410.62,,,,410.62,567.9
STENT 4.BFR 26 CM URET,C1874,HCPCS,278,RC,,both,695.96,626.36,United Healthcare,Default,Fee Schedule,567.9,,,,410.62,567.9
7x26 CONTOUR URETERAL STENT,C1874,HCPCS,278,RC,,both,368.23,331.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.76,,,,217.26,300.48
7x26 CONTOUR URETERAL STENT,C1874,HCPCS,278,RC,,both,368.23,331.41,Cigna,Default,Percent of Total Billed Charges,217.26,,,,217.26,300.48
7x26 CONTOUR URETERAL STENT,C1874,HCPCS,278,RC,,both,368.23,331.41,United Healthcare,Default,Fee Schedule,300.48,,,,217.26,300.48
STENT 7FR X 24CM URETERAL SOFT,C1874,HCPCS,278,RC,,both,492.37,443.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.66,,,,290.5,401.77
STENT 7FR X 24CM URETERAL SOFT,C1874,HCPCS,278,RC,,both,492.37,443.13,Cigna,Default,Percent of Total Billed Charges,290.5,,,,290.5,401.77
STENT 7FR X 24CM URETERAL SOFT,C1874,HCPCS,278,RC,,both,492.37,443.13,United Healthcare,Default,Fee Schedule,401.77,,,,290.5,401.77
CATH 18FR X 4CM URETERAL BALLOON,272,RC,,,,both,892.61,803.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,624.83,,,,526.64,728.37
CATH 18FR X 4CM URETERAL BALLOON,272,RC,,,,both,892.61,803.35,Cigna,Default,Percent of Total Billed Charges,526.64,,,,526.64,728.37
CATH 18FR X 4CM URETERAL BALLOON,272,RC,,,,both,892.61,803.35,United Healthcare,Default,Fee Schedule,728.37,,,,526.64,728.37
STENT CAROTID 6MMX30MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5128.12,,,,4322.28,5977.93
STENT CAROTID 6MMX30MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,Cigna,Default,Percent of Total Billed Charges,4322.28,,,,4322.28,5977.93
STENT CAROTID 6MMX30MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,United Healthcare,Default,Fee Schedule,5977.93,,,,4322.28,5977.93
STENT CAROTID 6MMX20MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5128.12,,,,4322.28,5977.93
STENT CAROTID 6MMX20MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,Cigna,Default,Percent of Total Billed Charges,4322.28,,,,4322.28,5977.93
STENT CAROTID 6MMX20MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,United Healthcare,Default,Fee Schedule,5977.93,,,,4322.28,5977.93
STENT CAROTID 7MMX20MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5128.12,,,,4322.28,5977.93
STENT CAROTID 7MMX20MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,Cigna,Default,Percent of Total Billed Charges,4322.28,,,,4322.28,5977.93
STENT CAROTID 7MMX20MM,C1874,HCPCS,278,RC,,both,7325.89,6593.3,United Healthcare,Default,Fee Schedule,5977.93,,,,4322.28,5977.93
PAPILLOTOME HUIBRESGS,272,RC,,,,both,846.43,761.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,592.5,,,,499.39,690.69
PAPILLOTOME HUIBRESGS,272,RC,,,,both,846.43,761.79,Cigna,Default,Percent of Total Billed Charges,499.39,,,,499.39,690.69
PAPILLOTOME HUIBRESGS,272,RC,,,,both,846.43,761.79,United Healthcare,Default,Fee Schedule,690.69,,,,499.39,690.69
SUCTION IRRIGATION KIT W/TUBING,272,RC,,,,both,156.69,141.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.68,,,,92.45,127.86
SUCTION IRRIGATION KIT W/TUBING,272,RC,,,,both,156.69,141.02,Cigna,Default,Percent of Total Billed Charges,92.45,,,,92.45,127.86
SUCTION IRRIGATION KIT W/TUBING,272,RC,,,,both,156.69,141.02,United Healthcare,Default,Fee Schedule,127.86,,,,92.45,127.86
ENDOPATH PROBE SHAFT,272,RC,,,,both,76.76,69.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.73,,,,45.29,62.64
ENDOPATH PROBE SHAFT,272,RC,,,,both,76.76,69.08,Cigna,Default,Percent of Total Billed Charges,45.29,,,,45.29,62.64
ENDOPATH PROBE SHAFT,272,RC,,,,both,76.76,69.08,United Healthcare,Default,Fee Schedule,62.64,,,,45.29,62.64
*SHAFT EPS 04,272,RC,,,,both,142.72,128.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.9,,,,84.2,116.46
*SHAFT EPS 04,272,RC,,,,both,142.72,128.45,Cigna,Default,Percent of Total Billed Charges,84.2,,,,84.2,116.46
*SHAFT EPS 04,272,RC,,,,both,142.72,128.45,United Healthcare,Default,Fee Schedule,116.46,,,,84.2,116.46
SUCTION IRRIGATOR HANDPIECE - ENDOPATH,272,RC,,,,both,146.07,131.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.25,,,,86.18,119.19
SUCTION IRRIGATOR HANDPIECE - ENDOPATH,272,RC,,,,both,146.07,131.46,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.19
SUCTION IRRIGATOR HANDPIECE - ENDOPATH,272,RC,,,,both,146.07,131.46,United Healthcare,Default,Fee Schedule,119.19,,,,86.18,119.19
HOOK ENDOPATH ELECTRODE,272,RC,,,,both,76.76,69.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.73,,,,45.29,62.64
HOOK ENDOPATH ELECTRODE,272,RC,,,,both,76.76,69.08,Cigna,Default,Percent of Total Billed Charges,45.29,,,,45.29,62.64
HOOK ENDOPATH ELECTRODE,272,RC,,,,both,76.76,69.08,United Healthcare,Default,Fee Schedule,62.64,,,,45.29,62.64
EPIX SUCTION IRRIGATOR SYSTEM W/5MM PROB,272,RC,,,,both,236.43,212.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.5,,,,139.49,192.93
EPIX SUCTION IRRIGATOR SYSTEM W/5MM PROB,272,RC,,,,both,236.43,212.79,Cigna,Default,Percent of Total Billed Charges,139.49,,,,139.49,192.93
EPIX SUCTION IRRIGATOR SYSTEM W/5MM PROB,272,RC,,,,both,236.43,212.79,United Healthcare,Default,Fee Schedule,192.93,,,,139.49,192.93
TUBE NASOPHARYNGEAL 32,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
TUBE NASOPHARYNGEAL 32,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
TUBE NASOPHARYNGEAL 32,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
TUBE NASOPHARYNGEAL 30,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
TUBE NASOPHARYNGEAL 30,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
TUBE NASOPHARYNGEAL 30,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNU TRAY THORACOSTOMY,272,RC,,,,both,59.5,53.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.65,,,,35.1,48.55
DNU TRAY THORACOSTOMY,272,RC,,,,both,59.5,53.55,Cigna,Default,Percent of Total Billed Charges,35.1,,,,35.1,48.55
DNU TRAY THORACOSTOMY,272,RC,,,,both,59.5,53.55,United Healthcare,Default,Fee Schedule,48.55,,,,35.1,48.55
VALVE TRACH/VENT SWALLOWING,272,RC,,,,both,235.49,211.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.84,,,,138.94,192.16
VALVE TRACH/VENT SWALLOWING,272,RC,,,,both,235.49,211.94,Cigna,Default,Percent of Total Billed Charges,138.94,,,,138.94,192.16
VALVE TRACH/VENT SWALLOWING,272,RC,,,,both,235.49,211.94,United Healthcare,Default,Fee Schedule,192.16,,,,138.94,192.16
URINEMETER 400 ML BAG 2500 CC,A4357,HCPCS,272,RC,,both,26.92,24.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.84,,,,15.88,21.97
URINEMETER 400 ML BAG 2500 CC,A4357,HCPCS,272,RC,,both,26.92,24.23,Cigna,Default,Percent of Total Billed Charges,15.88,,,,15.88,21.97
URINEMETER 400 ML BAG 2500 CC,A4357,HCPCS,272,RC,,both,26.92,24.23,United Healthcare,Default,Fee Schedule,21.97,,,,15.88,21.97
PACK ANGIO (CUSTOM),272,RC,,,,both,229.83,206.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.88,,,,135.6,187.54
PACK ANGIO (CUSTOM),272,RC,,,,both,229.83,206.85,Cigna,Default,Percent of Total Billed Charges,135.6,,,,135.6,187.54
PACK ANGIO (CUSTOM),272,RC,,,,both,229.83,206.85,United Healthcare,Default,Fee Schedule,187.54,,,,135.6,187.54
SET MANOMETER W/STOPC,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SET MANOMETER W/STOPC,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SET MANOMETER W/STOPC,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
ENDO TUBE 3.0MM HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,22.7,20.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.89,,,,13.39,18.52
ENDO TUBE 3.0MM HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,22.7,20.43,Cigna,Default,Percent of Total Billed Charges,13.39,,,,13.39,18.52
ENDO TUBE 3.0MM HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,22.7,20.43,United Healthcare,Default,Fee Schedule,18.52,,,,13.39,18.52
DNO TUBE TRACH 5.0 UNCUFFED,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNO TUBE TRACH 5.0 UNCUFFED,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNO TUBE TRACH 5.0 UNCUFFED,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
ENDO TUBE ORAL RAE CUFFED 4.0,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 4.0,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE ORAL RAE CUFFED 4.0,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO TUBE TRACH 2.5 UNCUFFED,272,RC,,,,both,112.13,100.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.49,,,,66.16,91.5
DNO TUBE TRACH 2.5 UNCUFFED,272,RC,,,,both,112.13,100.92,Cigna,Default,Percent of Total Billed Charges,66.16,,,,66.16,91.5
DNO TUBE TRACH 2.5 UNCUFFED,272,RC,,,,both,112.13,100.92,United Healthcare,Default,Fee Schedule,91.5,,,,66.16,91.5
*TUBE TRACH 4.0 UNCUFFED,272,RC,,,,both,68.55,61.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.98,,,,40.44,55.94
*TUBE TRACH 4.0 UNCUFFED,272,RC,,,,both,68.55,61.7,Cigna,Default,Percent of Total Billed Charges,40.44,,,,40.44,55.94
*TUBE TRACH 4.0 UNCUFFED,272,RC,,,,both,68.55,61.7,United Healthcare,Default,Fee Schedule,55.94,,,,40.44,55.94
PH PROBE PAC-50015M,272,RC,,,,both,181.62,163.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.13,,,,107.16,148.2
PH PROBE PAC-50015M,272,RC,,,,both,181.62,163.46,Cigna,Default,Percent of Total Billed Charges,107.16,,,,107.16,148.2
PH PROBE PAC-50015M,272,RC,,,,both,181.62,163.46,United Healthcare,Default,Fee Schedule,148.2,,,,107.16,148.2
ENDO TUBE 3.5MM ORAL RAE MICROCUFF PED,272,RC,,,,both,38.88,34.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.22,,,,22.94,31.73
ENDO TUBE 3.5MM ORAL RAE MICROCUFF PED,272,RC,,,,both,38.88,34.99,Cigna,Default,Percent of Total Billed Charges,22.94,,,,22.94,31.73
ENDO TUBE 3.5MM ORAL RAE MICROCUFF PED,272,RC,,,,both,38.88,34.99,United Healthcare,Default,Fee Schedule,31.73,,,,22.94,31.73
DNO ENDO TUBE 4.0MM ORAL RAE CUFFED PED,272,RC,,,,both,82.68,74.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.88,,,,48.78,67.47
DNO ENDO TUBE 4.0MM ORAL RAE CUFFED PED,272,RC,,,,both,82.68,74.41,Cigna,Default,Percent of Total Billed Charges,48.78,,,,48.78,67.47
DNO ENDO TUBE 4.0MM ORAL RAE CUFFED PED,272,RC,,,,both,82.68,74.41,United Healthcare,Default,Fee Schedule,67.47,,,,48.78,67.47
ENDO TUBE ORAL RAE CUFFED 4.5,272,RC,,,,both,47.44,42.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.21,,,,27.99,38.71
ENDO TUBE ORAL RAE CUFFED 4.5,272,RC,,,,both,47.44,42.7,Cigna,Default,Percent of Total Billed Charges,27.99,,,,27.99,38.71
ENDO TUBE ORAL RAE CUFFED 4.5,272,RC,,,,both,47.44,42.7,United Healthcare,Default,Fee Schedule,38.71,,,,27.99,38.71
DNO ENDO TUBE 5.0MM ORAL RAE CUFFED PED,272,RC,,,,both,36.43,32.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.5,,,,21.49,29.73
DNO ENDO TUBE 5.0MM ORAL RAE CUFFED PED,272,RC,,,,both,36.43,32.79,Cigna,Default,Percent of Total Billed Charges,21.49,,,,21.49,29.73
DNO ENDO TUBE 5.0MM ORAL RAE CUFFED PED,272,RC,,,,both,36.43,32.79,United Healthcare,Default,Fee Schedule,29.73,,,,21.49,29.73
DNO ENDO TUBE 5.5 ORAL RAE CUFFED PED,272,RC,,,,both,47.44,42.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.21,,,,27.99,38.71
DNO ENDO TUBE 5.5 ORAL RAE CUFFED PED,272,RC,,,,both,47.44,42.7,Cigna,Default,Percent of Total Billed Charges,27.99,,,,27.99,38.71
DNO ENDO TUBE 5.5 ORAL RAE CUFFED PED,272,RC,,,,both,47.44,42.7,United Healthcare,Default,Fee Schedule,38.71,,,,27.99,38.71
DNO TUBE TRACH 4.0 UNCUFFED,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO TUBE TRACH 4.0 UNCUFFED,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO TUBE TRACH 4.0 UNCUFFED,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
ENDO TUBE 4.0 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
ENDO TUBE 4.0 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
ENDO TUBE 4.0 HI-LO CUFFED ORAL/NASAL,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
LEADWIRE 4470,C1899,HCPCS,275,RC,,both,3163.45,2847.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2214.42,,,,1866.44,2581.38
LEADWIRE 4470,C1899,HCPCS,275,RC,,both,3163.45,2847.11,Cigna,Default,Percent of Total Billed Charges,1866.44,,,,1866.44,2581.38
LEADWIRE 4470,C1899,HCPCS,275,RC,,both,3163.45,2847.11,United Healthcare,Default,Fee Schedule,2581.38,,,,1866.44,2581.38
LEADWIRE 4457,C1899,HCPCS,275,RC,,both,3163.45,2847.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2214.42,,,,1866.44,2581.38
LEADWIRE 4457,C1899,HCPCS,275,RC,,both,3163.45,2847.11,Cigna,Default,Percent of Total Billed Charges,1866.44,,,,1866.44,2581.38
LEADWIRE 4457,C1899,HCPCS,275,RC,,both,3163.45,2847.11,United Healthcare,Default,Fee Schedule,2581.38,,,,1866.44,2581.38
AUTOMATIC ICD IMPLANT,C1785,HCPCS,275,RC,,both,60022.35,54020.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42015.64,,,,35413.19,48978.24
AUTOMATIC ICD IMPLANT,C1785,HCPCS,275,RC,,both,60022.35,54020.12,Cigna,Default,Percent of Total Billed Charges,35413.19,,,,35413.19,48978.24
AUTOMATIC ICD IMPLANT,C1785,HCPCS,275,RC,,both,60022.35,54020.12,United Healthcare,Default,Fee Schedule,48978.24,,,,35413.19,48978.24
LEADWIRE 0148-141619  ICD,C1896,HCPCS,275,RC,,both,24008.94,21608.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16806.26,,,,14165.27,19591.3
LEADWIRE 0148-141619  ICD,C1896,HCPCS,275,RC,,both,24008.94,21608.05,Cigna,Default,Percent of Total Billed Charges,14165.27,,,,14165.27,19591.3
LEADWIRE 0148-141619  ICD,C1896,HCPCS,275,RC,,both,24008.94,21608.05,United Healthcare,Default,Fee Schedule,19591.3,,,,14165.27,19591.3
INTRODUCER HEMOSTASIS 6FR 12CM,272,RC,,,,both,34.24,30.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.97,,,,20.2,27.94
INTRODUCER HEMOSTASIS 6FR 12CM,272,RC,,,,both,34.24,30.82,Cigna,Default,Percent of Total Billed Charges,20.2,,,,20.2,27.94
INTRODUCER HEMOSTASIS 6FR 12CM,272,RC,,,,both,34.24,30.82,United Healthcare,Default,Fee Schedule,27.94,,,,20.2,27.94
INTRODUCER HEMOSTASIS 6FR 5CM,272,RC,,,,both,43.24,38.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.27,,,,25.51,35.28
INTRODUCER HEMOSTASIS 6FR 5CM,272,RC,,,,both,43.24,38.92,Cigna,Default,Percent of Total Billed Charges,25.51,,,,25.51,35.28
INTRODUCER HEMOSTASIS 6FR 5CM,272,RC,,,,both,43.24,38.92,United Healthcare,Default,Fee Schedule,35.28,,,,25.51,35.28
NEEDLE ASPERATION 21G 13MM,272,RC,,,,both,242.32,218.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.62,,,,142.97,197.73
NEEDLE ASPERATION 21G 13MM,272,RC,,,,both,242.32,218.09,Cigna,Default,Percent of Total Billed Charges,142.97,,,,142.97,197.73
NEEDLE ASPERATION 21G 13MM,272,RC,,,,both,242.32,218.09,United Healthcare,Default,Fee Schedule,197.73,,,,142.97,197.73
NEEDLE ASPERATION 21G W/PORT 13MM,272,RC,,,,both,272.93,245.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.05,,,,161.03,222.71
NEEDLE ASPERATION 21G W/PORT 13MM,272,RC,,,,both,272.93,245.64,Cigna,Default,Percent of Total Billed Charges,161.03,,,,161.03,222.71
NEEDLE ASPERATION 21G W/PORT 13MM,272,RC,,,,both,272.93,245.64,United Healthcare,Default,Fee Schedule,222.71,,,,161.03,222.71
NEEDLE ASPIRATION NA2 SMOOTHSHOT 21G,272,RC,,,,both,272.93,245.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,191.05,,,,161.03,222.71
NEEDLE ASPIRATION NA2 SMOOTHSHOT 21G,272,RC,,,,both,272.93,245.64,Cigna,Default,Percent of Total Billed Charges,161.03,,,,161.03,222.71
NEEDLE ASPIRATION NA2 SMOOTHSHOT 21G,272,RC,,,,both,272.93,245.64,United Healthcare,Default,Fee Schedule,222.71,,,,161.03,222.71
NEEDLE SPINAL 18 X 3 1/2,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
NEEDLE SPINAL 18 X 3 1/2,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
NEEDLE SPINAL 18 X 3 1/2,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO NEEDLE 22 X 3/4 NON-C,272,RC,,,,both,50.76,45.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.53,,,,29.95,41.42
DNO NEEDLE 22 X 3/4 NON-C,272,RC,,,,both,50.76,45.68,Cigna,Default,Percent of Total Billed Charges,29.95,,,,29.95,41.42
DNO NEEDLE 22 X 3/4 NON-C,272,RC,,,,both,50.76,45.68,United Healthcare,Default,Fee Schedule,41.42,,,,29.95,41.42
TUBE UNIVENT ENDO 6.5,272,RC,,,,both,628.68,565.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.08,,,,370.92,513
TUBE UNIVENT ENDO 6.5,272,RC,,,,both,628.68,565.81,Cigna,Default,Percent of Total Billed Charges,370.92,,,,370.92,513
TUBE UNIVENT ENDO 6.5,272,RC,,,,both,628.68,565.81,United Healthcare,Default,Fee Schedule,513,,,,370.92,513
*TUBE UNIVENT 6.0,272,RC,,,,both,628.68,565.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.08,,,,370.92,513
*TUBE UNIVENT 6.0,272,RC,,,,both,628.68,565.81,Cigna,Default,Percent of Total Billed Charges,370.92,,,,370.92,513
*TUBE UNIVENT 6.0,272,RC,,,,both,628.68,565.81,United Healthcare,Default,Fee Schedule,513,,,,370.92,513
TUBE UNIVENT ENDO 7.5MM,272,RC,,,,both,628.68,565.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.08,,,,370.92,513
TUBE UNIVENT ENDO 7.5MM,272,RC,,,,both,628.68,565.81,Cigna,Default,Percent of Total Billed Charges,370.92,,,,370.92,513
TUBE UNIVENT ENDO 7.5MM,272,RC,,,,both,628.68,565.81,United Healthcare,Default,Fee Schedule,513,,,,370.92,513
TUBE UNIVENT ENDO 7.0MM,272,RC,,,,both,628.68,565.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.08,,,,370.92,513
TUBE UNIVENT ENDO 7.0MM,272,RC,,,,both,628.68,565.81,Cigna,Default,Percent of Total Billed Charges,370.92,,,,370.92,513
TUBE UNIVENT ENDO 7.0MM,272,RC,,,,both,628.68,565.81,United Healthcare,Default,Fee Schedule,513,,,,370.92,513
TUBE UNIVENT ENDO 8.5,272,RC,,,,both,628.68,565.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.08,,,,370.92,513
TUBE UNIVENT ENDO 8.5,272,RC,,,,both,628.68,565.81,Cigna,Default,Percent of Total Billed Charges,370.92,,,,370.92,513
TUBE UNIVENT ENDO 8.5,272,RC,,,,both,628.68,565.81,United Healthcare,Default,Fee Schedule,513,,,,370.92,513
TUBE UNIVENT ENDO 8.0,272,RC,,,,both,628.68,565.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.08,,,,370.92,513
TUBE UNIVENT ENDO 8.0,272,RC,,,,both,628.68,565.81,Cigna,Default,Percent of Total Billed Charges,370.92,,,,370.92,513
TUBE UNIVENT ENDO 8.0,272,RC,,,,both,628.68,565.81,United Healthcare,Default,Fee Schedule,513,,,,370.92,513
NEEDLE SPINAL 22 X 3.5,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
NEEDLE SPINAL 22 X 3.5,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
NEEDLE SPINAL 22 X 3.5,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
DNU NEEDLE SPINAL 22 X 5,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNU NEEDLE SPINAL 22 X 5,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNU NEEDLE SPINAL 22 X 5,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
DNO NEEDLE RIGHT ANGLE 20G X 1,272,RC,,,,both,30.75,27.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.52,,,,18.14,25.09
DNO NEEDLE RIGHT ANGLE 20G X 1,272,RC,,,,both,30.75,27.68,Cigna,Default,Percent of Total Billed Charges,18.14,,,,18.14,25.09
DNO NEEDLE RIGHT ANGLE 20G X 1,272,RC,,,,both,30.75,27.68,United Healthcare,Default,Fee Schedule,25.09,,,,18.14,25.09
DNO NEEDLE 20 X 3/4 NDN-C,272,RC,,,,both,24.3,21.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.01,,,,14.34,19.83
DNO NEEDLE 20 X 3/4 NDN-C,272,RC,,,,both,24.3,21.87,Cigna,Default,Percent of Total Billed Charges,14.34,,,,14.34,19.83
DNO NEEDLE 20 X 3/4 NDN-C,272,RC,,,,both,24.3,21.87,United Healthcare,Default,Fee Schedule,19.83,,,,14.34,19.83
DNO NEEDLE 22 X 1 NON-COR,272,RC,,,,both,52.32,47.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.62,,,,30.87,42.69
DNO NEEDLE 22 X 1 NON-COR,272,RC,,,,both,52.32,47.09,Cigna,Default,Percent of Total Billed Charges,30.87,,,,30.87,42.69
DNO NEEDLE 22 X 1 NON-COR,272,RC,,,,both,52.32,47.09,United Healthcare,Default,Fee Schedule,42.69,,,,30.87,42.69
DNO NEEDLE 19 X 1.5 NON-CORING RT,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO NEEDLE 19 X 1.5 NON-CORING RT,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO NEEDLE 19 X 1.5 NON-CORING RT,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO NEEDLE 19 X 3/4 NDN-C,272,RC,,,,both,23.22,20.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.25,,,,13.7,18.95
DNO NEEDLE 19 X 3/4 NDN-C,272,RC,,,,both,23.22,20.9,Cigna,Default,Percent of Total Billed Charges,13.7,,,,13.7,18.95
DNO NEEDLE 19 X 3/4 NDN-C,272,RC,,,,both,23.22,20.9,United Healthcare,Default,Fee Schedule,18.95,,,,13.7,18.95
GUIDE WIRE STEERABLE,C1769,HCPCS,278,RC,,both,466.19,419.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,326.33,,,,275.05,380.41
GUIDE WIRE STEERABLE,C1769,HCPCS,278,RC,,both,466.19,419.57,Cigna,Default,Percent of Total Billed Charges,275.05,,,,275.05,380.41
GUIDE WIRE STEERABLE,C1769,HCPCS,278,RC,,both,466.19,419.57,United Healthcare,Default,Fee Schedule,380.41,,,,275.05,380.41
CANNULA 100MM 20G,272,RC,,,,both,182.19,163.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.53,,,,107.49,148.67
CANNULA 100MM 20G,272,RC,,,,both,182.19,163.97,Cigna,Default,Percent of Total Billed Charges,107.49,,,,107.49,148.67
CANNULA 100MM 20G,272,RC,,,,both,182.19,163.97,United Healthcare,Default,Fee Schedule,148.67,,,,107.49,148.67
GROUNDING PAD RFA,272,RC,,,,both,105.47,94.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.83,,,,62.23,86.06
GROUNDING PAD RFA,272,RC,,,,both,105.47,94.92,Cigna,Default,Percent of Total Billed Charges,62.23,,,,62.23,86.06
GROUNDING PAD RFA,272,RC,,,,both,105.47,94.92,United Healthcare,Default,Fee Schedule,86.06,,,,62.23,86.06
ALEXIS WOUND PROTECTOR/RETRACTOR X-LARG,272,RC,,,,both,206.46,185.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.52,,,,121.81,168.47
ALEXIS WOUND PROTECTOR/RETRACTOR X-LARG,272,RC,,,,both,206.46,185.81,Cigna,Default,Percent of Total Billed Charges,121.81,,,,121.81,168.47
ALEXIS WOUND PROTECTOR/RETRACTOR X-LARG,272,RC,,,,both,206.46,185.81,United Healthcare,Default,Fee Schedule,168.47,,,,121.81,168.47
ALEXIS WOUND PROTECTOR/RETRACTOR XX-LARG,272,RC,,,,both,319.68,287.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.78,,,,188.61,260.86
ALEXIS WOUND PROTECTOR/RETRACTOR XX-LARG,272,RC,,,,both,319.68,287.71,Cigna,Default,Percent of Total Billed Charges,188.61,,,,188.61,260.86
ALEXIS WOUND PROTECTOR/RETRACTOR XX-LARG,272,RC,,,,both,319.68,287.71,United Healthcare,Default,Fee Schedule,260.86,,,,188.61,260.86
ALEXIS WOUND PROTECTOR/RETRACTOR LARGE,272,RC,,,,both,200.9,180.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.63,,,,118.53,163.93
ALEXIS WOUND PROTECTOR/RETRACTOR LARGE,272,RC,,,,both,200.9,180.81,Cigna,Default,Percent of Total Billed Charges,118.53,,,,118.53,163.93
ALEXIS WOUND PROTECTOR/RETRACTOR LARGE,272,RC,,,,both,200.9,180.81,United Healthcare,Default,Fee Schedule,163.93,,,,118.53,163.93
ALEXIS WOUND PROTECTOR/RETRACTOR MEDIU,272,RC,,,,both,131.2,118.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.84,,,,77.41,107.06
ALEXIS WOUND PROTECTOR/RETRACTOR MEDIU,272,RC,,,,both,131.2,118.08,Cigna,Default,Percent of Total Billed Charges,77.41,,,,77.41,107.06
ALEXIS WOUND PROTECTOR/RETRACTOR MEDIU,272,RC,,,,both,131.2,118.08,United Healthcare,Default,Fee Schedule,107.06,,,,77.41,107.06
DNU STENT SMART 6X20CM,C1874,HCPCS,278,RC,,both,5162.75,4646.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3613.92,,,,3046.02,4212.8
DNU STENT SMART 6X20CM,C1874,HCPCS,278,RC,,both,5162.75,4646.48,Cigna,Default,Percent of Total Billed Charges,3046.02,,,,3046.02,4212.8
DNU STENT SMART 6X20CM,C1874,HCPCS,278,RC,,both,5162.75,4646.48,United Healthcare,Default,Fee Schedule,4212.8,,,,3046.02,4212.8
STENT SMART 14X40,C1874,HCPCS,278,RC,,both,4706.72,4236.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3294.7,,,,2776.96,3840.68
STENT SMART 14X40,C1874,HCPCS,278,RC,,both,4706.72,4236.05,Cigna,Default,Percent of Total Billed Charges,2776.96,,,,2776.96,3840.68
STENT SMART 14X40,C1874,HCPCS,278,RC,,both,4706.72,4236.05,United Healthcare,Default,Fee Schedule,3840.68,,,,2776.96,3840.68
STENT SMART 14X60,C1874,HCPCS,278,RC,,both,4706.72,4236.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3294.7,,,,2776.96,3840.68
STENT SMART 14X60,C1874,HCPCS,278,RC,,both,4706.72,4236.05,Cigna,Default,Percent of Total Billed Charges,2776.96,,,,2776.96,3840.68
STENT SMART 14X60,C1874,HCPCS,278,RC,,both,4706.72,4236.05,United Healthcare,Default,Fee Schedule,3840.68,,,,2776.96,3840.68
DNU SENSOR OXISENSOR II N-25,272,RC,,,,both,45.06,40.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.54,,,,26.59,36.77
DNU SENSOR OXISENSOR II N-25,272,RC,,,,both,45.06,40.55,Cigna,Default,Percent of Total Billed Charges,26.59,,,,26.59,36.77
DNU SENSOR OXISENSOR II N-25,272,RC,,,,both,45.06,40.55,United Healthcare,Default,Fee Schedule,36.77,,,,26.59,36.77
SYRINGE EPIDURAL 7CC,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SYRINGE EPIDURAL 7CC,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SYRINGE EPIDURAL 7CC,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
LIGACLIP ALLPORT M/L,272,RC,,,,both,1948.22,1753.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1363.75,,,,1149.45,1589.75
LIGACLIP ALLPORT M/L,272,RC,,,,both,1948.22,1753.4,Cigna,Default,Percent of Total Billed Charges,1149.45,,,,1149.45,1589.75
LIGACLIP ALLPORT M/L,272,RC,,,,both,1948.22,1753.4,United Healthcare,Default,Fee Schedule,1589.75,,,,1149.45,1589.75
UROSTOMY POST OP 3/4,272,RC,,,,both,30.25,27.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.18,,,,17.85,24.68
UROSTOMY POST OP 3/4,272,RC,,,,both,30.25,27.23,Cigna,Default,Percent of Total Billed Charges,17.85,,,,17.85,24.68
UROSTOMY POST OP 3/4,272,RC,,,,both,30.25,27.23,United Healthcare,Default,Fee Schedule,24.68,,,,17.85,24.68
BLADE BEAVER MINI,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
BLADE BEAVER MINI,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
BLADE BEAVER MINI,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH ULTRA 5FR/120CM,272,RC,,,,both,948.3,853.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,663.81,,,,559.5,773.81
CATH ULTRA 5FR/120CM,272,RC,,,,both,948.3,853.47,Cigna,Default,Percent of Total Billed Charges,559.5,,,,559.5,773.81
CATH ULTRA 5FR/120CM,272,RC,,,,both,948.3,853.47,United Healthcare,Default,Fee Schedule,773.81,,,,559.5,773.81
SHEATH 6FR 11C BRIGHT,C1874,HCPCS,278,RC,,both,51.25,46.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.88,,,,30.24,41.82
SHEATH 6FR 11C BRIGHT,C1874,HCPCS,278,RC,,both,51.25,46.13,Cigna,Default,Percent of Total Billed Charges,30.24,,,,30.24,41.82
SHEATH 6FR 11C BRIGHT,C1874,HCPCS,278,RC,,both,51.25,46.13,United Healthcare,Default,Fee Schedule,41.82,,,,30.24,41.82
DNU CATH 5X2X120 ULTRA DI,272,RC,,,,both,631.25,568.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,441.88,,,,372.44,515.1
DNU CATH 5X2X120 ULTRA DI,272,RC,,,,both,631.25,568.13,Cigna,Default,Percent of Total Billed Charges,372.44,,,,372.44,515.1
DNU CATH 5X2X120 ULTRA DI,272,RC,,,,both,631.25,568.13,United Healthcare,Default,Fee Schedule,515.1,,,,372.44,515.1
*CATH BRONCHO 41FR RIGHT,272,RC,,,,both,397.93,358.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,278.55,,,,234.78,324.71
*CATH BRONCHO 41FR RIGHT,272,RC,,,,both,397.93,358.14,Cigna,Default,Percent of Total Billed Charges,234.78,,,,234.78,324.71
*CATH BRONCHO 41FR RIGHT,272,RC,,,,both,397.93,358.14,United Healthcare,Default,Fee Schedule,324.71,,,,234.78,324.71
DNO NEEDLE SPINAL 22 X 8 INCH,270,RC,,,,both,64.87,58.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.41,,,,38.27,52.93
DNO NEEDLE SPINAL 22 X 8 INCH,270,RC,,,,both,64.87,58.38,Cigna,Default,Percent of Total Billed Charges,38.27,,,,38.27,52.93
DNO NEEDLE SPINAL 22 X 8 INCH,270,RC,,,,both,64.87,58.38,United Healthcare,Default,Fee Schedule,52.93,,,,38.27,52.93
*NEEDLE SPINAL 25G 3 1/2,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*NEEDLE SPINAL 25G 3 1/2,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*NEEDLE SPINAL 25G 3 1/2,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO NEEDLE SPINAL 20G X6IN LONG LENGTH,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO NEEDLE SPINAL 20G X6IN LONG LENGTH,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO NEEDLE SPINAL 20G X6IN LONG LENGTH,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO NEEDLE SPINAL 18G X 6IN LONG LENGTH,272,RC,,,,both,25.17,22.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.62,,,,14.85,20.54
DNO NEEDLE SPINAL 18G X 6IN LONG LENGTH,272,RC,,,,both,25.17,22.65,Cigna,Default,Percent of Total Billed Charges,14.85,,,,14.85,20.54
DNO NEEDLE SPINAL 18G X 6IN LONG LENGTH,272,RC,,,,both,25.17,22.65,United Healthcare,Default,Fee Schedule,20.54,,,,14.85,20.54
DNO NEEDLE SPINAL 22X5,272,RC,,,,both,31.64,28.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.15,,,,18.67,25.82
DNO NEEDLE SPINAL 22X5,272,RC,,,,both,31.64,28.48,Cigna,Default,Percent of Total Billed Charges,18.67,,,,18.67,25.82
DNO NEEDLE SPINAL 22X5,272,RC,,,,both,31.64,28.48,United Healthcare,Default,Fee Schedule,25.82,,,,18.67,25.82
DNO NEEDLE SPINAL 20X5,272,RC,,,,both,31.64,28.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.15,,,,18.67,25.82
DNO NEEDLE SPINAL 20X5,272,RC,,,,both,31.64,28.48,Cigna,Default,Percent of Total Billed Charges,18.67,,,,18.67,25.82
DNO NEEDLE SPINAL 20X5,272,RC,,,,both,31.64,28.48,United Healthcare,Default,Fee Schedule,25.82,,,,18.67,25.82
NEEDLE SPINAL TUOHY 20GX6,272,RC,,,,both,27.55,24.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.28,,,,16.25,22.48
NEEDLE SPINAL TUOHY 20GX6,272,RC,,,,both,27.55,24.8,Cigna,Default,Percent of Total Billed Charges,16.25,,,,16.25,22.48
NEEDLE SPINAL TUOHY 20GX6,272,RC,,,,both,27.55,24.8,United Healthcare,Default,Fee Schedule,22.48,,,,16.25,22.48
NEEDLE SPINAL TUOHY 22GX5,272,RC,,,,both,44.9,40.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.43,,,,26.49,36.64
NEEDLE SPINAL TUOHY 22GX5,272,RC,,,,both,44.9,40.41,Cigna,Default,Percent of Total Billed Charges,26.49,,,,26.49,36.64
NEEDLE SPINAL TUOHY 22GX5,272,RC,,,,both,44.9,40.41,United Healthcare,Default,Fee Schedule,36.64,,,,26.49,36.64
BASKET STONE 2.4 FR GEMINI 3 WIRE,272,RC,,,,both,1045.74,941.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,732.02,,,,616.99,853.32
BASKET STONE 2.4 FR GEMINI 3 WIRE,272,RC,,,,both,1045.74,941.17,Cigna,Default,Percent of Total Billed Charges,616.99,,,,616.99,853.32
BASKET STONE 2.4 FR GEMINI 3 WIRE,272,RC,,,,both,1045.74,941.17,United Healthcare,Default,Fee Schedule,853.32,,,,616.99,853.32
SHEATH 7FR BRIGHT TIP 5.5CM,272,RC,,,,both,110.87,99.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.61,,,,65.41,90.47
SHEATH 7FR BRIGHT TIP 5.5CM,272,RC,,,,both,110.87,99.78,Cigna,Default,Percent of Total Billed Charges,65.41,,,,65.41,90.47
SHEATH 7FR BRIGHT TIP 5.5CM,272,RC,,,,both,110.87,99.78,United Healthcare,Default,Fee Schedule,90.47,,,,65.41,90.47
SHEATH 7FR BRIGHT TI,272,RC,,,,both,137.21,123.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.05,,,,80.95,111.96
SHEATH 7FR BRIGHT TI,272,RC,,,,both,137.21,123.49,Cigna,Default,Percent of Total Billed Charges,80.95,,,,80.95,111.96
SHEATH 7FR BRIGHT TI,272,RC,,,,both,137.21,123.49,United Healthcare,Default,Fee Schedule,111.96,,,,80.95,111.96
CATH PIGTAIL 4FR 110CM,C1887,HCPCS,272,RC,,both,46.9,42.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.83,,,,27.67,38.27
CATH PIGTAIL 4FR 110CM,C1887,HCPCS,272,RC,,both,46.9,42.21,Cigna,Default,Percent of Total Billed Charges,27.67,,,,27.67,38.27
CATH PIGTAIL 4FR 110CM,C1887,HCPCS,272,RC,,both,46.9,42.21,United Healthcare,Default,Fee Schedule,38.27,,,,27.67,38.27
CATH PIGTAIL 4FR  65CM,C1887,HCPCS,272,RC,,both,49.2,44.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.44,,,,29.03,40.15
CATH PIGTAIL 4FR  65CM,C1887,HCPCS,272,RC,,both,49.2,44.28,Cigna,Default,Percent of Total Billed Charges,29.03,,,,29.03,40.15
CATH PIGTAIL 4FR  65CM,C1887,HCPCS,272,RC,,both,49.2,44.28,United Healthcare,Default,Fee Schedule,40.15,,,,29.03,40.15
ACCU-VU PIGTAIL 4FX70CM,C1887,HCPCS,272,RC,,both,949.65,854.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,664.76,,,,560.29,774.91
ACCU-VU PIGTAIL 4FX70CM,C1887,HCPCS,272,RC,,both,949.65,854.69,Cigna,Default,Percent of Total Billed Charges,560.29,,,,560.29,774.91
ACCU-VU PIGTAIL 4FX70CM,C1887,HCPCS,272,RC,,both,949.65,854.69,United Healthcare,Default,Fee Schedule,774.91,,,,560.29,774.91
GUIDE WIRE 300CM X 035 STORQ,C1769,HCPCS,278,RC,,both,216.78,195.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.75,,,,127.9,176.89
GUIDE WIRE 300CM X 035 STORQ,C1769,HCPCS,278,RC,,both,216.78,195.1,Cigna,Default,Percent of Total Billed Charges,127.9,,,,127.9,176.89
GUIDE WIRE 300CM X 035 STORQ,C1769,HCPCS,278,RC,,both,216.78,195.1,United Healthcare,Default,Fee Schedule,176.89,,,,127.9,176.89
WIRE INFUSION KATZEN,272,RC,,,,both,705.95,635.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,494.16,,,,416.51,576.06
WIRE INFUSION KATZEN,272,RC,,,,both,705.95,635.36,Cigna,Default,Percent of Total Billed Charges,416.51,,,,416.51,576.06
WIRE INFUSION KATZEN,272,RC,,,,both,705.95,635.36,United Healthcare,Default,Fee Schedule,576.06,,,,416.51,576.06
STENT WALL 20 X 40 CM,C1874,HCPCS,278,RC,,both,3979.29,3581.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2785.5,,,,2347.78,3247.1
STENT WALL 20 X 40 CM,C1874,HCPCS,278,RC,,both,3979.29,3581.36,Cigna,Default,Percent of Total Billed Charges,2347.78,,,,2347.78,3247.1
STENT WALL 20 X 40 CM,C1874,HCPCS,278,RC,,both,3979.29,3581.36,United Healthcare,Default,Fee Schedule,3247.1,,,,2347.78,3247.1
*CATH SELECTIVE C2X.035X65CM,272,RC,,,,both,60.55,54.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.38,,,,35.72,49.41
*CATH SELECTIVE C2X.035X65CM,272,RC,,,,both,60.55,54.5,Cigna,Default,Percent of Total Billed Charges,35.72,,,,35.72,49.41
*CATH SELECTIVE C2X.035X65CM,272,RC,,,,both,60.55,54.5,United Healthcare,Default,Fee Schedule,49.41,,,,35.72,49.41
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,10722.6,9650.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7505.82,,,,6326.33,8749.64
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,10722.6,9650.34,Cigna,Default,Percent of Total Billed Charges,6326.33,,,,6326.33,8749.64
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,10722.6,9650.34,United Healthcare,Default,Fee Schedule,8749.64,,,,6326.33,8749.64
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,10822.34,9740.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7575.64,,,,6385.18,8831.03
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,10822.34,9740.11,Cigna,Default,Percent of Total Billed Charges,6385.18,,,,6385.18,8831.03
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,10822.34,9740.11,United Healthcare,Default,Fee Schedule,8831.03,,,,6385.18,8831.03
VIABAHN BALLOON EXPANDABLE ENDOPROSTHESI,C1874,HCPCS,278,RC,,both,10838.99,9755.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7587.29,,,,6395,8844.62
VIABAHN BALLOON EXPANDABLE ENDOPROSTHESI,C1874,HCPCS,278,RC,,both,10838.99,9755.09,Cigna,Default,Percent of Total Billed Charges,6395,,,,6395,8844.62
VIABAHN BALLOON EXPANDABLE ENDOPROSTHESI,C1874,HCPCS,278,RC,,both,10838.99,9755.09,United Healthcare,Default,Fee Schedule,8844.62,,,,6395,8844.62
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11108.71,9997.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7776.1,,,,6554.14,9064.71
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11108.71,9997.84,Cigna,Default,Percent of Total Billed Charges,6554.14,,,,6554.14,9064.71
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11108.71,9997.84,United Healthcare,Default,Fee Schedule,9064.71,,,,6554.14,9064.71
CATH GLIDE TERUMO 4FR 65 LONG,272,RC,,,,both,242,217.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.4,,,,142.78,197.47
CATH GLIDE TERUMO 4FR 65 LONG,272,RC,,,,both,242,217.8,Cigna,Default,Percent of Total Billed Charges,142.78,,,,142.78,197.47
CATH GLIDE TERUMO 4FR 65 LONG,272,RC,,,,both,242,217.8,United Healthcare,Default,Fee Schedule,197.47,,,,142.78,197.47
CATH GLIDE TERUMO 120CM,272,RC,,,,both,242,217.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.4,,,,142.78,197.47
CATH GLIDE TERUMO 120CM,272,RC,,,,both,242,217.8,Cigna,Default,Percent of Total Billed Charges,142.78,,,,142.78,197.47
CATH GLIDE TERUMO 120CM,272,RC,,,,both,242,217.8,United Healthcare,Default,Fee Schedule,197.47,,,,142.78,197.47
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11108.71,9997.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7776.1,,,,6554.14,9064.71
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11108.71,9997.84,Cigna,Default,Percent of Total Billed Charges,6554.14,,,,6554.14,9064.71
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11108.71,9997.84,United Healthcare,Default,Fee Schedule,9064.71,,,,6554.14,9064.71
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,10722.6,9650.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7505.82,,,,6326.33,8749.64
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,10722.6,9650.34,Cigna,Default,Percent of Total Billed Charges,6326.33,,,,6326.33,8749.64
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,10722.6,9650.34,United Healthcare,Default,Fee Schedule,8749.64,,,,6326.33,8749.64
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,23861.45,21475.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16703.02,,,,14078.26,19470.94
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,23861.45,21475.31,Cigna,Default,Percent of Total Billed Charges,14078.26,,,,14078.26,19470.94
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,23861.45,21475.31,United Healthcare,Default,Fee Schedule,19470.94,,,,14078.26,19470.94
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11851.47,10666.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8296.03,,,,6992.37,9670.8
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11851.47,10666.32,Cigna,Default,Percent of Total Billed Charges,6992.37,,,,6992.37,9670.8
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11851.47,10666.32,United Healthcare,Default,Fee Schedule,9670.8,,,,6992.37,9670.8
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11385.27,10246.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7969.69,,,,6717.31,9290.38
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11385.27,10246.74,Cigna,Default,Percent of Total Billed Charges,6717.31,,,,6717.31,9290.38
VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,C1874,HCPCS,278,RC,,both,11385.27,10246.74,United Healthcare,Default,Fee Schedule,9290.38,,,,6717.31,9290.38
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11388.6,10249.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7972.02,,,,6719.27,9293.1
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11388.6,10249.74,Cigna,Default,Percent of Total Billed Charges,6719.27,,,,6719.27,9293.1
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11388.6,10249.74,United Healthcare,Default,Fee Schedule,9293.1,,,,6719.27,9293.1
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,12087.9,10879.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8461.53,,,,7131.86,9863.73
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,12087.9,10879.11,Cigna,Default,Percent of Total Billed Charges,7131.86,,,,7131.86,9863.73
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,12087.9,10879.11,United Healthcare,Default,Fee Schedule,9863.73,,,,7131.86,9863.73
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11048.94,9944.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7734.26,,,,6518.87,9015.94
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11048.94,9944.05,Cigna,Default,Percent of Total Billed Charges,6518.87,,,,6518.87,9015.94
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,11048.94,9944.05,United Healthcare,Default,Fee Schedule,9015.94,,,,6518.87,9015.94
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,23021.49,20719.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16115.04,,,,13582.68,18785.54
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,23021.49,20719.34,Cigna,Default,Percent of Total Billed Charges,13582.68,,,,13582.68,18785.54
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,23021.49,20719.34,United Healthcare,Default,Fee Schedule,18785.54,,,,13582.68,18785.54
VIABAHN SX ENDO HEPARIN 18 RO 6MMX15CM 6,C1874,HCPCS,278,RC,,both,13469.85,12122.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9428.9,,,,7947.21,10991.4
VIABAHN SX ENDO HEPARIN 18 RO 6MMX15CM 6,C1874,HCPCS,278,RC,,both,13469.85,12122.87,Cigna,Default,Percent of Total Billed Charges,7947.21,,,,7947.21,10991.4
VIABAHN SX ENDO HEPARIN 18 RO 6MMX15CM 6,C1874,HCPCS,278,RC,,both,13469.85,12122.87,United Healthcare,Default,Fee Schedule,10991.4,,,,7947.21,10991.4
VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,C1874,HCPCS,278,RC,,both,11088.9,9980.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7762.23,,,,6542.45,9048.54
VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,C1874,HCPCS,278,RC,,both,11088.9,9980.01,Cigna,Default,Percent of Total Billed Charges,6542.45,,,,6542.45,9048.54
VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,C1874,HCPCS,278,RC,,both,11088.9,9980.01,United Healthcare,Default,Fee Schedule,9048.54,,,,6542.45,9048.54
VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,C1874,HCPCS,278,RC,,both,11088.9,9980.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7762.23,,,,6542.45,9048.54
VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,C1874,HCPCS,278,RC,,both,11088.9,9980.01,Cigna,Default,Percent of Total Billed Charges,6542.45,,,,6542.45,9048.54
VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,C1874,HCPCS,278,RC,,both,11088.9,9980.01,United Healthcare,Default,Fee Schedule,9048.54,,,,6542.45,9048.54
VIABAHN BX BALLOON EXP ENDO 7X79MM 7FR,C1874,HCPCS,278,RC,,both,11866.21,10679.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8306.35,,,,7001.06,9682.83
VIABAHN BX BALLOON EXP ENDO 7X79MM 7FR,C1874,HCPCS,278,RC,,both,11866.21,10679.59,Cigna,Default,Percent of Total Billed Charges,7001.06,,,,7001.06,9682.83
VIABAHN BX BALLOON EXP ENDO 7X79MM 7FR,C1874,HCPCS,278,RC,,both,11866.21,10679.59,United Healthcare,Default,Fee Schedule,9682.83,,,,7001.06,9682.83
ACAPELLA DM BLUE W/T GHPC MED FLOW,270,RC,,,,both,138.39,124.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.87,,,,81.65,112.93
ACAPELLA DM BLUE W/T GHPC MED FLOW,270,RC,,,,both,138.39,124.55,Cigna,Default,Percent of Total Billed Charges,81.65,,,,81.65,112.93
ACAPELLA DM BLUE W/T GHPC MED FLOW,270,RC,,,,both,138.39,124.55,United Healthcare,Default,Fee Schedule,112.93,,,,81.65,112.93
SHEATH 6FR BRITE TIP 23CM,272,RC,,,,both,147.16,132.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.01,,,,86.82,120.08
SHEATH 6FR BRITE TIP 23CM,272,RC,,,,both,147.16,132.44,Cigna,Default,Percent of Total Billed Charges,86.82,,,,86.82,120.08
SHEATH 6FR BRITE TIP 23CM,272,RC,,,,both,147.16,132.44,United Healthcare,Default,Fee Schedule,120.08,,,,86.82,120.08
SHEATH 7FR BRITE TIP,272,RC,,,,both,150.45,135.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.32,,,,88.77,122.77
SHEATH 7FR BRITE TIP,272,RC,,,,both,150.45,135.41,Cigna,Default,Percent of Total Billed Charges,88.77,,,,88.77,122.77
SHEATH 7FR BRITE TIP,272,RC,,,,both,150.45,135.41,United Healthcare,Default,Fee Schedule,122.77,,,,88.77,122.77
SHEATH 7FR BRITE TIP 23CM .97MM,272,RC,,,,both,167.79,151.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.45,,,,99,136.92
SHEATH 7FR BRITE TIP 23CM .97MM,272,RC,,,,both,167.79,151.01,Cigna,Default,Percent of Total Billed Charges,99,,,,99,136.92
SHEATH 7FR BRITE TIP 23CM .97MM,272,RC,,,,both,167.79,151.01,United Healthcare,Default,Fee Schedule,136.92,,,,99,136.92
SHEATH 7FR X 11CM BRITE TIP,272,RC,,,,both,136.53,122.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.57,,,,80.55,111.41
SHEATH 7FR X 11CM BRITE TIP,272,RC,,,,both,136.53,122.88,Cigna,Default,Percent of Total Billed Charges,80.55,,,,80.55,111.41
SHEATH 7FR X 11CM BRITE TIP,272,RC,,,,both,136.53,122.88,United Healthcare,Default,Fee Schedule,111.41,,,,80.55,111.41
SHEATH 8FR X 35CM BRITE TIP,272,RC,,,,both,149.36,134.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.55,,,,88.12,121.88
SHEATH 8FR X 35CM BRITE TIP,272,RC,,,,both,149.36,134.42,Cigna,Default,Percent of Total Billed Charges,88.12,,,,88.12,121.88
SHEATH 8FR X 35CM BRITE TIP,272,RC,,,,both,149.36,134.42,United Healthcare,Default,Fee Schedule,121.88,,,,88.12,121.88
SHEATH 9FR X 23CM BRITE TIP,272,RC,,,,both,151.18,136.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.83,,,,89.2,123.36
SHEATH 9FR X 23CM BRITE TIP,272,RC,,,,both,151.18,136.06,Cigna,Default,Percent of Total Billed Charges,89.2,,,,89.2,123.36
SHEATH 9FR X 23CM BRITE TIP,272,RC,,,,both,151.18,136.06,United Healthcare,Default,Fee Schedule,123.36,,,,89.2,123.36
SHEATH 10FR X 11CM BRITE TIP,272,RC,,,,both,51.25,46.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.88,,,,30.24,41.82
SHEATH 10FR X 11CM BRITE TIP,272,RC,,,,both,51.25,46.13,Cigna,Default,Percent of Total Billed Charges,30.24,,,,30.24,41.82
SHEATH 10FR X 11CM BRITE TIP,272,RC,,,,both,51.25,46.13,United Healthcare,Default,Fee Schedule,41.82,,,,30.24,41.82
SHEATH 9FR X 35CM BRITE TIP,272,RC,,,,both,245.57,221.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.9,,,,144.89,200.39
SHEATH 9FR X 35CM BRITE TIP,272,RC,,,,both,245.57,221.01,Cigna,Default,Percent of Total Billed Charges,144.89,,,,144.89,200.39
SHEATH 9FR X 35CM BRITE TIP,272,RC,,,,both,245.57,221.01,United Healthcare,Default,Fee Schedule,200.39,,,,144.89,200.39
SHEATH 6FR BRITE TIP 5.5CM,272,RC,,,,both,110.87,99.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.61,,,,65.41,90.47
SHEATH 6FR BRITE TIP 5.5CM,272,RC,,,,both,110.87,99.78,Cigna,Default,Percent of Total Billed Charges,65.41,,,,65.41,90.47
SHEATH 6FR BRITE TIP 5.5CM,272,RC,,,,both,110.87,99.78,United Healthcare,Default,Fee Schedule,90.47,,,,65.41,90.47
SHEATH SUPER 9FR,272,RC,,,,both,77.9,70.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.53,,,,45.96,63.57
SHEATH SUPER 9FR,272,RC,,,,both,77.9,70.11,Cigna,Default,Percent of Total Billed Charges,45.96,,,,45.96,63.57
SHEATH SUPER 9FR,272,RC,,,,both,77.9,70.11,United Healthcare,Default,Fee Schedule,63.57,,,,45.96,63.57
SHEATH SUPER 10FR,272,RC,,,,both,37.52,33.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.26,,,,22.14,30.62
SHEATH SUPER 10FR,272,RC,,,,both,37.52,33.77,Cigna,Default,Percent of Total Billed Charges,22.14,,,,22.14,30.62
SHEATH SUPER 10FR,272,RC,,,,both,37.52,33.77,United Healthcare,Default,Fee Schedule,30.62,,,,22.14,30.62
STENT PALMAZ 7FR X 80 CM CORINTHIAN,C1874,HCPCS,278,RC,,both,3916.02,3524.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2741.21,,,,2310.45,3195.47
STENT PALMAZ 7FR X 80 CM CORINTHIAN,C1874,HCPCS,278,RC,,both,3916.02,3524.42,Cigna,Default,Percent of Total Billed Charges,2310.45,,,,2310.45,3195.47
STENT PALMAZ 7FR X 80 CM CORINTHIAN,C1874,HCPCS,278,RC,,both,3916.02,3524.42,United Healthcare,Default,Fee Schedule,3195.47,,,,2310.45,3195.47
*CATH BLUE MAX 5.8 FR,272,RC,,,,both,909.66,818.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,636.76,,,,536.7,742.28
*CATH BLUE MAX 5.8 FR,272,RC,,,,both,909.66,818.69,Cigna,Default,Percent of Total Billed Charges,536.7,,,,536.7,742.28
*CATH BLUE MAX 5.8 FR,272,RC,,,,both,909.66,818.69,United Healthcare,Default,Fee Schedule,742.28,,,,536.7,742.28
CATHETER STERLING MONORAIL BALLOON DILAT,272,RC,,,,both,749.75,674.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.82,,,,442.35,611.8
CATHETER STERLING MONORAIL BALLOON DILAT,272,RC,,,,both,749.75,674.78,Cigna,Default,Percent of Total Billed Charges,442.35,,,,442.35,611.8
CATHETER STERLING MONORAIL BALLOON DILAT,272,RC,,,,both,749.75,674.78,United Healthcare,Default,Fee Schedule,611.8,,,,442.35,611.8
CATH TRANSIT MICRO 3MMX135CM,272,RC,,,,both,1141.46,1027.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,799.02,,,,673.46,931.43
CATH TRANSIT MICRO 3MMX135CM,272,RC,,,,both,1141.46,1027.31,Cigna,Default,Percent of Total Billed Charges,673.46,,,,673.46,931.43
CATH TRANSIT MICRO 3MMX135CM,272,RC,,,,both,1141.46,1027.31,United Healthcare,Default,Fee Schedule,931.43,,,,673.46,931.43
CATH GLIDE 4FR 100CM NON-TAPER ANGLE,272,RC,,,,both,319.68,287.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.78,,,,188.61,260.86
CATH GLIDE 4FR 100CM NON-TAPER ANGLE,272,RC,,,,both,319.68,287.71,Cigna,Default,Percent of Total Billed Charges,188.61,,,,188.61,260.86
CATH GLIDE 4FR 100CM NON-TAPER ANGLE,272,RC,,,,both,319.68,287.71,United Healthcare,Default,Fee Schedule,260.86,,,,188.61,260.86
CATH GLIDE 4FR 65CM,272,RC,,,,both,251.12,226.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,175.78,,,,148.16,204.91
CATH GLIDE 4FR 65CM,272,RC,,,,both,251.12,226.01,Cigna,Default,Percent of Total Billed Charges,148.16,,,,148.16,204.91
CATH GLIDE 4FR 65CM,272,RC,,,,both,251.12,226.01,United Healthcare,Default,Fee Schedule,204.91,,,,148.16,204.91
WIRE MAGIC TORQUE,272,RC,,,,both,247.22,222.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.05,,,,145.86,201.73
WIRE MAGIC TORQUE,272,RC,,,,both,247.22,222.5,Cigna,Default,Percent of Total Billed Charges,145.86,,,,145.86,201.73
WIRE MAGIC TORQUE,272,RC,,,,both,247.22,222.5,United Healthcare,Default,Fee Schedule,201.73,,,,145.86,201.73
GUIDE WIRE AMPLATE,C1769,HCPCS,278,RC,,both,201.72,181.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.2,,,,119.01,164.6
GUIDE WIRE AMPLATE,C1769,HCPCS,278,RC,,both,201.72,181.55,Cigna,Default,Percent of Total Billed Charges,119.01,,,,119.01,164.6
GUIDE WIRE AMPLATE,C1769,HCPCS,278,RC,,both,201.72,181.55,United Healthcare,Default,Fee Schedule,164.6,,,,119.01,164.6
STENT SMART 10X20X120,C1874,HCPCS,278,RC,,both,4944.98,4450.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3461.49,,,,2917.54,4035.1
STENT SMART 10X20X120,C1874,HCPCS,278,RC,,both,4944.98,4450.48,Cigna,Default,Percent of Total Billed Charges,2917.54,,,,2917.54,4035.1
STENT SMART 10X20X120,C1874,HCPCS,278,RC,,both,4944.98,4450.48,United Healthcare,Default,Fee Schedule,4035.1,,,,2917.54,4035.1
DNU STENT SMART 12X30X80,C1874,HCPCS,278,RC,,both,4706.89,4236.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3294.82,,,,2777.07,3840.82
DNU STENT SMART 12X30X80,C1874,HCPCS,278,RC,,both,4706.89,4236.2,Cigna,Default,Percent of Total Billed Charges,2777.07,,,,2777.07,3840.82
DNU STENT SMART 12X30X80,C1874,HCPCS,278,RC,,both,4706.89,4236.2,United Healthcare,Default,Fee Schedule,3840.82,,,,2777.07,3840.82
STENT SMART 14X40X80,C1874,HCPCS,278,RC,,both,4706.72,4236.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3294.7,,,,2776.96,3840.68
STENT SMART 14X40X80,C1874,HCPCS,278,RC,,both,4706.72,4236.05,Cigna,Default,Percent of Total Billed Charges,2776.96,,,,2776.96,3840.68
STENT SMART 14X40X80,C1874,HCPCS,278,RC,,both,4706.72,4236.05,United Healthcare,Default,Fee Schedule,3840.68,,,,2776.96,3840.68
CATH DILATION PTA PRO 8MMX4CMX80CM,272,RC,,,,both,744.58,670.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,521.21,,,,439.3,607.58
CATH DILATION PTA PRO 8MMX4CMX80CM,272,RC,,,,both,744.58,670.12,Cigna,Default,Percent of Total Billed Charges,439.3,,,,439.3,607.58
CATH DILATION PTA PRO 8MMX4CMX80CM,272,RC,,,,both,744.58,670.12,United Healthcare,Default,Fee Schedule,607.58,,,,439.3,607.58
CATH PIGTAIL 4FR 65CM,272,RC,,,,both,299.7,269.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209.79,,,,176.82,244.56
CATH PIGTAIL 4FR 65CM,272,RC,,,,both,299.7,269.73,Cigna,Default,Percent of Total Billed Charges,176.82,,,,176.82,244.56
CATH PIGTAIL 4FR 65CM,272,RC,,,,both,299.7,269.73,United Healthcare,Default,Fee Schedule,244.56,,,,176.82,244.56
CATH PIGTAIL 4FR 100CM,272,RC,,,,both,301.4,271.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.98,,,,177.83,245.94
CATH PIGTAIL 4FR 100CM,272,RC,,,,both,301.4,271.26,Cigna,Default,Percent of Total Billed Charges,177.83,,,,177.83,245.94
CATH PIGTAIL 4FR 100CM,272,RC,,,,both,301.4,271.26,United Healthcare,Default,Fee Schedule,245.94,,,,177.83,245.94
CATH PIGTAIL 5FR 65CM,272,RC,,,,both,439.02,395.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.31,,,,259.02,358.24
CATH PIGTAIL 5FR 65CM,272,RC,,,,both,439.02,395.12,Cigna,Default,Percent of Total Billed Charges,259.02,,,,259.02,358.24
CATH PIGTAIL 5FR 65CM,272,RC,,,,both,439.02,395.12,United Healthcare,Default,Fee Schedule,358.24,,,,259.02,358.24
CATHETER CENTESIS ONE STEP 6FR,C1725,HCPCS,272,RC,,both,133.2,119.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.24,,,,78.59,108.69
CATHETER CENTESIS ONE STEP 6FR,C1725,HCPCS,272,RC,,both,133.2,119.88,Cigna,Default,Percent of Total Billed Charges,78.59,,,,78.59,108.69
CATHETER CENTESIS ONE STEP 6FR,C1725,HCPCS,272,RC,,both,133.2,119.88,United Healthcare,Default,Fee Schedule,108.69,,,,78.59,108.69
CATH GUIDE 6FR 90CM PV MACH 1,C1725,HCPCS,278,RC,,both,200.9,180.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.63,,,,118.53,163.93
CATH GUIDE 6FR 90CM PV MACH 1,C1725,HCPCS,278,RC,,both,200.9,180.81,Cigna,Default,Percent of Total Billed Charges,118.53,,,,118.53,163.93
CATH GUIDE 6FR 90CM PV MACH 1,C1725,HCPCS,278,RC,,both,200.9,180.81,United Healthcare,Default,Fee Schedule,163.93,,,,118.53,163.93
CATH GUIDE RUNWAY MP2,C1725,HCPCS,278,RC,,both,532.79,479.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.95,,,,314.35,434.76
CATH GUIDE RUNWAY MP2,C1725,HCPCS,278,RC,,both,532.79,479.51,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH GUIDE RUNWAY MP2,C1725,HCPCS,278,RC,,both,532.79,479.51,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
CATH GUIDE RUNWAY JR4,C1725,HCPCS,278,RC,,both,532.79,479.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.95,,,,314.35,434.76
CATH GUIDE RUNWAY JR4,C1725,HCPCS,278,RC,,both,532.79,479.51,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH GUIDE RUNWAY JR4,C1725,HCPCS,278,RC,,both,532.79,479.51,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
CATH VIPER SMALL VESSEL BA,272,RC,,,,both,1418.92,1277.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,993.24,,,,837.16,1157.84
CATH VIPER SMALL VESSEL BA,272,RC,,,,both,1418.92,1277.03,Cigna,Default,Percent of Total Billed Charges,837.16,,,,837.16,1157.84
CATH VIPER SMALL VESSEL BA,272,RC,,,,both,1418.92,1277.03,United Healthcare,Default,Fee Schedule,1157.84,,,,837.16,1157.84
KIT BIO PREP,272,RC,,,,both,1053.64,948.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,737.55,,,,621.65,859.77
KIT BIO PREP,272,RC,,,,both,1053.64,948.28,Cigna,Default,Percent of Total Billed Charges,621.65,,,,621.65,859.77
KIT BIO PREP,272,RC,,,,both,1053.64,948.28,United Healthcare,Default,Fee Schedule,859.77,,,,621.65,859.77
BONE CEMENT MIXING AND DELIVERY SYSTEM C,272,RC,,,,both,423.21,380.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,296.25,,,,249.69,345.34
BONE CEMENT MIXING AND DELIVERY SYSTEM C,272,RC,,,,both,423.21,380.89,Cigna,Default,Percent of Total Billed Charges,249.69,,,,249.69,345.34
BONE CEMENT MIXING AND DELIVERY SYSTEM C,272,RC,,,,both,423.21,380.89,United Healthcare,Default,Fee Schedule,345.34,,,,249.69,345.34
CLEARMIX SINGLE DOUBLE MIX,272,RC,,,,both,353.15,317.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,247.2,,,,208.36,288.17
CLEARMIX SINGLE DOUBLE MIX,272,RC,,,,both,353.15,317.84,Cigna,Default,Percent of Total Billed Charges,208.36,,,,208.36,288.17
CLEARMIX SINGLE DOUBLE MIX,272,RC,,,,both,353.15,317.84,United Healthcare,Default,Fee Schedule,288.17,,,,208.36,288.17
STENT EPIC 10X20  x 75CM SELF EXPANDING,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 10X20  x 75CM SELF EXPANDING,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 10X20  x 75CM SELF EXPANDING,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 12X60X75CM  SELF EXPANDING VA,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 12X60X75CM  SELF EXPANDING VA,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 12X60X75CM  SELF EXPANDING VA,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 6X30 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 6X30 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 6X30 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 6X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 6X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 6X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 8X30 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 8X30 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 8X30 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 8X40 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 8X40 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 8X40 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 8X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 8X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 8X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 10X40 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 10X40 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 10X40 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 10X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 10X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 10X60 SELF EXPANDING VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 10X40X120 VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 10X40X120 VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 10X40X120 VASCULAR,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
STENT EPIC 10X20X120 SELF EXPANDING VASC,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.16,,,,2357.6,3260.69
STENT EPIC 10X20X120 SELF EXPANDING VASC,C1874,HCPCS,278,RC,,both,3995.94,3596.35,Cigna,Default,Percent of Total Billed Charges,2357.6,,,,2357.6,3260.69
STENT EPIC 10X20X120 SELF EXPANDING VASC,C1874,HCPCS,278,RC,,both,3995.94,3596.35,United Healthcare,Default,Fee Schedule,3260.69,,,,2357.6,3260.69
GUIDE WIRE V-14 300CM,C1769,HCPCS,278,RC,,both,716.96,645.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.87,,,,423.01,585.04
GUIDE WIRE V-14 300CM,C1769,HCPCS,278,RC,,both,716.96,645.26,Cigna,Default,Percent of Total Billed Charges,423.01,,,,423.01,585.04
GUIDE WIRE V-14 300CM,C1769,HCPCS,278,RC,,both,716.96,645.26,United Healthcare,Default,Fee Schedule,585.04,,,,423.01,585.04
GUIDE WIRE V-18 300CM,C1769,HCPCS,278,RC,,both,338.66,304.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,237.06,,,,199.81,276.35
GUIDE WIRE V-18 300CM,C1769,HCPCS,278,RC,,both,338.66,304.79,Cigna,Default,Percent of Total Billed Charges,199.81,,,,199.81,276.35
GUIDE WIRE V-18 300CM,C1769,HCPCS,278,RC,,both,338.66,304.79,United Healthcare,Default,Fee Schedule,276.35,,,,199.81,276.35
*CATH PIGTAIL 5FR,272,RC,,,,both,80,72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56,,,,47.2,65.28
*CATH PIGTAIL 5FR,272,RC,,,,both,80,72,Cigna,Default,Percent of Total Billed Charges,47.2,,,,47.2,65.28
*CATH PIGTAIL 5FR,272,RC,,,,both,80,72,United Healthcare,Default,Fee Schedule,65.28,,,,47.2,65.28
*CATH PIGTAIL 5FR 90CM,272,RC,,,,both,66.16,59.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.31,,,,39.03,53.99
*CATH PIGTAIL 5FR 90CM,272,RC,,,,both,66.16,59.54,Cigna,Default,Percent of Total Billed Charges,39.03,,,,39.03,53.99
*CATH PIGTAIL 5FR 90CM,272,RC,,,,both,66.16,59.54,United Healthcare,Default,Fee Schedule,53.99,,,,39.03,53.99
GUIDE WIRE TSFNB-38-1,C1769,HCPCS,278,RC,,both,38.74,34.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.12,,,,22.86,31.61
GUIDE WIRE TSFNB-38-1,C1769,HCPCS,278,RC,,both,38.74,34.87,Cigna,Default,Percent of Total Billed Charges,22.86,,,,22.86,31.61
GUIDE WIRE TSFNB-38-1,C1769,HCPCS,278,RC,,both,38.74,34.87,United Healthcare,Default,Fee Schedule,31.61,,,,22.86,31.61
*DNU EXERCISER VOLUMETRIC 2500ML,270,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
*DNU EXERCISER VOLUMETRIC 2500ML,270,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
*DNU EXERCISER VOLUMETRIC 2500ML,270,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
COIL TORNADO 3MM 2MM,272,RC,,,,both,374.75,337.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.32,,,,221.1,305.8
COIL TORNADO 3MM 2MM,272,RC,,,,both,374.75,337.28,Cigna,Default,Percent of Total Billed Charges,221.1,,,,221.1,305.8
COIL TORNADO 3MM 2MM,272,RC,,,,both,374.75,337.28,United Healthcare,Default,Fee Schedule,305.8,,,,221.1,305.8
COIL TORNADO 4MM 2MM,272,RC,,,,both,374.75,337.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.32,,,,221.1,305.8
COIL TORNADO 4MM 2MM,272,RC,,,,both,374.75,337.28,Cigna,Default,Percent of Total Billed Charges,221.1,,,,221.1,305.8
COIL TORNADO 4MM 2MM,272,RC,,,,both,374.75,337.28,United Healthcare,Default,Fee Schedule,305.8,,,,221.1,305.8
COIL TORNADO 5MM 2MM,272,RC,,,,both,374.75,337.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.32,,,,221.1,305.8
COIL TORNADO 5MM 2MM,272,RC,,,,both,374.75,337.28,Cigna,Default,Percent of Total Billed Charges,221.1,,,,221.1,305.8
COIL TORNADO 5MM 2MM,272,RC,,,,both,374.75,337.28,United Healthcare,Default,Fee Schedule,305.8,,,,221.1,305.8
COIL TORNADO 6MM 2MM,272,RC,,,,both,374.75,337.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.32,,,,221.1,305.8
COIL TORNADO 6MM 2MM,272,RC,,,,both,374.75,337.28,Cigna,Default,Percent of Total Billed Charges,221.1,,,,221.1,305.8
COIL TORNADO 6MM 2MM,272,RC,,,,both,374.75,337.28,United Healthcare,Default,Fee Schedule,305.8,,,,221.1,305.8
STENT SMART 8X20,C1874,HCPCS,278,RC,,both,4944.98,4450.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3461.49,,,,2917.54,4035.1
STENT SMART 8X20,C1874,HCPCS,278,RC,,both,4944.98,4450.48,Cigna,Default,Percent of Total Billed Charges,2917.54,,,,2917.54,4035.1
STENT SMART 8X20,C1874,HCPCS,278,RC,,both,4944.98,4450.48,United Healthcare,Default,Fee Schedule,4035.1,,,,2917.54,4035.1
STENT WALL 10FR 20X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3807.64,,,,3209.29,4438.62
STENT WALL 10FR 20X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Cigna,Default,Percent of Total Billed Charges,3209.29,,,,3209.29,4438.62
STENT WALL 10FR 20X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,United Healthcare,Default,Fee Schedule,4438.62,,,,3209.29,4438.62
STENT WALL 10FR 22X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3807.64,,,,3209.29,4438.62
STENT WALL 10FR 22X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Cigna,Default,Percent of Total Billed Charges,3209.29,,,,3209.29,4438.62
STENT WALL 10FR 22X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,United Healthcare,Default,Fee Schedule,4438.62,,,,3209.29,4438.62
STENT WALL 10FR 20X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3807.64,,,,3209.29,4438.62
STENT WALL 10FR 20X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Cigna,Default,Percent of Total Billed Charges,3209.29,,,,3209.29,4438.62
STENT WALL 10FR 20X60 230 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,United Healthcare,Default,Fee Schedule,4438.62,,,,3209.29,4438.62
STENT WALL 10FR 22X60 135 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3807.64,,,,3209.29,4438.62
STENT WALL 10FR 22X60 135 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,Cigna,Default,Percent of Total Billed Charges,3209.29,,,,3209.29,4438.62
STENT WALL 10FR 22X60 135 CM,C1874,HCPCS,278,RC,,both,5439.48,4895.53,United Healthcare,Default,Fee Schedule,4438.62,,,,3209.29,4438.62
PASSER (PUNCTURE CLOSURE DEVICE,272,RC,,,,both,185.01,166.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.51,,,,109.16,150.97
PASSER (PUNCTURE CLOSURE DEVICE,272,RC,,,,both,185.01,166.51,Cigna,Default,Percent of Total Billed Charges,109.16,,,,109.16,150.97
PASSER (PUNCTURE CLOSURE DEVICE,272,RC,,,,both,185.01,166.51,United Healthcare,Default,Fee Schedule,150.97,,,,109.16,150.97
GUIDE WIRE AX 21 480,272,RC,,,,both,237,213.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.9,,,,139.83,193.39
GUIDE WIRE AX 21 480,272,RC,,,,both,237,213.3,Cigna,Default,Percent of Total Billed Charges,139.83,,,,139.83,193.39
GUIDE WIRE AX 21 480,272,RC,,,,both,237,213.3,United Healthcare,Default,Fee Schedule,193.39,,,,139.83,193.39
STENT BEV WL 7.5 10X42X75,C1874,HCPCS,278,RC,,both,3579.7,3221.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2505.79,,,,2112.02,2921.04
STENT BEV WL 7.5 10X42X75,C1874,HCPCS,278,RC,,both,3579.7,3221.73,Cigna,Default,Percent of Total Billed Charges,2112.02,,,,2112.02,2921.04
STENT BEV WL 7.5 10X42X75,C1874,HCPCS,278,RC,,both,3579.7,3221.73,United Healthcare,Default,Fee Schedule,2921.04,,,,2112.02,2921.04
GUIDE WIRE ANPLATZ STIFF,C1769,HCPCS,278,RC,,both,195.84,176.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.09,,,,115.55,159.81
GUIDE WIRE ANPLATZ STIFF,C1769,HCPCS,278,RC,,both,195.84,176.26,Cigna,Default,Percent of Total Billed Charges,115.55,,,,115.55,159.81
GUIDE WIRE ANPLATZ STIFF,C1769,HCPCS,278,RC,,both,195.84,176.26,United Healthcare,Default,Fee Schedule,159.81,,,,115.55,159.81
STENT WALL B10687110,C1874,HCPCS,278,RC,,both,3579.7,3221.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2505.79,,,,2112.02,2921.04
STENT WALL B10687110,C1874,HCPCS,278,RC,,both,3579.7,3221.73,Cigna,Default,Percent of Total Billed Charges,2112.02,,,,2112.02,2921.04
STENT WALL B10687110,C1874,HCPCS,278,RC,,both,3579.7,3221.73,United Healthcare,Default,Fee Schedule,2921.04,,,,2112.02,2921.04
STENT WALL B8607110,C1874,HCPCS,278,RC,,both,3579.7,3221.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2505.79,,,,2112.02,2921.04
STENT WALL B8607110,C1874,HCPCS,278,RC,,both,3579.7,3221.73,Cigna,Default,Percent of Total Billed Charges,2112.02,,,,2112.02,2921.04
STENT WALL B8607110,C1874,HCPCS,278,RC,,both,3579.7,3221.73,United Healthcare,Default,Fee Schedule,2921.04,,,,2112.02,2921.04
CATH TNT PER GD15-87,272,RC,,,,both,315.25,283.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.68,,,,186,257.24
CATH TNT PER GD15-87,272,RC,,,,both,315.25,283.73,Cigna,Default,Percent of Total Billed Charges,186,,,,186,257.24
CATH TNT PER GD15-87,272,RC,,,,both,315.25,283.73,United Healthcare,Default,Fee Schedule,257.24,,,,186,257.24
CATH POWER FLEX 80 CM,272,RC,,,,both,743.71,669.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,520.6,,,,438.79,606.87
CATH POWER FLEX 80 CM,272,RC,,,,both,743.71,669.34,Cigna,Default,Percent of Total Billed Charges,438.79,,,,438.79,606.87
CATH POWER FLEX 80 CM,272,RC,,,,both,743.71,669.34,United Healthcare,Default,Fee Schedule,606.87,,,,438.79,606.87
CATH BRONCHO 35FR LEFT,272,RC,,,,both,164.47,148.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.13,,,,97.04,134.21
CATH BRONCHO 35FR LEFT,272,RC,,,,both,164.47,148.02,Cigna,Default,Percent of Total Billed Charges,97.04,,,,97.04,134.21
CATH BRONCHO 35FR LEFT,272,RC,,,,both,164.47,148.02,United Healthcare,Default,Fee Schedule,134.21,,,,97.04,134.21
CATH COOK 159683,272,RC,,,,both,164.28,147.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115,,,,96.93,134.05
CATH COOK 159683,272,RC,,,,both,164.28,147.85,Cigna,Default,Percent of Total Billed Charges,96.93,,,,96.93,134.05
CATH COOK 159683,272,RC,,,,both,164.28,147.85,United Healthcare,Default,Fee Schedule,134.05,,,,96.93,134.05
CATH 5FR-100CM-.035-STRAIGHT,272,RC,,,,both,60.55,54.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.38,,,,35.72,49.41
CATH 5FR-100CM-.035-STRAIGHT,272,RC,,,,both,60.55,54.5,Cigna,Default,Percent of Total Billed Charges,35.72,,,,35.72,49.41
CATH 5FR-100CM-.035-STRAIGHT,272,RC,,,,both,60.55,54.5,United Healthcare,Default,Fee Schedule,49.41,,,,35.72,49.41
SHEATH FLO CHECK 4FR X 12CM,272,RC,,,,both,30.59,27.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.41,,,,18.05,24.96
SHEATH FLO CHECK 4FR X 12CM,272,RC,,,,both,30.59,27.53,Cigna,Default,Percent of Total Billed Charges,18.05,,,,18.05,24.96
SHEATH FLO CHECK 4FR X 12CM,272,RC,,,,both,30.59,27.53,United Healthcare,Default,Fee Schedule,24.96,,,,18.05,24.96
CATH STRAIGHT P5.0B-38-65-M-NS-0 CUST4-6,272,RC,,,,both,115.63,104.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.94,,,,68.22,94.35
CATH STRAIGHT P5.0B-38-65-M-NS-0 CUST4-6,272,RC,,,,both,115.63,104.07,Cigna,Default,Percent of Total Billed Charges,68.22,,,,68.22,94.35
CATH STRAIGHT P5.0B-38-65-M-NS-0 CUST4-6,272,RC,,,,both,115.63,104.07,United Healthcare,Default,Fee Schedule,94.35,,,,68.22,94.35
CATH STRAIGHT .035 4FR 100 CM,272,RC,,,,both,131.8,118.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.26,,,,77.76,107.55
CATH STRAIGHT .035 4FR 100 CM,272,RC,,,,both,131.8,118.62,Cigna,Default,Percent of Total Billed Charges,77.76,,,,77.76,107.55
CATH STRAIGHT .035 4FR 100 CM,272,RC,,,,both,131.8,118.62,United Healthcare,Default,Fee Schedule,107.55,,,,77.76,107.55
CATH TORCON ADV/5FR,272,RC,,,,both,78.91,71.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.24,,,,46.56,64.39
CATH TORCON ADV/5FR,272,RC,,,,both,78.91,71.02,Cigna,Default,Percent of Total Billed Charges,46.56,,,,46.56,64.39
CATH TORCON ADV/5FR,272,RC,,,,both,78.91,71.02,United Healthcare,Default,Fee Schedule,64.39,,,,46.56,64.39
WIRE KIRCHNER .045,272,RC,,,,both,29.18,26.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.43,,,,17.22,23.81
WIRE KIRCHNER .045,272,RC,,,,both,29.18,26.26,Cigna,Default,Percent of Total Billed Charges,17.22,,,,17.22,23.81
WIRE KIRCHNER .045,272,RC,,,,both,29.18,26.26,United Healthcare,Default,Fee Schedule,23.81,,,,17.22,23.81
"WIRE KIRCHNER .9MM LENGTH 9"" STYLE 7",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"WIRE KIRCHNER .9MM LENGTH 9"" STYLE 7",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"WIRE KIRCHNER .9MM LENGTH 9"" STYLE 7",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
CATH TRIGUIDE 7FR,272,RC,,,,both,347.71,312.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.4,,,,205.15,283.73
CATH TRIGUIDE 7FR,272,RC,,,,both,347.71,312.94,Cigna,Default,Percent of Total Billed Charges,205.15,,,,205.15,283.73
CATH TRIGUIDE 7FR,272,RC,,,,both,347.71,312.94,United Healthcare,Default,Fee Schedule,283.73,,,,205.15,283.73
*NEEDLE C-SDIN 15.5 G 3CM,272,RC,,,,both,445.62,401.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.93,,,,262.92,363.63
*NEEDLE C-SDIN 15.5 G 3CM,272,RC,,,,both,445.62,401.06,Cigna,Default,Percent of Total Billed Charges,262.92,,,,262.92,363.63
*NEEDLE C-SDIN 15.5 G 3CM,272,RC,,,,both,445.62,401.06,United Healthcare,Default,Fee Schedule,363.63,,,,262.92,363.63
NEEDLE INTRA CDIN 14G  3CM,272,RC,,,,both,227.57,204.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.3,,,,134.27,185.7
NEEDLE INTRA CDIN 14G  3CM,272,RC,,,,both,227.57,204.81,Cigna,Default,Percent of Total Billed Charges,134.27,,,,134.27,185.7
NEEDLE INTRA CDIN 14G  3CM,272,RC,,,,both,227.57,204.81,United Healthcare,Default,Fee Schedule,185.7,,,,134.27,185.7
NEEDLE C-DIN 16G 3CM,272,RC,,,,both,188.25,169.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.78,,,,111.07,153.61
NEEDLE C-DIN 16G 3CM,272,RC,,,,both,188.25,169.43,Cigna,Default,Percent of Total Billed Charges,111.07,,,,111.07,153.61
NEEDLE C-DIN 16G 3CM,272,RC,,,,both,188.25,169.43,United Healthcare,Default,Fee Schedule,153.61,,,,111.07,153.61
CATH PIGTAIL 4FR X 125CM INFINITY,272,RC,,,,both,145.95,131.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.16,,,,86.11,119.1
CATH PIGTAIL 4FR X 125CM INFINITY,272,RC,,,,both,145.95,131.36,Cigna,Default,Percent of Total Billed Charges,86.11,,,,86.11,119.1
CATH PIGTAIL 4FR X 125CM INFINITY,272,RC,,,,both,145.95,131.36,United Healthcare,Default,Fee Schedule,119.1,,,,86.11,119.1
CATH STRAIGHT 5.0,272,RC,,,,both,93.44,84.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.41,,,,55.13,76.25
CATH STRAIGHT 5.0,272,RC,,,,both,93.44,84.1,Cigna,Default,Percent of Total Billed Charges,55.13,,,,55.13,76.25
CATH STRAIGHT 5.0,272,RC,,,,both,93.44,84.1,United Healthcare,Default,Fee Schedule,76.25,,,,55.13,76.25
CATH STRAIGHT 4FR,A4353,HCPCS,272,RC,,both,75.67,68.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.97,,,,44.65,61.75
CATH STRAIGHT 4FR,A4353,HCPCS,272,RC,,both,75.67,68.1,Cigna,Default,Percent of Total Billed Charges,44.65,,,,44.65,61.75
CATH STRAIGHT 4FR,A4353,HCPCS,272,RC,,both,75.67,68.1,United Healthcare,Default,Fee Schedule,61.75,,,,44.65,61.75
WIRE INFUSION KATZEN,272,RC,,,,both,670.83,603.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,469.58,,,,395.79,547.4
WIRE INFUSION KATZEN,272,RC,,,,both,670.83,603.75,Cigna,Default,Percent of Total Billed Charges,395.79,,,,395.79,547.4
WIRE INFUSION KATZEN,272,RC,,,,both,670.83,603.75,United Healthcare,Default,Fee Schedule,547.4,,,,395.79,547.4
CATH STRAIGHT 4FR 125CM,272,RC,,,,both,75.67,68.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.97,,,,44.65,61.75
CATH STRAIGHT 4FR 125CM,272,RC,,,,both,75.67,68.1,Cigna,Default,Percent of Total Billed Charges,44.65,,,,44.65,61.75
CATH STRAIGHT 4FR 125CM,272,RC,,,,both,75.67,68.1,United Healthcare,Default,Fee Schedule,61.75,,,,44.65,61.75
BALLON DILATATION CATH XXL 7F 12MM X 2C,C1725,HCPCS,278,RC,,both,954.19,858.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,667.93,,,,562.97,778.62
BALLON DILATATION CATH XXL 7F 12MM X 2C,C1725,HCPCS,278,RC,,both,954.19,858.77,Cigna,Default,Percent of Total Billed Charges,562.97,,,,562.97,778.62
BALLON DILATATION CATH XXL 7F 12MM X 2C,C1725,HCPCS,278,RC,,both,954.19,858.77,United Healthcare,Default,Fee Schedule,778.62,,,,562.97,778.62
*BALLOON DILATATION CATH XXL 7FR 14MM X,C1725,HCPCS,278,RC,,both,954.19,858.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,667.93,,,,562.97,778.62
*BALLOON DILATATION CATH XXL 7FR 14MM X,C1725,HCPCS,278,RC,,both,954.19,858.77,Cigna,Default,Percent of Total Billed Charges,562.97,,,,562.97,778.62
*BALLOON DILATATION CATH XXL 7FR 14MM X,C1725,HCPCS,278,RC,,both,954.19,858.77,United Healthcare,Default,Fee Schedule,778.62,,,,562.97,778.62
GUIDE WIRE 180CM PLATINUM,C1769,HCPCS,278,RC,,both,411.29,370.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.9,,,,242.66,335.61
GUIDE WIRE 180CM PLATINUM,C1769,HCPCS,278,RC,,both,411.29,370.16,Cigna,Default,Percent of Total Billed Charges,242.66,,,,242.66,335.61
GUIDE WIRE 180CM PLATINUM,C1769,HCPCS,278,RC,,both,411.29,370.16,United Healthcare,Default,Fee Schedule,335.61,,,,242.66,335.61
STENT 24MMX3.5MM,C1874,HCPCS,278,RC,,both,6626.6,5963.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4638.62,,,,3909.69,5407.31
STENT 24MMX3.5MM,C1874,HCPCS,278,RC,,both,6626.6,5963.94,Cigna,Default,Percent of Total Billed Charges,3909.69,,,,3909.69,5407.31
STENT 24MMX3.5MM,C1874,HCPCS,278,RC,,both,6626.6,5963.94,United Healthcare,Default,Fee Schedule,5407.31,,,,3909.69,5407.31
STENT PROMUS PREMIER 4.00MM X 12MM,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4895.02,,,,4125.81,5706.2
STENT PROMUS PREMIER 4.00MM X 12MM,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Cigna,Default,Percent of Total Billed Charges,4125.81,,,,4125.81,5706.2
STENT PROMUS PREMIER 4.00MM X 12MM,C1874,HCPCS,278,RC,,both,6992.89,6293.6,United Healthcare,Default,Fee Schedule,5706.2,,,,4125.81,5706.2
CATH HI-FLOW 4FR 110CM,272,RC,,,,both,80,72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56,,,,47.2,65.28
CATH HI-FLOW 4FR 110CM,272,RC,,,,both,80,72,Cigna,Default,Percent of Total Billed Charges,47.2,,,,47.2,65.28
CATH HI-FLOW 4FR 110CM,272,RC,,,,both,80,72,United Healthcare,Default,Fee Schedule,65.28,,,,47.2,65.28
CATH DILATION 2.5MMX10CMX135CM,C1725,HCPCS,278,RC,,both,1135.01,1021.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,794.51,,,,669.66,926.17
CATH DILATION 2.5MMX10CMX135CM,C1725,HCPCS,278,RC,,both,1135.01,1021.51,Cigna,Default,Percent of Total Billed Charges,669.66,,,,669.66,926.17
CATH DILATION 2.5MMX10CMX135CM,C1725,HCPCS,278,RC,,both,1135.01,1021.51,United Healthcare,Default,Fee Schedule,926.17,,,,669.66,926.17
CATH DILATION 3.0MMX10CMX135CM,C1725,HCPCS,278,RC,,both,1135.01,1021.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,794.51,,,,669.66,926.17
CATH DILATION 3.0MMX10CMX135CM,C1725,HCPCS,278,RC,,both,1135.01,1021.51,Cigna,Default,Percent of Total Billed Charges,669.66,,,,669.66,926.17
CATH DILATION 3.0MMX10CMX135CM,C1725,HCPCS,278,RC,,both,1135.01,1021.51,United Healthcare,Default,Fee Schedule,926.17,,,,669.66,926.17
CATH POLAR 2.5MMX100CMX135CM,C1725,HCPCS,278,RC,,both,2996.95,2697.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.86,,,,1768.2,2445.51
CATH POLAR 2.5MMX100CMX135CM,C1725,HCPCS,278,RC,,both,2996.95,2697.26,Cigna,Default,Percent of Total Billed Charges,1768.2,,,,1768.2,2445.51
CATH POLAR 2.5MMX100CMX135CM,C1725,HCPCS,278,RC,,both,2996.95,2697.26,United Healthcare,Default,Fee Schedule,2445.51,,,,1768.2,2445.51
CATH BALLOON STERLING 5MMX12CMX80CM,272,RC,,,,both,834.28,750.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,584,,,,492.23,680.77
CATH BALLOON STERLING 5MMX12CMX80CM,272,RC,,,,both,834.28,750.85,Cigna,Default,Percent of Total Billed Charges,492.23,,,,492.23,680.77
CATH BALLOON STERLING 5MMX12CMX80CM,272,RC,,,,both,834.28,750.85,United Healthcare,Default,Fee Schedule,680.77,,,,492.23,680.77
GUIDE WIRE PLATINUM PLUS .018X260CM,C1769,HCPCS,272,RC,,both,266.4,239.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.48,,,,157.18,217.38
GUIDE WIRE PLATINUM PLUS .018X260CM,C1769,HCPCS,272,RC,,both,266.4,239.76,Cigna,Default,Percent of Total Billed Charges,157.18,,,,157.18,217.38
GUIDE WIRE PLATINUM PLUS .018X260CM,C1769,HCPCS,272,RC,,both,266.4,239.76,United Healthcare,Default,Fee Schedule,217.38,,,,157.18,217.38
GUIDE WIRE M 46-254,C1769,HCPCS,278,RC,,both,246.79,222.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.75,,,,145.61,201.38
GUIDE WIRE M 46-254,C1769,HCPCS,278,RC,,both,246.79,222.11,Cigna,Default,Percent of Total Billed Charges,145.61,,,,145.61,201.38
GUIDE WIRE M 46-254,C1769,HCPCS,278,RC,,both,246.79,222.11,United Healthcare,Default,Fee Schedule,201.38,,,,145.61,201.38
CATH PIGTAIL COOK 5057,272,RC,,,,both,65.73,59.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.01,,,,38.78,53.64
CATH PIGTAIL COOK 5057,272,RC,,,,both,65.73,59.16,Cigna,Default,Percent of Total Billed Charges,38.78,,,,38.78,53.64
CATH PIGTAIL COOK 5057,272,RC,,,,both,65.73,59.16,United Healthcare,Default,Fee Schedule,53.64,,,,38.78,53.64
TORQUE DEVICE 7017 DNU,C1769,HCPCS,272,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
TORQUE DEVICE 7017 DNU,C1769,HCPCS,272,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
TORQUE DEVICE 7017 DNU,C1769,HCPCS,272,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
GUIDE WIRE CRAGG FX46-214,C1769,HCPCS,278,RC,,both,737.25,663.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,516.08,,,,434.98,601.6
GUIDE WIRE CRAGG FX46-214,C1769,HCPCS,278,RC,,both,737.25,663.53,Cigna,Default,Percent of Total Billed Charges,434.98,,,,434.98,601.6
GUIDE WIRE CRAGG FX46-214,C1769,HCPCS,278,RC,,both,737.25,663.53,United Healthcare,Default,Fee Schedule,601.6,,,,434.98,601.6
SHUTTLE SL 6FR 90CM,272,RC,,,,both,528.06,475.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,369.64,,,,311.56,430.9
SHUTTLE SL 6FR 90CM,272,RC,,,,both,528.06,475.25,Cigna,Default,Percent of Total Billed Charges,311.56,,,,311.56,430.9
SHUTTLE SL 6FR 90CM,272,RC,,,,both,528.06,475.25,United Healthcare,Default,Fee Schedule,430.9,,,,311.56,430.9
SHUTTLE SL 7FR 90CM,272,RC,,,,both,528.06,475.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,369.64,,,,311.56,430.9
SHUTTLE SL 7FR 90CM,272,RC,,,,both,528.06,475.25,Cigna,Default,Percent of Total Billed Charges,311.56,,,,311.56,430.9
SHUTTLE SL 7FR 90CM,272,RC,,,,both,528.06,475.25,United Healthcare,Default,Fee Schedule,430.9,,,,311.56,430.9
CATH SLIP 5FR 100CM HI,272,RC,,,,both,218.88,196.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.22,,,,129.14,178.61
CATH SLIP 5FR 100CM HI,272,RC,,,,both,218.88,196.99,Cigna,Default,Percent of Total Billed Charges,129.14,,,,129.14,178.61
CATH SLIP 5FR 100CM HI,272,RC,,,,both,218.88,196.99,United Healthcare,Default,Fee Schedule,178.61,,,,129.14,178.61
CATH SLIP 5FR 100CM JB1,272,RC,,,,both,218.88,196.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.22,,,,129.14,178.61
CATH SLIP 5FR 100CM JB1,272,RC,,,,both,218.88,196.99,Cigna,Default,Percent of Total Billed Charges,129.14,,,,129.14,178.61
CATH SLIP 5FR 100CM JB1,272,RC,,,,both,218.88,196.99,United Healthcare,Default,Fee Schedule,178.61,,,,129.14,178.61
CATH SLIP 5FR 100CM JB2,272,RC,,,,both,218.88,196.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.22,,,,129.14,178.61
CATH SLIP 5FR 100CM JB2,272,RC,,,,both,218.88,196.99,Cigna,Default,Percent of Total Billed Charges,129.14,,,,129.14,178.61
CATH SLIP 5FR 100CM JB2,272,RC,,,,both,218.88,196.99,United Healthcare,Default,Fee Schedule,178.61,,,,129.14,178.61
STENT ICAST 8X59X80,C1874,HCPCS,278,RC,,both,9407.11,8466.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6584.98,,,,5550.19,7676.2
STENT ICAST 8X59X80,C1874,HCPCS,278,RC,,both,9407.11,8466.4,Cigna,Default,Percent of Total Billed Charges,5550.19,,,,5550.19,7676.2
STENT ICAST 8X59X80,C1874,HCPCS,278,RC,,both,9407.11,8466.4,United Healthcare,Default,Fee Schedule,7676.2,,,,5550.19,7676.2
DNU STENT URETHERAL SOFT 6X26,C1874,HCPCS,278,RC,,both,679.31,611.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,475.52,,,,400.79,554.32
DNU STENT URETHERAL SOFT 6X26,C1874,HCPCS,278,RC,,both,679.31,611.38,Cigna,Default,Percent of Total Billed Charges,400.79,,,,400.79,554.32
DNU STENT URETHERAL SOFT 6X26,C1874,HCPCS,278,RC,,both,679.31,611.38,United Healthcare,Default,Fee Schedule,554.32,,,,400.79,554.32
DNU STENT URETHERAL SOFT 6X24,C1874,HCPCS,278,RC,,both,695.96,626.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,487.17,,,,410.62,567.9
DNU STENT URETHERAL SOFT 6X24,C1874,HCPCS,278,RC,,both,695.96,626.36,Cigna,Default,Percent of Total Billed Charges,410.62,,,,410.62,567.9
DNU STENT URETHERAL SOFT 6X24,C1874,HCPCS,278,RC,,both,695.96,626.36,United Healthcare,Default,Fee Schedule,567.9,,,,410.62,567.9
STENT URETHERAL SOFT 4.87FRX22CM,C1874,HCPCS,278,RC,,both,679.31,611.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,475.52,,,,400.79,554.32
STENT URETHERAL SOFT 4.87FRX22CM,C1874,HCPCS,278,RC,,both,679.31,611.38,Cigna,Default,Percent of Total Billed Charges,400.79,,,,400.79,554.32
STENT URETHERAL SOFT 4.87FRX22CM,C1874,HCPCS,278,RC,,both,679.31,611.38,United Healthcare,Default,Fee Schedule,554.32,,,,400.79,554.32
STENT COLONIC 4CM 31FR,C1874,HCPCS,278,RC,,both,3740.4,3366.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2618.28,,,,2206.84,3052.17
STENT COLONIC 4CM 31FR,C1874,HCPCS,278,RC,,both,3740.4,3366.36,Cigna,Default,Percent of Total Billed Charges,2206.84,,,,2206.84,3052.17
STENT COLONIC 4CM 31FR,C1874,HCPCS,278,RC,,both,3740.4,3366.36,United Healthcare,Default,Fee Schedule,3052.17,,,,2206.84,3052.17
STENT COLONIC 6CM 31FR,C1874,HCPCS,278,RC,,both,3901.9,3511.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2731.33,,,,2302.12,3183.95
STENT COLONIC 6CM 31FR,C1874,HCPCS,278,RC,,both,3901.9,3511.71,Cigna,Default,Percent of Total Billed Charges,2302.12,,,,2302.12,3183.95
STENT COLONIC 6CM 31FR,C1874,HCPCS,278,RC,,both,3901.9,3511.71,United Healthcare,Default,Fee Schedule,3183.95,,,,2302.12,3183.95
STENT COLONIC 10CM 31FR,C1874,HCPCS,278,RC,,both,4696.49,4226.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3287.54,,,,2770.93,3832.34
STENT COLONIC 10CM 31FR,C1874,HCPCS,278,RC,,both,4696.49,4226.84,Cigna,Default,Percent of Total Billed Charges,2770.93,,,,2770.93,3832.34
STENT COLONIC 10CM 31FR,C1874,HCPCS,278,RC,,both,4696.49,4226.84,United Healthcare,Default,Fee Schedule,3832.34,,,,2770.93,3832.34
STENT URETHERAL SOFT 6X22-30,C1874,HCPCS,278,RC,,both,371.93,334.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.35,,,,219.44,303.49
STENT URETHERAL SOFT 6X22-30,C1874,HCPCS,278,RC,,both,371.93,334.74,Cigna,Default,Percent of Total Billed Charges,219.44,,,,219.44,303.49
STENT URETHERAL SOFT 6X22-30,C1874,HCPCS,278,RC,,both,371.93,334.74,United Healthcare,Default,Fee Schedule,303.49,,,,219.44,303.49
CATH BALLOON STERLING 6MMX40CMX135QCM,C1725,HCPCS,272,RC,,both,632.7,569.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.89,,,,373.29,516.28
CATH BALLOON STERLING 6MMX40CMX135QCM,C1725,HCPCS,272,RC,,both,632.7,569.43,Cigna,Default,Percent of Total Billed Charges,373.29,,,,373.29,516.28
CATH BALLOON STERLING 6MMX40CMX135QCM,C1725,HCPCS,272,RC,,both,632.7,569.43,United Healthcare,Default,Fee Schedule,516.28,,,,373.29,516.28
CATH PTA BALLOON DILATION 4MMX40CMX146CM,C1725,HCPCS,272,RC,,both,994.65,895.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,696.26,,,,586.84,811.63
CATH PTA BALLOON DILATION 4MMX40CMX146CM,C1725,HCPCS,272,RC,,both,994.65,895.19,Cigna,Default,Percent of Total Billed Charges,586.84,,,,586.84,811.63
CATH PTA BALLOON DILATION 4MMX40CMX146CM,C1725,HCPCS,272,RC,,both,994.65,895.19,United Healthcare,Default,Fee Schedule,811.63,,,,586.84,811.63
GUIDE  MPA 1 598 942,C1769,HCPCS,278,RC,,both,399.59,359.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.71,,,,235.76,326.07
GUIDE  MPA 1 598 942,C1769,HCPCS,278,RC,,both,399.59,359.63,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
GUIDE  MPA 1 598 942,C1769,HCPCS,278,RC,,both,399.59,359.63,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
STENT PERCUFLEX 8FRX30CM,C1874,HCPCS,278,RC,,both,258.41,232.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.89,,,,152.46,210.86
STENT PERCUFLEX 8FRX30CM,C1874,HCPCS,278,RC,,both,258.41,232.57,Cigna,Default,Percent of Total Billed Charges,152.46,,,,152.46,210.86
STENT PERCUFLEX 8FRX30CM,C1874,HCPCS,278,RC,,both,258.41,232.57,United Healthcare,Default,Fee Schedule,210.86,,,,152.46,210.86
*CATH 4FR 100CM .035 IMAGER II SELECTIVE,272,RC,,,,both,60.55,54.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.38,,,,35.72,49.41
*CATH 4FR 100CM .035 IMAGER II SELECTIVE,272,RC,,,,both,60.55,54.5,Cigna,Default,Percent of Total Billed Charges,35.72,,,,35.72,49.41
*CATH 4FR 100CM .035 IMAGER II SELECTIVE,272,RC,,,,both,60.55,54.5,United Healthcare,Default,Fee Schedule,49.41,,,,35.72,49.41
CATH 4FR 65CM .035 IMAGER II SELECTIVE,272,RC,,,,both,60.55,54.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.38,,,,35.72,49.41
CATH 4FR 65CM .035 IMAGER II SELECTIVE,272,RC,,,,both,60.55,54.5,Cigna,Default,Percent of Total Billed Charges,35.72,,,,35.72,49.41
CATH 4FR 65CM .035 IMAGER II SELECTIVE,272,RC,,,,both,60.55,54.5,United Healthcare,Default,Fee Schedule,49.41,,,,35.72,49.41
STENT EXPRESS RENAL 5X15 90CM,C1874,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
STENT EXPRESS RENAL 5X15 90CM,C1874,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
STENT EXPRESS RENAL 5X15 90CM,C1874,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
GATEWAY ADVANTAGE Y-ADAPTER,272,RC,,,,both,66.21,59.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.35,,,,39.06,54.03
GATEWAY ADVANTAGE Y-ADAPTER,272,RC,,,,both,66.21,59.59,Cigna,Default,Percent of Total Billed Charges,39.06,,,,39.06,54.03
GATEWAY ADVANTAGE Y-ADAPTER,272,RC,,,,both,66.21,59.59,United Healthcare,Default,Fee Schedule,54.03,,,,39.06,54.03
COYOTE ES MONORAIL 3X20X114,C1725,HCPCS,272,RC,,both,1176.8,1059.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,823.76,,,,694.31,960.27
COYOTE ES MONORAIL 3X20X114,C1725,HCPCS,272,RC,,both,1176.8,1059.12,Cigna,Default,Percent of Total Billed Charges,694.31,,,,694.31,960.27
COYOTE ES MONORAIL 3X20X114,C1725,HCPCS,272,RC,,both,1176.8,1059.12,United Healthcare,Default,Fee Schedule,960.27,,,,694.31,960.27
GUIDE WIRE 9316,C1769,HCPCS,278,RC,,both,74.58,67.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.21,,,,44,60.86
GUIDE WIRE 9316,C1769,HCPCS,278,RC,,both,74.58,67.12,Cigna,Default,Percent of Total Billed Charges,44,,,,44,60.86
GUIDE WIRE 9316,C1769,HCPCS,278,RC,,both,74.58,67.12,United Healthcare,Default,Fee Schedule,60.86,,,,44,60.86
GUIDE WIRE ANGIOGUARD EMBOLI,C1769,HCPCS,278,RC,,both,5827.41,5244.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.19,,,,3438.17,4755.17
GUIDE WIRE ANGIOGUARD EMBOLI,C1769,HCPCS,278,RC,,both,5827.41,5244.67,Cigna,Default,Percent of Total Billed Charges,3438.17,,,,3438.17,4755.17
GUIDE WIRE ANGIOGUARD EMBOLI,C1769,HCPCS,278,RC,,both,5827.41,5244.67,United Healthcare,Default,Fee Schedule,4755.17,,,,3438.17,4755.17
STERLING 5X40MM X 135CM 4FR SHEATH,C1725,HCPCS,272,RC,,both,632.7,569.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.89,,,,373.29,516.28
STERLING 5X40MM X 135CM 4FR SHEATH,C1725,HCPCS,272,RC,,both,632.7,569.43,Cigna,Default,Percent of Total Billed Charges,373.29,,,,373.29,516.28
STERLING 5X40MM X 135CM 4FR SHEATH,C1725,HCPCS,272,RC,,both,632.7,569.43,United Healthcare,Default,Fee Schedule,516.28,,,,373.29,516.28
STERLING OVER THE WIRE BALLOON,C1725,HCPCS,272,RC,,both,632.7,569.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.89,,,,373.29,516.28
STERLING OVER THE WIRE BALLOON,C1725,HCPCS,272,RC,,both,632.7,569.43,Cigna,Default,Percent of Total Billed Charges,373.29,,,,373.29,516.28
STERLING OVER THE WIRE BALLOON,C1725,HCPCS,272,RC,,both,632.7,569.43,United Healthcare,Default,Fee Schedule,516.28,,,,373.29,516.28
STERLING OVER THE WIRE BALLOON 6X20X135,C1725,HCPCS,272,RC,,both,632.7,569.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.89,,,,373.29,516.28
STERLING OVER THE WIRE BALLOON 6X20X135,C1725,HCPCS,272,RC,,both,632.7,569.43,Cigna,Default,Percent of Total Billed Charges,373.29,,,,373.29,516.28
STERLING OVER THE WIRE BALLOON 6X20X135,C1725,HCPCS,272,RC,,both,632.7,569.43,United Healthcare,Default,Fee Schedule,516.28,,,,373.29,516.28
STENT ESOPHAGEAL W/DUA 12CM,278,RC,,,,both,9075.47,8167.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6352.83,,,,5354.53,7405.58
STENT ESOPHAGEAL W/DUA 12CM,278,RC,,,,both,9075.47,8167.92,Cigna,Default,Percent of Total Billed Charges,5354.53,,,,5354.53,7405.58
STENT ESOPHAGEAL W/DUA 12CM,278,RC,,,,both,9075.47,8167.92,United Healthcare,Default,Fee Schedule,7405.58,,,,5354.53,7405.58
SYMMETRY BALLOON DILATION CATH 2.5MMX100,C1725,HCPCS,278,RC,,both,1075.59,968.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,752.91,,,,634.6,877.68
SYMMETRY BALLOON DILATION CATH 2.5MMX100,C1725,HCPCS,278,RC,,both,1075.59,968.03,Cigna,Default,Percent of Total Billed Charges,634.6,,,,634.6,877.68
SYMMETRY BALLOON DILATION CATH 2.5MMX100,C1725,HCPCS,278,RC,,both,1075.59,968.03,United Healthcare,Default,Fee Schedule,877.68,,,,634.6,877.68
STENT 4.8FR 22-30CM CONTOUR URETERAL,C1874,HCPCS,278,RC,,both,368.23,331.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.76,,,,217.26,300.48
STENT 4.8FR 22-30CM CONTOUR URETERAL,C1874,HCPCS,278,RC,,both,368.23,331.41,Cigna,Default,Percent of Total Billed Charges,217.26,,,,217.26,300.48
STENT 4.8FR 22-30CM CONTOUR URETERAL,C1874,HCPCS,278,RC,,both,368.23,331.41,United Healthcare,Default,Fee Schedule,300.48,,,,217.26,300.48
GUIDE WIRE 9911,C1769,HCPCS,278,RC,,both,65.64,59.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.95,,,,38.73,53.56
GUIDE WIRE 9911,C1769,HCPCS,278,RC,,both,65.64,59.08,Cigna,Default,Percent of Total Billed Charges,38.73,,,,38.73,53.56
GUIDE WIRE 9911,C1769,HCPCS,278,RC,,both,65.64,59.08,United Healthcare,Default,Fee Schedule,53.56,,,,38.73,53.56
CATH STRAIGHT 4FRX65CMX.035 0 SIDE HOLES,272,RC,,,,both,108.11,97.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.68,,,,63.78,88.22
CATH STRAIGHT 4FRX65CMX.035 0 SIDE HOLES,272,RC,,,,both,108.11,97.3,Cigna,Default,Percent of Total Billed Charges,63.78,,,,63.78,88.22
CATH STRAIGHT 4FRX65CMX.035 0 SIDE HOLES,272,RC,,,,both,108.11,97.3,United Healthcare,Default,Fee Schedule,88.22,,,,63.78,88.22
CATH STRAIGHT 4FRX100CMX.035 0 SIDE HOLE,272,RC,,,,both,90.81,81.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.57,,,,53.58,74.1
CATH STRAIGHT 4FRX100CMX.035 0 SIDE HOLE,272,RC,,,,both,90.81,81.73,Cigna,Default,Percent of Total Billed Charges,53.58,,,,53.58,74.1
CATH STRAIGHT 4FRX100CMX.035 0 SIDE HOLE,272,RC,,,,both,90.81,81.73,United Healthcare,Default,Fee Schedule,74.1,,,,53.58,74.1
CATH STRAIGHT 4FRX65CM,272,RC,,,,both,82.17,73.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.52,,,,48.48,67.05
CATH STRAIGHT 4FRX65CM,272,RC,,,,both,82.17,73.95,Cigna,Default,Percent of Total Billed Charges,48.48,,,,48.48,67.05
CATH STRAIGHT 4FRX65CM,272,RC,,,,both,82.17,73.95,United Healthcare,Default,Fee Schedule,67.05,,,,48.48,67.05
GUIDE WIRE AMPLATZ EMERALD .035X180CM,C1769,HCPCS,278,RC,,both,188.69,169.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.08,,,,111.33,153.97
GUIDE WIRE AMPLATZ EMERALD .035X180CM,C1769,HCPCS,278,RC,,both,188.69,169.82,Cigna,Default,Percent of Total Billed Charges,111.33,,,,111.33,153.97
GUIDE WIRE AMPLATZ EMERALD .035X180CM,C1769,HCPCS,278,RC,,both,188.69,169.82,United Healthcare,Default,Fee Schedule,153.97,,,,111.33,153.97
GUIDE WIRE STRAIGHT CATH EXCHANGE,C1769,HCPCS,278,RC,,both,59.45,53.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.62,,,,35.08,48.51
GUIDE WIRE STRAIGHT CATH EXCHANGE,C1769,HCPCS,278,RC,,both,59.45,53.51,Cigna,Default,Percent of Total Billed Charges,35.08,,,,35.08,48.51
GUIDE WIRE STRAIGHT CATH EXCHANGE,C1769,HCPCS,278,RC,,both,59.45,53.51,United Healthcare,Default,Fee Schedule,48.51,,,,35.08,48.51
GUIDE WIRE AMPLATZ EMERALD,C1769,HCPCS,278,RC,,both,172.2,154.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.54,,,,101.6,140.52
GUIDE WIRE AMPLATZ EMERALD,C1769,HCPCS,278,RC,,both,172.2,154.98,Cigna,Default,Percent of Total Billed Charges,101.6,,,,101.6,140.52
GUIDE WIRE AMPLATZ EMERALD,C1769,HCPCS,278,RC,,both,172.2,154.98,United Healthcare,Default,Fee Schedule,140.52,,,,101.6,140.52
CATH STRAIGHT 4FRX65CM,272,RC,,,,both,82.17,73.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.52,,,,48.48,67.05
CATH STRAIGHT 4FRX65CM,272,RC,,,,both,82.17,73.95,Cigna,Default,Percent of Total Billed Charges,48.48,,,,48.48,67.05
CATH STRAIGHT 4FRX65CM,272,RC,,,,both,82.17,73.95,United Healthcare,Default,Fee Schedule,67.05,,,,48.48,67.05
GUIDE MPA1 586 842,C1769,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
GUIDE MPA1 586 842,C1769,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
GUIDE MPA1 586 842,C1769,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
GUIDE SON 1 586 880,C1769,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
GUIDE SON 1 586 880,C1769,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
GUIDE SON 1 586 880,C1769,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
SHEATH 5FR CHECK-FLO,272,RC,,,,both,78.66,70.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.06,,,,46.41,64.19
SHEATH 5FR CHECK-FLO,272,RC,,,,both,78.66,70.79,Cigna,Default,Percent of Total Billed Charges,46.41,,,,46.41,64.19
SHEATH 5FR CHECK-FLO,272,RC,,,,both,78.66,70.79,United Healthcare,Default,Fee Schedule,64.19,,,,46.41,64.19
GUIDE WIRE TM 480 A,C1769,HCPCS,278,RC,,both,500.66,450.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,350.46,,,,295.39,408.54
GUIDE WIRE TM 480 A,C1769,HCPCS,278,RC,,both,500.66,450.59,Cigna,Default,Percent of Total Billed Charges,295.39,,,,295.39,408.54
GUIDE WIRE TM 480 A,C1769,HCPCS,278,RC,,both,500.66,450.59,United Healthcare,Default,Fee Schedule,408.54,,,,295.39,408.54
GUIDE WIRE TM 260 A,C1769,HCPCS,278,RC,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
GUIDE WIRE TM 260 A,C1769,HCPCS,278,RC,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
GUIDE WIRE TM 260 A,C1769,HCPCS,278,RC,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
IMPRESS KA2 CATHETER 4F 65CM,272,RC,,,,both,166.79,150.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.75,,,,98.41,136.1
IMPRESS KA2 CATHETER 4F 65CM,272,RC,,,,both,166.79,150.11,Cigna,Default,Percent of Total Billed Charges,98.41,,,,98.41,136.1
IMPRESS KA2 CATHETER 4F 65CM,272,RC,,,,both,166.79,150.11,United Healthcare,Default,Fee Schedule,136.1,,,,98.41,136.1
9FR 35CM FLEXOR CHECK FLO INTRODUCER SET,272,RC,,,,both,568.98,512.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,398.29,,,,335.7,464.29
9FR 35CM FLEXOR CHECK FLO INTRODUCER SET,272,RC,,,,both,568.98,512.08,Cigna,Default,Percent of Total Billed Charges,335.7,,,,335.7,464.29
9FR 35CM FLEXOR CHECK FLO INTRODUCER SET,272,RC,,,,both,568.98,512.08,United Healthcare,Default,Fee Schedule,464.29,,,,335.7,464.29
MULITPORT  ADAPTER,272,RC,,,,both,151.36,136.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.95,,,,89.3,123.51
MULITPORT  ADAPTER,272,RC,,,,both,151.36,136.22,Cigna,Default,Percent of Total Billed Charges,89.3,,,,89.3,123.51
MULITPORT  ADAPTER,272,RC,,,,both,151.36,136.22,United Healthcare,Default,Fee Schedule,123.51,,,,89.3,123.51
DNU ADAPTER HEMOSTASIS VALVE,272,RC,,,,both,27.5,24.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.25,,,,16.22,22.44
DNU ADAPTER HEMOSTASIS VALVE,272,RC,,,,both,27.5,24.75,Cigna,Default,Percent of Total Billed Charges,16.22,,,,16.22,22.44
DNU ADAPTER HEMOSTASIS VALVE,272,RC,,,,both,27.5,24.75,United Healthcare,Default,Fee Schedule,22.44,,,,16.22,22.44
NEEDLE W/SELDINGER SHIELD ONE WALL,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
NEEDLE W/SELDINGER SHIELD ONE WALL,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
NEEDLE W/SELDINGER SHIELD ONE WALL,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
GUIDE WIRE ROSEN 260,C1769,HCPCS,272,RC,,both,111.36,100.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.95,,,,65.7,90.87
GUIDE WIRE ROSEN 260,C1769,HCPCS,272,RC,,both,111.36,100.22,Cigna,Default,Percent of Total Billed Charges,65.7,,,,65.7,90.87
GUIDE WIRE ROSEN 260,C1769,HCPCS,272,RC,,both,111.36,100.22,United Healthcare,Default,Fee Schedule,90.87,,,,65.7,90.87
"GUIDE WIRE STIFF D.035""L260 STRAIGHT",C1769,HCPCS,272,RC,,both,118.86,106.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.2,,,,70.13,96.99
"GUIDE WIRE STIFF D.035""L260 STRAIGHT",C1769,HCPCS,272,RC,,both,118.86,106.97,Cigna,Default,Percent of Total Billed Charges,70.13,,,,70.13,96.99
"GUIDE WIRE STIFF D.035""L260 STRAIGHT",C1769,HCPCS,272,RC,,both,118.86,106.97,United Healthcare,Default,Fee Schedule,96.99,,,,70.13,96.99
"GUIDE WIRE STIFF D.035""L180 STRAIGHT",272,RC,,,,both,141.46,127.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.02,,,,83.46,115.43
"GUIDE WIRE STIFF D.035""L180 STRAIGHT",272,RC,,,,both,141.46,127.31,Cigna,Default,Percent of Total Billed Charges,83.46,,,,83.46,115.43
"GUIDE WIRE STIFF D.035""L180 STRAIGHT",272,RC,,,,both,141.46,127.31,United Healthcare,Default,Fee Schedule,115.43,,,,83.46,115.43
GUIDE WIRE PLAT PLUS,C1769,HCPCS,278,RC,,both,313.89,282.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.72,,,,185.2,256.13
GUIDE WIRE PLAT PLUS,C1769,HCPCS,278,RC,,both,313.89,282.5,Cigna,Default,Percent of Total Billed Charges,185.2,,,,185.2,256.13
GUIDE WIRE PLAT PLUS,C1769,HCPCS,278,RC,,both,313.89,282.5,United Healthcare,Default,Fee Schedule,256.13,,,,185.2,256.13
GUIDE WIRE 46-601,C1769,HCPCS,278,RC,,both,288.05,259.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.64,,,,169.95,235.05
GUIDE WIRE 46-601,C1769,HCPCS,278,RC,,both,288.05,259.25,Cigna,Default,Percent of Total Billed Charges,169.95,,,,169.95,235.05
GUIDE WIRE 46-601,C1769,HCPCS,278,RC,,both,288.05,259.25,United Healthcare,Default,Fee Schedule,235.05,,,,169.95,235.05
GUIDE WIRE 68029,C1769,HCPCS,278,RC,,both,71.75,64.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.22,,,,42.33,58.55
GUIDE WIRE 68029,C1769,HCPCS,278,RC,,both,71.75,64.58,Cigna,Default,Percent of Total Billed Charges,42.33,,,,42.33,58.55
GUIDE WIRE 68029,C1769,HCPCS,278,RC,,both,71.75,64.58,United Healthcare,Default,Fee Schedule,58.55,,,,42.33,58.55
GUIDE WIRE 55601,C1769,HCPCS,278,RC,,both,62.52,56.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.76,,,,36.89,51.02
GUIDE WIRE 55601,C1769,HCPCS,278,RC,,both,62.52,56.27,Cigna,Default,Percent of Total Billed Charges,36.89,,,,36.89,51.02
GUIDE WIRE 55601,C1769,HCPCS,278,RC,,both,62.52,56.27,United Healthcare,Default,Fee Schedule,51.02,,,,36.89,51.02
GUIDE WIRE PLATINUM PLUS 300CM .014,C1769,HCPCS,278,RC,,both,266.4,239.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.48,,,,157.18,217.38
GUIDE WIRE PLATINUM PLUS 300CM .014,C1769,HCPCS,278,RC,,both,266.4,239.76,Cigna,Default,Percent of Total Billed Charges,157.18,,,,157.18,217.38
GUIDE WIRE PLATINUM PLUS 300CM .014,C1769,HCPCS,278,RC,,both,266.4,239.76,United Healthcare,Default,Fee Schedule,217.38,,,,157.18,217.38
GUIDE WIRE AMPLATZ STIFF 46 51A,C1769,HCPCS,278,RC,,both,193.52,174.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.46,,,,114.18,157.91
GUIDE WIRE AMPLATZ STIFF 46 51A,C1769,HCPCS,278,RC,,both,193.52,174.17,Cigna,Default,Percent of Total Billed Charges,114.18,,,,114.18,157.91
GUIDE WIRE AMPLATZ STIFF 46 51A,C1769,HCPCS,278,RC,,both,193.52,174.17,United Healthcare,Default,Fee Schedule,157.91,,,,114.18,157.91
CATH PIGTAIL 4FR 100 CM,272,RC,,,,both,169.72,152.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.8,,,,100.13,138.49
CATH PIGTAIL 4FR 100 CM,272,RC,,,,both,169.72,152.75,Cigna,Default,Percent of Total Billed Charges,100.13,,,,100.13,138.49
CATH PIGTAIL 4FR 100 CM,272,RC,,,,both,169.72,152.75,United Healthcare,Default,Fee Schedule,138.49,,,,100.13,138.49
*CATH PIGTAIL 5FR,272,RC,,,,both,76.75,69.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.72,,,,45.28,62.63
*CATH PIGTAIL 5FR,272,RC,,,,both,76.75,69.08,Cigna,Default,Percent of Total Billed Charges,45.28,,,,45.28,62.63
*CATH PIGTAIL 5FR,272,RC,,,,both,76.75,69.08,United Healthcare,Default,Fee Schedule,62.63,,,,45.28,62.63
CATH DILATION 6MMX4CMX80CM,272,RC,,,,both,614.63,553.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.24,,,,362.63,501.54
CATH DILATION 6MMX4CMX80CM,272,RC,,,,both,614.63,553.17,Cigna,Default,Percent of Total Billed Charges,362.63,,,,362.63,501.54
CATH DILATION 6MMX4CMX80CM,272,RC,,,,both,614.63,553.17,United Healthcare,Default,Fee Schedule,501.54,,,,362.63,501.54
CATH BALLOON STERLING 3.0MMX60MM 150CM,C1725,HCPCS,272,RC,,both,791,711.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.7,,,,466.69,645.46
CATH BALLOON STERLING 3.0MMX60MM 150CM,C1725,HCPCS,272,RC,,both,791,711.9,Cigna,Default,Percent of Total Billed Charges,466.69,,,,466.69,645.46
CATH BALLOON STERLING 3.0MMX60MM 150CM,C1725,HCPCS,272,RC,,both,791,711.9,United Healthcare,Default,Fee Schedule,645.46,,,,466.69,645.46
CATH 156894 (CUSTOM),272,RC,,,,both,65.73,59.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.01,,,,38.78,53.64
CATH 156894 (CUSTOM),272,RC,,,,both,65.73,59.16,Cigna,Default,Percent of Total Billed Charges,38.78,,,,38.78,53.64
CATH 156894 (CUSTOM),272,RC,,,,both,65.73,59.16,United Healthcare,Default,Fee Schedule,53.64,,,,38.78,53.64
SHEATH 8FR/25CM 15-64,272,RC,,,,both,149.19,134.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.43,,,,88.02,121.74
SHEATH 8FR/25CM 15-64,272,RC,,,,both,149.19,134.27,Cigna,Default,Percent of Total Billed Charges,88.02,,,,88.02,121.74
SHEATH 8FR/25CM 15-64,272,RC,,,,both,149.19,134.27,United Healthcare,Default,Fee Schedule,121.74,,,,88.02,121.74
*CATH PIGTAIL 5FR,272,RC,,,,both,86.26,77.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.38,,,,50.89,70.39
*CATH PIGTAIL 5FR,272,RC,,,,both,86.26,77.63,Cigna,Default,Percent of Total Billed Charges,50.89,,,,50.89,70.39
*CATH PIGTAIL 5FR,272,RC,,,,both,86.26,77.63,United Healthcare,Default,Fee Schedule,70.39,,,,50.89,70.39
CATH STRAIGHT 4FR  .035X80CM,272,RC,,,,both,124.32,111.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.02,,,,73.35,101.45
CATH STRAIGHT 4FR  .035X80CM,272,RC,,,,both,124.32,111.89,Cigna,Default,Percent of Total Billed Charges,73.35,,,,73.35,101.45
CATH STRAIGHT 4FR  .035X80CM,272,RC,,,,both,124.32,111.89,United Healthcare,Default,Fee Schedule,101.45,,,,73.35,101.45
CATH TUNNEL 14.5FR RT 28CM,272,RC,,,,both,1211.7,1090.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,848.19,,,,714.9,988.75
CATH TUNNEL 14.5FR RT 28CM,272,RC,,,,both,1211.7,1090.53,Cigna,Default,Percent of Total Billed Charges,714.9,,,,714.9,988.75
CATH TUNNEL 14.5FR RT 28CM,272,RC,,,,both,1211.7,1090.53,United Healthcare,Default,Fee Schedule,988.75,,,,714.9,988.75
CATH TUNNEL 14.5FR RT 32CM,272,RC,,,,both,1211.7,1090.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,848.19,,,,714.9,988.75
CATH TUNNEL 14.5FR RT 32CM,272,RC,,,,both,1211.7,1090.53,Cigna,Default,Percent of Total Billed Charges,714.9,,,,714.9,988.75
CATH TUNNEL 14.5FR RT 32CM,272,RC,,,,both,1211.7,1090.53,United Healthcare,Default,Fee Schedule,988.75,,,,714.9,988.75
*CATH BALLOON DILATORS 30DX90CMX10CMX,272,RC,,,,both,2160.03,1944.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1512.02,,,,1274.42,1762.58
*CATH BALLOON DILATORS 30DX90CMX10CMX,272,RC,,,,both,2160.03,1944.03,Cigna,Default,Percent of Total Billed Charges,1274.42,,,,1274.42,1762.58
*CATH BALLOON DILATORS 30DX90CMX10CMX,272,RC,,,,both,2160.03,1944.03,United Healthcare,Default,Fee Schedule,1762.58,,,,1274.42,1762.58
CATH STRAIGHT 5.0,A4351,HCPCS,272,RC,,both,69.19,62.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.43,,,,40.82,56.46
CATH STRAIGHT 5.0,A4351,HCPCS,272,RC,,both,69.19,62.27,Cigna,Default,Percent of Total Billed Charges,40.82,,,,40.82,56.46
CATH STRAIGHT 5.0,A4351,HCPCS,272,RC,,both,69.19,62.27,United Healthcare,Default,Fee Schedule,56.46,,,,40.82,56.46
"*CATH PERMCATH 19CM, 36CM OVERALL",272,RC,,,,both,779.74,701.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,545.82,,,,460.05,636.27
"*CATH PERMCATH 19CM, 36CM OVERALL",272,RC,,,,both,779.74,701.77,Cigna,Default,Percent of Total Billed Charges,460.05,,,,460.05,636.27
"*CATH PERMCATH 19CM, 36CM OVERALL",272,RC,,,,both,779.74,701.77,United Healthcare,Default,Fee Schedule,636.27,,,,460.05,636.27
CATH SPY G 4 FR .038-100CM-JR 3.5,272,RC,,,,both,43.24,38.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.27,,,,25.51,35.28
CATH SPY G 4 FR .038-100CM-JR 3.5,272,RC,,,,both,43.24,38.92,Cigna,Default,Percent of Total Billed Charges,25.51,,,,25.51,35.28
CATH SPY G 4 FR .038-100CM-JR 3.5,272,RC,,,,both,43.24,38.92,United Healthcare,Default,Fee Schedule,35.28,,,,25.51,35.28
CATH SPY G 4 FR .038-100CM-JL 3.5,272,RC,,,,both,43.24,38.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.27,,,,25.51,35.28
CATH SPY G 4 FR .038-100CM-JL 3.5,272,RC,,,,both,43.24,38.92,Cigna,Default,Percent of Total Billed Charges,25.51,,,,25.51,35.28
CATH SPY G 4 FR .038-100CM-JL 3.5,272,RC,,,,both,43.24,38.92,United Healthcare,Default,Fee Schedule,35.28,,,,25.51,35.28
"CATH PERMCATH 23CM, 40CM OVERALL",272,RC,,,,both,800.07,720.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,560.05,,,,472.04,652.86
"CATH PERMCATH 23CM, 40CM OVERALL",272,RC,,,,both,800.07,720.06,Cigna,Default,Percent of Total Billed Charges,472.04,,,,472.04,652.86
"CATH PERMCATH 23CM, 40CM OVERALL",272,RC,,,,both,800.07,720.06,United Healthcare,Default,Fee Schedule,652.86,,,,472.04,652.86
CATH SPY G 4 FR .038-100CM-JR 5,272,RC,,,,both,66.95,60.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.86,,,,39.5,54.63
CATH SPY G 4 FR .038-100CM-JR 5,272,RC,,,,both,66.95,60.26,Cigna,Default,Percent of Total Billed Charges,39.5,,,,39.5,54.63
CATH SPY G 4 FR .038-100CM-JR 5,272,RC,,,,both,66.95,60.26,United Healthcare,Default,Fee Schedule,54.63,,,,39.5,54.63
SET MICROPUNCTURE 4.0,272,RC,,,,both,99.84,89.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.89,,,,58.91,81.47
SET MICROPUNCTURE 4.0,272,RC,,,,both,99.84,89.86,Cigna,Default,Percent of Total Billed Charges,58.91,,,,58.91,81.47
SET MICROPUNCTURE 4.0,272,RC,,,,both,99.84,89.86,United Healthcare,Default,Fee Schedule,81.47,,,,58.91,81.47
CATH PERMCATH 40CM,272,RC,,,,both,598.09,538.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,418.66,,,,352.87,488.04
CATH PERMCATH 40CM,272,RC,,,,both,598.09,538.28,Cigna,Default,Percent of Total Billed Charges,352.87,,,,352.87,488.04
CATH PERMCATH 40CM,272,RC,,,,both,598.09,538.28,United Healthcare,Default,Fee Schedule,488.04,,,,352.87,488.04
CATH SPY G 4 FR .038-100CM-JL 5,272,RC,,,,both,34.24,30.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.97,,,,20.2,27.94
CATH SPY G 4 FR .038-100CM-JL 5,272,RC,,,,both,34.24,30.82,Cigna,Default,Percent of Total Billed Charges,20.2,,,,20.2,27.94
CATH SPY G 4 FR .038-100CM-JL 5,272,RC,,,,both,34.24,30.82,United Healthcare,Default,Fee Schedule,27.94,,,,20.2,27.94
CATH ULTRA THIN DIAM 4X80CM,272,RC,,,,both,744.58,670.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,521.21,,,,439.3,607.58
CATH ULTRA THIN DIAM 4X80CM,272,RC,,,,both,744.58,670.12,Cigna,Default,Percent of Total Billed Charges,439.3,,,,439.3,607.58
CATH ULTRA THIN DIAM 4X80CM,272,RC,,,,both,744.58,670.12,United Healthcare,Default,Fee Schedule,607.58,,,,439.3,607.58
CATH 5FR SIM-1 SIDEWINDER,272,RC,,,,both,64.64,58.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.25,,,,38.14,52.75
CATH 5FR SIM-1 SIDEWINDER,272,RC,,,,both,64.64,58.18,Cigna,Default,Percent of Total Billed Charges,38.14,,,,38.14,52.75
CATH 5FR SIM-1 SIDEWINDER,272,RC,,,,both,64.64,58.18,United Healthcare,Default,Fee Schedule,52.75,,,,38.14,52.75
CATH OCCLUSION BALLOON,272,RC,,,,both,2078.5,1870.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1454.95,,,,1226.32,1696.06
CATH OCCLUSION BALLOON,272,RC,,,,both,2078.5,1870.65,Cigna,Default,Percent of Total Billed Charges,1226.32,,,,1226.32,1696.06
CATH OCCLUSION BALLOON,272,RC,,,,both,2078.5,1870.65,United Healthcare,Default,Fee Schedule,1696.06,,,,1226.32,1696.06
CATH SIMMONS II,272,RC,,,,both,65.73,59.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.01,,,,38.78,53.64
CATH SIMMONS II,272,RC,,,,both,65.73,59.16,Cigna,Default,Percent of Total Billed Charges,38.78,,,,38.78,53.64
CATH SIMMONS II,272,RC,,,,both,65.73,59.16,United Healthcare,Default,Fee Schedule,53.64,,,,38.78,53.64
CATH DRAINAGE FLEXIMA APD/10/20,272,RC,,,,both,209.09,188.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.36,,,,123.36,170.62
CATH DRAINAGE FLEXIMA APD/10/20,272,RC,,,,both,209.09,188.18,Cigna,Default,Percent of Total Billed Charges,123.36,,,,123.36,170.62
CATH DRAINAGE FLEXIMA APD/10/20,272,RC,,,,both,209.09,188.18,United Healthcare,Default,Fee Schedule,170.62,,,,123.36,170.62
CATH DRAINAGE FLEXIMA APD/12/25,272,RC,,,,both,203.8,183.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.66,,,,120.24,166.3
CATH DRAINAGE FLEXIMA APD/12/25,272,RC,,,,both,203.8,183.42,Cigna,Default,Percent of Total Billed Charges,120.24,,,,120.24,166.3
CATH DRAINAGE FLEXIMA APD/12/25,272,RC,,,,both,203.8,183.42,United Healthcare,Default,Fee Schedule,166.3,,,,120.24,166.3
CATH DRAINAGE 18 FR LOOP TYPE W/O STYLET,C1729,HCPCS,272,RC,,both,385.95,347.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.16,,,,227.71,314.94
CATH DRAINAGE 18 FR LOOP TYPE W/O STYLET,C1729,HCPCS,272,RC,,both,385.95,347.36,Cigna,Default,Percent of Total Billed Charges,227.71,,,,227.71,314.94
CATH DRAINAGE 18 FR LOOP TYPE W/O STYLET,C1729,HCPCS,272,RC,,both,385.95,347.36,United Healthcare,Default,Fee Schedule,314.94,,,,227.71,314.94
CATH DRAINAGE 16 FR LOOP W/O STYLET,272,RC,,,,both,290.25,261.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,203.18,,,,171.25,236.84
CATH DRAINAGE 16 FR LOOP W/O STYLET,272,RC,,,,both,290.25,261.23,Cigna,Default,Percent of Total Billed Charges,171.25,,,,171.25,236.84
CATH DRAINAGE 16 FR LOOP W/O STYLET,272,RC,,,,both,290.25,261.23,United Healthcare,Default,Fee Schedule,236.84,,,,171.25,236.84
CATH POLY RADPICC LINE,272,RC,,,,both,166.97,150.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.88,,,,98.51,136.25
CATH POLY RADPICC LINE,272,RC,,,,both,166.97,150.27,Cigna,Default,Percent of Total Billed Charges,98.51,,,,98.51,136.25
CATH POLY RADPICC LINE,272,RC,,,,both,166.97,150.27,United Healthcare,Default,Fee Schedule,136.25,,,,98.51,136.25
CATH DRAINAGE FLEXIMA 14FR,272,RC,,,,both,329.97,296.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,230.98,,,,194.68,269.26
CATH DRAINAGE FLEXIMA 14FR,272,RC,,,,both,329.97,296.97,Cigna,Default,Percent of Total Billed Charges,194.68,,,,194.68,269.26
CATH DRAINAGE FLEXIMA 14FR,272,RC,,,,both,329.97,296.97,United Healthcare,Default,Fee Schedule,269.26,,,,194.68,269.26
CATH POWERPICC,272,RC,,,,both,345.31,310.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,241.72,,,,203.73,281.77
CATH POWERPICC,272,RC,,,,both,345.31,310.78,Cigna,Default,Percent of Total Billed Charges,203.73,,,,203.73,281.77
CATH POWERPICC,272,RC,,,,both,345.31,310.78,United Healthcare,Default,Fee Schedule,281.77,,,,203.73,281.77
CATH SUPRAPUBIC INTRODUCER,272,RC,,,,both,82.17,73.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.52,,,,48.48,67.05
CATH SUPRAPUBIC INTRODUCER,272,RC,,,,both,82.17,73.95,Cigna,Default,Percent of Total Billed Charges,48.48,,,,48.48,67.05
CATH SUPRAPUBIC INTRODUCER,272,RC,,,,both,82.17,73.95,United Healthcare,Default,Fee Schedule,67.05,,,,48.48,67.05
MICROPUNCTURE WIRE,272,RC,,,,both,80.36,72.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.25,,,,47.41,65.57
MICROPUNCTURE WIRE,272,RC,,,,both,80.36,72.32,Cigna,Default,Percent of Total Billed Charges,47.41,,,,47.41,65.57
MICROPUNCTURE WIRE,272,RC,,,,both,80.36,72.32,United Healthcare,Default,Fee Schedule,65.57,,,,47.41,65.57
CATH BALLOON DIAMOND ULTRA 7X4X75,C1725,HCPCS,278,RC,,both,582.74,524.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,407.92,,,,343.82,475.52
CATH BALLOON DIAMOND ULTRA 7X4X75,C1725,HCPCS,278,RC,,both,582.74,524.47,Cigna,Default,Percent of Total Billed Charges,343.82,,,,343.82,475.52
CATH BALLOON DIAMOND ULTRA 7X4X75,C1725,HCPCS,278,RC,,both,582.74,524.47,United Healthcare,Default,Fee Schedule,475.52,,,,343.82,475.52
GUIDEWIRE SHEATH FLO CHECK 4FR X 11CM,272,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
GUIDEWIRE SHEATH FLO CHECK 4FR X 11CM,272,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
GUIDEWIRE SHEATH FLO CHECK 4FR X 11CM,272,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
CATH PIGTAIL 5FR 100CM,272,RC,,,,both,60.55,54.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.38,,,,35.72,49.41
CATH PIGTAIL 5FR 100CM,272,RC,,,,both,60.55,54.5,Cigna,Default,Percent of Total Billed Charges,35.72,,,,35.72,49.41
CATH PIGTAIL 5FR 100CM,272,RC,,,,both,60.55,54.5,United Healthcare,Default,Fee Schedule,49.41,,,,35.72,49.41
CATH C2 4FR,272,RC,,,,both,73.51,66.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.46,,,,43.37,59.98
CATH C2 4FR,272,RC,,,,both,73.51,66.16,Cigna,Default,Percent of Total Billed Charges,43.37,,,,43.37,59.98
CATH C2 4FR,272,RC,,,,both,73.51,66.16,United Healthcare,Default,Fee Schedule,59.98,,,,43.37,59.98
CATH COBRA II 65CM 4FR,272,RC,,,,both,80,72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56,,,,47.2,65.28
CATH COBRA II 65CM 4FR,272,RC,,,,both,80,72,Cigna,Default,Percent of Total Billed Charges,47.2,,,,47.2,65.28
CATH COBRA II 65CM 4FR,272,RC,,,,both,80,72,United Healthcare,Default,Fee Schedule,65.28,,,,47.2,65.28
CATH COBRA 2 AT 100 4FR,272,RC,,,,both,55.97,50.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.18,,,,33.02,45.67
CATH COBRA 2 AT 100 4FR,272,RC,,,,both,55.97,50.37,Cigna,Default,Percent of Total Billed Charges,33.02,,,,33.02,45.67
CATH COBRA 2 AT 100 4FR,272,RC,,,,both,55.97,50.37,United Healthcare,Default,Fee Schedule,45.67,,,,33.02,45.67
CATH BALLOON 5FRX110CM FLOW ASSISTED,C1725,HCPCS,278,RC,,both,717.58,645.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,502.31,,,,423.37,585.55
CATH BALLOON 5FRX110CM FLOW ASSISTED,C1725,HCPCS,278,RC,,both,717.58,645.82,Cigna,Default,Percent of Total Billed Charges,423.37,,,,423.37,585.55
CATH BALLOON 5FRX110CM FLOW ASSISTED,C1725,HCPCS,278,RC,,both,717.58,645.82,United Healthcare,Default,Fee Schedule,585.55,,,,423.37,585.55
CATH SOFT-VU 4FR 80CM,272,RC,,,,both,87.91,79.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.54,,,,51.87,71.73
CATH SOFT-VU 4FR 80CM,272,RC,,,,both,87.91,79.12,Cigna,Default,Percent of Total Billed Charges,51.87,,,,51.87,71.73
CATH SOFT-VU 4FR 80CM,272,RC,,,,both,87.91,79.12,United Healthcare,Default,Fee Schedule,71.73,,,,51.87,71.73
*CATH 5FR SOFT-VU,272,RC,,,,both,148.76,133.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.13,,,,87.77,121.39
*CATH 5FR SOFT-VU,272,RC,,,,both,148.76,133.88,Cigna,Default,Percent of Total Billed Charges,87.77,,,,87.77,121.39
*CATH 5FR SOFT-VU,272,RC,,,,both,148.76,133.88,United Healthcare,Default,Fee Schedule,121.39,,,,87.77,121.39
*CATH BILIARY DRAINAGE 8.5FR,C1729,HCPCS,272,RC,,both,469.52,422.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,328.66,,,,277.02,383.13
*CATH BILIARY DRAINAGE 8.5FR,C1729,HCPCS,272,RC,,both,469.52,422.57,Cigna,Default,Percent of Total Billed Charges,277.02,,,,277.02,383.13
*CATH BILIARY DRAINAGE 8.5FR,C1729,HCPCS,272,RC,,both,469.52,422.57,United Healthcare,Default,Fee Schedule,383.13,,,,277.02,383.13
CATH FLEXIMA OPEN ENDED URO 5FR 70CM,272,RC,,,,both,38.48,34.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.94,,,,22.7,31.4
CATH FLEXIMA OPEN ENDED URO 5FR 70CM,272,RC,,,,both,38.48,34.63,Cigna,Default,Percent of Total Billed Charges,22.7,,,,22.7,31.4
CATH FLEXIMA OPEN ENDED URO 5FR 70CM,272,RC,,,,both,38.48,34.63,United Healthcare,Default,Fee Schedule,31.4,,,,22.7,31.4
DNO CATH RUTNER 8F CONE TIPPED,272,RC,,,,both,70.11,63.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.08,,,,41.36,57.21
DNO CATH RUTNER 8F CONE TIPPED,272,RC,,,,both,70.11,63.1,Cigna,Default,Percent of Total Billed Charges,41.36,,,,41.36,57.21
DNO CATH RUTNER 8F CONE TIPPED,272,RC,,,,both,70.11,63.1,United Healthcare,Default,Fee Schedule,57.21,,,,41.36,57.21
CATH OPEN ENDED URETE,272,RC,,,,both,61.66,55.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.16,,,,36.38,50.31
CATH OPEN ENDED URETE,272,RC,,,,both,61.66,55.49,Cigna,Default,Percent of Total Billed Charges,36.38,,,,36.38,50.31
CATH OPEN ENDED URETE,272,RC,,,,both,61.66,55.49,United Healthcare,Default,Fee Schedule,50.31,,,,36.38,50.31
CATH BALLOON 5MMX4CMX8CM,C1725,HCPCS,272,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON 5MMX4CMX8CM,C1725,HCPCS,272,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON 5MMX4CMX8CM,C1725,HCPCS,272,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
CATH THRUWAY 190CMX0.14,272,RC,,,,both,452.31,407.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.62,,,,266.86,369.08
CATH THRUWAY 190CMX0.14,272,RC,,,,both,452.31,407.08,Cigna,Default,Percent of Total Billed Charges,266.86,,,,266.86,369.08
CATH THRUWAY 190CMX0.14,272,RC,,,,both,452.31,407.08,United Healthcare,Default,Fee Schedule,369.08,,,,266.86,369.08
CATH ULTRA THIN DIAMOND 7MMX2CMX75CM,272,RC,,,,both,614.63,553.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.24,,,,362.63,501.54
CATH ULTRA THIN DIAMOND 7MMX2CMX75CM,272,RC,,,,both,614.63,553.17,Cigna,Default,Percent of Total Billed Charges,362.63,,,,362.63,501.54
CATH ULTRA THIN DIAMOND 7MMX2CMX75CM,272,RC,,,,both,614.63,553.17,United Healthcare,Default,Fee Schedule,501.54,,,,362.63,501.54
CATH BALLOON MUSTANG 7X40X75CM,C1725,HCPCS,272,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH BALLOON MUSTANG 7X40X75CM,C1725,HCPCS,272,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH BALLOON MUSTANG 7X40X75CM,C1725,HCPCS,272,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
ADAPTER INTUBATED FOR CAPONE CO2 SENSOR,272,RC,,,,both,41.61,37.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.13,,,,24.55,33.95
ADAPTER INTUBATED FOR CAPONE CO2 SENSOR,272,RC,,,,both,41.61,37.45,Cigna,Default,Percent of Total Billed Charges,24.55,,,,24.55,33.95
ADAPTER INTUBATED FOR CAPONE CO2 SENSOR,272,RC,,,,both,41.61,37.45,United Healthcare,Default,Fee Schedule,33.95,,,,24.55,33.95
ADAPTER NON INTUBATED W/O2 SEATING CAPON,272,RC,,,,both,39.05,35.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.34,,,,23.04,31.86
ADAPTER NON INTUBATED W/O2 SEATING CAPON,272,RC,,,,both,39.05,35.15,Cigna,Default,Percent of Total Billed Charges,23.04,,,,23.04,31.86
ADAPTER NON INTUBATED W/O2 SEATING CAPON,272,RC,,,,both,39.05,35.15,United Healthcare,Default,Fee Schedule,31.86,,,,23.04,31.86
CATH THRUWAY 300CMX0.14,272,RC,,,,both,470.39,423.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,329.27,,,,277.53,383.84
CATH THRUWAY 300CMX0.14,272,RC,,,,both,470.39,423.35,Cigna,Default,Percent of Total Billed Charges,277.53,,,,277.53,383.84
CATH THRUWAY 300CMX0.14,272,RC,,,,both,470.39,423.35,United Healthcare,Default,Fee Schedule,383.84,,,,277.53,383.84
SET MICROPUNCTURE MPIS,272,RC,,,,both,98.2,88.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.74,,,,57.94,80.13
SET MICROPUNCTURE MPIS,272,RC,,,,both,98.2,88.38,Cigna,Default,Percent of Total Billed Charges,57.94,,,,57.94,80.13
SET MICROPUNCTURE MPIS,272,RC,,,,both,98.2,88.38,United Healthcare,Default,Fee Schedule,80.13,,,,57.94,80.13
FANELLI BILIARY STENT SET,C2625,HCPCS,278,RC,,both,2097.87,1888.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1468.51,,,,1237.74,1711.86
FANELLI BILIARY STENT SET,C2625,HCPCS,278,RC,,both,2097.87,1888.08,Cigna,Default,Percent of Total Billed Charges,1237.74,,,,1237.74,1711.86
FANELLI BILIARY STENT SET,C2625,HCPCS,278,RC,,both,2097.87,1888.08,United Healthcare,Default,Fee Schedule,1711.86,,,,1237.74,1711.86
DILATOR NOTTINGHAM,272,RC,,,,both,410.56,369.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.39,,,,242.23,335.02
DILATOR NOTTINGHAM,272,RC,,,,both,410.56,369.5,Cigna,Default,Percent of Total Billed Charges,242.23,,,,242.23,335.02
DILATOR NOTTINGHAM,272,RC,,,,both,410.56,369.5,United Healthcare,Default,Fee Schedule,335.02,,,,242.23,335.02
DILATOR VESSEL,272,RC,,,,both,27.11,24.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.98,,,,15.99,22.12
DILATOR VESSEL,272,RC,,,,both,27.11,24.4,Cigna,Default,Percent of Total Billed Charges,15.99,,,,15.99,22.12
DILATOR VESSEL,272,RC,,,,both,27.11,24.4,United Healthcare,Default,Fee Schedule,22.12,,,,15.99,22.12
DIALATOR VESSEL 26146,272,RC,,,,both,22.62,20.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.83,,,,13.35,18.46
DIALATOR VESSEL 26146,272,RC,,,,both,22.62,20.36,Cigna,Default,Percent of Total Billed Charges,13.35,,,,13.35,18.46
DIALATOR VESSEL 26146,272,RC,,,,both,22.62,20.36,United Healthcare,Default,Fee Schedule,18.46,,,,13.35,18.46
DILATOR 48-153,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DILATOR 48-153,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DILATOR 48-153,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SET DIALATOR 50-314,272,RC,,,,both,333.66,300.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.56,,,,196.86,272.27
SET DIALATOR 50-314,272,RC,,,,both,333.66,300.29,Cigna,Default,Percent of Total Billed Charges,196.86,,,,196.86,272.27
SET DIALATOR 50-314,272,RC,,,,both,333.66,300.29,United Healthcare,Default,Fee Schedule,272.27,,,,196.86,272.27
CATH ACHALASIA BALLOON DILATOR 30MM,C1726,HCPCS,272,RC,,both,2047.92,1843.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1433.54,,,,1208.27,1671.1
CATH ACHALASIA BALLOON DILATOR 30MM,C1726,HCPCS,272,RC,,both,2047.92,1843.13,Cigna,Default,Percent of Total Billed Charges,1208.27,,,,1208.27,1671.1
CATH ACHALASIA BALLOON DILATOR 30MM,C1726,HCPCS,272,RC,,both,2047.92,1843.13,United Healthcare,Default,Fee Schedule,1671.1,,,,1208.27,1671.1
CATH ACHALASIA BALLOON DILATOR 35MM,C1726,HCPCS,272,RC,,both,2099.12,1889.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1469.38,,,,1238.48,1712.88
CATH ACHALASIA BALLOON DILATOR 35MM,C1726,HCPCS,272,RC,,both,2099.12,1889.21,Cigna,Default,Percent of Total Billed Charges,1238.48,,,,1238.48,1712.88
CATH ACHALASIA BALLOON DILATOR 35MM,C1726,HCPCS,272,RC,,both,2099.12,1889.21,United Healthcare,Default,Fee Schedule,1712.88,,,,1238.48,1712.88
WIRE INFUSION 46-192,272,RC,,,,both,705.95,635.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,494.16,,,,416.51,576.06
WIRE INFUSION 46-192,272,RC,,,,both,705.95,635.36,Cigna,Default,Percent of Total Billed Charges,416.51,,,,416.51,576.06
WIRE INFUSION 46-192,272,RC,,,,both,705.95,635.36,United Healthcare,Default,Fee Schedule,576.06,,,,416.51,576.06
CATH ACHALASIA BALLOON DILATOR 40MM,272,RC,,,,both,2159.99,1943.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1511.99,,,,1274.39,1762.55
CATH ACHALASIA BALLOON DILATOR 40MM,272,RC,,,,both,2159.99,1943.99,Cigna,Default,Percent of Total Billed Charges,1274.39,,,,1274.39,1762.55
CATH ACHALASIA BALLOON DILATOR 40MM,272,RC,,,,both,2159.99,1943.99,United Healthcare,Default,Fee Schedule,1762.55,,,,1274.39,1762.55
WIRE INFUSION KATZEN,272,RC,,,,both,705.95,635.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,494.16,,,,416.51,576.06
WIRE INFUSION KATZEN,272,RC,,,,both,705.95,635.36,Cigna,Default,Percent of Total Billed Charges,416.51,,,,416.51,576.06
WIRE INFUSION KATZEN,272,RC,,,,both,705.95,635.36,United Healthcare,Default,Fee Schedule,576.06,,,,416.51,576.06
BALLOON ESOPHAGEAL FIXED WIRE 5865,C1726,HCPCS,272,RC,,both,692.19,622.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,484.53,,,,408.39,564.83
BALLOON ESOPHAGEAL FIXED WIRE 5865,C1726,HCPCS,272,RC,,both,692.19,622.97,Cigna,Default,Percent of Total Billed Charges,408.39,,,,408.39,564.83
BALLOON ESOPHAGEAL FIXED WIRE 5865,C1726,HCPCS,272,RC,,both,692.19,622.97,United Healthcare,Default,Fee Schedule,564.83,,,,408.39,564.83
*CATH POLY RADPICC DUAL LINE,272,RC,,,,both,225.24,202.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.67,,,,132.89,183.8
*CATH POLY RADPICC DUAL LINE,272,RC,,,,both,225.24,202.72,Cigna,Default,Percent of Total Billed Charges,132.89,,,,132.89,183.8
*CATH POLY RADPICC DUAL LINE,272,RC,,,,both,225.24,202.72,United Healthcare,Default,Fee Schedule,183.8,,,,132.89,183.8
DILATOR VESSEL COOK,272,RC,,,,both,55.62,50.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.93,,,,32.82,45.39
DILATOR VESSEL COOK,272,RC,,,,both,55.62,50.06,Cigna,Default,Percent of Total Billed Charges,32.82,,,,32.82,45.39
DILATOR VESSEL COOK,272,RC,,,,both,55.62,50.06,United Healthcare,Default,Fee Schedule,45.39,,,,32.82,45.39
DILATOR JCD 8.0-38-20,272,RC,,,,both,37.74,33.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.42,,,,22.27,30.8
DILATOR JCD 8.0-38-20,272,RC,,,,both,37.74,33.97,Cigna,Default,Percent of Total Billed Charges,22.27,,,,22.27,30.8
DILATOR JCD 8.0-38-20,272,RC,,,,both,37.74,33.97,United Healthcare,Default,Fee Schedule,30.8,,,,22.27,30.8
DILATOR JCD 8.0-38-20,272,RC,,,,both,34.81,31.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.37,,,,20.54,28.4
DILATOR JCD 8.0-38-20,272,RC,,,,both,34.81,31.33,Cigna,Default,Percent of Total Billed Charges,20.54,,,,20.54,28.4
DILATOR JCD 8.0-38-20,272,RC,,,,both,34.81,31.33,United Healthcare,Default,Fee Schedule,28.4,,,,20.54,28.4
COON 14 FR DILATOR,272,RC,,,,both,65.35,58.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.74,,,,38.56,53.33
COON 14 FR DILATOR,272,RC,,,,both,65.35,58.82,Cigna,Default,Percent of Total Billed Charges,38.56,,,,38.56,53.33
COON 14 FR DILATOR,272,RC,,,,both,65.35,58.82,United Healthcare,Default,Fee Schedule,53.33,,,,38.56,53.33
SHEATH W/UNI-VALVE 10,272,RC,,,,both,78.91,71.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.24,,,,46.56,64.39
SHEATH W/UNI-VALVE 10,272,RC,,,,both,78.91,71.02,Cigna,Default,Percent of Total Billed Charges,46.56,,,,46.56,64.39
SHEATH W/UNI-VALVE 10,272,RC,,,,both,78.91,71.02,United Healthcare,Default,Fee Schedule,64.39,,,,46.56,64.39
CATH BALLOON MUSTANG 8X40X75,C1725,HCPCS,272,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH BALLOON MUSTANG 8X40X75,C1725,HCPCS,272,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH BALLOON MUSTANG 8X40X75,C1725,HCPCS,272,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
SHEATH 9FR X 10CM PINNACLE,272,RC,,,,both,151.36,136.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.95,,,,89.3,123.51
SHEATH 9FR X 10CM PINNACLE,272,RC,,,,both,151.36,136.22,Cigna,Default,Percent of Total Billed Charges,89.3,,,,89.3,123.51
SHEATH 9FR X 10CM PINNACLE,272,RC,,,,both,151.36,136.22,United Healthcare,Default,Fee Schedule,123.51,,,,89.3,123.51
"SUTURE SILK 4-0 18"" TIES ETH A183H",272,RC,,,,both,21.72,19.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.2,,,,12.81,17.72
"SUTURE SILK 4-0 18"" TIES ETH A183H",272,RC,,,,both,21.72,19.55,Cigna,Default,Percent of Total Billed Charges,12.81,,,,12.81,17.72
"SUTURE SILK 4-0 18"" TIES ETH A183H",272,RC,,,,both,21.72,19.55,United Healthcare,Default,Fee Schedule,17.72,,,,12.81,17.72
CATH BALLOON MUSTANG 8X40X135,C1725,HCPCS,272,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH BALLOON MUSTANG 8X40X135,C1725,HCPCS,272,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH BALLOON MUSTANG 8X40X135,C1725,HCPCS,272,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
SYRINGE INJECTION MEDRAD,272,RC,,,,both,38.91,35.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.24,,,,22.96,31.75
SYRINGE INJECTION MEDRAD,272,RC,,,,both,38.91,35.02,Cigna,Default,Percent of Total Billed Charges,22.96,,,,22.96,31.75
SYRINGE INJECTION MEDRAD,272,RC,,,,both,38.91,35.02,United Healthcare,Default,Fee Schedule,31.75,,,,22.96,31.75
WAND TURBINATE REFLEX-45,272,RC,,,,both,614.63,553.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.24,,,,362.63,501.54
WAND TURBINATE REFLEX-45,272,RC,,,,both,614.63,553.17,Cigna,Default,Percent of Total Billed Charges,362.63,,,,362.63,501.54
WAND TURBINATE REFLEX-45,272,RC,,,,both,614.63,553.17,United Healthcare,Default,Fee Schedule,501.54,,,,362.63,501.54
WAND EVAC-XTRA TONSIL/ADENOID,272,RC,,,,both,614.63,553.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.24,,,,362.63,501.54
WAND EVAC-XTRA TONSIL/ADENOID,272,RC,,,,both,614.63,553.17,Cigna,Default,Percent of Total Billed Charges,362.63,,,,362.63,501.54
WAND EVAC-XTRA TONSIL/ADENOID,272,RC,,,,both,614.63,553.17,United Healthcare,Default,Fee Schedule,501.54,,,,362.63,501.54
SHEATH 9FR X 11CM INTERVENTIONAL,272,RC,,,,both,151.36,136.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.95,,,,89.3,123.51
SHEATH 9FR X 11CM INTERVENTIONAL,272,RC,,,,both,151.36,136.22,Cigna,Default,Percent of Total Billed Charges,89.3,,,,89.3,123.51
SHEATH 9FR X 11CM INTERVENTIONAL,272,RC,,,,both,151.36,136.22,United Healthcare,Default,Fee Schedule,123.51,,,,89.3,123.51
WIRE SUPER STIFF .035X75CM,272,RC,,,,both,110.7,99.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.49,,,,65.31,90.33
WIRE SUPER STIFF .035X75CM,272,RC,,,,both,110.7,99.63,Cigna,Default,Percent of Total Billed Charges,65.31,,,,65.31,90.33
WIRE SUPER STIFF .035X75CM,272,RC,,,,both,110.7,99.63,United Healthcare,Default,Fee Schedule,90.33,,,,65.31,90.33
SYRINGE INJECTION 200,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SYRINGE INJECTION 200,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SYRINGE INJECTION 200,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
5 FR DILATOR (CUSTOM),272,RC,,,,both,34.81,31.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.37,,,,20.54,28.4
5 FR DILATOR (CUSTOM),272,RC,,,,both,34.81,31.33,Cigna,Default,Percent of Total Billed Charges,20.54,,,,20.54,28.4
5 FR DILATOR (CUSTOM),272,RC,,,,both,34.81,31.33,United Healthcare,Default,Fee Schedule,28.4,,,,20.54,28.4
COON 7 FR DILATOR (CUSTOM),272,RC,,,,both,75.85,68.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.1,,,,44.75,61.89
COON 7 FR DILATOR (CUSTOM),272,RC,,,,both,75.85,68.27,Cigna,Default,Percent of Total Billed Charges,44.75,,,,44.75,61.89
COON 7 FR DILATOR (CUSTOM),272,RC,,,,both,75.85,68.27,United Healthcare,Default,Fee Schedule,61.89,,,,44.75,61.89
COON 6 FR DILATOR 20CM .038,272,RC,,,,both,65.35,58.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.74,,,,38.56,53.33
COON 6 FR DILATOR 20CM .038,272,RC,,,,both,65.35,58.82,Cigna,Default,Percent of Total Billed Charges,38.56,,,,38.56,53.33
COON 6 FR DILATOR 20CM .038,272,RC,,,,both,65.35,58.82,United Healthcare,Default,Fee Schedule,53.33,,,,38.56,53.33
CATH BALLOON MUSTANG 8X30X75,C1725,HCPCS,272,RC,,both,599.39,539.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.57,,,,353.64,489.1
CATH BALLOON MUSTANG 8X30X75,C1725,HCPCS,272,RC,,both,599.39,539.45,Cigna,Default,Percent of Total Billed Charges,353.64,,,,353.64,489.1
CATH BALLOON MUSTANG 8X30X75,C1725,HCPCS,272,RC,,both,599.39,539.45,United Healthcare,Default,Fee Schedule,489.1,,,,353.64,489.1
COON 10 FR DILATOR,272,RC,,,,both,65.35,58.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.74,,,,38.56,53.33
COON 10 FR DILATOR,272,RC,,,,both,65.35,58.82,Cigna,Default,Percent of Total Billed Charges,38.56,,,,38.56,53.33
COON 10 FR DILATOR,272,RC,,,,both,65.35,58.82,United Healthcare,Default,Fee Schedule,53.33,,,,38.56,53.33
CATH BALLOON CODA 10FR 100CM,272,RC,,,,both,860.5,774.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,602.35,,,,507.7,702.17
CATH BALLOON CODA 10FR 100CM,272,RC,,,,both,860.5,774.45,Cigna,Default,Percent of Total Billed Charges,507.7,,,,507.7,702.17
CATH BALLOON CODA 10FR 100CM,272,RC,,,,both,860.5,774.45,United Healthcare,Default,Fee Schedule,702.17,,,,507.7,702.17
CATH BALLOON CODA 9FR 120CM,C1725,HCPCS,278,RC,,both,1475.17,1327.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1032.62,,,,870.35,1203.74
CATH BALLOON CODA 9FR 120CM,C1725,HCPCS,278,RC,,both,1475.17,1327.65,Cigna,Default,Percent of Total Billed Charges,870.35,,,,870.35,1203.74
CATH BALLOON CODA 9FR 120CM,C1725,HCPCS,278,RC,,both,1475.17,1327.65,United Healthcare,Default,Fee Schedule,1203.74,,,,870.35,1203.74
COON 12 FR DILATOR,272,RC,,,,both,65.34,58.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.74,,,,38.55,53.32
COON 12 FR DILATOR,272,RC,,,,both,65.34,58.81,Cigna,Default,Percent of Total Billed Charges,38.55,,,,38.55,53.32
COON 12 FR DILATOR,272,RC,,,,both,65.34,58.81,United Healthcare,Default,Fee Schedule,53.32,,,,38.55,53.32
CATH SUPER TORQUE 5FR/J,272,RC,,,,both,80,72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56,,,,47.2,65.28
CATH SUPER TORQUE 5FR/J,272,RC,,,,both,80,72,Cigna,Default,Percent of Total Billed Charges,47.2,,,,47.2,65.28
CATH SUPER TORQUE 5FR/J,272,RC,,,,both,80,72,United Healthcare,Default,Fee Schedule,65.28,,,,47.2,65.28
RADIFOCUS GUIDEWIRETORQUE DEVICE,272,RC,,,,both,37.64,33.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.35,,,,22.21,30.71
RADIFOCUS GUIDEWIRETORQUE DEVICE,272,RC,,,,both,37.64,33.88,Cigna,Default,Percent of Total Billed Charges,22.21,,,,22.21,30.71
RADIFOCUS GUIDEWIRETORQUE DEVICE,272,RC,,,,both,37.64,33.88,United Healthcare,Default,Fee Schedule,30.71,,,,22.21,30.71
STENT INTRO SYSTEM 10-7,C1874,HCPCS,278,RC,,both,410.22,369.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.15,,,,242.03,334.74
STENT INTRO SYSTEM 10-7,C1874,HCPCS,278,RC,,both,410.22,369.2,Cigna,Default,Percent of Total Billed Charges,242.03,,,,242.03,334.74
STENT INTRO SYSTEM 10-7,C1874,HCPCS,278,RC,,both,410.22,369.2,United Healthcare,Default,Fee Schedule,334.74,,,,242.03,334.74
"GUIDE WIRE - STRAIGHT TIP 0.35"" 150CM",C1769,HCPCS,272,RC,,both,160.51,144.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.36,,,,94.7,130.98
"GUIDE WIRE - STRAIGHT TIP 0.35"" 150CM",C1769,HCPCS,272,RC,,both,160.51,144.46,Cigna,Default,Percent of Total Billed Charges,94.7,,,,94.7,130.98
"GUIDE WIRE - STRAIGHT TIP 0.35"" 150CM",C1769,HCPCS,272,RC,,both,160.51,144.46,United Healthcare,Default,Fee Schedule,130.98,,,,94.7,130.98
GLIDE WIRE 46 154,C1769,HCPCS,278,RC,,both,195.61,176.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.93,,,,115.41,159.62
GLIDE WIRE 46 154,C1769,HCPCS,278,RC,,both,195.61,176.05,Cigna,Default,Percent of Total Billed Charges,115.41,,,,115.41,159.62
GLIDE WIRE 46 154,C1769,HCPCS,278,RC,,both,195.61,176.05,United Healthcare,Default,Fee Schedule,159.62,,,,115.41,159.62
GLIDE WIRE 46-152,C1769,HCPCS,278,RC,,both,174.14,156.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.9,,,,102.74,142.1
GLIDE WIRE 46-152,C1769,HCPCS,278,RC,,both,174.14,156.73,Cigna,Default,Percent of Total Billed Charges,102.74,,,,102.74,142.1
GLIDE WIRE 46-152,C1769,HCPCS,278,RC,,both,174.14,156.73,United Healthcare,Default,Fee Schedule,142.1,,,,102.74,142.1
STENT INTRO SYSTEM 10-5,C1874,HCPCS,278,RC,,both,586.07,527.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,410.25,,,,345.78,478.23
STENT INTRO SYSTEM 10-5,C1874,HCPCS,278,RC,,both,586.07,527.46,Cigna,Default,Percent of Total Billed Charges,345.78,,,,345.78,478.23
STENT INTRO SYSTEM 10-5,C1874,HCPCS,278,RC,,both,586.07,527.46,United Healthcare,Default,Fee Schedule,478.23,,,,345.78,478.23
CATH GLO TIP ERCP,272,RC,,,,both,196.75,177.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.72,,,,116.08,160.55
CATH GLO TIP ERCP,272,RC,,,,both,196.75,177.08,Cigna,Default,Percent of Total Billed Charges,116.08,,,,116.08,160.55
CATH GLO TIP ERCP,272,RC,,,,both,196.75,177.08,United Healthcare,Default,Fee Schedule,160.55,,,,116.08,160.55
SHEATH INTRODUCER 7 F,272,RC,,,,both,84.33,75.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.03,,,,49.75,68.81
SHEATH INTRODUCER 7 F,272,RC,,,,both,84.33,75.9,Cigna,Default,Percent of Total Billed Charges,49.75,,,,49.75,68.81
SHEATH INTRODUCER 7 F,272,RC,,,,both,84.33,75.9,United Healthcare,Default,Fee Schedule,68.81,,,,49.75,68.81
CATH MICRO 3FR 150CM L HI-FLOW,272,RC,,,,both,1317.07,1185.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,921.95,,,,777.07,1074.73
CATH MICRO 3FR 150CM L HI-FLOW,272,RC,,,,both,1317.07,1185.36,Cigna,Default,Percent of Total Billed Charges,777.07,,,,777.07,1074.73
CATH MICRO 3FR 150CM L HI-FLOW,272,RC,,,,both,1317.07,1185.36,United Healthcare,Default,Fee Schedule,1074.73,,,,777.07,1074.73
SHEATH INTRODUCER 15-712-1,272,RC,,,,both,84.33,75.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.03,,,,49.75,68.81
SHEATH INTRODUCER 15-712-1,272,RC,,,,both,84.33,75.9,Cigna,Default,Percent of Total Billed Charges,49.75,,,,49.75,68.81
SHEATH INTRODUCER 15-712-1,272,RC,,,,both,84.33,75.9,United Healthcare,Default,Fee Schedule,68.81,,,,49.75,68.81
INTRODUCER SHEATH 15-731,272,RC,,,,both,149.19,134.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.43,,,,88.02,121.74
INTRODUCER SHEATH 15-731,272,RC,,,,both,149.19,134.27,Cigna,Default,Percent of Total Billed Charges,88.02,,,,88.02,121.74
INTRODUCER SHEATH 15-731,272,RC,,,,both,149.19,134.27,United Healthcare,Default,Fee Schedule,121.74,,,,88.02,121.74
SHEATH PINNACLE 15-73,272,RC,,,,both,149.19,134.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.43,,,,88.02,121.74
SHEATH PINNACLE 15-73,272,RC,,,,both,149.19,134.27,Cigna,Default,Percent of Total Billed Charges,88.02,,,,88.02,121.74
SHEATH PINNACLE 15-73,272,RC,,,,both,149.19,134.27,United Healthcare,Default,Fee Schedule,121.74,,,,88.02,121.74
INTRODUCER COUDE TIP 15X70CM,272,RC,,,,both,34.04,30.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.83,,,,20.08,27.78
INTRODUCER COUDE TIP 15X70CM,272,RC,,,,both,34.04,30.64,Cigna,Default,Percent of Total Billed Charges,20.08,,,,20.08,27.78
INTRODUCER COUDE TIP 15X70CM,272,RC,,,,both,34.04,30.64,United Healthcare,Default,Fee Schedule,27.78,,,,20.08,27.78
CATH MICRO INFUSION 2.9DX150LX5,C1887,HCPCS,278,RC,,both,649.34,584.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.54,,,,383.11,529.86
CATH MICRO INFUSION 2.9DX150LX5,C1887,HCPCS,278,RC,,both,649.34,584.41,Cigna,Default,Percent of Total Billed Charges,383.11,,,,383.11,529.86
CATH MICRO INFUSION 2.9DX150LX5,C1887,HCPCS,278,RC,,both,649.34,584.41,United Healthcare,Default,Fee Schedule,529.86,,,,383.11,529.86
CATH MICRO INFUSION 2.9DX150LX10,C1887,HCPCS,278,RC,,both,649.34,584.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.54,,,,383.11,529.86
CATH MICRO INFUSION 2.9DX150LX10,C1887,HCPCS,278,RC,,both,649.34,584.41,Cigna,Default,Percent of Total Billed Charges,383.11,,,,383.11,529.86
CATH MICRO INFUSION 2.9DX150LX10,C1887,HCPCS,278,RC,,both,649.34,584.41,United Healthcare,Default,Fee Schedule,529.86,,,,383.11,529.86
PAINPUMP BLOCK AID REUSABLE,272,RC,,,,both,1192.73,1073.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,834.91,,,,703.71,973.27
PAINPUMP BLOCK AID REUSABLE,272,RC,,,,both,1192.73,1073.46,Cigna,Default,Percent of Total Billed Charges,703.71,,,,703.71,973.27
PAINPUMP BLOCK AID REUSABLE,272,RC,,,,both,1192.73,1073.46,United Healthcare,Default,Fee Schedule,973.27,,,,703.71,973.27
PAINPUMP 2 400ML,272,RC,,,,both,736.32,662.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,515.42,,,,434.43,600.84
PAINPUMP 2 400ML,272,RC,,,,both,736.32,662.69,Cigna,Default,Percent of Total Billed Charges,434.43,,,,434.43,600.84
PAINPUMP 2 400ML,272,RC,,,,both,736.32,662.69,United Healthcare,Default,Fee Schedule,600.84,,,,434.43,600.84
DNU STENT URETERAL 6FR X 22-30CM,278,RC,,,,both,340,306,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238,,,,200.6,277.44
DNU STENT URETERAL 6FR X 22-30CM,278,RC,,,,both,340,306,Cigna,Default,Percent of Total Billed Charges,200.6,,,,200.6,277.44
DNU STENT URETERAL 6FR X 22-30CM,278,RC,,,,both,340,306,United Healthcare,Default,Fee Schedule,277.44,,,,200.6,277.44
SHEATH SUPER 15-735B,272,RC,,,,both,153.68,138.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.58,,,,90.67,125.4
SHEATH SUPER 15-735B,272,RC,,,,both,153.68,138.31,Cigna,Default,Percent of Total Billed Charges,90.67,,,,90.67,125.4
SHEATH SUPER 15-735B,272,RC,,,,both,153.68,138.31,United Healthcare,Default,Fee Schedule,125.4,,,,90.67,125.4
PERITONEAL DIALYSIS CATH UNIVERSAL TENCK,272,RC,,,,both,187.79,169.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.45,,,,110.8,153.24
PERITONEAL DIALYSIS CATH UNIVERSAL TENCK,272,RC,,,,both,187.79,169.01,Cigna,Default,Percent of Total Billed Charges,110.8,,,,110.8,153.24
PERITONEAL DIALYSIS CATH UNIVERSAL TENCK,272,RC,,,,both,187.79,169.01,United Healthcare,Default,Fee Schedule,153.24,,,,110.8,153.24
GUIDEWIRE THRUWAY 300CM 49-297,272,RC,,,,both,470.39,423.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,329.27,,,,277.53,383.84
GUIDEWIRE THRUWAY 300CM 49-297,272,RC,,,,both,470.39,423.35,Cigna,Default,Percent of Total Billed Charges,277.53,,,,277.53,383.84
GUIDEWIRE THRUWAY 300CM 49-297,272,RC,,,,both,470.39,423.35,United Healthcare,Default,Fee Schedule,383.84,,,,277.53,383.84
CHRONIC CATHETER ACCESSORY 16FR,272,RC,,,,both,166.92,150.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.84,,,,98.48,136.21
CHRONIC CATHETER ACCESSORY 16FR,272,RC,,,,both,166.92,150.23,Cigna,Default,Percent of Total Billed Charges,98.48,,,,98.48,136.21
CHRONIC CATHETER ACCESSORY 16FR,272,RC,,,,both,166.92,150.23,United Healthcare,Default,Fee Schedule,136.21,,,,98.48,136.21
CATH PERITONEAL DIALYSIS TENCKHOFF 47CM,272,RC,,,,both,192.33,173.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.63,,,,113.47,156.94
CATH PERITONEAL DIALYSIS TENCKHOFF 47CM,272,RC,,,,both,192.33,173.1,Cigna,Default,Percent of Total Billed Charges,113.47,,,,113.47,156.94
CATH PERITONEAL DIALYSIS TENCKHOFF 47CM,272,RC,,,,both,192.33,173.1,United Healthcare,Default,Fee Schedule,156.94,,,,113.47,156.94
WIRE GUIDE EXTRA STIFF LUNDERQUIST,272,RC,,,,both,358.24,322.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,250.77,,,,211.36,292.32
WIRE GUIDE EXTRA STIFF LUNDERQUIST,272,RC,,,,both,358.24,322.42,Cigna,Default,Percent of Total Billed Charges,211.36,,,,211.36,292.32
WIRE GUIDE EXTRA STIFF LUNDERQUIST,272,RC,,,,both,358.24,322.42,United Healthcare,Default,Fee Schedule,292.32,,,,211.36,292.32
TWISTER PLUS 22LD ROTATABLE RETRIEVAL DE,272,RC,,,,both,245.86,221.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.1,,,,145.06,200.62
TWISTER PLUS 22LD ROTATABLE RETRIEVAL DE,272,RC,,,,both,245.86,221.27,Cigna,Default,Percent of Total Billed Charges,145.06,,,,145.06,200.62
TWISTER PLUS 22LD ROTATABLE RETRIEVAL DE,272,RC,,,,both,245.86,221.27,United Healthcare,Default,Fee Schedule,200.62,,,,145.06,200.62
CATH TNT GUIDEWIRE TR,C1769,HCPCS,278,RC,,both,337.91,304.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.54,,,,199.37,275.73
CATH TNT GUIDEWIRE TR,C1769,HCPCS,278,RC,,both,337.91,304.12,Cigna,Default,Percent of Total Billed Charges,199.37,,,,199.37,275.73
CATH TNT GUIDEWIRE TR,C1769,HCPCS,278,RC,,both,337.91,304.12,United Healthcare,Default,Fee Schedule,275.73,,,,199.37,275.73
TWISTER PLUS 26LD ROTATABLE RETREVAL DEV,272,RC,,,,both,245.86,221.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.1,,,,145.06,200.62
TWISTER PLUS 26LD ROTATABLE RETREVAL DEV,272,RC,,,,both,245.86,221.27,Cigna,Default,Percent of Total Billed Charges,145.06,,,,145.06,200.62
TWISTER PLUS 26LD ROTATABLE RETREVAL DEV,272,RC,,,,both,245.86,221.27,United Healthcare,Default,Fee Schedule,200.62,,,,145.06,200.62
RETRIEVER SUTURE BLUE LASSO,272,RC,,,,both,129.15,116.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.4,,,,76.2,105.39
RETRIEVER SUTURE BLUE LASSO,272,RC,,,,both,129.15,116.24,Cigna,Default,Percent of Total Billed Charges,76.2,,,,76.2,105.39
RETRIEVER SUTURE BLUE LASSO,272,RC,,,,both,129.15,116.24,United Healthcare,Default,Fee Schedule,105.39,,,,76.2,105.39
RETRIEVER SUTURE 10.1,272,RC,,,,both,947.16,852.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,663.01,,,,558.82,772.88
RETRIEVER SUTURE 10.1,272,RC,,,,both,947.16,852.44,Cigna,Default,Percent of Total Billed Charges,558.82,,,,558.82,772.88
RETRIEVER SUTURE 10.1,272,RC,,,,both,947.16,852.44,United Healthcare,Default,Fee Schedule,772.88,,,,558.82,772.88
RETRIEVER ROTH NET FOOD BOLUS PLATINUM,272,RC,,,,both,342.99,308.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,240.09,,,,202.36,279.88
RETRIEVER ROTH NET FOOD BOLUS PLATINUM,272,RC,,,,both,342.99,308.69,Cigna,Default,Percent of Total Billed Charges,202.36,,,,202.36,279.88
RETRIEVER ROTH NET FOOD BOLUS PLATINUM,272,RC,,,,both,342.99,308.69,United Healthcare,Default,Fee Schedule,279.88,,,,202.36,279.88
*CATH SYMMETRY,272,RC,,,,both,1134.43,1020.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,794.1,,,,669.31,925.69
*CATH SYMMETRY,272,RC,,,,both,1134.43,1020.99,Cigna,Default,Percent of Total Billed Charges,669.31,,,,669.31,925.69
*CATH SYMMETRY,272,RC,,,,both,1134.43,1020.99,United Healthcare,Default,Fee Schedule,925.69,,,,669.31,925.69
CATH STRAIGHT 5 FR .038X70CM,272,RC,,,,both,104.87,94.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.41,,,,61.87,85.57
CATH STRAIGHT 5 FR .038X70CM,272,RC,,,,both,104.87,94.38,Cigna,Default,Percent of Total Billed Charges,61.87,,,,61.87,85.57
CATH STRAIGHT 5 FR .038X70CM,272,RC,,,,both,104.87,94.38,United Healthcare,Default,Fee Schedule,85.57,,,,61.87,85.57
CATH STRAIGHT 5 FR .038X100CM,272,RC,,,,both,104.87,94.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.41,,,,61.87,85.57
CATH STRAIGHT 5 FR .038X100CM,272,RC,,,,both,104.87,94.38,Cigna,Default,Percent of Total Billed Charges,61.87,,,,61.87,85.57
CATH STRAIGHT 5 FR .038X100CM,272,RC,,,,both,104.87,94.38,United Healthcare,Default,Fee Schedule,85.57,,,,61.87,85.57
CATH WIRE 5 FR .035X260CM,272,RC,,,,both,259.25,233.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,181.48,,,,152.96,211.55
CATH WIRE 5 FR .035X260CM,272,RC,,,,both,259.25,233.33,Cigna,Default,Percent of Total Billed Charges,152.96,,,,152.96,211.55
CATH WIRE 5 FR .035X260CM,272,RC,,,,both,259.25,233.33,United Healthcare,Default,Fee Schedule,211.55,,,,152.96,211.55
"KIT BLOOD CONSERVATION 1/4"" WOUND DRAIN",272,RC,,,,both,434.63,391.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,304.24,,,,256.43,354.66
"KIT BLOOD CONSERVATION 1/4"" WOUND DRAIN",272,RC,,,,both,434.63,391.17,Cigna,Default,Percent of Total Billed Charges,256.43,,,,256.43,354.66
"KIT BLOOD CONSERVATION 1/4"" WOUND DRAIN",272,RC,,,,both,434.63,391.17,United Healthcare,Default,Fee Schedule,354.66,,,,256.43,354.66
CATH BALLOON DIL 10X40 MUSTANG,C1725,HCPCS,278,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH BALLOON DIL 10X40 MUSTANG,C1725,HCPCS,278,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH BALLOON DIL 10X40 MUSTANG,C1725,HCPCS,278,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
HYDROPHILIC WIRE GUIDE HIWIRE,272,RC,,,,both,302.05,271.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.44,,,,178.21,246.47
HYDROPHILIC WIRE GUIDE HIWIRE,272,RC,,,,both,302.05,271.85,Cigna,Default,Percent of Total Billed Charges,178.21,,,,178.21,246.47
HYDROPHILIC WIRE GUIDE HIWIRE,272,RC,,,,both,302.05,271.85,United Healthcare,Default,Fee Schedule,246.47,,,,178.21,246.47
CATH BALLOON DILATION STERLING 4x20x135,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON DILATION STERLING 4x20x135,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON DILATION STERLING 4x20x135,C1725,HCPCS,278,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
CATH BALLOON 5X2X80 STERLING,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON 5X2X80 STERLING,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON 5X2X80 STERLING,C1725,HCPCS,278,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
CATH MUSTANG 9X40X135 6FR,C1725,HCPCS,278,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH MUSTANG 9X40X135 6FR,C1725,HCPCS,278,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH MUSTANG 9X40X135 6FR,C1725,HCPCS,278,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
CATH BALLOON 4X40X145 COYOTE,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON 4X40X145 COYOTE,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON 4X40X145 COYOTE,C1725,HCPCS,278,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
GUIDE WIRE  ROADRUNNER .035 260CM,C1769,HCPCS,278,RC,,both,339.65,305.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,237.76,,,,200.39,277.15
GUIDE WIRE  ROADRUNNER .035 260CM,C1769,HCPCS,278,RC,,both,339.65,305.69,Cigna,Default,Percent of Total Billed Charges,200.39,,,,200.39,277.15
GUIDE WIRE  ROADRUNNER .035 260CM,C1769,HCPCS,278,RC,,both,339.65,305.69,United Healthcare,Default,Fee Schedule,277.15,,,,200.39,277.15
CATH BALLOON 3X40X145 COYOTE,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON 3X40X145 COYOTE,C1725,HCPCS,278,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON 3X40X145 COYOTE,C1725,HCPCS,278,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
GUIDE WIRE 197303,C1769,HCPCS,278,RC,,both,30.75,27.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.52,,,,18.14,25.09
GUIDE WIRE 197303,C1769,HCPCS,278,RC,,both,30.75,27.68,Cigna,Default,Percent of Total Billed Charges,18.14,,,,18.14,25.09
GUIDE WIRE 197303,C1769,HCPCS,278,RC,,both,30.75,27.68,United Healthcare,Default,Fee Schedule,25.09,,,,18.14,25.09
4FR WOVEN FILIFORM SPIRAL TIP,272,RC,,,,both,251.68,226.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.18,,,,148.49,205.37
4FR WOVEN FILIFORM SPIRAL TIP,272,RC,,,,both,251.68,226.51,Cigna,Default,Percent of Total Billed Charges,148.49,,,,148.49,205.37
4FR WOVEN FILIFORM SPIRAL TIP,272,RC,,,,both,251.68,226.51,United Healthcare,Default,Fee Schedule,205.37,,,,148.49,205.37
PERI-STRIPS DRY,272,RC,,,,both,708.4,637.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,495.88,,,,417.96,578.05
PERI-STRIPS DRY,272,RC,,,,both,708.4,637.56,Cigna,Default,Percent of Total Billed Charges,417.96,,,,417.96,578.05
PERI-STRIPS DRY,272,RC,,,,both,708.4,637.56,United Healthcare,Default,Fee Schedule,578.05,,,,417.96,578.05
5F WOVEN FILIFORMS SPIRAL TIP,272,RC,,,,both,251.68,226.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.18,,,,148.49,205.37
5F WOVEN FILIFORMS SPIRAL TIP,272,RC,,,,both,251.68,226.51,Cigna,Default,Percent of Total Billed Charges,148.49,,,,148.49,205.37
5F WOVEN FILIFORMS SPIRAL TIP,272,RC,,,,both,251.68,226.51,United Healthcare,Default,Fee Schedule,205.37,,,,148.49,205.37
6F WOVEN FILIFORMS SPIRAL TIP,272,RC,,,,both,251.68,226.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.18,,,,148.49,205.37
6F WOVEN FILIFORMS SPIRAL TIP,272,RC,,,,both,251.68,226.51,Cigna,Default,Percent of Total Billed Charges,148.49,,,,148.49,205.37
6F WOVEN FILIFORMS SPIRAL TIP,272,RC,,,,both,251.68,226.51,United Healthcare,Default,Fee Schedule,205.37,,,,148.49,205.37
8FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
8FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
8FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
10FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
10FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
10FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
12FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
12FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
12FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
14FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
14FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
14FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
VASC RET FORC 191687,272,RC,,,,both,1056.11,950.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,739.28,,,,623.1,861.79
VASC RET FORC 191687,272,RC,,,,both,1056.11,950.5,Cigna,Default,Percent of Total Billed Charges,623.1,,,,623.1,861.79
VASC RET FORC 191687,272,RC,,,,both,1056.11,950.5,United Healthcare,Default,Fee Schedule,861.79,,,,623.1,861.79
16FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
16FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
16FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
18FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
18FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
18FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
20FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
20FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
20FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
CATH PIGTAIL 7FR,272,RC,,,,both,65.73,59.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.01,,,,38.78,53.64
CATH PIGTAIL 7FR,272,RC,,,,both,65.73,59.16,Cigna,Default,Percent of Total Billed Charges,38.78,,,,38.78,53.64
CATH PIGTAIL 7FR,272,RC,,,,both,65.73,59.16,United Healthcare,Default,Fee Schedule,53.64,,,,38.78,53.64
22FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
22FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
22FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
COIL EMBOLIZATION,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
COIL EMBOLIZATION,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
COIL EMBOLIZATION MWC,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION MWC,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION MWC,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
COIL EMBOLIZATION,272,RC,,,,both,194.59,175.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.21,,,,114.81,158.79
COIL EMBOLIZATION,272,RC,,,,both,194.59,175.13,Cigna,Default,Percent of Total Billed Charges,114.81,,,,114.81,158.79
COIL EMBOLIZATION,272,RC,,,,both,194.59,175.13,United Healthcare,Default,Fee Schedule,158.79,,,,114.81,158.79
COIL EMBOLIZATION 959,272,RC,,,,both,194.59,175.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.21,,,,114.81,158.79
COIL EMBOLIZATION 959,272,RC,,,,both,194.59,175.13,Cigna,Default,Percent of Total Billed Charges,114.81,,,,114.81,158.79
COIL EMBOLIZATION 959,272,RC,,,,both,194.59,175.13,United Healthcare,Default,Fee Schedule,158.79,,,,114.81,158.79
COIL EMBOLIZATION 390,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION 390,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION 390,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.12,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,Cigna,Default,Percent of Total Billed Charges,111.36,,,,111.36,154.02
COIL EMBOLIZATION 5 X,272,RC,,,,both,188.75,169.88,United Healthcare,Default,Fee Schedule,154.02,,,,111.36,154.02
HUMIDIFIER PRE-FILLED,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
HUMIDIFIER PRE-FILLED,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
HUMIDIFIER PRE-FILLED,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
COIL EMBOLIZATION MWC,272,RC,,,,both,231.8,208.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.26,,,,136.76,189.15
COIL EMBOLIZATION MWC,272,RC,,,,both,231.8,208.62,Cigna,Default,Percent of Total Billed Charges,136.76,,,,136.76,189.15
COIL EMBOLIZATION MWC,272,RC,,,,both,231.8,208.62,United Healthcare,Default,Fee Schedule,189.15,,,,136.76,189.15
SHEATH 14 FR X 30 CM,272,RC,,,,both,175.67,158.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.97,,,,103.65,143.35
SHEATH 14 FR X 30 CM,272,RC,,,,both,175.67,158.1,Cigna,Default,Percent of Total Billed Charges,103.65,,,,103.65,143.35
SHEATH 14 FR X 30 CM,272,RC,,,,both,175.67,158.1,United Healthcare,Default,Fee Schedule,143.35,,,,103.65,143.35
SHEATH 10 FR 90 CM DA,272,RC,,,,both,316.1,284.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.27,,,,186.5,257.94
SHEATH 10 FR 90 CM DA,272,RC,,,,both,316.1,284.49,Cigna,Default,Percent of Total Billed Charges,186.5,,,,186.5,257.94
SHEATH 10 FR 90 CM DA,272,RC,,,,both,316.1,284.49,United Healthcare,Default,Fee Schedule,257.94,,,,186.5,257.94
SHEATH 12FR X 75CM 40,272,RC,,,,both,351.22,316.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,245.85,,,,207.22,286.6
SHEATH 12FR X 75CM 40,272,RC,,,,both,351.22,316.1,Cigna,Default,Percent of Total Billed Charges,207.22,,,,207.22,286.6
SHEATH 12FR X 75CM 40,272,RC,,,,both,351.22,316.1,United Healthcare,Default,Fee Schedule,286.6,,,,207.22,286.6
24FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.38,,,,222.84,308.2
24FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,Cigna,Default,Percent of Total Billed Charges,222.84,,,,222.84,308.2
24FR WOVEN PHILLIPS FOLLOWER,272,RC,,,,both,377.69,339.92,United Healthcare,Default,Fee Schedule,308.2,,,,222.84,308.2
SHEATH 7FR LONG 501-6,272,RC,,,,both,185.34,166.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.74,,,,109.35,151.24
SHEATH 7FR LONG 501-6,272,RC,,,,both,185.34,166.81,Cigna,Default,Percent of Total Billed Charges,109.35,,,,109.35,151.24
SHEATH 7FR LONG 501-6,272,RC,,,,both,185.34,166.81,United Healthcare,Default,Fee Schedule,151.24,,,,109.35,151.24
SET COPE LOOP NEPRROSTOMY,272,RC,,,,both,598.9,539.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.23,,,,353.35,488.7
SET COPE LOOP NEPRROSTOMY,272,RC,,,,both,598.9,539.01,Cigna,Default,Percent of Total Billed Charges,353.35,,,,353.35,488.7
SET COPE LOOP NEPRROSTOMY,272,RC,,,,both,598.9,539.01,United Healthcare,Default,Fee Schedule,488.7,,,,353.35,488.7
HIGH FLOW MULTI 8FR 5,271,RC,,,,both,82.17,73.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.52,,,,48.48,67.05
HIGH FLOW MULTI 8FR 5,271,RC,,,,both,82.17,73.95,Cigna,Default,Percent of Total Billed Charges,48.48,,,,48.48,67.05
HIGH FLOW MULTI 8FR 5,271,RC,,,,both,82.17,73.95,United Healthcare,Default,Fee Schedule,67.05,,,,48.48,67.05
WIRE SENSOR DUAL FLEX PTFE,272,RC,,,,both,268.26,241.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.78,,,,158.27,218.9
WIRE SENSOR DUAL FLEX PTFE,272,RC,,,,both,268.26,241.43,Cigna,Default,Percent of Total Billed Charges,158.27,,,,158.27,218.9
WIRE SENSOR DUAL FLEX PTFE,272,RC,,,,both,268.26,241.43,United Healthcare,Default,Fee Schedule,218.9,,,,158.27,218.9
PACK TUR LINGERMAN,272,RC,,,,both,236.93,213.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.85,,,,139.79,193.33
PACK TUR LINGERMAN,272,RC,,,,both,236.93,213.24,Cigna,Default,Percent of Total Billed Charges,139.79,,,,139.79,193.33
PACK TUR LINGERMAN,272,RC,,,,both,236.93,213.24,United Healthcare,Default,Fee Schedule,193.33,,,,139.79,193.33
CATH BALLOON COYOTE ES 3X40X146,C1725,HCPCS,278,RC,,both,1176.82,1059.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,823.77,,,,694.32,960.29
CATH BALLOON COYOTE ES 3X40X146,C1725,HCPCS,278,RC,,both,1176.82,1059.14,Cigna,Default,Percent of Total Billed Charges,694.32,,,,694.32,960.29
CATH BALLOON COYOTE ES 3X40X146,C1725,HCPCS,278,RC,,both,1176.82,1059.14,United Healthcare,Default,Fee Schedule,960.29,,,,694.32,960.29
COIL EMBOLIZATION 38-,272,RC,,,,both,231.8,208.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.26,,,,136.76,189.15
COIL EMBOLIZATION 38-,272,RC,,,,both,231.8,208.62,Cigna,Default,Percent of Total Billed Charges,136.76,,,,136.76,189.15
COIL EMBOLIZATION 38-,272,RC,,,,both,231.8,208.62,United Healthcare,Default,Fee Schedule,189.15,,,,136.76,189.15
DNU SHEATH INTRO 10FR 501,272,RC,,,,both,87,78.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.9,,,,51.33,70.99
DNU SHEATH INTRO 10FR 501,272,RC,,,,both,87,78.3,Cigna,Default,Percent of Total Billed Charges,51.33,,,,51.33,70.99
DNU SHEATH INTRO 10FR 501,272,RC,,,,both,87,78.3,United Healthcare,Default,Fee Schedule,70.99,,,,51.33,70.99
CATH SUCTION IN LINE ENDOTRACHEAL KIT,272,RC,,,,both,64.5,58.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.15,,,,38.06,52.63
CATH SUCTION IN LINE ENDOTRACHEAL KIT,272,RC,,,,both,64.5,58.05,Cigna,Default,Percent of Total Billed Charges,38.06,,,,38.06,52.63
CATH SUCTION IN LINE ENDOTRACHEAL KIT,272,RC,,,,both,64.5,58.05,United Healthcare,Default,Fee Schedule,52.63,,,,38.06,52.63
COIL EMBOLIZATION MReye 35-2-3,272,RC,,,,both,313.19,281.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.23,,,,184.78,255.56
COIL EMBOLIZATION MReye 35-2-3,272,RC,,,,both,313.19,281.87,Cigna,Default,Percent of Total Billed Charges,184.78,,,,184.78,255.56
COIL EMBOLIZATION MReye 35-2-3,272,RC,,,,both,313.19,281.87,United Healthcare,Default,Fee Schedule,255.56,,,,184.78,255.56
COIL EMBOLIZATION MReye 35-3-3,272,RC,,,,both,333.66,300.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.56,,,,196.86,272.27
COIL EMBOLIZATION MReye 35-3-3,272,RC,,,,both,333.66,300.29,Cigna,Default,Percent of Total Billed Charges,196.86,,,,196.86,272.27
COIL EMBOLIZATION MReye 35-3-3,272,RC,,,,both,333.66,300.29,United Healthcare,Default,Fee Schedule,272.27,,,,196.86,272.27
COIL EMBOLIZATION MReye 35-3-4,272,RC,,,,both,313.19,281.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.23,,,,184.78,255.56
COIL EMBOLIZATION MReye 35-3-4,272,RC,,,,both,313.19,281.87,Cigna,Default,Percent of Total Billed Charges,184.78,,,,184.78,255.56
COIL EMBOLIZATION MReye 35-3-4,272,RC,,,,both,313.19,281.87,United Healthcare,Default,Fee Schedule,255.56,,,,184.78,255.56
COIL EMBOLIZATION MReye 35-3-5,272,RC,,,,both,428.5,385.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,299.95,,,,252.82,349.66
COIL EMBOLIZATION MReye 35-3-5,272,RC,,,,both,428.5,385.65,Cigna,Default,Percent of Total Billed Charges,252.82,,,,252.82,349.66
COIL EMBOLIZATION MReye 35-3-5,272,RC,,,,both,428.5,385.65,United Healthcare,Default,Fee Schedule,349.66,,,,252.82,349.66
STENT WALL 22X35,C1874,HCPCS,278,RC,,both,3844.76,3460.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2691.33,,,,2268.41,3137.32
STENT WALL 22X35,C1874,HCPCS,278,RC,,both,3844.76,3460.28,Cigna,Default,Percent of Total Billed Charges,2268.41,,,,2268.41,3137.32
STENT WALL 22X35,C1874,HCPCS,278,RC,,both,3844.76,3460.28,United Healthcare,Default,Fee Schedule,3137.32,,,,2268.41,3137.32
STENT WALL 20X40,C1874,HCPCS,278,RC,,both,3844.76,3460.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2691.33,,,,2268.41,3137.32
STENT WALL 20X40,C1874,HCPCS,278,RC,,both,3844.76,3460.28,Cigna,Default,Percent of Total Billed Charges,2268.41,,,,2268.41,3137.32
STENT WALL 20X40,C1874,HCPCS,278,RC,,both,3844.76,3460.28,United Healthcare,Default,Fee Schedule,3137.32,,,,2268.41,3137.32
CATH SUCTION IN LINE ENDOTRACH REPLACEM,272,RC,,,,both,24.86,22.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.4,,,,14.67,20.29
CATH SUCTION IN LINE ENDOTRACH REPLACEM,272,RC,,,,both,24.86,22.37,Cigna,Default,Percent of Total Billed Charges,14.67,,,,14.67,20.29
CATH SUCTION IN LINE ENDOTRACH REPLACEM,272,RC,,,,both,24.86,22.37,United Healthcare,Default,Fee Schedule,20.29,,,,14.67,20.29
SHEATH 11FR 10CM,272,RC,,,,both,84.33,75.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.03,,,,49.75,68.81
SHEATH 11FR 10CM,272,RC,,,,both,84.33,75.9,Cigna,Default,Percent of Total Billed Charges,49.75,,,,49.75,68.81
SHEATH 11FR 10CM,272,RC,,,,both,84.33,75.9,United Healthcare,Default,Fee Schedule,68.81,,,,49.75,68.81
CATH SUCTION ENDOTRACH 14 FR,272,RC,,,,both,35.6,32.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.92,,,,21,29.05
CATH SUCTION ENDOTRACH 14 FR,272,RC,,,,both,35.6,32.04,Cigna,Default,Percent of Total Billed Charges,21,,,,21,29.05
CATH SUCTION ENDOTRACH 14 FR,272,RC,,,,both,35.6,32.04,United Healthcare,Default,Fee Schedule,29.05,,,,21,29.05
CATH SYMMETRY 4X2 135,272,RC,,,,both,1197.13,1077.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,837.99,,,,706.31,976.86
CATH SYMMETRY 4X2 135,272,RC,,,,both,1197.13,1077.42,Cigna,Default,Percent of Total Billed Charges,706.31,,,,706.31,976.86
CATH SYMMETRY 4X2 135,272,RC,,,,both,1197.13,1077.42,United Healthcare,Default,Fee Schedule,976.86,,,,706.31,976.86
SHEATH 5FR ULTIMUM HEMOSTASIS INTRODUCER,272,RC,,,,both,34.24,30.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.97,,,,20.2,27.94
SHEATH 5FR ULTIMUM HEMOSTASIS INTRODUCER,272,RC,,,,both,34.24,30.82,Cigna,Default,Percent of Total Billed Charges,20.2,,,,20.2,27.94
SHEATH 5FR ULTIMUM HEMOSTASIS INTRODUCER,272,RC,,,,both,34.24,30.82,United Healthcare,Default,Fee Schedule,27.94,,,,20.2,27.94
CATH SYMMETRY 3X4X135,272,RC,,,,both,1197.13,1077.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,837.99,,,,706.31,976.86
CATH SYMMETRY 3X4X135,272,RC,,,,both,1197.13,1077.42,Cigna,Default,Percent of Total Billed Charges,706.31,,,,706.31,976.86
CATH SYMMETRY 3X4X135,272,RC,,,,both,1197.13,1077.42,United Healthcare,Default,Fee Schedule,976.86,,,,706.31,976.86
*CATH SYMMETRY 2 X 2 X,272,RC,,,,both,1366.23,1229.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,956.36,,,,806.08,1114.84
*CATH SYMMETRY 2 X 2 X,272,RC,,,,both,1366.23,1229.61,Cigna,Default,Percent of Total Billed Charges,806.08,,,,806.08,1114.84
*CATH SYMMETRY 2 X 2 X,272,RC,,,,both,1366.23,1229.61,United Healthcare,Default,Fee Schedule,1114.84,,,,806.08,1114.84
CATH SYMMETRY 3X2X135,272,RC,,,,both,1197.13,1077.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,837.99,,,,706.31,976.86
CATH SYMMETRY 3X2X135,272,RC,,,,both,1197.13,1077.42,Cigna,Default,Percent of Total Billed Charges,706.31,,,,706.31,976.86
CATH SYMMETRY 3X2X135,272,RC,,,,both,1197.13,1077.42,United Healthcare,Default,Fee Schedule,976.86,,,,706.31,976.86
CATH SYMMETRY BALLOON 3X100,272,RC,,,,both,685.5,616.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,479.85,,,,404.44,559.37
CATH SYMMETRY BALLOON 3X100,272,RC,,,,both,685.5,616.95,Cigna,Default,Percent of Total Billed Charges,404.44,,,,404.44,559.37
CATH SYMMETRY BALLOON 3X100,272,RC,,,,both,685.5,616.95,United Healthcare,Default,Fee Schedule,559.37,,,,404.44,559.37
CATH SYMMETRY 5X,272,RC,,,,both,1134.43,1020.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,794.1,,,,669.31,925.69
CATH SYMMETRY 5X,272,RC,,,,both,1134.43,1020.99,Cigna,Default,Percent of Total Billed Charges,669.31,,,,669.31,925.69
CATH SYMMETRY 5X,272,RC,,,,both,1134.43,1020.99,United Healthcare,Default,Fee Schedule,925.69,,,,669.31,925.69
GUIDE WIRE .035 X 180,C1769,HCPCS,278,RC,,both,234.39,210.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.07,,,,138.29,191.26
GUIDE WIRE .035 X 180,C1769,HCPCS,278,RC,,both,234.39,210.95,Cigna,Default,Percent of Total Billed Charges,138.29,,,,138.29,191.26
GUIDE WIRE .035 X 180,C1769,HCPCS,278,RC,,both,234.39,210.95,United Healthcare,Default,Fee Schedule,191.26,,,,138.29,191.26
GUIDE WIRE .035 X 260 STRAIGHT TIP,C1769,HCPCS,278,RC,,both,189.88,170.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.92,,,,112.03,154.94
GUIDE WIRE .035 X 260 STRAIGHT TIP,C1769,HCPCS,278,RC,,both,189.88,170.89,Cigna,Default,Percent of Total Billed Charges,112.03,,,,112.03,154.94
GUIDE WIRE .035 X 260 STRAIGHT TIP,C1769,HCPCS,278,RC,,both,189.88,170.89,United Healthcare,Default,Fee Schedule,154.94,,,,112.03,154.94
CATH POWER FLEX 8 X 3,272,RC,,,,both,743.71,669.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,520.6,,,,438.79,606.87
CATH POWER FLEX 8 X 3,272,RC,,,,both,743.71,669.34,Cigna,Default,Percent of Total Billed Charges,438.79,,,,438.79,606.87
CATH POWER FLEX 8 X 3,272,RC,,,,both,743.71,669.34,United Healthcare,Default,Fee Schedule,606.87,,,,438.79,606.87
SENSOR OXYGEN ADULT NELLCOR OXIMAX,272,RC,,,,both,61,54.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.7,,,,35.99,49.78
SENSOR OXYGEN ADULT NELLCOR OXIMAX,272,RC,,,,both,61,54.9,Cigna,Default,Percent of Total Billed Charges,35.99,,,,35.99,49.78
SENSOR OXYGEN ADULT NELLCOR OXIMAX,272,RC,,,,both,61,54.9,United Healthcare,Default,Fee Schedule,49.78,,,,35.99,49.78
SHEATH UTLTIMUM 5 FR X 23 CM,272,RC,,,,both,77.83,70.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.48,,,,45.92,63.51
SHEATH UTLTIMUM 5 FR X 23 CM,272,RC,,,,both,77.83,70.05,Cigna,Default,Percent of Total Billed Charges,45.92,,,,45.92,63.51
SHEATH UTLTIMUM 5 FR X 23 CM,272,RC,,,,both,77.83,70.05,United Healthcare,Default,Fee Schedule,63.51,,,,45.92,63.51
STENT WALL 6X45X75,C1874,HCPCS,278,RC,,both,3759.51,3383.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2631.66,,,,2218.11,3067.76
STENT WALL 6X45X75,C1874,HCPCS,278,RC,,both,3759.51,3383.56,Cigna,Default,Percent of Total Billed Charges,2218.11,,,,2218.11,3067.76
STENT WALL 6X45X75,C1874,HCPCS,278,RC,,both,3759.51,3383.56,United Healthcare,Default,Fee Schedule,3067.76,,,,2218.11,3067.76
CATH SYMMETRY 2X4X135,272,RC,,,,both,1197.13,1077.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,837.99,,,,706.31,976.86
CATH SYMMETRY 2X4X135,272,RC,,,,both,1197.13,1077.42,Cigna,Default,Percent of Total Billed Charges,706.31,,,,706.31,976.86
CATH SYMMETRY 2X4X135,272,RC,,,,both,1197.13,1077.42,United Healthcare,Default,Fee Schedule,976.86,,,,706.31,976.86
GUIDE WIRE RLPC ROAD RUNNER,C1769,HCPCS,272,RC,,both,172.16,154.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.51,,,,101.57,140.48
GUIDE WIRE RLPC ROAD RUNNER,C1769,HCPCS,272,RC,,both,172.16,154.94,Cigna,Default,Percent of Total Billed Charges,101.57,,,,101.57,140.48
GUIDE WIRE RLPC ROAD RUNNER,C1769,HCPCS,272,RC,,both,172.16,154.94,United Healthcare,Default,Fee Schedule,140.48,,,,101.57,140.48
CATH SPY G 4 FR .038-100CM-3DRC,272,RC,,,,both,35.96,32.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.17,,,,21.22,29.34
CATH SPY G 4 FR .038-100CM-3DRC,272,RC,,,,both,35.96,32.36,Cigna,Default,Percent of Total Billed Charges,21.22,,,,21.22,29.34
CATH SPY G 4 FR .038-100CM-3DRC,272,RC,,,,both,35.96,32.36,United Healthcare,Default,Fee Schedule,29.34,,,,21.22,29.34
CATH SPY GLASS 4 FR .038-100CM-JL4,272,RC,,,,both,35.96,32.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.17,,,,21.22,29.34
CATH SPY GLASS 4 FR .038-100CM-JL4,272,RC,,,,both,35.96,32.36,Cigna,Default,Percent of Total Billed Charges,21.22,,,,21.22,29.34
CATH SPY GLASS 4 FR .038-100CM-JL4,272,RC,,,,both,35.96,32.36,United Healthcare,Default,Fee Schedule,29.34,,,,21.22,29.34
STENT PALMZ BAL EXP,C1874,HCPCS,278,RC,,both,2730.56,2457.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.39,,,,1611.03,2228.14
STENT PALMZ BAL EXP,C1874,HCPCS,278,RC,,both,2730.56,2457.5,Cigna,Default,Percent of Total Billed Charges,1611.03,,,,1611.03,2228.14
STENT PALMZ BAL EXP,C1874,HCPCS,278,RC,,both,2730.56,2457.5,United Healthcare,Default,Fee Schedule,2228.14,,,,1611.03,2228.14
*CATH PLTFRM 6FR 4MA1,272,RC,,,,both,351.22,316.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,245.85,,,,207.22,286.6
*CATH PLTFRM 6FR 4MA1,272,RC,,,,both,351.22,316.1,Cigna,Default,Percent of Total Billed Charges,207.22,,,,207.22,286.6
*CATH PLTFRM 6FR 4MA1,272,RC,,,,both,351.22,316.1,United Healthcare,Default,Fee Schedule,286.6,,,,207.22,286.6
DNU CATH SYMMETRY 6X4X90,272,RC,,,,both,712.75,641.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,498.92,,,,420.52,581.6
DNU CATH SYMMETRY 6X4X90,272,RC,,,,both,712.75,641.48,Cigna,Default,Percent of Total Billed Charges,420.52,,,,420.52,581.6
DNU CATH SYMMETRY 6X4X90,272,RC,,,,both,712.75,641.48,United Healthcare,Default,Fee Schedule,581.6,,,,420.52,581.6
*CATH PLTFM 6FR 4MC,272,RC,,,,both,351.22,316.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,245.85,,,,207.22,286.6
*CATH PLTFM 6FR 4MC,272,RC,,,,both,351.22,316.1,Cigna,Default,Percent of Total Billed Charges,207.22,,,,207.22,286.6
*CATH PLTFM 6FR 4MC,272,RC,,,,both,351.22,316.1,United Healthcare,Default,Fee Schedule,286.6,,,,207.22,286.6
STENT PRLOAD P3008M,C1874,HCPCS,278,RC,,both,3379.9,3041.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2365.93,,,,1994.14,2758
STENT PRLOAD P3008M,C1874,HCPCS,278,RC,,both,3379.9,3041.91,Cigna,Default,Percent of Total Billed Charges,1994.14,,,,1994.14,2758
STENT PRLOAD P3008M,C1874,HCPCS,278,RC,,both,3379.9,3041.91,United Healthcare,Default,Fee Schedule,2758,,,,1994.14,2758
STENT PALMAZ 8MM2908,C1874,HCPCS,278,RC,,both,3379.9,3041.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2365.93,,,,1994.14,2758
STENT PALMAZ 8MM2908,C1874,HCPCS,278,RC,,both,3379.9,3041.91,Cigna,Default,Percent of Total Billed Charges,1994.14,,,,1994.14,2758
STENT PALMAZ 8MM2908,C1874,HCPCS,278,RC,,both,3379.9,3041.91,United Healthcare,Default,Fee Schedule,2758,,,,1994.14,2758
STENT PALMZ EXP BALL,C1874,HCPCS,278,RC,,both,2730.56,2457.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.39,,,,1611.03,2228.14
STENT PALMZ EXP BALL,C1874,HCPCS,278,RC,,both,2730.56,2457.5,Cigna,Default,Percent of Total Billed Charges,1611.03,,,,1611.03,2228.14
STENT PALMZ EXP BALL,C1874,HCPCS,278,RC,,both,2730.56,2457.5,United Healthcare,Default,Fee Schedule,2228.14,,,,1611.03,2228.14
PURAPLY AM 2X2 COMMERCIAL 4SQ CM,Q4196,HCPCS,278,RC,,both,2634.18,2370.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1843.93,,,,1554.17,2149.49
PURAPLY AM 2X2 COMMERCIAL 4SQ CM,Q4196,HCPCS,278,RC,,both,2634.18,2370.76,Cigna,Default,Percent of Total Billed Charges,1554.17,,,,1554.17,2149.49
PURAPLY AM 2X2 COMMERCIAL 4SQ CM,Q4196,HCPCS,278,RC,,both,2634.18,2370.76,United Healthcare,Default,Fee Schedule,2149.49,,,,1554.17,2149.49
BREAST IMPLANT SIZER CONTOUR PROFILE SAL,272,RC,,,,both,175.67,158.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.97,,,,103.65,143.35
BREAST IMPLANT SIZER CONTOUR PROFILE SAL,272,RC,,,,both,175.67,158.1,Cigna,Default,Percent of Total Billed Charges,103.65,,,,103.65,143.35
BREAST IMPLANT SIZER CONTOUR PROFILE SAL,272,RC,,,,both,175.67,158.1,United Healthcare,Default,Fee Schedule,143.35,,,,103.65,143.35
CONTOUR PROFILE SALINE MAMMARY SIZERS,278,RC,,,,both,194.59,175.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.21,,,,114.81,158.79
CONTOUR PROFILE SALINE MAMMARY SIZERS,278,RC,,,,both,194.59,175.13,Cigna,Default,Percent of Total Billed Charges,114.81,,,,114.81,158.79
CONTOUR PROFILE SALINE MAMMARY SIZERS,278,RC,,,,both,194.59,175.13,United Healthcare,Default,Fee Schedule,158.79,,,,114.81,158.79
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,2897.55,2607.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2028.28,,,,1709.55,2364.4
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,2897.55,2607.8,Cigna,Default,Percent of Total Billed Charges,1709.55,,,,1709.55,2364.4
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,2897.55,2607.8,United Healthcare,Default,Fee Schedule,2364.4,,,,1709.55,2364.4
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,2107.31,1896.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1475.12,,,,1243.31,1719.56
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,2107.31,1896.58,Cigna,Default,Percent of Total Billed Charges,1243.31,,,,1243.31,1719.56
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,2107.31,1896.58,United Healthcare,Default,Fee Schedule,1719.56,,,,1243.31,1719.56
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,4214.62,3793.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2950.23,,,,2486.63,3439.13
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,4214.62,3793.16,Cigna,Default,Percent of Total Billed Charges,2486.63,,,,2486.63,3439.13
CONTOUR PROFILE SALINE MAMMARY IMPLANT,278,RC,,,,both,4214.62,3793.16,United Healthcare,Default,Fee Schedule,3439.13,,,,2486.63,3439.13
SHEATH STRAIGHT 6FR X 45CM,272,RC,,,,both,491.01,441.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,343.71,,,,289.7,400.66
SHEATH STRAIGHT 6FR X 45CM,272,RC,,,,both,491.01,441.91,Cigna,Default,Percent of Total Billed Charges,289.7,,,,289.7,400.66
SHEATH STRAIGHT 6FR X 45CM,272,RC,,,,both,491.01,441.91,United Healthcare,Default,Fee Schedule,400.66,,,,289.7,400.66
SHEATH ANGLED 6FR X 45CM,272,RC,,,,both,483.98,435.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.79,,,,285.55,394.93
SHEATH ANGLED 6FR X 45CM,272,RC,,,,both,483.98,435.58,Cigna,Default,Percent of Total Billed Charges,285.55,,,,285.55,394.93
SHEATH ANGLED 6FR X 45CM,272,RC,,,,both,483.98,435.58,United Healthcare,Default,Fee Schedule,394.93,,,,285.55,394.93
SHEATH STRAIGHT 7FR X 45CM,272,RC,,,,both,483.98,435.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.79,,,,285.55,394.93
SHEATH STRAIGHT 7FR X 45CM,272,RC,,,,both,483.98,435.58,Cigna,Default,Percent of Total Billed Charges,285.55,,,,285.55,394.93
SHEATH STRAIGHT 7FR X 45CM,272,RC,,,,both,483.98,435.58,United Healthcare,Default,Fee Schedule,394.93,,,,285.55,394.93
SHEATH ANGLED 7FR X 45CM,272,RC,,,,both,541.26,487.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,378.88,,,,319.34,441.67
SHEATH ANGLED 7FR X 45CM,272,RC,,,,both,541.26,487.13,Cigna,Default,Percent of Total Billed Charges,319.34,,,,319.34,441.67
SHEATH ANGLED 7FR X 45CM,272,RC,,,,both,541.26,487.13,United Healthcare,Default,Fee Schedule,441.67,,,,319.34,441.67
NAVIGATOR 13/15x36CM SHEATH ACCESS,272,RC,,,,both,424.28,381.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,297,,,,250.33,346.21
NAVIGATOR 13/15x36CM SHEATH ACCESS,272,RC,,,,both,424.28,381.85,Cigna,Default,Percent of Total Billed Charges,250.33,,,,250.33,346.21
NAVIGATOR 13/15x36CM SHEATH ACCESS,272,RC,,,,both,424.28,381.85,United Healthcare,Default,Fee Schedule,346.21,,,,250.33,346.21
NAVIGATOR 11/13X36CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,280.19,,,,236.16,326.62
NAVIGATOR 11/13X36CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Cigna,Default,Percent of Total Billed Charges,236.16,,,,236.16,326.62
NAVIGATOR 11/13X36CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,United Healthcare,Default,Fee Schedule,326.62,,,,236.16,326.62
SINGLE ACTION PUMP 1-WAY CHECK VALVE,272,RC,,,,both,158.24,142.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.77,,,,93.36,129.12
SINGLE ACTION PUMP 1-WAY CHECK VALVE,272,RC,,,,both,158.24,142.42,Cigna,Default,Percent of Total Billed Charges,93.36,,,,93.36,129.12
SINGLE ACTION PUMP 1-WAY CHECK VALVE,272,RC,,,,both,158.24,142.42,United Healthcare,Default,Fee Schedule,129.12,,,,93.36,129.12
NAVIGATOR 11/13X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,280.19,,,,236.16,326.62
NAVIGATOR 11/13X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Cigna,Default,Percent of Total Billed Charges,236.16,,,,236.16,326.62
NAVIGATOR 11/13X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,United Healthcare,Default,Fee Schedule,326.62,,,,236.16,326.62
NAVIGATOR 12/14X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,280.19,,,,236.16,326.62
NAVIGATOR 12/14X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Cigna,Default,Percent of Total Billed Charges,236.16,,,,236.16,326.62
NAVIGATOR 12/14X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,United Healthcare,Default,Fee Schedule,326.62,,,,236.16,326.62
NAVIGATOR 13/15X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,280.19,,,,236.16,326.62
NAVIGATOR 13/15X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,Cigna,Default,Percent of Total Billed Charges,236.16,,,,236.16,326.62
NAVIGATOR 13/15X28CM SHEATH ACCESS,272,RC,,,,both,400.27,360.24,United Healthcare,Default,Fee Schedule,326.62,,,,236.16,326.62
SENSOR FLOW,271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
SENSOR FLOW,271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
SENSOR FLOW,271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
CATH BALLOON MUSTANG 9X40X75,C1725,HCPCS,272,RC,,both,599.39,539.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.57,,,,353.64,489.1
CATH BALLOON MUSTANG 9X40X75,C1725,HCPCS,272,RC,,both,599.39,539.45,Cigna,Default,Percent of Total Billed Charges,353.64,,,,353.64,489.1
CATH BALLOON MUSTANG 9X40X75,C1725,HCPCS,272,RC,,both,599.39,539.45,United Healthcare,Default,Fee Schedule,489.1,,,,353.64,489.1
CATH BALLOON COYOTE 2X20X142,C1725,HCPCS,272,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON COYOTE 2X20X142,C1725,HCPCS,272,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON COYOTE 2X20X142,C1725,HCPCS,272,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
CATH BALLOON COYOTE 3X20X143,C1725,HCPCS,272,RC,,both,1126.19,1013.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.33,,,,664.45,918.97
CATH BALLOON COYOTE 3X20X143,C1725,HCPCS,272,RC,,both,1126.19,1013.57,Cigna,Default,Percent of Total Billed Charges,664.45,,,,664.45,918.97
CATH BALLOON COYOTE 3X20X143,C1725,HCPCS,272,RC,,both,1126.19,1013.57,United Healthcare,Default,Fee Schedule,918.97,,,,664.45,918.97
DNO TROCAR 10/12MM ETHICON,272,RC,,,,both,261.17,235.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,182.82,,,,154.09,213.11
DNO TROCAR 10/12MM ETHICON,272,RC,,,,both,261.17,235.05,Cigna,Default,Percent of Total Billed Charges,154.09,,,,154.09,213.11
DNO TROCAR 10/12MM ETHICON,272,RC,,,,both,261.17,235.05,United Healthcare,Default,Fee Schedule,213.11,,,,154.09,213.11
CIRCUIT ANESTHESIA PED 2 LITER BAG,370,RC,,,,both,25.68,23.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.98,,,,15.15,20.95
CIRCUIT ANESTHESIA PED 2 LITER BAG,370,RC,,,,both,25.68,23.11,Cigna,Default,Percent of Total Billed Charges,15.15,,,,15.15,20.95
CIRCUIT ANESTHESIA PED 2 LITER BAG,370,RC,,,,both,25.68,23.11,United Healthcare,Default,Fee Schedule,20.95,,,,15.15,20.95
CIRCUIT ANESTHESIA,370,RC,,,,both,42.76,38.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.93,,,,25.23,34.89
CIRCUIT ANESTHESIA,370,RC,,,,both,42.76,38.48,Cigna,Default,Percent of Total Billed Charges,25.23,,,,25.23,34.89
CIRCUIT ANESTHESIA,370,RC,,,,both,42.76,38.48,United Healthcare,Default,Fee Schedule,34.89,,,,25.23,34.89
CIRCUIT JACKSON-REES MODIFIED PED,270,RC,,,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
CIRCUIT JACKSON-REES MODIFIED PED,270,RC,,,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
CIRCUIT JACKSON-REES MODIFIED PED,270,RC,,,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
DNO STOPCOCK 3-WAY,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNO STOPCOCK 3-WAY,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNO STOPCOCK 3-WAY,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO CIRCUIT JACKSON-REES 2 LITER,270,RC,,,,both,49.73,44.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.81,,,,29.34,40.58
DNO CIRCUIT JACKSON-REES 2 LITER,270,RC,,,,both,49.73,44.76,Cigna,Default,Percent of Total Billed Charges,29.34,,,,29.34,40.58
DNO CIRCUIT JACKSON-REES 2 LITER,270,RC,,,,both,49.73,44.76,United Healthcare,Default,Fee Schedule,40.58,,,,29.34,40.58
DNU MANIFOLD HI-FLO STOPCOCK,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNU MANIFOLD HI-FLO STOPCOCK,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNU MANIFOLD HI-FLO STOPCOCK,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"SET ULTRA EXTENSION 36""",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"SET ULTRA EXTENSION 36""",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"SET ULTRA EXTENSION 36""",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
*MANIFOLD TWO PORT,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*MANIFOLD TWO PORT,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*MANIFOLD TWO PORT,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
MANIFOLD THREE PORT,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
MANIFOLD THREE PORT,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
MANIFOLD THREE PORT,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
STOPCOCK FOUR GANG,272,RC,,,,both,21.85,19.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.3,,,,12.89,17.83
STOPCOCK FOUR GANG,272,RC,,,,both,21.85,19.67,Cigna,Default,Percent of Total Billed Charges,12.89,,,,12.89,17.83
STOPCOCK FOUR GANG,272,RC,,,,both,21.85,19.67,United Healthcare,Default,Fee Schedule,17.83,,,,12.89,17.83
CIRCUIT VENT W/MR290 SINGLE LIMB HEATED,A4618,HCPCS,271,RC,,both,116.56,104.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.59,,,,68.77,95.11
CIRCUIT VENT W/MR290 SINGLE LIMB HEATED,A4618,HCPCS,271,RC,,both,116.56,104.9,Cigna,Default,Percent of Total Billed Charges,68.77,,,,68.77,95.11
CIRCUIT VENT W/MR290 SINGLE LIMB HEATED,A4618,HCPCS,271,RC,,both,116.56,104.9,United Healthcare,Default,Fee Schedule,95.11,,,,68.77,95.11
OPTIFLOW NASAL CANNULA SMALL,A4615,HCPCS,270,RC,,both,100.68,90.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.48,,,,59.4,82.15
OPTIFLOW NASAL CANNULA SMALL,A4615,HCPCS,270,RC,,both,100.68,90.61,Cigna,Default,Percent of Total Billed Charges,59.4,,,,59.4,82.15
OPTIFLOW NASAL CANNULA SMALL,A4615,HCPCS,270,RC,,both,100.68,90.61,United Healthcare,Default,Fee Schedule,82.15,,,,59.4,82.15
OPTIFLOW NASAL CANNULA MEDIUM,A4615,HCPCS,270,RC,,both,95.82,86.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.07,,,,56.53,78.19
OPTIFLOW NASAL CANNULA MEDIUM,A4615,HCPCS,270,RC,,both,95.82,86.24,Cigna,Default,Percent of Total Billed Charges,56.53,,,,56.53,78.19
OPTIFLOW NASAL CANNULA MEDIUM,A4615,HCPCS,270,RC,,both,95.82,86.24,United Healthcare,Default,Fee Schedule,78.19,,,,56.53,78.19
GRASPER REPOSABLE 38CM,272,RC,,,,both,233.1,209.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.17,,,,137.53,190.21
GRASPER REPOSABLE 38CM,272,RC,,,,both,233.1,209.79,Cigna,Default,Percent of Total Billed Charges,137.53,,,,137.53,190.21
GRASPER REPOSABLE 38CM,272,RC,,,,both,233.1,209.79,United Healthcare,Default,Fee Schedule,190.21,,,,137.53,190.21
OPTIFLOW PLUS CANNULA LARGE,A4615,HCPCS,270,RC,,both,95.82,86.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.07,,,,56.53,78.19
OPTIFLOW PLUS CANNULA LARGE,A4615,HCPCS,270,RC,,both,95.82,86.24,Cigna,Default,Percent of Total Billed Charges,56.53,,,,56.53,78.19
OPTIFLOW PLUS CANNULA LARGE,A4615,HCPCS,270,RC,,both,95.82,86.24,United Healthcare,Default,Fee Schedule,78.19,,,,56.53,78.19
DISPOSABLE 5MM BABCOCK,272,RC,,,,both,172.92,155.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.04,,,,102.02,141.1
DISPOSABLE 5MM BABCOCK,272,RC,,,,both,172.92,155.63,Cigna,Default,Percent of Total Billed Charges,102.02,,,,102.02,141.1
DISPOSABLE 5MM BABCOCK,272,RC,,,,both,172.92,155.63,United Healthcare,Default,Fee Schedule,141.1,,,,102.02,141.1
GRASPER 10MM BABCOCK,272,RC,,,,both,176.38,158.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.47,,,,104.06,143.93
GRASPER 10MM BABCOCK,272,RC,,,,both,176.38,158.74,Cigna,Default,Percent of Total Billed Charges,104.06,,,,104.06,143.93
GRASPER 10MM BABCOCK,272,RC,,,,both,176.38,158.74,United Healthcare,Default,Fee Schedule,143.93,,,,104.06,143.93
DNU GRASPER BABCOCK SINGLE ACTION,272,RC,,,,both,1336.25,1202.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,935.38,,,,788.39,1090.38
DNU GRASPER BABCOCK SINGLE ACTION,272,RC,,,,both,1336.25,1202.63,Cigna,Default,Percent of Total Billed Charges,788.39,,,,788.39,1090.38
DNU GRASPER BABCOCK SINGLE ACTION,272,RC,,,,both,1336.25,1202.63,United Healthcare,Default,Fee Schedule,1090.38,,,,788.39,1090.38
DNU GRASPER BABCOCK DOUBLE ACTION,272,RC,,,,both,1336.25,1202.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,935.38,,,,788.39,1090.38
DNU GRASPER BABCOCK DOUBLE ACTION,272,RC,,,,both,1336.25,1202.63,Cigna,Default,Percent of Total Billed Charges,788.39,,,,788.39,1090.38
DNU GRASPER BABCOCK DOUBLE ACTION,272,RC,,,,both,1336.25,1202.63,United Healthcare,Default,Fee Schedule,1090.38,,,,788.39,1090.38
SUB GRASPER 10MM BABCOCK,272,RC,,,,both,705.06,634.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,493.54,,,,415.99,575.33
SUB GRASPER 10MM BABCOCK,272,RC,,,,both,705.06,634.55,Cigna,Default,Percent of Total Billed Charges,415.99,,,,415.99,575.33
SUB GRASPER 10MM BABCOCK,272,RC,,,,both,705.06,634.55,United Healthcare,Default,Fee Schedule,575.33,,,,415.99,575.33
DNU DUET TRS 45-4.8,272,RC,,,,both,1224,1101.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,856.8,,,,722.16,998.78
DNU DUET TRS 45-4.8,272,RC,,,,both,1224,1101.6,Cigna,Default,Percent of Total Billed Charges,722.16,,,,722.16,998.78
DNU DUET TRS 45-4.8,272,RC,,,,both,1224,1101.6,United Healthcare,Default,Fee Schedule,998.78,,,,722.16,998.78
DNU DUET TRS 60-4.8,272,RC,,,,both,1048.75,943.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,734.12,,,,618.76,855.78
DNU DUET TRS 60-4.8,272,RC,,,,both,1048.75,943.88,Cigna,Default,Percent of Total Billed Charges,618.76,,,,618.76,855.78
DNU DUET TRS 60-4.8,272,RC,,,,both,1048.75,943.88,United Healthcare,Default,Fee Schedule,855.78,,,,618.76,855.78
CATH SPYGLASS JR 3.5,272,RC,,,,both,47.57,42.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.3,,,,28.07,38.82
CATH SPYGLASS JR 3.5,272,RC,,,,both,47.57,42.81,Cigna,Default,Percent of Total Billed Charges,28.07,,,,28.07,38.82
CATH SPYGLASS JR 3.5,272,RC,,,,both,47.57,42.81,United Healthcare,Default,Fee Schedule,38.82,,,,28.07,38.82
*NEEDLE DISPOSABLE PROBLOC INSULATED,272,RC,,,,both,67.19,60.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.03,,,,39.64,54.83
*NEEDLE DISPOSABLE PROBLOC INSULATED,272,RC,,,,both,67.19,60.47,Cigna,Default,Percent of Total Billed Charges,39.64,,,,39.64,54.83
*NEEDLE DISPOSABLE PROBLOC INSULATED,272,RC,,,,both,67.19,60.47,United Healthcare,Default,Fee Schedule,54.83,,,,39.64,54.83
*NEEDLE HAKKA BLOCK BEVEL 152MM25G,272,RC,,,,both,30.05,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.73,24.52
*NEEDLE HAKKA BLOCK BEVEL 152MM25G,272,RC,,,,both,30.05,27.05,Cigna,Default,Percent of Total Billed Charges,17.73,,,,17.73,24.52
*NEEDLE HAKKA BLOCK BEVEL 152MM25G,272,RC,,,,both,30.05,27.05,United Healthcare,Default,Fee Schedule,24.52,,,,17.73,24.52
NEEDLE ATRAUMATIC SPROTTE SPINAL 22G31/2,272,RC,,,,both,43.02,38.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.11,,,,25.38,35.1
NEEDLE ATRAUMATIC SPROTTE SPINAL 22G31/2,272,RC,,,,both,43.02,38.72,Cigna,Default,Percent of Total Billed Charges,25.38,,,,25.38,35.1
NEEDLE ATRAUMATIC SPROTTE SPINAL 22G31/2,272,RC,,,,both,43.02,38.72,United Healthcare,Default,Fee Schedule,35.1,,,,25.38,35.1
"NEEDLE ATRAUMATIC SPROTTE SPINAL 22G 6""",272,RC,,,,both,51.03,45.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.72,,,,30.11,41.64
"NEEDLE ATRAUMATIC SPROTTE SPINAL 22G 6""",272,RC,,,,both,51.03,45.93,Cigna,Default,Percent of Total Billed Charges,30.11,,,,30.11,41.64
"NEEDLE ATRAUMATIC SPROTTE SPINAL 22G 6""",272,RC,,,,both,51.03,45.93,United Healthcare,Default,Fee Schedule,41.64,,,,30.11,41.64
NEEDLE ATRAUMATIC SPROTTE SPINAL 25G31/2,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
NEEDLE ATRAUMATIC SPROTTE SPINAL 25G31/2,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
NEEDLE ATRAUMATIC SPROTTE SPINAL 25G31/2,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
"*NEEDLE HAKKO TUOHY 6"" 17G",272,RC,,,,both,46.91,42.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.84,,,,27.68,38.28
"*NEEDLE HAKKO TUOHY 6"" 17G",272,RC,,,,both,46.91,42.22,Cigna,Default,Percent of Total Billed Charges,27.68,,,,27.68,38.28
"*NEEDLE HAKKO TUOHY 6"" 17G",272,RC,,,,both,46.91,42.22,United Healthcare,Default,Fee Schedule,38.28,,,,27.68,38.28
"DNO NEEDLE HAKKO TUOHY 3 1/2"" 17G",272,RC,,,,both,36.7,33.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.69,,,,21.65,29.95
"DNO NEEDLE HAKKO TUOHY 3 1/2"" 17G",272,RC,,,,both,36.7,33.03,Cigna,Default,Percent of Total Billed Charges,21.65,,,,21.65,29.95
"DNO NEEDLE HAKKO TUOHY 3 1/2"" 17G",272,RC,,,,both,36.7,33.03,United Healthcare,Default,Fee Schedule,29.95,,,,21.65,29.95
"*NEEDLE HAKKO TUOHY 6"" 22G",272,RC,,,,both,32.43,29.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.7,,,,19.13,26.46
"*NEEDLE HAKKO TUOHY 6"" 22G",272,RC,,,,both,32.43,29.19,Cigna,Default,Percent of Total Billed Charges,19.13,,,,19.13,26.46
"*NEEDLE HAKKO TUOHY 6"" 22G",272,RC,,,,both,32.43,29.19,United Healthcare,Default,Fee Schedule,26.46,,,,19.13,26.46
"*NEEDLE HAKKO TUOHY 6"" 25G",272,RC,,,,both,31.34,28.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.94,,,,18.49,25.57
"*NEEDLE HAKKO TUOHY 6"" 25G",272,RC,,,,both,31.34,28.21,Cigna,Default,Percent of Total Billed Charges,18.49,,,,18.49,25.57
"*NEEDLE HAKKO TUOHY 6"" 25G",272,RC,,,,both,31.34,28.21,United Healthcare,Default,Fee Schedule,25.57,,,,18.49,25.57
"DNO NEEDLE HAKKO SPINAL 20G 3 1/2""",272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
"DNO NEEDLE HAKKO SPINAL 20G 3 1/2""",272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
"DNO NEEDLE HAKKO SPINAL 20G 3 1/2""",272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
*NEEDLE HAKKO TWIN-BUEL SPINAL 25G 3 1/2,272,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
*NEEDLE HAKKO TWIN-BUEL SPINAL 25G 3 1/2,272,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
*NEEDLE HAKKO TWIN-BUEL SPINAL 25G 3 1/2,272,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
"*NEEDLE HAKKO ECHOGENIC 7"" 22G",272,RC,,,,both,34.37,30.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.06,,,,20.28,28.05
"*NEEDLE HAKKO ECHOGENIC 7"" 22G",272,RC,,,,both,34.37,30.93,Cigna,Default,Percent of Total Billed Charges,20.28,,,,20.28,28.05
"*NEEDLE HAKKO ECHOGENIC 7"" 22G",272,RC,,,,both,34.37,30.93,United Healthcare,Default,Fee Schedule,28.05,,,,20.28,28.05
"*NEEDLE HAKKO ECHOGENIC 6"" 25G",272,RC,,,,both,34.37,30.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.06,,,,20.28,28.05
"*NEEDLE HAKKO ECHOGENIC 6"" 25G",272,RC,,,,both,34.37,30.93,Cigna,Default,Percent of Total Billed Charges,20.28,,,,20.28,28.05
"*NEEDLE HAKKO ECHOGENIC 6"" 25G",272,RC,,,,both,34.37,30.93,United Healthcare,Default,Fee Schedule,28.05,,,,20.28,28.05
"*NEEDLE HAKKO ECHOGENIC 4"" 25G",272,RC,,,,both,30.05,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.73,24.52
"*NEEDLE HAKKO ECHOGENIC 4"" 25G",272,RC,,,,both,30.05,27.05,Cigna,Default,Percent of Total Billed Charges,17.73,,,,17.73,24.52
"*NEEDLE HAKKO ECHOGENIC 4"" 25G",272,RC,,,,both,30.05,27.05,United Healthcare,Default,Fee Schedule,24.52,,,,17.73,24.52
DNO NEEDLE REG SPROTTE 25G 3 1/2,272,RC,,,,both,43.02,38.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.11,,,,25.38,35.1
DNO NEEDLE REG SPROTTE 25G 3 1/2,272,RC,,,,both,43.02,38.72,Cigna,Default,Percent of Total Billed Charges,25.38,,,,25.38,35.1
DNO NEEDLE REG SPROTTE 25G 3 1/2,272,RC,,,,both,43.02,38.72,United Healthcare,Default,Fee Schedule,35.1,,,,25.38,35.1
"*NEEDLE REG SPROTE + MAGNI HUB 25G 5""",272,RC,,,,both,43.02,38.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.11,,,,25.38,35.1
"*NEEDLE REG SPROTE + MAGNI HUB 25G 5""",272,RC,,,,both,43.02,38.72,Cigna,Default,Percent of Total Billed Charges,25.38,,,,25.38,35.1
"*NEEDLE REG SPROTE + MAGNI HUB 25G 5""",272,RC,,,,both,43.02,38.72,United Healthcare,Default,Fee Schedule,35.1,,,,25.38,35.1
SET TIP DEFLECT EBDOBRONCHIA BLOCKER,272,RC,,,,both,623.76,561.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,436.63,,,,368.02,508.99
SET TIP DEFLECT EBDOBRONCHIA BLOCKER,272,RC,,,,both,623.76,561.38,Cigna,Default,Percent of Total Billed Charges,368.02,,,,368.02,508.99
SET TIP DEFLECT EBDOBRONCHIA BLOCKER,272,RC,,,,both,623.76,561.38,United Healthcare,Default,Fee Schedule,508.99,,,,368.02,508.99
SET BLOCKER 5.0,272,RC,,,,both,623.76,561.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,436.63,,,,368.02,508.99
SET BLOCKER 5.0,272,RC,,,,both,623.76,561.38,Cigna,Default,Percent of Total Billed Charges,368.02,,,,368.02,508.99
SET BLOCKER 5.0,272,RC,,,,both,623.76,561.38,United Healthcare,Default,Fee Schedule,508.99,,,,368.02,508.99
SET BLOCKER 7.0,272,RC,,,,both,623.76,561.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,436.63,,,,368.02,508.99
SET BLOCKER 7.0,272,RC,,,,both,623.76,561.38,Cigna,Default,Percent of Total Billed Charges,368.02,,,,368.02,508.99
SET BLOCKER 7.0,272,RC,,,,both,623.76,561.38,United Healthcare,Default,Fee Schedule,508.99,,,,368.02,508.99
SET BLOCKER 9.0 78CM,272,RC,,,,both,623.76,561.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,436.63,,,,368.02,508.99
SET BLOCKER 9.0 78CM,272,RC,,,,both,623.76,561.38,Cigna,Default,Percent of Total Billed Charges,368.02,,,,368.02,508.99
SET BLOCKER 9.0 78CM,272,RC,,,,both,623.76,561.38,United Healthcare,Default,Fee Schedule,508.99,,,,368.02,508.99
SET BLOCKER ELCIP 9.0,272,RC,,,,both,571.51,514.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,400.06,,,,337.19,466.35
SET BLOCKER ELCIP 9.0,272,RC,,,,both,571.51,514.36,Cigna,Default,Percent of Total Billed Charges,337.19,,,,337.19,466.35
SET BLOCKER ELCIP 9.0,272,RC,,,,both,571.51,514.36,United Healthcare,Default,Fee Schedule,466.35,,,,337.19,466.35
"*NEEDLE ECHOBLOCK MSK 22G X 2"" (50MM)",272,RC,,,,both,36.11,32.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.28,,,,21.3,29.47
"*NEEDLE ECHOBLOCK MSK 22G X 2"" (50MM)",272,RC,,,,both,36.11,32.5,Cigna,Default,Percent of Total Billed Charges,21.3,,,,21.3,29.47
"*NEEDLE ECHOBLOCK MSK 22G X 2"" (50MM)",272,RC,,,,both,36.11,32.5,United Healthcare,Default,Fee Schedule,29.47,,,,21.3,29.47
"*NEEDLE ECHOBLOCK MSK 22G X 3 1/8"" 80MM",272,RC,,,,both,36.11,32.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.28,,,,21.3,29.47
"*NEEDLE ECHOBLOCK MSK 22G X 3 1/8"" 80MM",272,RC,,,,both,36.11,32.5,Cigna,Default,Percent of Total Billed Charges,21.3,,,,21.3,29.47
"*NEEDLE ECHOBLOCK MSK 22G X 3 1/8"" 80MM",272,RC,,,,both,36.11,32.5,United Healthcare,Default,Fee Schedule,29.47,,,,21.3,29.47
"DNO NEEDLE ECHOBLOCK NON-INS 21G X 2""",272,RC,,,,both,36.11,32.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.28,,,,21.3,29.47
"DNO NEEDLE ECHOBLOCK NON-INS 21G X 2""",272,RC,,,,both,36.11,32.5,Cigna,Default,Percent of Total Billed Charges,21.3,,,,21.3,29.47
"DNO NEEDLE ECHOBLOCK NON-INS 21G X 2""",272,RC,,,,both,36.11,32.5,United Healthcare,Default,Fee Schedule,29.47,,,,21.3,29.47
"*NEEDLE MLE PTC LUER 22G X 2 3/8""",272,RC,,,,both,28.11,25.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.68,,,,16.58,22.94
"*NEEDLE MLE PTC LUER 22G X 2 3/8""",272,RC,,,,both,28.11,25.3,Cigna,Default,Percent of Total Billed Charges,16.58,,,,16.58,22.94
"*NEEDLE MLE PTC LUER 22G X 2 3/8""",272,RC,,,,both,28.11,25.3,United Healthcare,Default,Fee Schedule,22.94,,,,16.58,22.94
"*NEEDLE MLE PTC LUER 22G X 3 1/2""",272,RC,,,,both,30.05,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.73,24.52
"*NEEDLE MLE PTC LUER 22G X 3 1/2""",272,RC,,,,both,30.05,27.05,Cigna,Default,Percent of Total Billed Charges,17.73,,,,17.73,24.52
"*NEEDLE MLE PTC LUER 22G X 3 1/2""",272,RC,,,,both,30.05,27.05,United Healthcare,Default,Fee Schedule,24.52,,,,17.73,24.52
"DNO NEEDLE TUOHY MLE 17G X 3 1/2""",272,RC,,,,both,43.02,38.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.11,,,,25.38,35.1
"DNO NEEDLE TUOHY MLE 17G X 3 1/2""",272,RC,,,,both,43.02,38.72,Cigna,Default,Percent of Total Billed Charges,25.38,,,,25.38,35.1
"DNO NEEDLE TUOHY MLE 17G X 3 1/2""",272,RC,,,,both,43.02,38.72,United Healthcare,Default,Fee Schedule,35.1,,,,25.38,35.1
"DNO NEEDLE TUOHY MLE 18G X 3 1/2""",272,RC,,,,both,43.02,38.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.11,,,,25.38,35.1
"DNO NEEDLE TUOHY MLE 18G X 3 1/2""",272,RC,,,,both,43.02,38.72,Cigna,Default,Percent of Total Billed Charges,25.38,,,,25.38,35.1
"DNO NEEDLE TUOHY MLE 18G X 3 1/2""",272,RC,,,,both,43.02,38.72,United Healthcare,Default,Fee Schedule,35.1,,,,25.38,35.1
STENT MEMOTHERM 8 X 40,C1874,HCPCS,278,RC,,both,3369.91,3032.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2358.94,,,,1988.25,2749.85
STENT MEMOTHERM 8 X 40,C1874,HCPCS,278,RC,,both,3369.91,3032.92,Cigna,Default,Percent of Total Billed Charges,1988.25,,,,1988.25,2749.85
STENT MEMOTHERM 8 X 40,C1874,HCPCS,278,RC,,both,3369.91,3032.92,United Healthcare,Default,Fee Schedule,2749.85,,,,1988.25,2749.85
STENT ACCULINK 6-80X30 190CM,C1874,HCPCS,278,RC,,both,7492.39,6743.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5244.67,,,,4420.51,6113.79
STENT ACCULINK 6-80X30 190CM,C1874,HCPCS,278,RC,,both,7492.39,6743.15,Cigna,Default,Percent of Total Billed Charges,4420.51,,,,4420.51,6113.79
STENT ACCULINK 6-80X30 190CM,C1874,HCPCS,278,RC,,both,7492.39,6743.15,United Healthcare,Default,Fee Schedule,6113.79,,,,4420.51,6113.79
FILTER ACCUNET 190CM,278,RC,,,,both,5443.88,4899.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3810.72,,,,3211.89,4442.21
FILTER ACCUNET 190CM,278,RC,,,,both,5443.88,4899.49,Cigna,Default,Percent of Total Billed Charges,3211.89,,,,3211.89,4442.21
FILTER ACCUNET 190CM,278,RC,,,,both,5443.88,4899.49,United Healthcare,Default,Fee Schedule,4442.21,,,,3211.89,4442.21
CATH BALLOON 95-15,C1725,HCPCS,278,RC,,both,748.57,673.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524,,,,441.66,610.83
CATH BALLOON 95-15,C1725,HCPCS,278,RC,,both,748.57,673.71,Cigna,Default,Percent of Total Billed Charges,441.66,,,,441.66,610.83
CATH BALLOON 95-15,C1725,HCPCS,278,RC,,both,748.57,673.71,United Healthcare,Default,Fee Schedule,610.83,,,,441.66,610.83
CATH BALLOON 89-15,272,RC,,,,both,690,621,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,483,,,,407.1,563.04
CATH BALLOON 89-15,272,RC,,,,both,690,621,Cigna,Default,Percent of Total Billed Charges,407.1,,,,407.1,563.04
CATH BALLOON 89-15,272,RC,,,,both,690,621,United Healthcare,Default,Fee Schedule,563.04,,,,407.1,563.04
CATH KUMAR CHOLANGIOGRAPHY,272,RC,,,,both,145.95,131.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.16,,,,86.11,119.1
CATH KUMAR CHOLANGIOGRAPHY,272,RC,,,,both,145.95,131.36,Cigna,Default,Percent of Total Billed Charges,86.11,,,,86.11,119.1
CATH KUMAR CHOLANGIOGRAPHY,272,RC,,,,both,145.95,131.36,United Healthcare,Default,Fee Schedule,119.1,,,,86.11,119.1
CATH CHOLANGIOGRAM 5FR,272,RC,,,,both,76.53,68.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.57,,,,45.15,62.45
CATH CHOLANGIOGRAM 5FR,272,RC,,,,both,76.53,68.88,Cigna,Default,Percent of Total Billed Charges,45.15,,,,45.15,62.45
CATH CHOLANGIOGRAM 5FR,272,RC,,,,both,76.53,68.88,United Healthcare,Default,Fee Schedule,62.45,,,,45.15,62.45
STENT SMART 8X40,C1874,HCPCS,278,RC,,both,4978.28,4480.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3484.8,,,,2937.19,4062.28
STENT SMART 8X40,C1874,HCPCS,278,RC,,both,4978.28,4480.45,Cigna,Default,Percent of Total Billed Charges,2937.19,,,,2937.19,4062.28
STENT SMART 8X40,C1874,HCPCS,278,RC,,both,4978.28,4480.45,United Healthcare,Default,Fee Schedule,4062.28,,,,2937.19,4062.28
*CATH T-TUBE 12FR,272,RC,,,,both,29.41,26.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.59,,,,17.35,24
*CATH T-TUBE 12FR,272,RC,,,,both,29.41,26.47,Cigna,Default,Percent of Total Billed Charges,17.35,,,,17.35,24
*CATH T-TUBE 12FR,272,RC,,,,both,29.41,26.47,United Healthcare,Default,Fee Schedule,24,,,,17.35,24
CATH T-TUBE 16FR,272,RC,,,,both,28.63,25.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.04,,,,16.89,23.36
CATH T-TUBE 16FR,272,RC,,,,both,28.63,25.77,Cigna,Default,Percent of Total Billed Charges,16.89,,,,16.89,23.36
CATH T-TUBE 16FR,272,RC,,,,both,28.63,25.77,United Healthcare,Default,Fee Schedule,23.36,,,,16.89,23.36
DNU STENT SMART 10X40,C1874,HCPCS,278,RC,,both,5477.77,4929.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3834.44,,,,3231.88,4469.86
DNU STENT SMART 10X40,C1874,HCPCS,278,RC,,both,5477.77,4929.99,Cigna,Default,Percent of Total Billed Charges,3231.88,,,,3231.88,4469.86
DNU STENT SMART 10X40,C1874,HCPCS,278,RC,,both,5477.77,4929.99,United Healthcare,Default,Fee Schedule,4469.86,,,,3231.88,4469.86
HEMOVAC 400 CC W/15 FR WOUND DRAIN/TROCA,272,RC,,,,both,29.16,26.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.41,,,,17.2,23.79
HEMOVAC 400 CC W/15 FR WOUND DRAIN/TROCA,272,RC,,,,both,29.16,26.24,Cigna,Default,Percent of Total Billed Charges,17.2,,,,17.2,23.79
HEMOVAC 400 CC W/15 FR WOUND DRAIN/TROCA,272,RC,,,,both,29.16,26.24,United Healthcare,Default,Fee Schedule,23.79,,,,17.2,23.79
SUB BARD 15 FR PVC WOUND DRAINW/TROCAR,272,RC,,,,both,21.85,19.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.3,,,,12.89,17.83
SUB BARD 15 FR PVC WOUND DRAINW/TROCAR,272,RC,,,,both,21.85,19.67,Cigna,Default,Percent of Total Billed Charges,12.89,,,,12.89,17.83
SUB BARD 15 FR PVC WOUND DRAINW/TROCAR,272,RC,,,,both,21.85,19.67,United Healthcare,Default,Fee Schedule,17.83,,,,12.89,17.83
SUB FOR WOUND DRAIN KIT 400CC W/TROCAR,A7048,HCPCS,272,RC,,both,39.09,35.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.36,,,,23.06,31.9
SUB FOR WOUND DRAIN KIT 400CC W/TROCAR,A7048,HCPCS,272,RC,,both,39.09,35.18,Cigna,Default,Percent of Total Billed Charges,23.06,,,,23.06,31.9
SUB FOR WOUND DRAIN KIT 400CC W/TROCAR,A7048,HCPCS,272,RC,,both,39.09,35.18,United Healthcare,Default,Fee Schedule,31.9,,,,23.06,31.9
CATH POLAR 3X100X135X0.014,C1725,HCPCS,278,RC,,both,2996.95,2697.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.86,,,,1768.2,2445.51
CATH POLAR 3X100X135X0.014,C1725,HCPCS,278,RC,,both,2996.95,2697.26,Cigna,Default,Percent of Total Billed Charges,1768.2,,,,1768.2,2445.51
CATH POLAR 3X100X135X0.014,C1725,HCPCS,278,RC,,both,2996.95,2697.26,United Healthcare,Default,Fee Schedule,2445.51,,,,1768.2,2445.51
CATH POLAR 4X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.77,,,,1571.74,2173.79
CATH POLAR 4X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Cigna,Default,Percent of Total Billed Charges,1571.74,,,,1571.74,2173.79
CATH POLAR 4X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,United Healthcare,Default,Fee Schedule,2173.79,,,,1571.74,2173.79
CATH POLAR 6X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.77,,,,1571.74,2173.79
CATH POLAR 6X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Cigna,Default,Percent of Total Billed Charges,1571.74,,,,1571.74,2173.79
CATH POLAR 6X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,United Healthcare,Default,Fee Schedule,2173.79,,,,1571.74,2173.79
CATH POLAR 2.5X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.77,,,,1571.74,2173.79
CATH POLAR 2.5X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Cigna,Default,Percent of Total Billed Charges,1571.74,,,,1571.74,2173.79
CATH POLAR 2.5X40X135X0.014,C1725,HCPCS,278,RC,,both,2663.96,2397.56,United Healthcare,Default,Fee Schedule,2173.79,,,,1571.74,2173.79
CATH POLAR,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.77,,,,1571.74,2173.79
CATH POLAR,C1725,HCPCS,278,RC,,both,2663.96,2397.56,Cigna,Default,Percent of Total Billed Charges,1571.74,,,,1571.74,2173.79
CATH POLAR,C1725,HCPCS,278,RC,,both,2663.96,2397.56,United Healthcare,Default,Fee Schedule,2173.79,,,,1571.74,2173.79
STENT SMART 7X80X40,C1876,HCPCS,278,RC,,both,4706.89,4236.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3294.82,,,,2777.07,3840.82
STENT SMART 7X80X40,C1876,HCPCS,278,RC,,both,4706.89,4236.2,Cigna,Default,Percent of Total Billed Charges,2777.07,,,,2777.07,3840.82
STENT SMART 7X80X40,C1876,HCPCS,278,RC,,both,4706.89,4236.2,United Healthcare,Default,Fee Schedule,3840.82,,,,2777.07,3840.82
"CATH GUID BRI TIP MP-A-1 100CM 6FR .070""",C1876,HCPCS,278,RC,,both,372.95,335.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.06,,,,220.04,304.33
"CATH GUID BRI TIP MP-A-1 100CM 6FR .070""",C1876,HCPCS,278,RC,,both,372.95,335.66,Cigna,Default,Percent of Total Billed Charges,220.04,,,,220.04,304.33
"CATH GUID BRI TIP MP-A-1 100CM 6FR .070""",C1876,HCPCS,278,RC,,both,372.95,335.66,United Healthcare,Default,Fee Schedule,304.33,,,,220.04,304.33
STENT SMART 6X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3111.84,,,,2622.83,3627.51
STENT SMART 6X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Cigna,Default,Percent of Total Billed Charges,2622.83,,,,2622.83,3627.51
STENT SMART 6X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,United Healthcare,Default,Fee Schedule,3627.51,,,,2622.83,3627.51
STENT SMART 6X2X135,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3111.84,,,,2622.83,3627.51
STENT SMART 6X2X135,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Cigna,Default,Percent of Total Billed Charges,2622.83,,,,2622.83,3627.51
STENT SMART 6X2X135,C1876,HCPCS,278,RC,,both,4445.48,4000.93,United Healthcare,Default,Fee Schedule,3627.51,,,,2622.83,3627.51
STENT SMART 7X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3111.84,,,,2622.83,3627.51
STENT SMART 7X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Cigna,Default,Percent of Total Billed Charges,2622.83,,,,2622.83,3627.51
STENT SMART 7X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,United Healthcare,Default,Fee Schedule,3627.51,,,,2622.83,3627.51
STENT SMART 7X2X135,C1876,HCPCS,278,RC,,both,4944.98,4450.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3461.49,,,,2917.54,4035.1
STENT SMART 7X2X135,C1876,HCPCS,278,RC,,both,4944.98,4450.48,Cigna,Default,Percent of Total Billed Charges,2917.54,,,,2917.54,4035.1
STENT SMART 7X2X135,C1876,HCPCS,278,RC,,both,4944.98,4450.48,United Healthcare,Default,Fee Schedule,4035.1,,,,2917.54,4035.1
STENT SMART 8X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3111.84,,,,2622.83,3627.51
STENT SMART 8X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,Cigna,Default,Percent of Total Billed Charges,2622.83,,,,2622.83,3627.51
STENT SMART 8X2X80,C1876,HCPCS,278,RC,,both,4445.48,4000.93,United Healthcare,Default,Fee Schedule,3627.51,,,,2622.83,3627.51
STENT SMART 8X2X135,C1876,HCPCS,278,RC,,both,4944.98,4450.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3461.49,,,,2917.54,4035.1
STENT SMART 8X2X135,C1876,HCPCS,278,RC,,both,4944.98,4450.48,Cigna,Default,Percent of Total Billed Charges,2917.54,,,,2917.54,4035.1
STENT SMART 8X2X135,C1876,HCPCS,278,RC,,both,4944.98,4450.48,United Healthcare,Default,Fee Schedule,4035.1,,,,2917.54,4035.1
STENT SMART 6X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 6X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 6X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 6X4X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 6X4X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 6X4X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 7X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 7X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 7X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 7X4X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 7X4X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 7X4X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 8X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 8X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 8X4X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 8X4X135,C1876,HCPCS,278,RC,,both,5477.77,4929.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3834.44,,,,3231.88,4469.86
STENT SMART 8X4X135,C1876,HCPCS,278,RC,,both,5477.77,4929.99,Cigna,Default,Percent of Total Billed Charges,3231.88,,,,3231.88,4469.86
STENT SMART 8X4X135,C1876,HCPCS,278,RC,,both,5477.77,4929.99,United Healthcare,Default,Fee Schedule,4469.86,,,,3231.88,4469.86
STENT SMART 6X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 6X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 6X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
DNU STENT SMART 6X6X135,C1876,HCPCS,278,RC,,both,6326.9,5694.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4428.83,,,,3732.87,5162.75
DNU STENT SMART 6X6X135,C1876,HCPCS,278,RC,,both,6326.9,5694.21,Cigna,Default,Percent of Total Billed Charges,3732.87,,,,3732.87,5162.75
DNU STENT SMART 6X6X135,C1876,HCPCS,278,RC,,both,6326.9,5694.21,United Healthcare,Default,Fee Schedule,5162.75,,,,3732.87,5162.75
STENT SMART 7X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 7X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 7X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 7X60MM 6FR,C1876,HCPCS,278,RC,,both,5477.77,4929.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3834.44,,,,3231.88,4469.86
STENT SMART 7X60MM 6FR,C1876,HCPCS,278,RC,,both,5477.77,4929.99,Cigna,Default,Percent of Total Billed Charges,3231.88,,,,3231.88,4469.86
STENT SMART 7X60MM 6FR,C1876,HCPCS,278,RC,,both,5477.77,4929.99,United Healthcare,Default,Fee Schedule,4469.86,,,,3231.88,4469.86
STENT SMART 8X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 8X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 8X6X80,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
STENT SMART 8X6X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3449.83,,,,2907.71,4021.52
STENT SMART 8X6X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,Cigna,Default,Percent of Total Billed Charges,2907.71,,,,2907.71,4021.52
STENT SMART 8X6X135,C1876,HCPCS,278,RC,,both,4928.33,4435.5,United Healthcare,Default,Fee Schedule,4021.52,,,,2907.71,4021.52
IMPLANT GEL-FILLED BREAST,99070,HCPCS,278,RC,,both,1737.75,1563.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1216.42,,,,1025.27,1418
IMPLANT GEL-FILLED BREAST,99070,HCPCS,278,RC,,both,1737.75,1563.98,Cigna,Default,Percent of Total Billed Charges,1025.27,,,,1025.27,1418
IMPLANT GEL-FILLED BREAST,99070,HCPCS,278,RC,,both,1737.75,1563.98,United Healthcare,Default,Fee Schedule,1418,,,,1025.27,1418
SIZIER SALINE,272,RC,,,,both,194.59,175.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.21,,,,114.81,158.79
SIZIER SALINE,272,RC,,,,both,194.59,175.13,Cigna,Default,Percent of Total Billed Charges,114.81,,,,114.81,158.79
SIZIER SALINE,272,RC,,,,both,194.59,175.13,United Healthcare,Default,Fee Schedule,158.79,,,,114.81,158.79
SUTURE PROLENE 0 CT-1 ETH C821G,272,RC,,,,both,78.28,70.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.8,,,,46.19,63.88
SUTURE PROLENE 0 CT-1 ETH C821G,272,RC,,,,both,78.28,70.45,Cigna,Default,Percent of Total Billed Charges,46.19,,,,46.19,63.88
SUTURE PROLENE 0 CT-1 ETH C821G,272,RC,,,,both,78.28,70.45,United Healthcare,Default,Fee Schedule,63.88,,,,46.19,63.88
BRACE KNEE SMALL,274,RC,,,,both,159.75,143.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.82,,,,94.25,130.36
BRACE KNEE SMALL,274,RC,,,,both,159.75,143.78,Cigna,Default,Percent of Total Billed Charges,94.25,,,,94.25,130.36
BRACE KNEE SMALL,274,RC,,,,both,159.75,143.78,United Healthcare,Default,Fee Schedule,130.36,,,,94.25,130.36
BRACE KNEE MEDIUM,274,RC,,,,both,159.75,143.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.82,,,,94.25,130.36
BRACE KNEE MEDIUM,274,RC,,,,both,159.75,143.78,Cigna,Default,Percent of Total Billed Charges,94.25,,,,94.25,130.36
BRACE KNEE MEDIUM,274,RC,,,,both,159.75,143.78,United Healthcare,Default,Fee Schedule,130.36,,,,94.25,130.36
BRACE KNEE LARGE,274,RC,,,,both,159.75,143.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.82,,,,94.25,130.36
BRACE KNEE LARGE,274,RC,,,,both,159.75,143.78,Cigna,Default,Percent of Total Billed Charges,94.25,,,,94.25,130.36
BRACE KNEE LARGE,274,RC,,,,both,159.75,143.78,United Healthcare,Default,Fee Schedule,130.36,,,,94.25,130.36
BRACE KNEEX-LARGE,270,RC,,,,both,159.75,143.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.82,,,,94.25,130.36
BRACE KNEEX-LARGE,270,RC,,,,both,159.75,143.78,Cigna,Default,Percent of Total Billed Charges,94.25,,,,94.25,130.36
BRACE KNEEX-LARGE,270,RC,,,,both,159.75,143.78,United Healthcare,Default,Fee Schedule,130.36,,,,94.25,130.36
STRAPS PATELLA TENDON SMALL,274,RC,,,,both,46.5,41.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.55,,,,27.44,37.94
STRAPS PATELLA TENDON SMALL,274,RC,,,,both,46.5,41.85,Cigna,Default,Percent of Total Billed Charges,27.44,,,,27.44,37.94
STRAPS PATELLA TENDON SMALL,274,RC,,,,both,46.5,41.85,United Healthcare,Default,Fee Schedule,37.94,,,,27.44,37.94
STRAPS PATELLA TENDON MEDIUM,274,RC,,,,both,46.5,41.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.55,,,,27.44,37.94
STRAPS PATELLA TENDON MEDIUM,274,RC,,,,both,46.5,41.85,Cigna,Default,Percent of Total Billed Charges,27.44,,,,27.44,37.94
STRAPS PATELLA TENDON MEDIUM,274,RC,,,,both,46.5,41.85,United Healthcare,Default,Fee Schedule,37.94,,,,27.44,37.94
STRAPS PATELLA TENDON LARGE,274,RC,,,,both,46.5,41.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.55,,,,27.44,37.94
STRAPS PATELLA TENDON LARGE,274,RC,,,,both,46.5,41.85,Cigna,Default,Percent of Total Billed Charges,27.44,,,,27.44,37.94
STRAPS PATELLA TENDON LARGE,274,RC,,,,both,46.5,41.85,United Healthcare,Default,Fee Schedule,37.94,,,,27.44,37.94
KNEE SUPPORT X-SMALL,274,RC,,,,both,49.75,44.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.82,,,,29.35,40.6
KNEE SUPPORT X-SMALL,274,RC,,,,both,49.75,44.78,Cigna,Default,Percent of Total Billed Charges,29.35,,,,29.35,40.6
KNEE SUPPORT X-SMALL,274,RC,,,,both,49.75,44.78,United Healthcare,Default,Fee Schedule,40.6,,,,29.35,40.6
KNEE SUPPORT SMALL,274,RC,,,,both,49.75,44.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.82,,,,29.35,40.6
KNEE SUPPORT SMALL,274,RC,,,,both,49.75,44.78,Cigna,Default,Percent of Total Billed Charges,29.35,,,,29.35,40.6
KNEE SUPPORT SMALL,274,RC,,,,both,49.75,44.78,United Healthcare,Default,Fee Schedule,40.6,,,,29.35,40.6
KNEE SUPPORT MEDIUM,274,RC,,,,both,49.75,44.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.82,,,,29.35,40.6
KNEE SUPPORT MEDIUM,274,RC,,,,both,49.75,44.78,Cigna,Default,Percent of Total Billed Charges,29.35,,,,29.35,40.6
KNEE SUPPORT MEDIUM,274,RC,,,,both,49.75,44.78,United Healthcare,Default,Fee Schedule,40.6,,,,29.35,40.6
SLEEVE THIGH SMALL,271,RC,,,,both,63.5,57.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.45,,,,37.46,51.82
SLEEVE THIGH SMALL,271,RC,,,,both,63.5,57.15,Cigna,Default,Percent of Total Billed Charges,37.46,,,,37.46,51.82
SLEEVE THIGH SMALL,271,RC,,,,both,63.5,57.15,United Healthcare,Default,Fee Schedule,51.82,,,,37.46,51.82
SLEEVE THIGH MEDIUM,271,RC,,,,both,63.5,57.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.45,,,,37.46,51.82
SLEEVE THIGH MEDIUM,271,RC,,,,both,63.5,57.15,Cigna,Default,Percent of Total Billed Charges,37.46,,,,37.46,51.82
SLEEVE THIGH MEDIUM,271,RC,,,,both,63.5,57.15,United Healthcare,Default,Fee Schedule,51.82,,,,37.46,51.82
NEOPRENE ELBOW,274,RC,,,,both,44.5,40.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.15,,,,26.26,36.31
NEOPRENE ELBOW,274,RC,,,,both,44.5,40.05,Cigna,Default,Percent of Total Billed Charges,26.26,,,,26.26,36.31
NEOPRENE ELBOW,274,RC,,,,both,44.5,40.05,United Healthcare,Default,Fee Schedule,36.31,,,,26.26,36.31
MASK LMA UNIQUE SZ 3,271,RC,,,,both,30.3,27.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.21,,,,17.88,24.72
MASK LMA UNIQUE SZ 3,271,RC,,,,both,30.3,27.27,Cigna,Default,Percent of Total Billed Charges,17.88,,,,17.88,24.72
MASK LMA UNIQUE SZ 3,271,RC,,,,both,30.3,27.27,United Healthcare,Default,Fee Schedule,24.72,,,,17.88,24.72
MASK LMA UNIQUE SZ 4,271,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
MASK LMA UNIQUE SZ 4,271,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
MASK LMA UNIQUE SZ 4,271,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
MASK LMA UNIQUE SZ 5,271,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
MASK LMA UNIQUE SZ 5,271,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
MASK LMA UNIQUE SZ 5,271,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SYRINGE INFLATION ENCORE 26,272,RC,,,,both,94.3,84.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.01,,,,55.64,76.95
SYRINGE INFLATION ENCORE 26,272,RC,,,,both,94.3,84.87,Cigna,Default,Percent of Total Billed Charges,55.64,,,,55.64,76.95
SYRINGE INFLATION ENCORE 26,272,RC,,,,both,94.3,84.87,United Healthcare,Default,Fee Schedule,76.95,,,,55.64,76.95
STENT POLYFLEX 21X90,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4895.02,,,,4125.81,5706.2
STENT POLYFLEX 21X90,C1874,HCPCS,278,RC,,both,6992.89,6293.6,Cigna,Default,Percent of Total Billed Charges,4125.81,,,,4125.81,5706.2
STENT POLYFLEX 21X90,C1874,HCPCS,278,RC,,both,6992.89,6293.6,United Healthcare,Default,Fee Schedule,5706.2,,,,4125.81,5706.2
WIRE HYDRA JAG .035X260CM STRAIGHT TIP,272,RC,,,,both,735.81,662.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,515.07,,,,434.13,600.42
WIRE HYDRA JAG .035X260CM STRAIGHT TIP,272,RC,,,,both,735.81,662.23,Cigna,Default,Percent of Total Billed Charges,434.13,,,,434.13,600.42
WIRE HYDRA JAG .035X260CM STRAIGHT TIP,272,RC,,,,both,735.81,662.23,United Healthcare,Default,Fee Schedule,600.42,,,,434.13,600.42
JAGWIRE .038IN X 260CM,C1769,HCPCS,272,RC,,both,512.81,461.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,358.97,,,,302.56,418.45
JAGWIRE .038IN X 260CM,C1769,HCPCS,272,RC,,both,512.81,461.53,Cigna,Default,Percent of Total Billed Charges,302.56,,,,302.56,418.45
JAGWIRE .038IN X 260CM,C1769,HCPCS,272,RC,,both,512.81,461.53,United Healthcare,Default,Fee Schedule,418.45,,,,302.56,418.45
JAGWIRE .035IN X 450CM,C1769,HCPCS,272,RC,,both,728.33,655.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,509.83,,,,429.71,594.32
JAGWIRE .035IN X 450CM,C1769,HCPCS,272,RC,,both,728.33,655.5,Cigna,Default,Percent of Total Billed Charges,429.71,,,,429.71,594.32
JAGWIRE .035IN X 450CM,C1769,HCPCS,272,RC,,both,728.33,655.5,United Healthcare,Default,Fee Schedule,594.32,,,,429.71,594.32
JAGWIRE .035IN X 450CM,C1769,HCPCS,272,RC,,both,1106.13,995.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,774.29,,,,652.62,902.6
JAGWIRE .035IN X 450CM,C1769,HCPCS,272,RC,,both,1106.13,995.52,Cigna,Default,Percent of Total Billed Charges,652.62,,,,652.62,902.6
JAGWIRE .035IN X 450CM,C1769,HCPCS,272,RC,,both,1106.13,995.52,United Healthcare,Default,Fee Schedule,902.6,,,,652.62,902.6
DRAIN SET-END NSL BILY,272,RC,,,,both,593.56,534.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,415.49,,,,350.2,484.34
DRAIN SET-END NSL BILY,272,RC,,,,both,593.56,534.2,Cigna,Default,Percent of Total Billed Charges,350.2,,,,350.2,484.34
DRAIN SET-END NSL BILY,272,RC,,,,both,593.56,534.2,United Healthcare,Default,Fee Schedule,484.34,,,,350.2,484.34
CATH GLO-TIP ANGLED ERCP,272,RC,,,,both,280.98,252.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.69,,,,165.78,229.28
CATH GLO-TIP ANGLED ERCP,272,RC,,,,both,280.98,252.88,Cigna,Default,Percent of Total Billed Charges,165.78,,,,165.78,229.28
CATH GLO-TIP ANGLED ERCP,272,RC,,,,both,280.98,252.88,United Healthcare,Default,Fee Schedule,229.28,,,,165.78,229.28
DNO SET NITROGLYCERIN 107,271,RC,,,,both,22.79,20.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.95,,,,13.45,18.6
DNO SET NITROGLYCERIN 107,271,RC,,,,both,22.79,20.51,Cigna,Default,Percent of Total Billed Charges,13.45,,,,13.45,18.6
DNO SET NITROGLYCERIN 107,271,RC,,,,both,22.79,20.51,United Healthcare,Default,Fee Schedule,18.6,,,,13.45,18.6
SET BLOOD PUMP SMARTSITE,271,RC,,,,both,29.67,26.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.77,,,,17.51,24.21
SET BLOOD PUMP SMARTSITE,271,RC,,,,both,29.67,26.7,Cigna,Default,Percent of Total Billed Charges,17.51,,,,17.51,24.21
SET BLOOD PUMP SMARTSITE,271,RC,,,,both,29.67,26.7,United Healthcare,Default,Fee Schedule,24.21,,,,17.51,24.21
DNU DUPLICATE TUBING PCA MINI BORE ALARI,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
DNU DUPLICATE TUBING PCA MINI BORE ALARI,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
DNU DUPLICATE TUBING PCA MINI BORE ALARI,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
DNO SET BLOOD Y-TYPE GRAVITY SMARTSITE,271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
DNO SET BLOOD Y-TYPE GRAVITY SMARTSITE,271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
DNO SET BLOOD Y-TYPE GRAVITY SMARTSITE,271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
SET PRIMARY GRAVITY WITH 2 PORTS,271,RC,,,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
SET PRIMARY GRAVITY WITH 2 PORTS,271,RC,,,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
SET PRIMARY GRAVITY WITH 2 PORTS,271,RC,,,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
SET INFUSION EPIDURAL MICROBORE,271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
SET INFUSION EPIDURAL MICROBORE,271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
SET INFUSION EPIDURAL MICROBORE,271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
SET INFUSION 4 PORT SMARTSITE,271,RC,,,,both,21.79,19.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.25,,,,12.86,17.78
SET INFUSION 4 PORT SMARTSITE,271,RC,,,,both,21.79,19.61,Cigna,Default,Percent of Total Billed Charges,12.86,,,,12.86,17.78
SET INFUSION 4 PORT SMARTSITE,271,RC,,,,both,21.79,19.61,United Healthcare,Default,Fee Schedule,17.78,,,,12.86,17.78
SET INFUSION  SHORT 2 PIECE,271,RC,,,,both,21,18.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.7,,,,12.39,17.14
SET INFUSION  SHORT 2 PIECE,271,RC,,,,both,21,18.9,Cigna,Default,Percent of Total Billed Charges,12.39,,,,12.39,17.14
SET INFUSION  SHORT 2 PIECE,271,RC,,,,both,21,18.9,United Healthcare,Default,Fee Schedule,17.14,,,,12.39,17.14
CLOSURE FAST PREM PCK MIS 7F07,272,RC,,,,both,4109.25,3698.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2876.48,,,,2424.46,3353.15
CLOSURE FAST PREM PCK MIS 7F07,272,RC,,,,both,4109.25,3698.33,Cigna,Default,Percent of Total Billed Charges,2424.46,,,,2424.46,3353.15
CLOSURE FAST PREM PCK MIS 7F07,272,RC,,,,both,4109.25,3698.33,United Healthcare,Default,Fee Schedule,3353.15,,,,2424.46,3353.15
INFILTRATION TUBING SET,272,RC,,,,both,64.87,58.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.41,,,,38.27,52.93
INFILTRATION TUBING SET,272,RC,,,,both,64.87,58.38,Cigna,Default,Percent of Total Billed Charges,38.27,,,,38.27,52.93
INFILTRATION TUBING SET,272,RC,,,,both,64.87,58.38,United Healthcare,Default,Fee Schedule,52.93,,,,38.27,52.93
MICRO INTRODUCER,272,RC,,,,both,131.9,118.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.33,,,,77.82,107.63
MICRO INTRODUCER,272,RC,,,,both,131.9,118.71,Cigna,Default,Percent of Total Billed Charges,77.82,,,,77.82,107.63
MICRO INTRODUCER,272,RC,,,,both,131.9,118.71,United Healthcare,Default,Fee Schedule,107.63,,,,77.82,107.63
DO NOT ORDER  BURR FLUTED 3MM MATCHSTICK,272,RC,,,,both,927.22,834.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,649.05,,,,547.06,756.61
DO NOT ORDER  BURR FLUTED 3MM MATCHSTICK,272,RC,,,,both,927.22,834.5,Cigna,Default,Percent of Total Billed Charges,547.06,,,,547.06,756.61
DO NOT ORDER  BURR FLUTED 3MM MATCHSTICK,272,RC,,,,both,927.22,834.5,United Healthcare,Default,Fee Schedule,756.61,,,,547.06,756.61
*BURR 6.4MM CYLINDRICAL CARBIDE,272,RC,,,,both,878.05,790.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,614.64,,,,518.05,716.49
*BURR 6.4MM CYLINDRICAL CARBIDE,272,RC,,,,both,878.05,790.25,Cigna,Default,Percent of Total Billed Charges,518.05,,,,518.05,716.49
*BURR 6.4MM CYLINDRICAL CARBIDE,272,RC,,,,both,878.05,790.25,United Healthcare,Default,Fee Schedule,716.49,,,,518.05,716.49
DO NOT ORDER BURR 3.2MM FLUTED  CUTTER,272,RC,,,,both,835.9,752.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,585.13,,,,493.18,682.09
DO NOT ORDER BURR 3.2MM FLUTED  CUTTER,272,RC,,,,both,835.9,752.31,Cigna,Default,Percent of Total Billed Charges,493.18,,,,493.18,682.09
DO NOT ORDER BURR 3.2MM FLUTED  CUTTER,272,RC,,,,both,835.9,752.31,United Healthcare,Default,Fee Schedule,682.09,,,,493.18,682.09
DO NOT ORDER SPINE DRILL TIP,272,RC,,,,both,672.66,605.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,470.86,,,,396.87,548.89
DO NOT ORDER SPINE DRILL TIP,272,RC,,,,both,672.66,605.39,Cigna,Default,Percent of Total Billed Charges,396.87,,,,396.87,548.89
DO NOT ORDER SPINE DRILL TIP,272,RC,,,,both,672.66,605.39,United Healthcare,Default,Fee Schedule,548.89,,,,396.87,548.89
CLIP FIXING DEVICE DISPOSABLE,272,RC,,,,both,227.27,204.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.09,,,,134.09,185.45
CLIP FIXING DEVICE DISPOSABLE,272,RC,,,,both,227.27,204.54,Cigna,Default,Percent of Total Billed Charges,134.09,,,,134.09,185.45
CLIP FIXING DEVICE DISPOSABLE,272,RC,,,,both,227.27,204.54,United Healthcare,Default,Fee Schedule,185.45,,,,134.09,185.45
QUICKCLIP2 2.6MM L 2300MM WL 2.8MM CHANL,272,RC,,,,both,272.72,245.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,190.9,,,,160.9,222.54
QUICKCLIP2 2.6MM L 2300MM WL 2.8MM CHANL,272,RC,,,,both,272.72,245.45,Cigna,Default,Percent of Total Billed Charges,160.9,,,,160.9,222.54
QUICKCLIP2 2.6MM L 2300MM WL 2.8MM CHANL,272,RC,,,,both,272.72,245.45,United Healthcare,Default,Fee Schedule,222.54,,,,160.9,222.54
SUTURE CAPTURING DEVICE CAPIO CL,272,RC,,,,both,2214,1992.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1549.8,,,,1306.26,1806.62
SUTURE CAPTURING DEVICE CAPIO CL,272,RC,,,,both,2214,1992.6,Cigna,Default,Percent of Total Billed Charges,1306.26,,,,1306.26,1806.62
SUTURE CAPTURING DEVICE CAPIO CL,272,RC,,,,both,2214,1992.6,United Healthcare,Default,Fee Schedule,1806.62,,,,1306.26,1806.62
CATH 7FR ULTRA THINK DIAMOND,272,RC,,,,both,614.63,553.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.24,,,,362.63,501.54
CATH 7FR ULTRA THINK DIAMOND,272,RC,,,,both,614.63,553.17,Cigna,Default,Percent of Total Billed Charges,362.63,,,,362.63,501.54
CATH 7FR ULTRA THINK DIAMOND,272,RC,,,,both,614.63,553.17,United Healthcare,Default,Fee Schedule,501.54,,,,362.63,501.54
STENT TRANSHEPATIC BILIARY 5X15,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3206.83,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 5X15,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Cigna,Default,Percent of Total Billed Charges,2702.9,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 5X15,C2625,HCPCS,278,RC,,both,4581.18,4123.06,United Healthcare,Default,Fee Schedule,3738.24,,,,2702.9,3738.24
DISP TOURNIQUET CUFF 18X3,272,RC,,,,both,78.97,71.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.28,,,,46.59,64.44
DISP TOURNIQUET CUFF 18X3,272,RC,,,,both,78.97,71.07,Cigna,Default,Percent of Total Billed Charges,46.59,,,,46.59,64.44
DISP TOURNIQUET CUFF 18X3,272,RC,,,,both,78.97,71.07,United Healthcare,Default,Fee Schedule,64.44,,,,46.59,64.44
DISP TOURNIQUET 24X4,272,RC,,,,both,87.74,78.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.42,,,,51.77,71.6
DISP TOURNIQUET 24X4,272,RC,,,,both,87.74,78.97,Cigna,Default,Percent of Total Billed Charges,51.77,,,,51.77,71.6
DISP TOURNIQUET 24X4,272,RC,,,,both,87.74,78.97,United Healthcare,Default,Fee Schedule,71.6,,,,51.77,71.6
DISP TOURNIQUET CUFF 34X4,272,RC,,,,both,101.07,90.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.75,,,,59.63,82.47
DISP TOURNIQUET CUFF 34X4,272,RC,,,,both,101.07,90.96,Cigna,Default,Percent of Total Billed Charges,59.63,,,,59.63,82.47
DISP TOURNIQUET CUFF 34X4,272,RC,,,,both,101.07,90.96,United Healthcare,Default,Fee Schedule,82.47,,,,59.63,82.47
*ABSORBABLE FIXATION SYSTEM,272,RC,,,,both,2423.41,2181.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1696.39,,,,1429.81,1977.5
*ABSORBABLE FIXATION SYSTEM,272,RC,,,,both,2423.41,2181.07,Cigna,Default,Percent of Total Billed Charges,1429.81,,,,1429.81,1977.5
*ABSORBABLE FIXATION SYSTEM,272,RC,,,,both,2423.41,2181.07,United Healthcare,Default,Fee Schedule,1977.5,,,,1429.81,1977.5
STENT TRANSHEPATIC BILIARY 5X12,C2625,HCPCS,278,RC,,both,4811.78,4330.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3368.25,,,,2838.95,3926.41
STENT TRANSHEPATIC BILIARY 5X12,C2625,HCPCS,278,RC,,both,4811.78,4330.6,Cigna,Default,Percent of Total Billed Charges,2838.95,,,,2838.95,3926.41
STENT TRANSHEPATIC BILIARY 5X12,C2625,HCPCS,278,RC,,both,4811.78,4330.6,United Healthcare,Default,Fee Schedule,3926.41,,,,2838.95,3926.41
CLARIVEIN IC 65CM,272,RC,,,,both,1914.75,1723.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1340.32,,,,1129.7,1562.44
CLARIVEIN IC 65CM,272,RC,,,,both,1914.75,1723.28,Cigna,Default,Percent of Total Billed Charges,1129.7,,,,1129.7,1562.44
CLARIVEIN IC 65CM,272,RC,,,,both,1914.75,1723.28,United Healthcare,Default,Fee Schedule,1562.44,,,,1129.7,1562.44
CAPNOLINE SMART H PLUS ADULT W/02,270,RC,,,,both,73.47,66.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.43,,,,43.35,59.95
CAPNOLINE SMART H PLUS ADULT W/02,270,RC,,,,both,73.47,66.12,Cigna,Default,Percent of Total Billed Charges,43.35,,,,43.35,59.95
CAPNOLINE SMART H PLUS ADULT W/02,270,RC,,,,both,73.47,66.12,United Healthcare,Default,Fee Schedule,59.95,,,,43.35,59.95
SORBAFIX FIXATION DEVICE LAPAROSCOPIC,272,RC,,,,both,2580.75,2322.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1806.52,,,,1522.64,2105.89
SORBAFIX FIXATION DEVICE LAPAROSCOPIC,272,RC,,,,both,2580.75,2322.68,Cigna,Default,Percent of Total Billed Charges,1522.64,,,,1522.64,2105.89
SORBAFIX FIXATION DEVICE LAPAROSCOPIC,272,RC,,,,both,2580.75,2322.68,United Healthcare,Default,Fee Schedule,2105.89,,,,1522.64,2105.89
CLARIVEIN IC 85CM,272,RC,,,,both,2282.95,2054.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1598.06,,,,1346.94,1862.89
CLARIVEIN IC 85CM,272,RC,,,,both,2282.95,2054.66,Cigna,Default,Percent of Total Billed Charges,1346.94,,,,1346.94,1862.89
CLARIVEIN IC 85CM,272,RC,,,,both,2282.95,2054.66,United Healthcare,Default,Fee Schedule,1862.89,,,,1346.94,1862.89
STENT TRANSHEPATIC BILIARY 7X29,C2625,HCPCS,278,RC,,both,4478.78,4030.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3135.15,,,,2642.48,3654.68
STENT TRANSHEPATIC BILIARY 7X29,C2625,HCPCS,278,RC,,both,4478.78,4030.9,Cigna,Default,Percent of Total Billed Charges,2642.48,,,,2642.48,3654.68
STENT TRANSHEPATIC BILIARY 7X29,C2625,HCPCS,278,RC,,both,4478.78,4030.9,United Healthcare,Default,Fee Schedule,3654.68,,,,2642.48,3654.68
STENT TRANSHEPATIC BILIARY 8X29,C2625,HCPCS,278,RC,,both,4254.85,3829.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2978.4,,,,2510.36,3471.96
STENT TRANSHEPATIC BILIARY 8X29,C2625,HCPCS,278,RC,,both,4254.85,3829.37,Cigna,Default,Percent of Total Billed Charges,2510.36,,,,2510.36,3471.96
STENT TRANSHEPATIC BILIARY 8X29,C2625,HCPCS,278,RC,,both,4254.85,3829.37,United Healthcare,Default,Fee Schedule,3471.96,,,,2510.36,3471.96
SECURESTRAP 5MM ABSORBABLE STRAP FIXATIO,272,RC,,,,both,1680.65,1512.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1176.46,,,,991.58,1371.41
SECURESTRAP 5MM ABSORBABLE STRAP FIXATIO,272,RC,,,,both,1680.65,1512.59,Cigna,Default,Percent of Total Billed Charges,991.58,,,,991.58,1371.41
SECURESTRAP 5MM ABSORBABLE STRAP FIXATIO,272,RC,,,,both,1680.65,1512.59,United Healthcare,Default,Fee Schedule,1371.41,,,,991.58,1371.41
STENT TRANSHEPATIC BILIARY 7X39,C2625,HCPCS,278,RC,,both,4413.01,3971.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3089.11,,,,2603.68,3601.02
STENT TRANSHEPATIC BILIARY 7X39,C2625,HCPCS,278,RC,,both,4413.01,3971.71,Cigna,Default,Percent of Total Billed Charges,2603.68,,,,2603.68,3601.02
STENT TRANSHEPATIC BILIARY 7X39,C2625,HCPCS,278,RC,,both,4413.01,3971.71,United Healthcare,Default,Fee Schedule,3601.02,,,,2603.68,3601.02
STENT TRANSHEPATIC BILIARY 8X39,C2625,HCPCS,278,RC,,both,4413.01,3971.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3089.11,,,,2603.68,3601.02
STENT TRANSHEPATIC BILIARY 8X39,C2625,HCPCS,278,RC,,both,4413.01,3971.71,Cigna,Default,Percent of Total Billed Charges,2603.68,,,,2603.68,3601.02
STENT TRANSHEPATIC BILIARY 8X39,C2625,HCPCS,278,RC,,both,4413.01,3971.71,United Healthcare,Default,Fee Schedule,3601.02,,,,2603.68,3601.02
CATH GUIDE  55CM 6F,C1887,HCPCS,278,RC,,both,193.37,174.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.36,,,,114.09,157.79
CATH GUIDE  55CM 6F,C1887,HCPCS,278,RC,,both,193.37,174.03,Cigna,Default,Percent of Total Billed Charges,114.09,,,,114.09,157.79
CATH GUIDE  55CM 6F,C1887,HCPCS,278,RC,,both,193.37,174.03,United Healthcare,Default,Fee Schedule,157.79,,,,114.09,157.79
CATH BERENSTEIN 4 FR X 125 CM,272,RC,,,,both,116.24,104.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.37,,,,68.58,94.85
CATH BERENSTEIN 4 FR X 125 CM,272,RC,,,,both,116.24,104.62,Cigna,Default,Percent of Total Billed Charges,68.58,,,,68.58,94.85
CATH BERENSTEIN 4 FR X 125 CM,272,RC,,,,both,116.24,104.62,United Healthcare,Default,Fee Schedule,94.85,,,,68.58,94.85
CATH CROSS OVER TEMPO 5F 65 CM 0 SIDE,272,RC,,,,both,95.13,85.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.59,,,,56.13,77.63
CATH CROSS OVER TEMPO 5F 65 CM 0 SIDE,272,RC,,,,both,95.13,85.62,Cigna,Default,Percent of Total Billed Charges,56.13,,,,56.13,77.63
CATH CROSS OVER TEMPO 5F 65 CM 0 SIDE,272,RC,,,,both,95.13,85.62,United Healthcare,Default,Fee Schedule,77.63,,,,56.13,77.63
CATH BERENSTEIN 4 FR X 150 CM,272,RC,,,,both,209.79,188.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.85,,,,123.78,171.19
CATH BERENSTEIN 4 FR X 150 CM,272,RC,,,,both,209.79,188.81,Cigna,Default,Percent of Total Billed Charges,123.78,,,,123.78,171.19
CATH BERENSTEIN 4 FR X 150 CM,272,RC,,,,both,209.79,188.81,United Healthcare,Default,Fee Schedule,171.19,,,,123.78,171.19
CATH INFUSION 4FR 135X5 CM,272,RC,,,,both,612.05,550.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,428.44,,,,361.11,499.43
CATH INFUSION 4FR 135X5 CM,272,RC,,,,both,612.05,550.85,Cigna,Default,Percent of Total Billed Charges,361.11,,,,361.11,499.43
CATH INFUSION 4FR 135X5 CM,272,RC,,,,both,612.05,550.85,United Healthcare,Default,Fee Schedule,499.43,,,,361.11,499.43
CATH BERENSTEIN 4 FR X 65 CM,272,RC,,,,both,54.85,49.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.4,,,,32.36,44.76
CATH BERENSTEIN 4 FR X 65 CM,272,RC,,,,both,54.85,49.37,Cigna,Default,Percent of Total Billed Charges,32.36,,,,32.36,44.76
CATH BERENSTEIN 4 FR X 65 CM,272,RC,,,,both,54.85,49.37,United Healthcare,Default,Fee Schedule,44.76,,,,32.36,44.76
CATH INFUSION 4FR 135X10 CM,272,RC,,,,both,612.05,550.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,428.44,,,,361.11,499.43
CATH INFUSION 4FR 135X10 CM,272,RC,,,,both,612.05,550.85,Cigna,Default,Percent of Total Billed Charges,361.11,,,,361.11,499.43
CATH INFUSION 4FR 135X10 CM,272,RC,,,,both,612.05,550.85,United Healthcare,Default,Fee Schedule,499.43,,,,361.11,499.43
STENT TRANSHEPATIC BILIARY 6X12,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3206.83,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X12,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Cigna,Default,Percent of Total Billed Charges,2702.9,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X12,C2625,HCPCS,278,RC,,both,4581.18,4123.06,United Healthcare,Default,Fee Schedule,3738.24,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X15,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3206.83,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X15,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Cigna,Default,Percent of Total Billed Charges,2702.9,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X15,C2625,HCPCS,278,RC,,both,4581.18,4123.06,United Healthcare,Default,Fee Schedule,3738.24,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 5X18,C2625,HCPCS,278,RC,,both,4811.78,4330.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3368.25,,,,2838.95,3926.41
STENT TRANSHEPATIC BILIARY 5X18,C2625,HCPCS,278,RC,,both,4811.78,4330.6,Cigna,Default,Percent of Total Billed Charges,2838.95,,,,2838.95,3926.41
STENT TRANSHEPATIC BILIARY 5X18,C2625,HCPCS,278,RC,,both,4811.78,4330.6,United Healthcare,Default,Fee Schedule,3926.41,,,,2838.95,3926.41
STENT TRANSHEPATIC BILIARY 6X18,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3206.83,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X18,C2625,HCPCS,278,RC,,both,4581.18,4123.06,Cigna,Default,Percent of Total Billed Charges,2702.9,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X18,C2625,HCPCS,278,RC,,both,4581.18,4123.06,United Healthcare,Default,Fee Schedule,3738.24,,,,2702.9,3738.24
STENT TRANSHEPATIC BILIARY 6X23,C2625,HCPCS,278,RC,,both,4634.46,4171.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3244.12,,,,2734.33,3781.72
STENT TRANSHEPATIC BILIARY 6X23,C2625,HCPCS,278,RC,,both,4634.46,4171.01,Cigna,Default,Percent of Total Billed Charges,2734.33,,,,2734.33,3781.72
STENT TRANSHEPATIC BILIARY 6X23,C2625,HCPCS,278,RC,,both,4634.46,4171.01,United Healthcare,Default,Fee Schedule,3781.72,,,,2734.33,3781.72
STENT BLUE 5MMX18MMX80CM,C2625,HCPCS,278,RC,,both,4438.82,3994.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3107.17,,,,2618.9,3622.08
STENT BLUE 5MMX18MMX80CM,C2625,HCPCS,278,RC,,both,4438.82,3994.94,Cigna,Default,Percent of Total Billed Charges,2618.9,,,,2618.9,3622.08
STENT BLUE 5MMX18MMX80CM,C2625,HCPCS,278,RC,,both,4438.82,3994.94,United Healthcare,Default,Fee Schedule,3622.08,,,,2618.9,3622.08
STENT BLUE 5MMX24MMX80CM,C2625,HCPCS,278,RC,,both,4634.62,4171.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3244.23,,,,2734.43,3781.85
STENT BLUE 5MMX24MMX80CM,C2625,HCPCS,278,RC,,both,4634.62,4171.16,Cigna,Default,Percent of Total Billed Charges,2734.43,,,,2734.43,3781.85
STENT BLUE 5MMX24MMX80CM,C2625,HCPCS,278,RC,,both,4634.62,4171.16,United Healthcare,Default,Fee Schedule,3781.85,,,,2734.43,3781.85
STENT RENAL BILIARY 5X15X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2894.01,,,,2439.24,3373.59
STENT RENAL BILIARY 5X15X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,Cigna,Default,Percent of Total Billed Charges,2439.24,,,,2439.24,3373.59
STENT RENAL BILIARY 5X15X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,United Healthcare,Default,Fee Schedule,3373.59,,,,2439.24,3373.59
STENT RENAL BILIARY 5X19X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2894.01,,,,2439.24,3373.59
STENT RENAL BILIARY 5X19X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,Cigna,Default,Percent of Total Billed Charges,2439.24,,,,2439.24,3373.59
STENT RENAL BILIARY 5X19X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,United Healthcare,Default,Fee Schedule,3373.59,,,,2439.24,3373.59
STENT RENAL BILIARY 6X14X90,C2625,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
STENT RENAL BILIARY 6X14X90,C2625,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
STENT RENAL BILIARY 6X14X90,C2625,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
STENT RENAL BILIARY 6X18X90,C2625,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
STENT RENAL BILIARY 6X18X90,C2625,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
STENT RENAL BILIARY 6X18X90,C2625,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
STENT RENAL BILIARY 4X19X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2894.01,,,,2439.24,3373.59
STENT RENAL BILIARY 4X19X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,Cigna,Default,Percent of Total Billed Charges,2439.24,,,,2439.24,3373.59
STENT RENAL BILIARY 4X19X90,C2625,HCPCS,278,RC,,both,4134.3,3720.87,United Healthcare,Default,Fee Schedule,3373.59,,,,2439.24,3373.59
TUBE MINNESOTA 18FR,272,RC,,,,both,2247.09,2022.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1572.96,,,,1325.78,1833.63
TUBE MINNESOTA 18FR,272,RC,,,,both,2247.09,2022.38,Cigna,Default,Percent of Total Billed Charges,1325.78,,,,1325.78,1833.63
TUBE MINNESOTA 18FR,272,RC,,,,both,2247.09,2022.38,United Healthcare,Default,Fee Schedule,1833.63,,,,1325.78,1833.63
REFLUX MANAGEMENT SYSTEM SIZE 13,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12820.3,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 13,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Cigna,Default,Percent of Total Billed Charges,10805.68,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 13,L8699,HCPCS,278,RC,,both,18314.72,16483.25,United Healthcare,Default,Fee Schedule,14944.81,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 14,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12820.3,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 14,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Cigna,Default,Percent of Total Billed Charges,10805.68,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 14,L8699,HCPCS,278,RC,,both,18314.72,16483.25,United Healthcare,Default,Fee Schedule,14944.81,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 15,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12820.3,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 15,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Cigna,Default,Percent of Total Billed Charges,10805.68,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 15,L8699,HCPCS,278,RC,,both,18314.72,16483.25,United Healthcare,Default,Fee Schedule,14944.81,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 16,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12820.3,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 16,L8699,HCPCS,278,RC,,both,18314.72,16483.25,Cigna,Default,Percent of Total Billed Charges,10805.68,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 16,L8699,HCPCS,278,RC,,both,18314.72,16483.25,United Healthcare,Default,Fee Schedule,14944.81,,,,10805.68,14944.81
REFLUX MANAGEMENT SYSTEM SIZE 17,L8699,HCPCS,278,RC,,both,19335.77,17402.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13535.04,,,,11408.1,15777.99
REFLUX MANAGEMENT SYSTEM SIZE 17,L8699,HCPCS,278,RC,,both,19335.77,17402.19,Cigna,Default,Percent of Total Billed Charges,11408.1,,,,11408.1,15777.99
REFLUX MANAGEMENT SYSTEM SIZE 17,L8699,HCPCS,278,RC,,both,19335.77,17402.19,United Healthcare,Default,Fee Schedule,15777.99,,,,11408.1,15777.99
REFLUX SIZING TOOL,272,RC,,,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
REFLUX SIZING TOOL,272,RC,,,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
REFLUX SIZING TOOL,272,RC,,,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
TIF SEROSAFUSE IMPLANTABLE CARTRIDGE KIT,L8699,HCPCS,278,RC,,both,17765.55,15989,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12435.88,,,,10481.67,14496.69
TIF SEROSAFUSE IMPLANTABLE CARTRIDGE KIT,L8699,HCPCS,278,RC,,both,17765.55,15989,Cigna,Default,Percent of Total Billed Charges,10481.67,,,,10481.67,14496.69
TIF SEROSAFUSE IMPLANTABLE CARTRIDGE KIT,L8699,HCPCS,278,RC,,both,17765.55,15989,United Healthcare,Default,Fee Schedule,14496.69,,,,10481.67,14496.69
STENT TRUNK IPSILATERIAL LEG,C2625,HCPCS,278,RC,,both,25031.04,22527.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17521.73,,,,14768.31,20425.33
STENT TRUNK IPSILATERIAL LEG,C2625,HCPCS,278,RC,,both,25031.04,22527.94,Cigna,Default,Percent of Total Billed Charges,14768.31,,,,14768.31,20425.33
STENT TRUNK IPSILATERIAL LEG,C2625,HCPCS,278,RC,,both,25031.04,22527.94,United Healthcare,Default,Fee Schedule,20425.33,,,,14768.31,20425.33
STENT CONTRALATERAL LEG 12MM X 14CM,C1874,HCPCS,278,RC,,both,11218.6,10096.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7853.02,,,,6618.97,9154.38
STENT CONTRALATERAL LEG 12MM X 14CM,C1874,HCPCS,278,RC,,both,11218.6,10096.74,Cigna,Default,Percent of Total Billed Charges,6618.97,,,,6618.97,9154.38
STENT CONTRALATERAL LEG 12MM X 14CM,C1874,HCPCS,278,RC,,both,11218.6,10096.74,United Healthcare,Default,Fee Schedule,9154.38,,,,6618.97,9154.38
SHEATH INTRODUCER 18FR X 30CM,272,RC,,,,both,421.46,379.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.02,,,,248.66,343.91
SHEATH INTRODUCER 18FR X 30CM,272,RC,,,,both,421.46,379.31,Cigna,Default,Percent of Total Billed Charges,248.66,,,,248.66,343.91
SHEATH INTRODUCER 18FR X 30CM,272,RC,,,,both,421.46,379.31,United Healthcare,Default,Fee Schedule,343.91,,,,248.66,343.91
SHEATH INTRODUCER 12FR X 30CM,272,RC,,,,both,263.41,237.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.39,,,,155.41,214.94
SHEATH INTRODUCER 12FR X 30CM,272,RC,,,,both,263.41,237.07,Cigna,Default,Percent of Total Billed Charges,155.41,,,,155.41,214.94
SHEATH INTRODUCER 12FR X 30CM,272,RC,,,,both,263.41,237.07,United Healthcare,Default,Fee Schedule,214.94,,,,155.41,214.94
GRAFT AORTIC HEMASHIE 16X30,C1768,HCPCS,278,RC,,both,2034.94,1831.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1424.46,,,,1200.61,1660.51
GRAFT AORTIC HEMASHIE 16X30,C1768,HCPCS,278,RC,,both,2034.94,1831.45,Cigna,Default,Percent of Total Billed Charges,1200.61,,,,1200.61,1660.51
GRAFT AORTIC HEMASHIE 16X30,C1768,HCPCS,278,RC,,both,2034.94,1831.45,United Healthcare,Default,Fee Schedule,1660.51,,,,1200.61,1660.51
GRAFT WALL ENDOPROSTHEIS,C1768,HCPCS,278,RC,,both,6493.4,5844.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4545.38,,,,3831.11,5298.61
GRAFT WALL ENDOPROSTHEIS,C1768,HCPCS,278,RC,,both,6493.4,5844.06,Cigna,Default,Percent of Total Billed Charges,3831.11,,,,3831.11,5298.61
GRAFT WALL ENDOPROSTHEIS,C1768,HCPCS,278,RC,,both,6493.4,5844.06,United Healthcare,Default,Fee Schedule,5298.61,,,,3831.11,5298.61
GRAFT WALL ENDOPROSTHEIS 8MM X 30MM,C1768,HCPCS,278,RC,,both,6655.73,5990.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4659.01,,,,3926.88,5431.08
GRAFT WALL ENDOPROSTHEIS 8MM X 30MM,C1768,HCPCS,278,RC,,both,6655.73,5990.16,Cigna,Default,Percent of Total Billed Charges,3926.88,,,,3926.88,5431.08
GRAFT WALL ENDOPROSTHEIS 8MM X 30MM,C1768,HCPCS,278,RC,,both,6655.73,5990.16,United Healthcare,Default,Fee Schedule,5431.08,,,,3926.88,5431.08
GRAFT WALL ENDOPROSTHEIS 8MM X 70MM,C1768,HCPCS,278,RC,,both,7492.39,6743.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5244.67,,,,4420.51,6113.79
GRAFT WALL ENDOPROSTHEIS 8MM X 70MM,C1768,HCPCS,278,RC,,both,7492.39,6743.15,Cigna,Default,Percent of Total Billed Charges,4420.51,,,,4420.51,6113.79
GRAFT WALL ENDOPROSTHEIS 8MM X 70MM,C1768,HCPCS,278,RC,,both,7492.39,6743.15,United Healthcare,Default,Fee Schedule,6113.79,,,,4420.51,6113.79
GRAFT AORTIC HEMASHIE 18X30,C1768,HCPCS,278,RC,,both,1864.77,1678.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1305.34,,,,1100.21,1521.65
GRAFT AORTIC HEMASHIE 18X30,C1768,HCPCS,278,RC,,both,1864.77,1678.29,Cigna,Default,Percent of Total Billed Charges,1100.21,,,,1100.21,1521.65
GRAFT AORTIC HEMASHIE 18X30,C1768,HCPCS,278,RC,,both,1864.77,1678.29,United Healthcare,Default,Fee Schedule,1521.65,,,,1100.21,1521.65
GRAFT SURGISIS BIODESIGN 9X14,C1768,HCPCS,278,RC,,both,2659.86,2393.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1861.9,,,,1569.32,2170.45
GRAFT SURGISIS BIODESIGN 9X14,C1768,HCPCS,278,RC,,both,2659.86,2393.87,Cigna,Default,Percent of Total Billed Charges,1569.32,,,,1569.32,2170.45
GRAFT SURGISIS BIODESIGN 9X14,C1768,HCPCS,278,RC,,both,2659.86,2393.87,United Healthcare,Default,Fee Schedule,2170.45,,,,1569.32,2170.45
GRAFT HEMASHIELD 20X3,C1768,HCPCS,278,RC,,both,1481.83,1333.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1037.28,,,,874.28,1209.17
GRAFT HEMASHIELD 20X3,C1768,HCPCS,278,RC,,both,1481.83,1333.65,Cigna,Default,Percent of Total Billed Charges,874.28,,,,874.28,1209.17
GRAFT HEMASHIELD 20X3,C1768,HCPCS,278,RC,,both,1481.83,1333.65,United Healthcare,Default,Fee Schedule,1209.17,,,,874.28,1209.17
GRAFT BIFURCATED 14 X 7,C1768,HCPCS,278,RC,,both,2167.8,1951.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1517.46,,,,1279,1768.92
GRAFT BIFURCATED 14 X 7,C1768,HCPCS,278,RC,,both,2167.8,1951.02,Cigna,Default,Percent of Total Billed Charges,1279,,,,1279,1768.92
GRAFT BIFURCATED 14 X 7,C1768,HCPCS,278,RC,,both,2167.8,1951.02,United Healthcare,Default,Fee Schedule,1768.92,,,,1279,1768.92
GRAFT BIFURCATED 18,C1768,HCPCS,278,RC,,both,3287.39,2958.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2301.17,,,,1939.56,2682.51
GRAFT BIFURCATED 18,C1768,HCPCS,278,RC,,both,3287.39,2958.65,Cigna,Default,Percent of Total Billed Charges,1939.56,,,,1939.56,2682.51
GRAFT BIFURCATED 18,C1768,HCPCS,278,RC,,both,3287.39,2958.65,United Healthcare,Default,Fee Schedule,2682.51,,,,1939.56,2682.51
CATH SILICONE 16FR 10CC LF,A4344,HCPCS,272,RC,,both,21.09,18.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.76,,,,12.44,17.21
CATH SILICONE 16FR 10CC LF,A4344,HCPCS,272,RC,,both,21.09,18.98,Cigna,Default,Percent of Total Billed Charges,12.44,,,,12.44,17.21
CATH SILICONE 16FR 10CC LF,A4344,HCPCS,272,RC,,both,21.09,18.98,United Healthcare,Default,Fee Schedule,17.21,,,,12.44,17.21
KIT MENISECTOMY BASIC,271,RC,,,,both,175.67,158.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.97,,,,103.65,143.35
KIT MENISECTOMY BASIC,271,RC,,,,both,175.67,158.1,Cigna,Default,Percent of Total Billed Charges,103.65,,,,103.65,143.35
KIT MENISECTOMY BASIC,271,RC,,,,both,175.67,158.1,United Healthcare,Default,Fee Schedule,143.35,,,,103.65,143.35
CATH BRITE TIP 6FR-.070-55CM-MPA-1,C1887,HCPCS,278,RC,,both,184.15,165.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.9,,,,108.65,150.27
CATH BRITE TIP 6FR-.070-55CM-MPA-1,C1887,HCPCS,278,RC,,both,184.15,165.74,Cigna,Default,Percent of Total Billed Charges,108.65,,,,108.65,150.27
CATH BRITE TIP 6FR-.070-55CM-MPA-1,C1887,HCPCS,278,RC,,both,184.15,165.74,United Healthcare,Default,Fee Schedule,150.27,,,,108.65,150.27
UROLOCK II ADAPTOR PT CHARGE,C1889,HCPCS,71,RC,,both,60.47,54.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.33,,,,35.68,49.34
UROLOCK II ADAPTOR PT CHARGE,C1889,HCPCS,71,RC,,both,60.47,54.42,Cigna,Default,Percent of Total Billed Charges,35.68,,,,35.68,49.34
UROLOCK II ADAPTOR PT CHARGE,C1889,HCPCS,71,RC,,both,60.47,54.42,United Healthcare,Default,Fee Schedule,49.34,,,,35.68,49.34
PT CHG CLOSED SUCTION CATH 14FR TPIECE,272,RC,,,,both,49.24,44.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.47,,,,29.05,40.18
PT CHG CLOSED SUCTION CATH 14FR TPIECE,272,RC,,,,both,49.24,44.32,Cigna,Default,Percent of Total Billed Charges,29.05,,,,29.05,40.18
PT CHG CLOSED SUCTION CATH 14FR TPIECE,272,RC,,,,both,49.24,44.32,United Healthcare,Default,Fee Schedule,40.18,,,,29.05,40.18
OR CHARGE INJECTION NEEDLE 23G 0.4 MM,272,RC,,,,both,178.63,160.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.04,,,,105.39,145.76
OR CHARGE INJECTION NEEDLE 23G 0.4 MM,272,RC,,,,both,178.63,160.77,Cigna,Default,Percent of Total Billed Charges,105.39,,,,105.39,145.76
OR CHARGE INJECTION NEEDLE 23G 0.4 MM,272,RC,,,,both,178.63,160.77,United Healthcare,Default,Fee Schedule,145.76,,,,105.39,145.76
TUBE HOLDER ENDOTRACHEAL PT CHARGE,272,RC,,,,both,68.83,61.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.18,,,,40.61,56.17
TUBE HOLDER ENDOTRACHEAL PT CHARGE,272,RC,,,,both,68.83,61.95,Cigna,Default,Percent of Total Billed Charges,40.61,,,,40.61,56.17
TUBE HOLDER ENDOTRACHEAL PT CHARGE,272,RC,,,,both,68.83,61.95,United Healthcare,Default,Fee Schedule,56.17,,,,40.61,56.17
ELECTRODE POLYHESIVE ( PT CHG),A4556,HCPCS,270,RC,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
ELECTRODE POLYHESIVE ( PT CHG),A4556,HCPCS,270,RC,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
ELECTRODE POLYHESIVE ( PT CHG),A4556,HCPCS,270,RC,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
SENSOR OXYGEN ADULT/CHILD OXIMAX MAX-N,272,RC,,,,both,46.41,41.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.49,,,,27.38,37.87
SENSOR OXYGEN ADULT/CHILD OXIMAX MAX-N,272,RC,,,,both,46.41,41.77,Cigna,Default,Percent of Total Billed Charges,27.38,,,,27.38,37.87
SENSOR OXYGEN ADULT/CHILD OXIMAX MAX-N,272,RC,,,,both,46.41,41.77,United Healthcare,Default,Fee Schedule,37.87,,,,27.38,37.87
HANDPIECE INTERPULSE W/HIGH FLOW TI,71,RC,,,,both,121.5,109.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.05,,,,71.68,99.14
HANDPIECE INTERPULSE W/HIGH FLOW TI,71,RC,,,,both,121.5,109.35,Cigna,Default,Percent of Total Billed Charges,71.68,,,,71.68,99.14
HANDPIECE INTERPULSE W/HIGH FLOW TI,71,RC,,,,both,121.5,109.35,United Healthcare,Default,Fee Schedule,99.14,,,,71.68,99.14
*PT CHG TUBE NASOJEJUNOSTOMY 10FR 140CM,272,RC,,,,both,93.86,84.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.7,,,,55.38,76.59
*PT CHG TUBE NASOJEJUNOSTOMY 10FR 140CM,272,RC,,,,both,93.86,84.47,Cigna,Default,Percent of Total Billed Charges,55.38,,,,55.38,76.59
*PT CHG TUBE NASOJEJUNOSTOMY 10FR 140CM,272,RC,,,,both,93.86,84.47,United Healthcare,Default,Fee Schedule,76.59,,,,55.38,76.59
DILATOR MALONEY 46FR BOUGIE,272,RC,,,,both,764.57,688.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,535.2,,,,451.1,623.89
DILATOR MALONEY 46FR BOUGIE,272,RC,,,,both,764.57,688.11,Cigna,Default,Percent of Total Billed Charges,451.1,,,,451.1,623.89
DILATOR MALONEY 46FR BOUGIE,272,RC,,,,both,764.57,688.11,United Healthcare,Default,Fee Schedule,623.89,,,,451.1,623.89
DILATOR MALONEY 42FR BOUGIE,272,RC,,,,both,715.62,644.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,500.93,,,,422.22,583.95
DILATOR MALONEY 42FR BOUGIE,272,RC,,,,both,715.62,644.06,Cigna,Default,Percent of Total Billed Charges,422.22,,,,422.22,583.95
DILATOR MALONEY 42FR BOUGIE,272,RC,,,,both,715.62,644.06,United Healthcare,Default,Fee Schedule,583.95,,,,422.22,583.95
SUTURE ANCHOR 4.5 GROSS FT.,272,RC,,,,both,807.81,727.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,565.47,,,,476.61,659.17
SUTURE ANCHOR 4.5 GROSS FT.,272,RC,,,,both,807.81,727.03,Cigna,Default,Percent of Total Billed Charges,476.61,,,,476.61,659.17
SUTURE ANCHOR 4.5 GROSS FT.,272,RC,,,,both,807.81,727.03,United Healthcare,Default,Fee Schedule,659.17,,,,476.61,659.17
TROCHANTERIC NAIL KIT 180 TI GAMMA 3,C1713,HCPCS,278,RC,,both,3696.24,3326.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2587.37,,,,2180.78,3016.13
TROCHANTERIC NAIL KIT 180 TI GAMMA 3,C1713,HCPCS,278,RC,,both,3696.24,3326.62,Cigna,Default,Percent of Total Billed Charges,2180.78,,,,2180.78,3016.13
TROCHANTERIC NAIL KIT 180 TI GAMMA 3,C1713,HCPCS,278,RC,,both,3696.24,3326.62,United Healthcare,Default,Fee Schedule,3016.13,,,,2180.78,3016.13
LAG SCREW TI GAMMA 3,C1713,HCPCS,278,RC,,both,1398.58,1258.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,979.01,,,,825.16,1141.24
LAG SCREW TI GAMMA 3,C1713,HCPCS,278,RC,,both,1398.58,1258.72,Cigna,Default,Percent of Total Billed Charges,825.16,,,,825.16,1141.24
LAG SCREW TI GAMMA 3,C1713,HCPCS,278,RC,,both,1398.58,1258.72,United Healthcare,Default,Fee Schedule,1141.24,,,,825.16,1141.24
LOCKING SCREW FULLY THREADED,C1713,HCPCS,278,RC,,both,580.24,522.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,406.17,,,,342.34,473.48
LOCKING SCREW FULLY THREADED,C1713,HCPCS,278,RC,,both,580.24,522.22,Cigna,Default,Percent of Total Billed Charges,342.34,,,,342.34,473.48
LOCKING SCREW FULLY THREADED,C1713,HCPCS,278,RC,,both,580.24,522.22,United Healthcare,Default,Fee Schedule,473.48,,,,342.34,473.48
K-WIRE,C1769,HCPCS,278,RC,,both,333,299.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.1,,,,196.47,271.73
K-WIRE,C1769,HCPCS,278,RC,,both,333,299.7,Cigna,Default,Percent of Total Billed Charges,196.47,,,,196.47,271.73
K-WIRE,C1769,HCPCS,278,RC,,both,333,299.7,United Healthcare,Default,Fee Schedule,271.73,,,,196.47,271.73
GUIDE WIRE BALL TIPPED STERILE,C1769,HCPCS,278,RC,,both,582.74,524.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,407.92,,,,343.82,475.52
GUIDE WIRE BALL TIPPED STERILE,C1769,HCPCS,278,RC,,both,582.74,524.47,Cigna,Default,Percent of Total Billed Charges,343.82,,,,343.82,475.52
GUIDE WIRE BALL TIPPED STERILE,C1769,HCPCS,278,RC,,both,582.74,524.47,United Healthcare,Default,Fee Schedule,475.52,,,,343.82,475.52
GUIDE WIRE PARTIALLY THREADED,C1769,HCPCS,278,RC,,both,86.1,77.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.27,,,,50.8,70.26
GUIDE WIRE PARTIALLY THREADED,C1769,HCPCS,278,RC,,both,86.1,77.49,Cigna,Default,Percent of Total Billed Charges,50.8,,,,50.8,70.26
GUIDE WIRE PARTIALLY THREADED,C1769,HCPCS,278,RC,,both,86.1,77.49,United Healthcare,Default,Fee Schedule,70.26,,,,50.8,70.26
ULTRAVERSE 035 7.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
GRAFT 10/10 BTB,C1768,HCPCS,278,RC,,both,11987.82,10789.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8391.47,,,,7072.81,9782.06
GRAFT 10/10 BTB,C1768,HCPCS,278,RC,,both,11987.82,10789.04,Cigna,Default,Percent of Total Billed Charges,7072.81,,,,7072.81,9782.06
GRAFT 10/10 BTB,C1768,HCPCS,278,RC,,both,11987.82,10789.04,United Healthcare,Default,Fee Schedule,9782.06,,,,7072.81,9782.06
PLATE LCP VOLAR DISTAL RADIUS 4H RIGHT,C1713,HCPCS,278,RC,,both,2467.49,2220.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1727.24,,,,1455.82,2013.47
PLATE LCP VOLAR DISTAL RADIUS 4H RIGHT,C1713,HCPCS,278,RC,,both,2467.49,2220.74,Cigna,Default,Percent of Total Billed Charges,1455.82,,,,1455.82,2013.47
PLATE LCP VOLAR DISTAL RADIUS 4H RIGHT,C1713,HCPCS,278,RC,,both,2467.49,2220.74,United Healthcare,Default,Fee Schedule,2013.47,,,,1455.82,2013.47
SCREW 2.4 LOCKING SLF-TPNG 14MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.42,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 14MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,Cigna,Default,Percent of Total Billed Charges,204.32,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 14MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,United Healthcare,Default,Fee Schedule,282.59,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 22MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.42,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 22MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,Cigna,Default,Percent of Total Billed Charges,204.32,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 22MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,United Healthcare,Default,Fee Schedule,282.59,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 24MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.42,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 24MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,Cigna,Default,Percent of Total Billed Charges,204.32,,,,204.32,282.59
SCREW 2.4 LOCKING SLF-TPNG 24MM RECESS,C1713,HCPCS,278,RC,,both,346.31,311.68,United Healthcare,Default,Fee Schedule,282.59,,,,204.32,282.59
SCREW 2.4 CORTEX SLF-TPNG 14MM RECESS,C1713,HCPCS,278,RC,,both,198.85,178.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.2,,,,117.32,162.26
SCREW 2.4 CORTEX SLF-TPNG 14MM RECESS,C1713,HCPCS,278,RC,,both,198.85,178.97,Cigna,Default,Percent of Total Billed Charges,117.32,,,,117.32,162.26
SCREW 2.4 CORTEX SLF-TPNG 14MM RECESS,C1713,HCPCS,278,RC,,both,198.85,178.97,United Healthcare,Default,Fee Schedule,162.26,,,,117.32,162.26
SCREW LAG 2.4MM X 16MM X 2,C1713,HCPCS,278,RC,,both,499.49,449.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.64,,,,294.7,407.58
SCREW LAG 2.4MM X 16MM X 2,C1713,HCPCS,278,RC,,both,499.49,449.54,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.58
SCREW LAG 2.4MM X 16MM X 2,C1713,HCPCS,278,RC,,both,499.49,449.54,United Healthcare,Default,Fee Schedule,407.58,,,,294.7,407.58
ULTRAVERSE 035 4.0MMX60MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX60MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX60MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
LUTONIX 035 DCB 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035 DCB 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035 DCB 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
SCREW 3.5 X 10MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
SCREW 3.5 X 10MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
SCREW 3.5 X 10MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
SCREW 3.5 X 8MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
SCREW 3.5 X 8MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
SCREW 3.5 X 8MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
SCREW 2.3X20MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,290.13,261.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,203.09,,,,171.18,236.75
SCREW 2.3X20MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,290.13,261.12,Cigna,Default,Percent of Total Billed Charges,171.18,,,,171.18,236.75
SCREW 2.3X20MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,290.13,261.12,United Healthcare,Default,Fee Schedule,236.75,,,,171.18,236.75
SCREW 3.5X12.0 MM CORTICAL SCREW,C1713,HCPCS,278,RC,,both,112.5,101.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.75,,,,66.38,91.8
SCREW 3.5X12.0 MM CORTICAL SCREW,C1713,HCPCS,278,RC,,both,112.5,101.25,Cigna,Default,Percent of Total Billed Charges,66.38,,,,66.38,91.8
SCREW 3.5X12.0 MM CORTICAL SCREW,C1713,HCPCS,278,RC,,both,112.5,101.25,United Healthcare,Default,Fee Schedule,91.8,,,,66.38,91.8
SCREW 3.5 X 12MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
SCREW 3.5 X 12MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
SCREW 3.5 X 12MM LOCKING CORTICAL SC,C1713,HCPCS,278,RC,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
SCREW 2.3X24MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
SCREW 2.3X24MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
SCREW 2.3X24MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
SCREW 2.3X22MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
SCREW 2.3X22MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
SCREW 2.3X22MM THREADED LOCKING,C1713,HCPCS,278,RC,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
SCREW 3.5 X 16MM  CORTICAL,C1713,HCPCS,278,RC,,both,112.5,101.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.75,,,,66.38,91.8
SCREW 3.5 X 16MM  CORTICAL,C1713,HCPCS,278,RC,,both,112.5,101.25,Cigna,Default,Percent of Total Billed Charges,66.38,,,,66.38,91.8
SCREW 3.5 X 16MM  CORTICAL,C1713,HCPCS,278,RC,,both,112.5,101.25,United Healthcare,Default,Fee Schedule,91.8,,,,66.38,91.8
SCREW 3.5 X 18MM  CORTICAL,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
SCREW 3.5 X 18MM  CORTICAL,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
SCREW 3.5 X 18MM  CORTICAL,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
SCREW 3.5 X 14MM  CORTICAL,C1713,HCPCS,278,RC,,both,112.5,101.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.75,,,,66.38,91.8
SCREW 3.5 X 14MM  CORTICAL,C1713,HCPCS,278,RC,,both,112.5,101.25,Cigna,Default,Percent of Total Billed Charges,66.38,,,,66.38,91.8
SCREW 3.5 X 14MM  CORTICAL,C1713,HCPCS,278,RC,,both,112.5,101.25,United Healthcare,Default,Fee Schedule,91.8,,,,66.38,91.8
SCREW SUPER REVO SUTURE ANCHOR KIT,C1713,HCPCS,278,RC,,both,716.77,645.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.74,,,,422.89,584.88
SCREW SUPER REVO SUTURE ANCHOR KIT,C1713,HCPCS,278,RC,,both,716.77,645.09,Cigna,Default,Percent of Total Billed Charges,422.89,,,,422.89,584.88
SCREW SUPER REVO SUTURE ANCHOR KIT,C1713,HCPCS,278,RC,,both,716.77,645.09,United Healthcare,Default,Fee Schedule,584.88,,,,422.89,584.88
ULTRAVERSE 03550 MM X 60MMX130CM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 03550 MM X 60MMX130CM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 03550 MM X 60MMX130CM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
SCREW 2.7 CORTEX 16MM,C1713,HCPCS,278,RC,,both,140.42,126.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.29,,,,82.85,114.58
SCREW 2.7 CORTEX 16MM,C1713,HCPCS,278,RC,,both,140.42,126.38,Cigna,Default,Percent of Total Billed Charges,82.85,,,,82.85,114.58
SCREW 2.7 CORTEX 16MM,C1713,HCPCS,278,RC,,both,140.42,126.38,United Healthcare,Default,Fee Schedule,114.58,,,,82.85,114.58
SCREW 2.4 CORTEX 20MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
SCREW 2.4 CORTEX 20MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
SCREW 2.4 CORTEX 20MM,C1713,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
SCREW 2.4 CORTEX 24MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
SCREW 2.4 CORTEX 24MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
SCREW 2.4 CORTEX 24MM,C1713,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
SCREW 2.4 CORTEX 26MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
SCREW 2.4 CORTEX 26MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
SCREW 2.4 CORTEX 26MM,C1713,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
SCREW 2.4 CORTEX 28MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
SCREW 2.4 CORTEX 28MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
SCREW 2.4 CORTEX 28MM,C1713,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
SCREW 2.4 LOCKING  18MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.4,,,,216.11,298.89
SCREW 2.4 LOCKING  18MM,C1713,HCPCS,278,RC,,both,366.29,329.66,Cigna,Default,Percent of Total Billed Charges,216.11,,,,216.11,298.89
SCREW 2.4 LOCKING  18MM,C1713,HCPCS,278,RC,,both,366.29,329.66,United Healthcare,Default,Fee Schedule,298.89,,,,216.11,298.89
SCREW 2.7 CORTEX 14MM,C1713,HCPCS,278,RC,,both,140.42,126.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.29,,,,82.85,114.58
SCREW 2.7 CORTEX 14MM,C1713,HCPCS,278,RC,,both,140.42,126.38,Cigna,Default,Percent of Total Billed Charges,82.85,,,,82.85,114.58
SCREW 2.7 CORTEX 14MM,C1713,HCPCS,278,RC,,both,140.42,126.38,United Healthcare,Default,Fee Schedule,114.58,,,,82.85,114.58
SCREW 3.5 LOCKING 36MM,C1713,HCPCS,278,RC,,both,392.93,353.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.05,,,,231.83,320.63
SCREW 3.5 LOCKING 36MM,C1713,HCPCS,278,RC,,both,392.93,353.64,Cigna,Default,Percent of Total Billed Charges,231.83,,,,231.83,320.63
SCREW 3.5 LOCKING 36MM,C1713,HCPCS,278,RC,,both,392.93,353.64,United Healthcare,Default,Fee Schedule,320.63,,,,231.83,320.63
SCREW3.5 LOCKING 50MM,C1713,HCPCS,278,RC,,both,392.93,353.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.05,,,,231.83,320.63
SCREW3.5 LOCKING 50MM,C1713,HCPCS,278,RC,,both,392.93,353.64,Cigna,Default,Percent of Total Billed Charges,231.83,,,,231.83,320.63
SCREW3.5 LOCKING 50MM,C1713,HCPCS,278,RC,,both,392.93,353.64,United Healthcare,Default,Fee Schedule,320.63,,,,231.83,320.63
SCREW 3.5 CORTEX 30MM,C1713,HCPCS,278,RC,,both,94.3,84.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.01,,,,55.64,76.95
SCREW 3.5 CORTEX 30MM,C1713,HCPCS,278,RC,,both,94.3,84.87,Cigna,Default,Percent of Total Billed Charges,55.64,,,,55.64,76.95
SCREW 3.5 CORTEX 30MM,C1713,HCPCS,278,RC,,both,94.3,84.87,United Healthcare,Default,Fee Schedule,76.95,,,,55.64,76.95
LUTONIX 035  5.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  5.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  5.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,935.72,842.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,655,,,,552.07,763.55
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,935.72,842.15,Cigna,Default,Percent of Total Billed Charges,552.07,,,,552.07,763.55
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,935.72,842.15,United Healthcare,Default,Fee Schedule,763.55,,,,552.07,763.55
SCREW 3.5 CORTEX12MM,C1713,HCPCS,278,RC,,both,103.52,93.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.46,,,,61.08,84.47
SCREW 3.5 CORTEX12MM,C1713,HCPCS,278,RC,,both,103.52,93.17,Cigna,Default,Percent of Total Billed Charges,61.08,,,,61.08,84.47
SCREW 3.5 CORTEX12MM,C1713,HCPCS,278,RC,,both,103.52,93.17,United Healthcare,Default,Fee Schedule,84.47,,,,61.08,84.47
SCREW 4.0 CORTEX16MM,C1713,HCPCS,278,RC,,both,90.2,81.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.14,,,,53.22,73.6
SCREW 4.0 CORTEX16MM,C1713,HCPCS,278,RC,,both,90.2,81.18,Cigna,Default,Percent of Total Billed Charges,53.22,,,,53.22,73.6
SCREW 4.0 CORTEX16MM,C1713,HCPCS,278,RC,,both,90.2,81.18,United Healthcare,Default,Fee Schedule,73.6,,,,53.22,73.6
SCREW 4.0 CORTEX18MM,C1713,HCPCS,278,RC,,both,88.25,79.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.78,,,,52.07,72.01
SCREW 4.0 CORTEX18MM,C1713,HCPCS,278,RC,,both,88.25,79.43,Cigna,Default,Percent of Total Billed Charges,52.07,,,,52.07,72.01
SCREW 4.0 CORTEX18MM,C1713,HCPCS,278,RC,,both,88.25,79.43,United Healthcare,Default,Fee Schedule,72.01,,,,52.07,72.01
SCREW 4.0 CORTEX20MM,C1713,HCPCS,278,RC,,both,86.1,77.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.27,,,,50.8,70.26
SCREW 4.0 CORTEX20MM,C1713,HCPCS,278,RC,,both,86.1,77.49,Cigna,Default,Percent of Total Billed Charges,50.8,,,,50.8,70.26
SCREW 4.0 CORTEX20MM,C1713,HCPCS,278,RC,,both,86.1,77.49,United Healthcare,Default,Fee Schedule,70.26,,,,50.8,70.26
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1102.21,991.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,771.55,,,,650.3,899.4
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1102.21,991.99,Cigna,Default,Percent of Total Billed Charges,650.3,,,,650.3,899.4
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1102.21,991.99,United Healthcare,Default,Fee Schedule,899.4,,,,650.3,899.4
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1102.21,991.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,771.55,,,,650.3,899.4
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1102.21,991.99,Cigna,Default,Percent of Total Billed Charges,650.3,,,,650.3,899.4
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1102.21,991.99,United Healthcare,Default,Fee Schedule,899.4,,,,650.3,899.4
SCREW 4.0 CORTEX18MM,C1713,HCPCS,278,RC,,both,90.2,81.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.14,,,,53.22,73.6
SCREW 4.0 CORTEX18MM,C1713,HCPCS,278,RC,,both,90.2,81.18,Cigna,Default,Percent of Total Billed Charges,53.22,,,,53.22,73.6
SCREW 4.0 CORTEX18MM,C1713,HCPCS,278,RC,,both,90.2,81.18,United Healthcare,Default,Fee Schedule,73.6,,,,53.22,73.6
LUTONIX 035  4.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  4.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  4.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
FIXATION PINS SET OF 3,C1713,HCPCS,278,RC,,both,832.49,749.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,582.74,,,,491.17,679.31
FIXATION PINS SET OF 3,C1713,HCPCS,278,RC,,both,832.49,749.24,Cigna,Default,Percent of Total Billed Charges,491.17,,,,491.17,679.31
FIXATION PINS SET OF 3,C1713,HCPCS,278,RC,,both,832.49,749.24,United Healthcare,Default,Fee Schedule,679.31,,,,491.17,679.31
ULTRAVERSE 035 5.0MMX40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,227.86,,,,192.06,265.62
ULTRAVERSE 035 5.0MMX40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,Cigna,Default,Percent of Total Billed Charges,192.06,,,,192.06,265.62
ULTRAVERSE 035 5.0MMX40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,United Healthcare,Default,Fee Schedule,265.62,,,,192.06,265.62
ULTRAVERSE 035 6.0MM X 40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,227.86,,,,192.06,265.62
ULTRAVERSE 035 6.0MM X 40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,Cigna,Default,Percent of Total Billed Charges,192.06,,,,192.06,265.62
ULTRAVERSE 035 6.0MM X 40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,United Healthcare,Default,Fee Schedule,265.62,,,,192.06,265.62
LUTONIX 035 6.0MM X 100MM,C1725,HCPCS,278,RC,,both,5535.15,4981.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3874.6,,,,3265.74,4516.68
LUTONIX 035 6.0MM X 100MM,C1725,HCPCS,278,RC,,both,5535.15,4981.64,Cigna,Default,Percent of Total Billed Charges,3265.74,,,,3265.74,4516.68
LUTONIX 035 6.0MM X 100MM,C1725,HCPCS,278,RC,,both,5535.15,4981.64,United Healthcare,Default,Fee Schedule,4516.68,,,,3265.74,4516.68
LUTONIX 035 5.0MM X 40MM,C1725,HCPCS,278,RC,,both,5535.15,4981.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3874.6,,,,3265.74,4516.68
LUTONIX 035 5.0MM X 40MM,C1725,HCPCS,278,RC,,both,5535.15,4981.64,Cigna,Default,Percent of Total Billed Charges,3265.74,,,,3265.74,4516.68
LUTONIX 035 5.0MM X 40MM,C1725,HCPCS,278,RC,,both,5535.15,4981.64,United Healthcare,Default,Fee Schedule,4516.68,,,,3265.74,4516.68
KIT RADIUS DISTAL,278,RC,,,,both,8780.46,7902.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6146.32,,,,5180.47,7164.86
KIT RADIUS DISTAL,278,RC,,,,both,8780.46,7902.41,Cigna,Default,Percent of Total Billed Charges,5180.47,,,,5180.47,7164.86
KIT RADIUS DISTAL,278,RC,,,,both,8780.46,7902.41,United Healthcare,Default,Fee Schedule,7164.86,,,,5180.47,7164.86
ULTRAVERSE 035 6.0MM X 80MM,C1725,HCPCS,272,RC,,both,325.52,292.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,227.86,,,,192.06,265.62
ULTRAVERSE 035 6.0MM X 80MM,C1725,HCPCS,272,RC,,both,325.52,292.97,Cigna,Default,Percent of Total Billed Charges,192.06,,,,192.06,265.62
ULTRAVERSE 035 6.0MM X 80MM,C1725,HCPCS,272,RC,,both,325.52,292.97,United Healthcare,Default,Fee Schedule,265.62,,,,192.06,265.62
LUTONIX 035  6.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  6.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  6.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
KIT RADIUS DISTAL,278,RC,,,,both,8780.46,7902.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6146.32,,,,5180.47,7164.86
KIT RADIUS DISTAL,278,RC,,,,both,8780.46,7902.41,Cigna,Default,Percent of Total Billed Charges,5180.47,,,,5180.47,7164.86
KIT RADIUS DISTAL,278,RC,,,,both,8780.46,7902.41,United Healthcare,Default,Fee Schedule,7164.86,,,,5180.47,7164.86
LUTONIX 035 7.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035 7.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035 7.0MM X 60MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
SCREW PROPEL 9X30MM I/F,C1713,HCPCS,278,RC,,both,333,299.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.1,,,,196.47,271.73
SCREW PROPEL 9X30MM I/F,C1713,HCPCS,278,RC,,both,333,299.7,Cigna,Default,Percent of Total Billed Charges,196.47,,,,196.47,271.73
SCREW PROPEL 9X30MM I/F,C1713,HCPCS,278,RC,,both,333,299.7,United Healthcare,Default,Fee Schedule,271.73,,,,196.47,271.73
SCREW CANNULATED 2.4 10MM,C1713,HCPCS,278,RC,,both,749.24,674.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.47,,,,442.05,611.38
SCREW CANNULATED 2.4 10MM,C1713,HCPCS,278,RC,,both,749.24,674.32,Cigna,Default,Percent of Total Billed Charges,442.05,,,,442.05,611.38
SCREW CANNULATED 2.4 10MM,C1713,HCPCS,278,RC,,both,749.24,674.32,United Healthcare,Default,Fee Schedule,611.38,,,,442.05,611.38
SCREW CANNULATED 2.4 16MM,C1713,HCPCS,278,RC,,both,749.24,674.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.47,,,,442.05,611.38
SCREW CANNULATED 2.4 16MM,C1713,HCPCS,278,RC,,both,749.24,674.32,Cigna,Default,Percent of Total Billed Charges,442.05,,,,442.05,611.38
SCREW CANNULATED 2.4 16MM,C1713,HCPCS,278,RC,,both,749.24,674.32,United Healthcare,Default,Fee Schedule,611.38,,,,442.05,611.38
SCREW CANNULATED 2.4 15MM,C1713,HCPCS,278,RC,,both,749.24,674.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.47,,,,442.05,611.38
SCREW CANNULATED 2.4 15MM,C1713,HCPCS,278,RC,,both,749.24,674.32,Cigna,Default,Percent of Total Billed Charges,442.05,,,,442.05,611.38
SCREW CANNULATED 2.4 15MM,C1713,HCPCS,278,RC,,both,749.24,674.32,United Healthcare,Default,Fee Schedule,611.38,,,,442.05,611.38
SCREW CANNULATED 2.4 14MM,C1713,HCPCS,278,RC,,both,767.97,691.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,537.58,,,,453.1,626.66
SCREW CANNULATED 2.4 14MM,C1713,HCPCS,278,RC,,both,767.97,691.17,Cigna,Default,Percent of Total Billed Charges,453.1,,,,453.1,626.66
SCREW CANNULATED 2.4 14MM,C1713,HCPCS,278,RC,,both,767.97,691.17,United Healthcare,Default,Fee Schedule,626.66,,,,453.1,626.66
GUARDSMAN FEM IFS 9X30MM,C1713,HCPCS,278,RC,,both,341.32,307.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.92,,,,201.38,278.52
GUARDSMAN FEM IFS 9X30MM,C1713,HCPCS,278,RC,,both,341.32,307.19,Cigna,Default,Percent of Total Billed Charges,201.38,,,,201.38,278.52
GUARDSMAN FEM IFS 9X30MM,C1713,HCPCS,278,RC,,both,341.32,307.19,United Healthcare,Default,Fee Schedule,278.52,,,,201.38,278.52
SUTURE ANCHOR TITANIUM 4.0MM,C1713,HCPCS,278,RC,,both,853.3,767.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,597.31,,,,503.45,696.29
SUTURE ANCHOR TITANIUM 4.0MM,C1713,HCPCS,278,RC,,both,853.3,767.97,Cigna,Default,Percent of Total Billed Charges,503.45,,,,503.45,696.29
SUTURE ANCHOR TITANIUM 4.0MM,C1713,HCPCS,278,RC,,both,853.3,767.97,United Healthcare,Default,Fee Schedule,696.29,,,,503.45,696.29
LUTONIX 035 5.0MM X 60MM,C1725,HCPCS,278,RC,,both,4283.15,3854.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2998.2,,,,2527.06,3495.05
LUTONIX 035 5.0MM X 60MM,C1725,HCPCS,278,RC,,both,4283.15,3854.84,Cigna,Default,Percent of Total Billed Charges,2527.06,,,,2527.06,3495.05
LUTONIX 035 5.0MM X 60MM,C1725,HCPCS,278,RC,,both,4283.15,3854.84,United Healthcare,Default,Fee Schedule,3495.05,,,,2527.06,3495.05
BIO A TISSUE REINFORCEMENT 8X8,C1781,HCPCS,278,RC,,both,1388.61,1249.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,972.03,,,,819.28,1133.11
BIO A TISSUE REINFORCEMENT 8X8,C1781,HCPCS,278,RC,,both,1388.61,1249.75,Cigna,Default,Percent of Total Billed Charges,819.28,,,,819.28,1133.11
BIO A TISSUE REINFORCEMENT 8X8,C1781,HCPCS,278,RC,,both,1388.61,1249.75,United Healthcare,Default,Fee Schedule,1133.11,,,,819.28,1133.11
ULTRAVERSE 035 4.0MMX40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,227.86,,,,192.06,265.62
ULTRAVERSE 035 4.0MMX40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,Cigna,Default,Percent of Total Billed Charges,192.06,,,,192.06,265.62
ULTRAVERSE 035 4.0MMX40MM,C1725,HCPCS,278,RC,,both,325.52,292.97,United Healthcare,Default,Fee Schedule,265.62,,,,192.06,265.62
CONGRUENT TRIBIAL INSERT 1/2 14MM RT,278,RC,,,,both,5113.74,4602.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3579.62,,,,3017.11,4172.81
CONGRUENT TRIBIAL INSERT 1/2 14MM RT,278,RC,,,,both,5113.74,4602.37,Cigna,Default,Percent of Total Billed Charges,3017.11,,,,3017.11,4172.81
CONGRUENT TRIBIAL INSERT 1/2 14MM RT,278,RC,,,,both,5113.74,4602.37,United Healthcare,Default,Fee Schedule,4172.81,,,,3017.11,4172.81
CONGRUENT TRIBIAL INSERT 1/2 12MM RT,278,RC,,,,both,3972.27,3575.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2780.59,,,,2343.64,3241.37
CONGRUENT TRIBIAL INSERT 1/2 12MM RT,278,RC,,,,both,3972.27,3575.04,Cigna,Default,Percent of Total Billed Charges,2343.64,,,,2343.64,3241.37
CONGRUENT TRIBIAL INSERT 1/2 12MM RT,278,RC,,,,both,3972.27,3575.04,United Healthcare,Default,Fee Schedule,3241.37,,,,2343.64,3241.37
CONGRUENT TIBIAL INSERT,278,RC,,,,both,3972.27,3575.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2780.59,,,,2343.64,3241.37
CONGRUENT TIBIAL INSERT,278,RC,,,,both,3972.27,3575.04,Cigna,Default,Percent of Total Billed Charges,2343.64,,,,2343.64,3241.37
CONGRUENT TIBIAL INSERT,278,RC,,,,both,3972.27,3575.04,United Healthcare,Default,Fee Schedule,3241.37,,,,2343.64,3241.37
CONGRUENT TIBIAL INSERT SIZE 5/6 12MM RT,278,RC,,,,both,4460.48,4014.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3122.34,,,,2631.68,3639.75
CONGRUENT TIBIAL INSERT SIZE 5/6 12MM RT,278,RC,,,,both,4460.48,4014.43,Cigna,Default,Percent of Total Billed Charges,2631.68,,,,2631.68,3639.75
CONGRUENT TIBIAL INSERT SIZE 5/6 12MM RT,278,RC,,,,both,4460.48,4014.43,United Healthcare,Default,Fee Schedule,3639.75,,,,2631.68,3639.75
LUTONIX 035  5.0MMX100MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  5.0MMX100MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  5.0MMX100MM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
LUTONIX 035  5.0MM X 150MM,C1725,HCPCS,278,RC,,both,4994.93,4495.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3496.45,,,,2947.01,4075.86
LUTONIX 035  5.0MM X 150MM,C1725,HCPCS,278,RC,,both,4994.93,4495.44,Cigna,Default,Percent of Total Billed Charges,2947.01,,,,2947.01,4075.86
LUTONIX 035  5.0MM X 150MM,C1725,HCPCS,278,RC,,both,4994.93,4495.44,United Healthcare,Default,Fee Schedule,4075.86,,,,2947.01,4075.86
LUTONIX 035 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
LUTONIX 035 DCB 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035 DCB 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035 DCB 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
BIO A TISSUE REINFORCEMENT 10X30,C1781,HCPCS,278,RC,,both,6730.83,6057.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4711.58,,,,3971.19,5492.36
BIO A TISSUE REINFORCEMENT 10X30,C1781,HCPCS,278,RC,,both,6730.83,6057.75,Cigna,Default,Percent of Total Billed Charges,3971.19,,,,3971.19,5492.36
BIO A TISSUE REINFORCEMENT 10X30,C1781,HCPCS,278,RC,,both,6730.83,6057.75,United Healthcare,Default,Fee Schedule,5492.36,,,,3971.19,5492.36
BIO A TISSUE REINFORCEMENT 20X30,C1781,HCPCS,278,RC,,both,12642.68,11378.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8849.88,,,,7459.18,10316.43
BIO A TISSUE REINFORCEMENT 20X30,C1781,HCPCS,278,RC,,both,12642.68,11378.41,Cigna,Default,Percent of Total Billed Charges,7459.18,,,,7459.18,10316.43
BIO A TISSUE REINFORCEMENT 20X30,C1781,HCPCS,278,RC,,both,12642.68,11378.41,United Healthcare,Default,Fee Schedule,10316.43,,,,7459.18,10316.43
ULTRAVERSE 035 4.0MMX100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 4.0MMX100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 5.0 MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 5.0 MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 5.0 MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
LUTONIX035DCB5F,C1725,HCPCS,278,RC,,both,4994.93,4495.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3496.45,,,,2947.01,4075.86
LUTONIX035DCB5F,C1725,HCPCS,278,RC,,both,4994.93,4495.44,Cigna,Default,Percent of Total Billed Charges,2947.01,,,,2947.01,4075.86
LUTONIX035DCB5F,C1725,HCPCS,278,RC,,both,4994.93,4495.44,United Healthcare,Default,Fee Schedule,4075.86,,,,2947.01,4075.86
BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,278,RC,,,,both,8938.5,8044.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6256.95,,,,5273.72,7293.82
BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,278,RC,,,,both,8938.5,8044.65,Cigna,Default,Percent of Total Billed Charges,5273.72,,,,5273.72,7293.82
BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,278,RC,,,,both,8938.5,8044.65,United Healthcare,Default,Fee Schedule,7293.82,,,,5273.72,7293.82
BASEPLATE CCM STEM TIBIAL SIZE 3 LEFT,278,RC,,,,both,8766.41,7889.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6136.49,,,,5172.18,7153.39
BASEPLATE CCM STEM TIBIAL SIZE 3 LEFT,278,RC,,,,both,8766.41,7889.77,Cigna,Default,Percent of Total Billed Charges,5172.18,,,,5172.18,7153.39
BASEPLATE CCM STEM TIBIAL SIZE 3 LEFT,278,RC,,,,both,8766.41,7889.77,United Healthcare,Default,Fee Schedule,7153.39,,,,5172.18,7153.39
LUTONIX035DCB5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX035DCB5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX035DCB5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
SCREW FEMORAL 8MM X 25MM,C1713,HCPCS,278,RC,,both,341.32,307.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.92,,,,201.38,278.52
SCREW FEMORAL 8MM X 25MM,C1713,HCPCS,278,RC,,both,341.32,307.19,Cigna,Default,Percent of Total Billed Charges,201.38,,,,201.38,278.52
SCREW FEMORAL 8MM X 25MM,C1713,HCPCS,278,RC,,both,341.32,307.19,United Healthcare,Default,Fee Schedule,278.52,,,,201.38,278.52
SCREW PROPEL TIBIAL,C1713,HCPCS,278,RC,,both,341.32,307.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.92,,,,201.38,278.52
SCREW PROPEL TIBIAL,C1713,HCPCS,278,RC,,both,341.32,307.19,Cigna,Default,Percent of Total Billed Charges,201.38,,,,201.38,278.52
SCREW PROPEL TIBIAL,C1713,HCPCS,278,RC,,both,341.32,307.19,United Healthcare,Default,Fee Schedule,278.52,,,,201.38,278.52
ULTRAVERSE 035 7.0MM X 40MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 40MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 40MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
LUTONIX 035 5.0MM X 40MM 130CM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035 5.0MM X 40MM 130CM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035 5.0MM X 40MM 130CM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
PIN GUIDE 2.5MM,278,RC,,,,both,312.59,281.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,218.81,,,,184.43,255.07
PIN GUIDE 2.5MM,278,RC,,,,both,312.59,281.33,Cigna,Default,Percent of Total Billed Charges,184.43,,,,184.43,255.07
PIN GUIDE 2.5MM,278,RC,,,,both,312.59,281.33,United Healthcare,Default,Fee Schedule,255.07,,,,184.43,255.07
POST TAPER HEMICAP 15.6MM,278,RC,,,,both,2528.77,2275.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1770.14,,,,1491.97,2063.48
POST TAPER HEMICAP 15.6MM,278,RC,,,,both,2528.77,2275.89,Cigna,Default,Percent of Total Billed Charges,1491.97,,,,1491.97,2063.48
POST TAPER HEMICAP 15.6MM,278,RC,,,,both,2528.77,2275.89,United Healthcare,Default,Fee Schedule,2063.48,,,,1491.97,2063.48
ARTICULAR HEMICAP 52MMX48MM,278,RC,,,,both,17806.76,16026.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12464.73,,,,10505.99,14530.32
ARTICULAR HEMICAP 52MMX48MM,278,RC,,,,both,17806.76,16026.08,Cigna,Default,Percent of Total Billed Charges,10505.99,,,,10505.99,14530.32
ARTICULAR HEMICAP 52MMX48MM,278,RC,,,,both,17806.76,16026.08,United Healthcare,Default,Fee Schedule,14530.32,,,,10505.99,14530.32
ANCHOR SUTURE TITANIUM 5.5 MM,278,RC,,,,both,1000.98,900.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,700.69,,,,590.58,816.8
ANCHOR SUTURE TITANIUM 5.5 MM,278,RC,,,,both,1000.98,900.88,Cigna,Default,Percent of Total Billed Charges,590.58,,,,590.58,816.8
ANCHOR SUTURE TITANIUM 5.5 MM,278,RC,,,,both,1000.98,900.88,United Healthcare,Default,Fee Schedule,816.8,,,,590.58,816.8
SCREW 6.5X40MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X40MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X40MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
ANCHOR SUTURE PEEK 5.5MM,278,RC,,,,both,1362.73,1226.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,953.91,,,,804.01,1111.99
ANCHOR SUTURE PEEK 5.5MM,278,RC,,,,both,1362.73,1226.46,Cigna,Default,Percent of Total Billed Charges,804.01,,,,804.01,1111.99
ANCHOR SUTURE PEEK 5.5MM,278,RC,,,,both,1362.73,1226.46,United Healthcare,Default,Fee Schedule,1111.99,,,,804.01,1111.99
ROD 6X40MM,278,RC,,,,both,1196.24,1076.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,837.37,,,,705.78,976.13
ROD 6X40MM,278,RC,,,,both,1196.24,1076.62,Cigna,Default,Percent of Total Billed Charges,705.78,,,,705.78,976.13
ROD 6X40MM,278,RC,,,,both,1196.24,1076.62,United Healthcare,Default,Fee Schedule,976.13,,,,705.78,976.13
SET SCREW,278,RC,,,,both,868.64,781.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,608.05,,,,512.5,708.81
SET SCREW,278,RC,,,,both,868.64,781.78,Cigna,Default,Percent of Total Billed Charges,512.5,,,,512.5,708.81
SET SCREW,278,RC,,,,both,868.64,781.78,United Healthcare,Default,Fee Schedule,708.81,,,,512.5,708.81
SCREW 6.5X35MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X35MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X35MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
GUIDE WIRE,278,RC,,,,both,482.92,434.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.04,,,,284.92,394.06
GUIDE WIRE,278,RC,,,,both,482.92,434.63,Cigna,Default,Percent of Total Billed Charges,284.92,,,,284.92,394.06
GUIDE WIRE,278,RC,,,,both,482.92,434.63,United Healthcare,Default,Fee Schedule,394.06,,,,284.92,394.06
PLATE NARROW VOLAR DISTAL RADIOUS RT,C1713,HCPCS,278,RC,,both,2730.56,2457.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.39,,,,1611.03,2228.14
PLATE NARROW VOLAR DISTAL RADIOUS RT,C1713,HCPCS,278,RC,,both,2730.56,2457.5,Cigna,Default,Percent of Total Billed Charges,1611.03,,,,1611.03,2228.14
PLATE NARROW VOLAR DISTAL RADIOUS RT,C1713,HCPCS,278,RC,,both,2730.56,2457.5,United Healthcare,Default,Fee Schedule,2228.14,,,,1611.03,2228.14
PLATE NARROW VOLAR DISTAL RADIUS RT,C1713,HCPCS,278,RC,,both,2730.56,2457.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.39,,,,1611.03,2228.14
PLATE NARROW VOLAR DISTAL RADIUS RT,C1713,HCPCS,278,RC,,both,2730.56,2457.5,Cigna,Default,Percent of Total Billed Charges,1611.03,,,,1611.03,2228.14
PLATE NARROW VOLAR DISTAL RADIUS RT,C1713,HCPCS,278,RC,,both,2730.56,2457.5,United Healthcare,Default,Fee Schedule,2228.14,,,,1611.03,2228.14
PLATE DISTAL RADIUS RT STANDARD,C1713,HCPCS,278,RC,,both,2730.56,2457.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.39,,,,1611.03,2228.14
PLATE DISTAL RADIUS RT STANDARD,C1713,HCPCS,278,RC,,both,2730.56,2457.5,Cigna,Default,Percent of Total Billed Charges,1611.03,,,,1611.03,2228.14
PLATE DISTAL RADIUS RT STANDARD,C1713,HCPCS,278,RC,,both,2730.56,2457.5,United Healthcare,Default,Fee Schedule,2228.14,,,,1611.03,2228.14
PLATE DISTAL RADIUS FIBULA LT 4H 86MM,C1713,HCPCS,278,RC,,both,2269.78,2042.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1588.85,,,,1339.17,1852.14
PLATE DISTAL RADIUS FIBULA LT 4H 86MM,C1713,HCPCS,278,RC,,both,2269.78,2042.8,Cigna,Default,Percent of Total Billed Charges,1339.17,,,,1339.17,1852.14
PLATE DISTAL RADIUS FIBULA LT 4H 86MM,C1713,HCPCS,278,RC,,both,2269.78,2042.8,United Healthcare,Default,Fee Schedule,1852.14,,,,1339.17,1852.14
JASHIDI NEEDLE,272,RC,,,,both,570.72,513.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,399.5,,,,336.72,465.71
JASHIDI NEEDLE,272,RC,,,,both,570.72,513.65,Cigna,Default,Percent of Total Billed Charges,336.72,,,,336.72,465.71
JASHIDI NEEDLE,272,RC,,,,both,570.72,513.65,United Healthcare,Default,Fee Schedule,465.71,,,,336.72,465.71
ARTICULATING CAGE 11X30X9,278,RC,,,,both,11414.59,10273.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7990.21,,,,6734.61,9314.31
ARTICULATING CAGE 11X30X9,278,RC,,,,both,11414.59,10273.13,Cigna,Default,Percent of Total Billed Charges,6734.61,,,,6734.61,9314.31
ARTICULATING CAGE 11X30X9,278,RC,,,,both,11414.59,10273.13,United Healthcare,Default,Fee Schedule,9314.31,,,,6734.61,9314.31
ARTICULATING CAGE 11X30X10,278,RC,,,,both,11414.59,10273.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7990.21,,,,6734.61,9314.31
ARTICULATING CAGE 11X30X10,278,RC,,,,both,11414.59,10273.13,Cigna,Default,Percent of Total Billed Charges,6734.61,,,,6734.61,9314.31
ARTICULATING CAGE 11X30X10,278,RC,,,,both,11414.59,10273.13,United Healthcare,Default,Fee Schedule,9314.31,,,,6734.61,9314.31
SCREW 6.5X40MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X40MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X40MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
JASHIDI NEEDLE,272,RC,,,,both,570.72,513.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,399.5,,,,336.72,465.71
JASHIDI NEEDLE,272,RC,,,,both,570.72,513.65,Cigna,Default,Percent of Total Billed Charges,336.72,,,,336.72,465.71
JASHIDI NEEDLE,272,RC,,,,both,570.72,513.65,United Healthcare,Default,Fee Schedule,465.71,,,,336.72,465.71
GUIDE WIRE,C1769,HCPCS,278,RC,,both,469.31,422.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,328.52,,,,276.89,382.96
GUIDE WIRE,C1769,HCPCS,278,RC,,both,469.31,422.38,Cigna,Default,Percent of Total Billed Charges,276.89,,,,276.89,382.96
GUIDE WIRE,C1769,HCPCS,278,RC,,both,469.31,422.38,United Healthcare,Default,Fee Schedule,382.96,,,,276.89,382.96
SCREW 6.5X45 TIGER MIS,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X45 TIGER MIS,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X45 TIGER MIS,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
SCREW 6.5X40 TIGER MIS,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X40 TIGER MIS,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X40 TIGER MIS,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
SET SCREW,278,RC,,,,both,868.64,781.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,608.05,,,,512.5,708.81
SET SCREW,278,RC,,,,both,868.64,781.78,Cigna,Default,Percent of Total Billed Charges,512.5,,,,512.5,708.81
SET SCREW,278,RC,,,,both,868.64,781.78,United Healthcare,Default,Fee Schedule,708.81,,,,512.5,708.81
ROD MIS  5.5X45MM,278,RC,,,,both,1196.24,1076.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,837.37,,,,705.78,976.13
ROD MIS  5.5X45MM,278,RC,,,,both,1196.24,1076.62,Cigna,Default,Percent of Total Billed Charges,705.78,,,,705.78,976.13
ROD MIS  5.5X45MM,278,RC,,,,both,1196.24,1076.62,United Healthcare,Default,Fee Schedule,976.13,,,,705.78,976.13
ARTICULATING CAGE 30X11X11,278,RC,,,,both,11414.59,10273.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7990.21,,,,6734.61,9314.31
ARTICULATING CAGE 30X11X11,278,RC,,,,both,11414.59,10273.13,Cigna,Default,Percent of Total Billed Charges,6734.61,,,,6734.61,9314.31
ARTICULATING CAGE 30X11X11,278,RC,,,,both,11414.59,10273.13,United Healthcare,Default,Fee Schedule,9314.31,,,,6734.61,9314.31
SCREW 6.5X50MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X50MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X50MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
SCREW 6.5X45MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4212.45,,,,3550.49,4910.51
SCREW 6.5X45MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,Cigna,Default,Percent of Total Billed Charges,3550.49,,,,3550.49,4910.51
SCREW 6.5X45MM EXTENDED TAB,278,RC,,,,both,6017.78,5416,United Healthcare,Default,Fee Schedule,4910.51,,,,3550.49,4910.51
GUIDE WIRE,278,RC,,,,both,482.92,434.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.04,,,,284.92,394.06
GUIDE WIRE,278,RC,,,,both,482.92,434.63,Cigna,Default,Percent of Total Billed Charges,284.92,,,,284.92,394.06
GUIDE WIRE,278,RC,,,,both,482.92,434.63,United Healthcare,Default,Fee Schedule,394.06,,,,284.92,394.06
OSTEO-SITE NEEDLE BIOPSY BONE,272,RC,,,,both,1352.19,1216.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,946.53,,,,797.79,1103.39
OSTEO-SITE NEEDLE BIOPSY BONE,272,RC,,,,both,1352.19,1216.97,Cigna,Default,Percent of Total Billed Charges,797.79,,,,797.79,1103.39
OSTEO-SITE NEEDLE BIOPSY BONE,272,RC,,,,both,1352.19,1216.97,United Healthcare,Default,Fee Schedule,1103.39,,,,797.79,1103.39
COTTON WEDGE 7MM,C1713,HCPCS,278,RC,,both,8277.01,7449.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5793.91,,,,4883.44,6754.04
COTTON WEDGE 7MM,C1713,HCPCS,278,RC,,both,8277.01,7449.31,Cigna,Default,Percent of Total Billed Charges,4883.44,,,,4883.44,6754.04
COTTON WEDGE 7MM,C1713,HCPCS,278,RC,,both,8277.01,7449.31,United Healthcare,Default,Fee Schedule,6754.04,,,,4883.44,6754.04
EVANS WEDGE 10MM,C1713,HCPCS,278,RC,,both,9471.63,8524.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6630.14,,,,5588.26,7728.85
EVANS WEDGE 10MM,C1713,HCPCS,278,RC,,both,9471.63,8524.47,Cigna,Default,Percent of Total Billed Charges,5588.26,,,,5588.26,7728.85
EVANS WEDGE 10MM,C1713,HCPCS,278,RC,,both,9471.63,8524.47,United Healthcare,Default,Fee Schedule,7728.85,,,,5588.26,7728.85
DRILL 2.0X110MM SOLID MEASURING AO,C1713,HCPCS,272,RC,,both,1058.09,952.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,740.66,,,,624.27,863.4
DRILL 2.0X110MM SOLID MEASURING AO,C1713,HCPCS,272,RC,,both,1058.09,952.28,Cigna,Default,Percent of Total Billed Charges,624.27,,,,624.27,863.4
DRILL 2.0X110MM SOLID MEASURING AO,C1713,HCPCS,272,RC,,both,1058.09,952.28,United Healthcare,Default,Fee Schedule,863.4,,,,624.27,863.4
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 2.,C1713,HCPCS,278,RC,,both,168.1,151.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.67,,,,99.18,137.17
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 2.,C1713,HCPCS,278,RC,,both,168.1,151.29,Cigna,Default,Percent of Total Billed Charges,99.18,,,,99.18,137.17
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 2.,C1713,HCPCS,278,RC,,both,168.1,151.29,United Healthcare,Default,Fee Schedule,137.17,,,,99.18,137.17
OLIVE WIRE SMOOTH 1.4MM,C1713,HCPCS,278,RC,,both,580.24,522.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,406.17,,,,342.34,473.48
OLIVE WIRE SMOOTH 1.4MM,C1713,HCPCS,278,RC,,both,580.24,522.22,Cigna,Default,Percent of Total Billed Charges,342.34,,,,342.34,473.48
OLIVE WIRE SMOOTH 1.4MM,C1713,HCPCS,278,RC,,both,580.24,522.22,United Healthcare,Default,Fee Schedule,473.48,,,,342.34,473.48
R3CON LOCKING PLATE SCREW 2.7X18,C1713,HCPCS,278,RC,,both,1058.09,952.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,740.66,,,,624.27,863.4
R3CON LOCKING PLATE SCREW 2.7X18,C1713,HCPCS,278,RC,,both,1058.09,952.28,Cigna,Default,Percent of Total Billed Charges,624.27,,,,624.27,863.4
R3CON LOCKING PLATE SCREW 2.7X18,C1713,HCPCS,278,RC,,both,1058.09,952.28,United Healthcare,Default,Fee Schedule,863.4,,,,624.27,863.4
R3CON NON-LOCKING PLATE SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREQ 2.7X14MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREQ 2.7X14MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREQ 2.7X14MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
HEVANS PLATE MEDOIUM LEFT 20MM,C1713,HCPCS,278,RC,,both,7509.04,6758.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5256.33,,,,4430.33,6127.38
HEVANS PLATE MEDOIUM LEFT 20MM,C1713,HCPCS,278,RC,,both,7509.04,6758.14,Cigna,Default,Percent of Total Billed Charges,4430.33,,,,4430.33,6127.38
HEVANS PLATE MEDOIUM LEFT 20MM,C1713,HCPCS,278,RC,,both,7509.04,6758.14,United Healthcare,Default,Fee Schedule,6127.38,,,,4430.33,6127.38
"DRILL 4.6X220MM CANNULATED 3/16"" SQ CONN",C1713,HCPCS,278,RC,,both,1279.95,1151.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,895.96,,,,755.17,1044.44
"DRILL 4.6X220MM CANNULATED 3/16"" SQ CONN",C1713,HCPCS,278,RC,,both,1279.95,1151.96,Cigna,Default,Percent of Total Billed Charges,755.17,,,,755.17,1044.44
"DRILL 4.6X220MM CANNULATED 3/16"" SQ CONN",C1713,HCPCS,278,RC,,both,1279.95,1151.96,United Healthcare,Default,Fee Schedule,1044.44,,,,755.17,1044.44
K-WIRE SINGLE TROCAR TIP SMOOTH W/ FLOUR,C1713,HCPCS,278,RC,,both,511.98,460.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,358.39,,,,302.07,417.78
K-WIRE SINGLE TROCAR TIP SMOOTH W/ FLOUR,C1713,HCPCS,278,RC,,both,511.98,460.78,Cigna,Default,Percent of Total Billed Charges,302.07,,,,302.07,417.78
K-WIRE SINGLE TROCAR TIP SMOOTH W/ FLOUR,C1713,HCPCS,278,RC,,both,511.98,460.78,United Healthcare,Default,Fee Schedule,417.78,,,,302.07,417.78
MONSTER CANNULATED MEDIUM THREAD SCREW H,C1713,HCPCS,278,RC,,both,4420.1,3978.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3094.07,,,,2607.86,3606.8
MONSTER CANNULATED MEDIUM THREAD SCREW H,C1713,HCPCS,278,RC,,both,4420.1,3978.09,Cigna,Default,Percent of Total Billed Charges,2607.86,,,,2607.86,3606.8
MONSTER CANNULATED MEDIUM THREAD SCREW H,C1713,HCPCS,278,RC,,both,4420.1,3978.09,United Healthcare,Default,Fee Schedule,3606.8,,,,2607.86,3606.8
MONSTER CANNULATED MEDIUM THREADED SCREW,C1713,HCPCS,278,RC,,both,4420.1,3978.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3094.07,,,,2607.86,3606.8
MONSTER CANNULATED MEDIUM THREADED SCREW,C1713,HCPCS,278,RC,,both,4420.1,3978.09,Cigna,Default,Percent of Total Billed Charges,2607.86,,,,2607.86,3606.8
MONSTER CANNULATED MEDIUM THREADED SCREW,C1713,HCPCS,278,RC,,both,4420.1,3978.09,United Healthcare,Default,Fee Schedule,3606.8,,,,2607.86,3606.8
LUTONIX 035  4MM X 40MM 130CM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  4MM X 40MM 130CM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  4MM X 40MM 130CM,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,C1713,HCPCS,278,RC,,both,103.11,92.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.18,,,,60.83,84.14
3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,C1713,HCPCS,278,RC,,both,103.11,92.8,Cigna,Default,Percent of Total Billed Charges,60.83,,,,60.83,84.14
3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,C1713,HCPCS,278,RC,,both,103.11,92.8,United Healthcare,Default,Fee Schedule,84.14,,,,60.83,84.14
CRUSHED CANCELLOUS CHIPS 15CC 1-4MM,C1713,HCPCS,278,RC,,both,1952.35,1757.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1366.64,,,,1151.89,1593.12
CRUSHED CANCELLOUS CHIPS 15CC 1-4MM,C1713,HCPCS,278,RC,,both,1952.35,1757.12,Cigna,Default,Percent of Total Billed Charges,1151.89,,,,1151.89,1593.12
CRUSHED CANCELLOUS CHIPS 15CC 1-4MM,C1713,HCPCS,278,RC,,both,1952.35,1757.12,United Healthcare,Default,Fee Schedule,1593.12,,,,1151.89,1593.12
GUIDE WIRE,C1769,HCPCS,278,RC,,both,469.31,422.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,328.52,,,,276.89,382.96
GUIDE WIRE,C1769,HCPCS,278,RC,,both,469.31,422.38,Cigna,Default,Percent of Total Billed Charges,276.89,,,,276.89,382.96
GUIDE WIRE,C1769,HCPCS,278,RC,,both,469.31,422.38,United Healthcare,Default,Fee Schedule,382.96,,,,276.89,382.96
DRILL 2.4X140MM SOLID MEASURING LONG AO,C1713,HCPCS,278,RC,,both,1058.09,952.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,740.66,,,,624.27,863.4
DRILL 2.4X140MM SOLID MEASURING LONG AO,C1713,HCPCS,278,RC,,both,1058.09,952.28,Cigna,Default,Percent of Total Billed Charges,624.27,,,,624.27,863.4
DRILL 2.4X140MM SOLID MEASURING LONG AO,C1713,HCPCS,278,RC,,both,1058.09,952.28,United Healthcare,Default,Fee Schedule,863.4,,,,624.27,863.4
ULTRAVERSE 035 5.0 MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 5.0 MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 5.0 MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
MTP PLATE SHORT-SHORT LEFT 2-HOLE DISTAL,C1713,HCPCS,278,RC,,both,8072.21,7264.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5650.55,,,,4762.6,6586.92
MTP PLATE SHORT-SHORT LEFT 2-HOLE DISTAL,C1713,HCPCS,278,RC,,both,8072.21,7264.99,Cigna,Default,Percent of Total Billed Charges,4762.6,,,,4762.6,6586.92
MTP PLATE SHORT-SHORT LEFT 2-HOLE DISTAL,C1713,HCPCS,278,RC,,both,8072.21,7264.99,United Healthcare,Default,Fee Schedule,6586.92,,,,4762.6,6586.92
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,C1713,HCPCS,278,RC,,both,176.5,158.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.55,,,,104.14,144.02
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,C1713,HCPCS,278,RC,,both,176.5,158.85,Cigna,Default,Percent of Total Billed Charges,104.14,,,,104.14,144.02
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,C1713,HCPCS,278,RC,,both,176.5,158.85,United Healthcare,Default,Fee Schedule,144.02,,,,104.14,144.02
R3CON LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.44,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Cigna,Default,Percent of Total Billed Charges,664.55,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,United Healthcare,Default,Fee Schedule,919.1,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.44,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Cigna,Default,Percent of Total Billed Charges,664.55,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,United Healthcare,Default,Fee Schedule,919.1,,,,664.55,919.1
R3CON NON-LOCKING PLATE SCREW 3.5X14MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X14MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X14MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X16MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X16MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X16MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 3.5X20MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
MINI-MONSTER CANNULATED SHORT THREAD SCR,C1713,HCPCS,278,RC,,both,1416.48,1274.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,991.54,,,,835.72,1155.85
MINI-MONSTER CANNULATED SHORT THREAD SCR,C1713,HCPCS,278,RC,,both,1416.48,1274.83,Cigna,Default,Percent of Total Billed Charges,835.72,,,,835.72,1155.85
MINI-MONSTER CANNULATED SHORT THREAD SCR,C1713,HCPCS,278,RC,,both,1416.48,1274.83,United Healthcare,Default,Fee Schedule,1155.85,,,,835.72,1155.85
COUNTERSINK 3.5MM HEADLESS,C1713,HCPCS,278,RC,,both,1058.09,952.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,740.66,,,,624.27,863.4
COUNTERSINK 3.5MM HEADLESS,C1713,HCPCS,278,RC,,both,1058.09,952.28,Cigna,Default,Percent of Total Billed Charges,624.27,,,,624.27,863.4
COUNTERSINK 3.5MM HEADLESS,C1713,HCPCS,278,RC,,both,1058.09,952.28,United Healthcare,Default,Fee Schedule,863.4,,,,624.27,863.4
DRILL 2.3X120MM CANNULATED AO,C1713,HCPCS,278,RC,,both,1058.09,952.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,740.66,,,,624.27,863.4
DRILL 2.3X120MM CANNULATED AO,C1713,HCPCS,278,RC,,both,1058.09,952.28,Cigna,Default,Percent of Total Billed Charges,624.27,,,,624.27,863.4
DRILL 2.3X120MM CANNULATED AO,C1713,HCPCS,278,RC,,both,1058.09,952.28,United Healthcare,Default,Fee Schedule,863.4,,,,624.27,863.4
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,C1713,HCPCS,278,RC,,both,176.5,158.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.55,,,,104.14,144.02
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,C1713,HCPCS,278,RC,,both,176.5,158.85,Cigna,Default,Percent of Total Billed Charges,104.14,,,,104.14,144.02
K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,C1713,HCPCS,278,RC,,both,176.5,158.85,United Healthcare,Default,Fee Schedule,144.02,,,,104.14,144.02
PIN 33MM HEADED,278,RC,,,,both,386.34,347.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.44,,,,227.94,315.25
PIN 33MM HEADED,278,RC,,,,both,386.34,347.71,Cigna,Default,Percent of Total Billed Charges,227.94,,,,227.94,315.25
PIN 33MM HEADED,278,RC,,,,both,386.34,347.71,United Healthcare,Default,Fee Schedule,315.25,,,,227.94,315.25
PIN,278,RC,,,,both,449.56,404.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.69,,,,265.24,366.84
PIN,278,RC,,,,both,449.56,404.6,Cigna,Default,Percent of Total Billed Charges,265.24,,,,265.24,366.84
PIN,278,RC,,,,both,449.56,404.6,United Healthcare,Default,Fee Schedule,366.84,,,,265.24,366.84
PIN TENSION BAND 70CM,278,RC,,,,both,403.89,363.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.72,,,,238.3,329.57
PIN TENSION BAND 70CM,278,RC,,,,both,403.89,363.5,Cigna,Default,Percent of Total Billed Charges,238.3,,,,238.3,329.57
PIN TENSION BAND 70CM,278,RC,,,,both,403.89,363.5,United Healthcare,Default,Fee Schedule,329.57,,,,238.3,329.57
LUTONIX 035  5X80,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  5X80,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  5X80,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
LUTONIX 035  5X80,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  5X80,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  5X80,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
LUTONIX 035  4X60 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  4X60 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  4X60 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
LUTONIX 035  4X80 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 035  4X80 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 035  4X80 5F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
ULTRAVERSE 035 6.0MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 100MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 7.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
HEAD RESURFACING 50X16,278,RC,,,,both,19625.19,17662.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13737.63,,,,11578.86,16014.16
HEAD RESURFACING 50X16,278,RC,,,,both,19625.19,17662.67,Cigna,Default,Percent of Total Billed Charges,11578.86,,,,11578.86,16014.16
HEAD RESURFACING 50X16,278,RC,,,,both,19625.19,17662.67,United Healthcare,Default,Fee Schedule,16014.16,,,,11578.86,16014.16
ULTRAVERSE 035 6.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 60MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 60MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 6.0MM X 60MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 5.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 5.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 5.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 5.0MM X 80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 5.0MM X 80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 5.0MM X 80MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 4.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 4.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 4.0MM X 150MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
ULTRAVERSE 035 4.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.44,,,,186.65,258.14
ULTRAVERSE 035 4.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,Cigna,Default,Percent of Total Billed Charges,186.65,,,,186.65,258.14
ULTRAVERSE 035 4.0MM X 120MM,C1725,HCPCS,278,RC,,both,316.35,284.72,United Healthcare,Default,Fee Schedule,258.14,,,,186.65,258.14
MINI-MONSTER CANNULATED SHORT THREADED S,C1713,HCPCS,278,RC,,both,1194.62,1075.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,836.23,,,,704.83,974.81
MINI-MONSTER CANNULATED SHORT THREADED S,C1713,HCPCS,278,RC,,both,1194.62,1075.16,Cigna,Default,Percent of Total Billed Charges,704.83,,,,704.83,974.81
MINI-MONSTER CANNULATED SHORT THREADED S,C1713,HCPCS,278,RC,,both,1194.62,1075.16,United Healthcare,Default,Fee Schedule,974.81,,,,704.83,974.81
R3CON NON-LOCKING PLATE SCREW 2.7X16MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X16MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X16MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X15MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,573.42,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X15MM,C1713,HCPCS,278,RC,,both,819.17,737.25,Cigna,Default,Percent of Total Billed Charges,483.31,,,,483.31,668.44
R3CON NON-LOCKING PLATE SCREW 2.7X15MM,C1713,HCPCS,278,RC,,both,819.17,737.25,United Healthcare,Default,Fee Schedule,668.44,,,,483.31,668.44
R3CON LOCKING PLATE SCREW 2.7X15MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.44,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 2.7X15MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Cigna,Default,Percent of Total Billed Charges,664.55,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 2.7X15MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,United Healthcare,Default,Fee Schedule,919.1,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,788.44,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,Cigna,Default,Percent of Total Billed Charges,664.55,,,,664.55,919.1
R3CON LOCKING PLATE SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,1126.35,1013.72,United Healthcare,Default,Fee Schedule,919.1,,,,664.55,919.1
MTP PLATE 0 DEGREE LONG RIGHT,C1713,HCPCS,278,RC,,both,8072.21,7264.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5650.55,,,,4762.6,6586.92
MTP PLATE 0 DEGREE LONG RIGHT,C1713,HCPCS,278,RC,,both,8072.21,7264.99,Cigna,Default,Percent of Total Billed Charges,4762.6,,,,4762.6,6586.92
MTP PLATE 0 DEGREE LONG RIGHT,C1713,HCPCS,278,RC,,both,8072.21,7264.99,United Healthcare,Default,Fee Schedule,6586.92,,,,4762.6,6586.92
MTP SPIN GUARD FEMALE REAMER 19MM,C1713,HCPCS,278,RC,,both,2218.58,1996.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1553.01,,,,1308.96,1810.36
MTP SPIN GUARD FEMALE REAMER 19MM,C1713,HCPCS,278,RC,,both,2218.58,1996.72,Cigna,Default,Percent of Total Billed Charges,1308.96,,,,1308.96,1810.36
MTP SPIN GUARD FEMALE REAMER 19MM,C1713,HCPCS,278,RC,,both,2218.58,1996.72,United Healthcare,Default,Fee Schedule,1810.36,,,,1308.96,1810.36
MTP DISC 19X5MM,C1762,HCPCS,278,RC,,both,12543.51,11289.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8780.46,,,,7400.67,10235.5
MTP DISC 19X5MM,C1762,HCPCS,278,RC,,both,12543.51,11289.16,Cigna,Default,Percent of Total Billed Charges,7400.67,,,,7400.67,10235.5
MTP DISC 19X5MM,C1762,HCPCS,278,RC,,both,12543.51,11289.16,United Healthcare,Default,Fee Schedule,10235.5,,,,7400.67,10235.5
MESH XL 10X14,C1781,HCPCS,278,RC,,both,6126.69,5514.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4288.68,,,,3614.75,4999.38
MESH XL 10X14,C1781,HCPCS,278,RC,,both,6126.69,5514.02,Cigna,Default,Percent of Total Billed Charges,3614.75,,,,3614.75,4999.38
MESH XL 10X14,C1781,HCPCS,278,RC,,both,6126.69,5514.02,United Healthcare,Default,Fee Schedule,4999.38,,,,3614.75,4999.38
MESH XL 8X12,C1781,HCPCS,278,RC,,both,4693.15,4223.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3285.2,,,,2768.96,3829.61
MESH XL 8X12,C1781,HCPCS,278,RC,,both,4693.15,4223.84,Cigna,Default,Percent of Total Billed Charges,2768.96,,,,2768.96,3829.61
MESH XL 8X12,C1781,HCPCS,278,RC,,both,4693.15,4223.84,United Healthcare,Default,Fee Schedule,3829.61,,,,2768.96,3829.61
MESH OVAL 6X9IN,C1781,HCPCS,278,RC,,both,3020.69,2718.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2114.48,,,,1782.21,2464.88
MESH OVAL 6X9IN,C1781,HCPCS,278,RC,,both,3020.69,2718.62,Cigna,Default,Percent of Total Billed Charges,1782.21,,,,1782.21,2464.88
MESH OVAL 6X9IN,C1781,HCPCS,278,RC,,both,3020.69,2718.62,United Healthcare,Default,Fee Schedule,2464.88,,,,1782.21,2464.88
MESH RECTANGLE 4X6IN,C1781,HCPCS,278,RC,,both,1279.95,1151.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,895.96,,,,755.17,1044.44
MESH RECTANGLE 4X6IN,C1781,HCPCS,278,RC,,both,1279.95,1151.96,Cigna,Default,Percent of Total Billed Charges,755.17,,,,755.17,1044.44
MESH RECTANGLE 4X6IN,C1781,HCPCS,278,RC,,both,1279.95,1151.96,United Healthcare,Default,Fee Schedule,1044.44,,,,755.17,1044.44
MESH SQUARE 5X5IN,C1781,HCPCS,278,RC,,both,1416.48,1274.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,991.54,,,,835.72,1155.85
MESH SQUARE 5X5IN,C1781,HCPCS,278,RC,,both,1416.48,1274.83,Cigna,Default,Percent of Total Billed Charges,835.72,,,,835.72,1155.85
MESH SQUARE 5X5IN,C1781,HCPCS,278,RC,,both,1416.48,1274.83,United Healthcare,Default,Fee Schedule,1155.85,,,,835.72,1155.85
MESH HERNIA,C1781,HCPCS,278,RC,,both,4095.84,3686.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2867.09,,,,2416.55,3342.21
MESH HERNIA,C1781,HCPCS,278,RC,,both,4095.84,3686.26,Cigna,Default,Percent of Total Billed Charges,2416.55,,,,2416.55,3342.21
MESH HERNIA,C1781,HCPCS,278,RC,,both,4095.84,3686.26,United Healthcare,Default,Fee Schedule,3342.21,,,,2416.55,3342.21
MESH  HERNIA,C1781,HCPCS,278,RC,,both,2559.9,2303.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1791.93,,,,1510.34,2088.88
MESH  HERNIA,C1781,HCPCS,278,RC,,both,2559.9,2303.91,Cigna,Default,Percent of Total Billed Charges,1510.34,,,,1510.34,2088.88
MESH  HERNIA,C1781,HCPCS,278,RC,,both,2559.9,2303.91,United Healthcare,Default,Fee Schedule,2088.88,,,,1510.34,2088.88
MESH  HERNIA,C1781,HCPCS,278,RC,,both,1757.79,1582.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1230.45,,,,1037.1,1434.36
MESH  HERNIA,C1781,HCPCS,278,RC,,both,1757.79,1582.01,Cigna,Default,Percent of Total Billed Charges,1037.1,,,,1037.1,1434.36
MESH  HERNIA,C1781,HCPCS,278,RC,,both,1757.79,1582.01,United Healthcare,Default,Fee Schedule,1434.36,,,,1037.1,1434.36
MESH  HERNIA,C1781,HCPCS,278,RC,,both,1928.46,1735.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1349.92,,,,1137.79,1573.62
MESH  HERNIA,C1781,HCPCS,278,RC,,both,1928.46,1735.61,Cigna,Default,Percent of Total Billed Charges,1137.79,,,,1137.79,1573.62
MESH  HERNIA,C1781,HCPCS,278,RC,,both,1928.46,1735.61,United Healthcare,Default,Fee Schedule,1573.62,,,,1137.79,1573.62
MESH  HERNIA,C1781,HCPCS,278,RC,,both,2832.96,2549.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1983.07,,,,1671.45,2311.7
MESH  HERNIA,C1781,HCPCS,278,RC,,both,2832.96,2549.66,Cigna,Default,Percent of Total Billed Charges,1671.45,,,,1671.45,2311.7
MESH  HERNIA,C1781,HCPCS,278,RC,,both,2832.96,2549.66,United Healthcare,Default,Fee Schedule,2311.7,,,,1671.45,2311.7
MESH,C1781,HCPCS,278,RC,,both,2480.54,2232.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1736.38,,,,1463.52,2024.12
MESH,C1781,HCPCS,278,RC,,both,2480.54,2232.49,Cigna,Default,Percent of Total Billed Charges,1463.52,,,,1463.52,2024.12
MESH,C1781,HCPCS,278,RC,,both,2480.54,2232.49,United Healthcare,Default,Fee Schedule,2024.12,,,,1463.52,2024.12
"MESH VENTRALIGHT ST ECHO 4.5""",C1781,HCPCS,278,RC,,both,3988.32,3589.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2791.82,,,,2353.11,3254.47
"MESH VENTRALIGHT ST ECHO 4.5""",C1781,HCPCS,278,RC,,both,3988.32,3589.49,Cigna,Default,Percent of Total Billed Charges,2353.11,,,,2353.11,3254.47
"MESH VENTRALIGHT ST ECHO 4.5""",C1781,HCPCS,278,RC,,both,3988.32,3589.49,United Healthcare,Default,Fee Schedule,3254.47,,,,2353.11,3254.47
"MESH VENTRALIGHT ST WITH ECHO 6""",C1781,HCPCS,278,RC,,both,4758,4282.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3330.6,,,,2807.22,3882.53
"MESH VENTRALIGHT ST WITH ECHO 6""",C1781,HCPCS,278,RC,,both,4758,4282.2,Cigna,Default,Percent of Total Billed Charges,2807.22,,,,2807.22,3882.53
"MESH VENTRALIGHT ST WITH ECHO 6""",C1781,HCPCS,278,RC,,both,4758,4282.2,United Healthcare,Default,Fee Schedule,3882.53,,,,2807.22,3882.53
MESH VENTRALIGHT ST WITH ECHO 10x15CM,C1781,HCPCS,278,RC,,both,13925.85,12533.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9748.1,,,,8216.25,11363.49
MESH VENTRALIGHT ST WITH ECHO 10x15CM,C1781,HCPCS,278,RC,,both,13925.85,12533.27,Cigna,Default,Percent of Total Billed Charges,8216.25,,,,8216.25,11363.49
MESH VENTRALIGHT ST WITH ECHO 10x15CM,C1781,HCPCS,278,RC,,both,13925.85,12533.27,United Healthcare,Default,Fee Schedule,11363.49,,,,8216.25,11363.49
MESH VENTRALIGHT ST WITH ECHO 15CM CIRCL,C1781,HCPCS,278,RC,,both,2,1.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.4,,,,1.18,1.63
MESH VENTRALIGHT ST WITH ECHO 15CM CIRCL,C1781,HCPCS,278,RC,,both,2,1.8,Cigna,Default,Percent of Total Billed Charges,1.18,,,,1.18,1.63
MESH VENTRALIGHT ST WITH ECHO 15CM CIRCL,C1781,HCPCS,278,RC,,both,2,1.8,United Healthcare,Default,Fee Schedule,1.63,,,,1.18,1.63
MESH HERNIA C-QUR 25CM X 35 CM,C1781,HCPCS,278,RC,,both,5542.06,4987.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3879.44,,,,3269.82,4522.32
MESH HERNIA C-QUR 25CM X 35 CM,C1781,HCPCS,278,RC,,both,5542.06,4987.85,Cigna,Default,Percent of Total Billed Charges,3269.82,,,,3269.82,4522.32
MESH HERNIA C-QUR 25CM X 35 CM,C1781,HCPCS,278,RC,,both,5542.06,4987.85,United Healthcare,Default,Fee Schedule,4522.32,,,,3269.82,4522.32
MESH VENTRALIGHT ST WITH ECHO 10X13 EL,C1781,HCPCS,278,RC,,both,11937.15,10743.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8356,,,,7042.92,9740.71
MESH VENTRALIGHT ST WITH ECHO 10X13 EL,C1781,HCPCS,278,RC,,both,11937.15,10743.44,Cigna,Default,Percent of Total Billed Charges,7042.92,,,,7042.92,9740.71
MESH VENTRALIGHT ST WITH ECHO 10X13 EL,C1781,HCPCS,278,RC,,both,11937.15,10743.44,United Healthcare,Default,Fee Schedule,9740.71,,,,7042.92,9740.71
MESH VENTRALIGHT ST WITH ECHO 8X10 EL,C1781,HCPCS,278,RC,,both,5907.09,5316.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4134.96,,,,3485.18,4820.19
MESH VENTRALIGHT ST WITH ECHO 8X10 EL,C1781,HCPCS,278,RC,,both,5907.09,5316.38,Cigna,Default,Percent of Total Billed Charges,3485.18,,,,3485.18,4820.19
MESH VENTRALIGHT ST WITH ECHO 8X10 EL,C1781,HCPCS,278,RC,,both,5907.09,5316.38,United Healthcare,Default,Fee Schedule,4820.19,,,,3485.18,4820.19
MESH VENTRALIGHT ST WITH ECHO 20CM CIRCL,C1781,HCPCS,278,RC,,both,8167.78,7351,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5717.45,,,,4818.99,6664.91
MESH VENTRALIGHT ST WITH ECHO 20CM CIRCL,C1781,HCPCS,278,RC,,both,8167.78,7351,Cigna,Default,Percent of Total Billed Charges,4818.99,,,,4818.99,6664.91
MESH VENTRALIGHT ST WITH ECHO 20CM CIRCL,C1781,HCPCS,278,RC,,both,8167.78,7351,United Healthcare,Default,Fee Schedule,6664.91,,,,4818.99,6664.91
MESH VENTALIGHT PS 4.5,C1781,HCPCS,278,RC,,both,2158.74,1942.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1511.12,,,,1273.66,1761.53
MESH VENTALIGHT PS 4.5,C1781,HCPCS,278,RC,,both,2158.74,1942.87,Cigna,Default,Percent of Total Billed Charges,1273.66,,,,1273.66,1761.53
MESH VENTALIGHT PS 4.5,C1781,HCPCS,278,RC,,both,2158.74,1942.87,United Healthcare,Default,Fee Schedule,1761.53,,,,1273.66,1761.53
MESH SURGICAL PARTIALLY ABSORBABLE PATCH,C1781,HCPCS,278,RC,,both,4758,4282.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3330.6,,,,2807.22,3882.53
MESH SURGICAL PARTIALLY ABSORBABLE PATCH,C1781,HCPCS,278,RC,,both,4758,4282.2,Cigna,Default,Percent of Total Billed Charges,2807.22,,,,2807.22,3882.53
MESH SURGICAL PARTIALLY ABSORBABLE PATCH,C1781,HCPCS,278,RC,,both,4758,4282.2,United Healthcare,Default,Fee Schedule,3882.53,,,,2807.22,3882.53
MESH VENTRIO ST HERNIA PATCH 15.5CMX25.7,C1781,HCPCS,278,RC,,both,8711.51,7840.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6098.06,,,,5139.79,7108.59
MESH VENTRIO ST HERNIA PATCH 15.5CMX25.7,C1781,HCPCS,278,RC,,both,8711.51,7840.36,Cigna,Default,Percent of Total Billed Charges,5139.79,,,,5139.79,7108.59
MESH VENTRIO ST HERNIA PATCH 15.5CMX25.7,C1781,HCPCS,278,RC,,both,8711.51,7840.36,United Healthcare,Default,Fee Schedule,7108.59,,,,5139.79,7108.59
MESH VENTRALIGHT ST WITH ECHO 6X8,C1781,HCPCS,278,RC,,both,3788.08,3409.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2651.66,,,,2234.97,3091.07
MESH VENTRALIGHT ST WITH ECHO 6X8,C1781,HCPCS,278,RC,,both,3788.08,3409.27,Cigna,Default,Percent of Total Billed Charges,2234.97,,,,2234.97,3091.07
MESH VENTRALIGHT ST WITH ECHO 6X8,C1781,HCPCS,278,RC,,both,3788.08,3409.27,United Healthcare,Default,Fee Schedule,3091.07,,,,2234.97,3091.07
MESH VENTRIO ST HERNIA PATCH 3X3,C1781,HCPCS,278,RC,,both,2414.15,2172.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1689.9,,,,1424.35,1969.95
MESH VENTRIO ST HERNIA PATCH 3X3,C1781,HCPCS,278,RC,,both,2414.15,2172.74,Cigna,Default,Percent of Total Billed Charges,1424.35,,,,1424.35,1969.95
MESH VENTRIO ST HERNIA PATCH 3X3,C1781,HCPCS,278,RC,,both,2414.15,2172.74,United Healthcare,Default,Fee Schedule,1969.95,,,,1424.35,1969.95
XEMPLIFI DBM GEL 5 CC,C1713,HCPCS,278,RC,,both,3413.25,3071.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2389.28,,,,2013.82,2785.21
XEMPLIFI DBM GEL 5 CC,C1713,HCPCS,278,RC,,both,3413.25,3071.93,Cigna,Default,Percent of Total Billed Charges,2013.82,,,,2013.82,2785.21
XEMPLIFI DBM GEL 5 CC,C1713,HCPCS,278,RC,,both,3413.25,3071.93,United Healthcare,Default,Fee Schedule,2785.21,,,,2013.82,2785.21
PLATLET RICH PLASMA,278,RC,,,,both,2704.38,2433.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1893.07,,,,1595.58,2206.77
PLATLET RICH PLASMA,278,RC,,,,both,2704.38,2433.94,Cigna,Default,Percent of Total Billed Charges,1595.58,,,,1595.58,2206.77
PLATLET RICH PLASMA,278,RC,,,,both,2704.38,2433.94,United Healthcare,Default,Fee Schedule,2206.77,,,,1595.58,2206.77
SET SCREW,C1713,HCPCS,278,RC,,both,183.15,164.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.2,,,,108.06,149.45
SET SCREW,C1713,HCPCS,278,RC,,both,183.15,164.84,Cigna,Default,Percent of Total Billed Charges,108.06,,,,108.06,149.45
SET SCREW,C1713,HCPCS,278,RC,,both,183.15,164.84,United Healthcare,Default,Fee Schedule,149.45,,,,108.06,149.45
VOYAGER 7.5X45,278,RC,,,,both,4390.23,3951.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3073.16,,,,2590.24,3582.43
VOYAGER 7.5X45,278,RC,,,,both,4390.23,3951.21,Cigna,Default,Percent of Total Billed Charges,2590.24,,,,2590.24,3582.43
VOYAGER 7.5X45,278,RC,,,,both,4390.23,3951.21,United Healthcare,Default,Fee Schedule,3582.43,,,,2590.24,3582.43
ELEVATE 28X7,278,RC,,,,both,16156.03,14540.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11309.22,,,,9532.06,13183.32
ELEVATE 28X7,278,RC,,,,both,16156.03,14540.43,Cigna,Default,Percent of Total Billed Charges,9532.06,,,,9532.06,13183.32
ELEVATE 28X7,278,RC,,,,both,16156.03,14540.43,United Healthcare,Default,Fee Schedule,13183.32,,,,9532.06,13183.32
VOYAGER 6.5X45,278,RC,,,,both,4390.23,3951.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3073.16,,,,2590.24,3582.43
VOYAGER 6.5X45,278,RC,,,,both,4390.23,3951.21,Cigna,Default,Percent of Total Billed Charges,2590.24,,,,2590.24,3582.43
VOYAGER 6.5X45,278,RC,,,,both,4390.23,3951.21,United Healthcare,Default,Fee Schedule,3582.43,,,,2590.24,3582.43
VOYAGER ROD 45MM,C1776,HCPCS,278,RC,,both,949.05,854.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,664.34,,,,559.94,774.42
VOYAGER ROD 45MM,C1776,HCPCS,278,RC,,both,949.05,854.15,Cigna,Default,Percent of Total Billed Charges,559.94,,,,559.94,774.42
VOYAGER ROD 45MM,C1776,HCPCS,278,RC,,both,949.05,854.15,United Healthcare,Default,Fee Schedule,774.42,,,,559.94,774.42
NEEDLE TROCAR PAK,278,RC,,,,both,502.23,452.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,351.56,,,,296.32,409.82
NEEDLE TROCAR PAK,278,RC,,,,both,502.23,452.01,Cigna,Default,Percent of Total Billed Charges,296.32,,,,296.32,409.82
NEEDLE TROCAR PAK,278,RC,,,,both,502.23,452.01,United Healthcare,Default,Fee Schedule,409.82,,,,296.32,409.82
NEEDLE BEVELED PAK,278,RC,,,,both,502.23,452.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,351.56,,,,296.32,409.82
NEEDLE BEVELED PAK,278,RC,,,,both,502.23,452.01,Cigna,Default,Percent of Total Billed Charges,296.32,,,,296.32,409.82
NEEDLE BEVELED PAK,278,RC,,,,both,502.23,452.01,United Healthcare,Default,Fee Schedule,409.82,,,,296.32,409.82
BAYONEXES KNIFE,278,RC,,,,both,1372.38,1235.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,960.67,,,,809.7,1119.86
BAYONEXES KNIFE,278,RC,,,,both,1372.38,1235.14,Cigna,Default,Percent of Total Billed Charges,809.7,,,,809.7,1119.86
BAYONEXES KNIFE,278,RC,,,,both,1372.38,1235.14,United Healthcare,Default,Fee Schedule,1119.86,,,,809.7,1119.86
MESH HERNIA C-QUR 20CM X 30 CM,C1781,HCPCS,278,RC,,both,4245.31,3820.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2971.72,,,,2504.73,3464.17
MESH HERNIA C-QUR 20CM X 30 CM,C1781,HCPCS,278,RC,,both,4245.31,3820.78,Cigna,Default,Percent of Total Billed Charges,2504.73,,,,2504.73,3464.17
MESH HERNIA C-QUR 20CM X 30 CM,C1781,HCPCS,278,RC,,both,4245.31,3820.78,United Healthcare,Default,Fee Schedule,3464.17,,,,2504.73,3464.17
GUIDE WIRE,272,RC,,,,both,166.5,149.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.55,,,,98.24,135.86
GUIDE WIRE,272,RC,,,,both,166.5,149.85,Cigna,Default,Percent of Total Billed Charges,98.24,,,,98.24,135.86
GUIDE WIRE,272,RC,,,,both,166.5,149.85,United Healthcare,Default,Fee Schedule,135.86,,,,98.24,135.86
ELEVATE 9X28MM,278,RC,,,,both,16156.03,14540.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11309.22,,,,9532.06,13183.32
ELEVATE 9X28MM,278,RC,,,,both,16156.03,14540.43,Cigna,Default,Percent of Total Billed Charges,9532.06,,,,9532.06,13183.32
ELEVATE 9X28MM,278,RC,,,,both,16156.03,14540.43,United Healthcare,Default,Fee Schedule,13183.32,,,,9532.06,13183.32
40MM ECLIF PLATE,278,RC,,,,both,3775.65,3398.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2642.96,,,,2227.63,3080.93
40MM ECLIF PLATE,278,RC,,,,both,3775.65,3398.09,Cigna,Default,Percent of Total Billed Charges,2227.63,,,,2227.63,3080.93
40MM ECLIF PLATE,278,RC,,,,both,3775.65,3398.09,United Healthcare,Default,Fee Schedule,3080.93,,,,2227.63,3080.93
VOYAGER 7.5X50,278,RC,,,,both,4390.23,3951.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3073.16,,,,2590.24,3582.43
VOYAGER 7.5X50,278,RC,,,,both,4390.23,3951.21,Cigna,Default,Percent of Total Billed Charges,2590.24,,,,2590.24,3582.43
VOYAGER 7.5X50,278,RC,,,,both,4390.23,3951.21,United Healthcare,Default,Fee Schedule,3582.43,,,,2590.24,3582.43
MESH HERNIA C-QUR 10CM X 15CM,C1781,HCPCS,278,RC,,both,1157.81,1042.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,810.47,,,,683.11,944.77
MESH HERNIA C-QUR 10CM X 15CM,C1781,HCPCS,278,RC,,both,1157.81,1042.03,Cigna,Default,Percent of Total Billed Charges,683.11,,,,683.11,944.77
MESH HERNIA C-QUR 10CM X 15CM,C1781,HCPCS,278,RC,,both,1157.81,1042.03,United Healthcare,Default,Fee Schedule,944.77,,,,683.11,944.77
PERC ROD 30MM,278,RC,,,,both,2546.33,2291.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1782.43,,,,1502.33,2077.81
PERC ROD 30MM,278,RC,,,,both,2546.33,2291.7,Cigna,Default,Percent of Total Billed Charges,1502.33,,,,1502.33,2077.81
PERC ROD 30MM,278,RC,,,,both,2546.33,2291.7,United Healthcare,Default,Fee Schedule,2077.81,,,,1502.33,2077.81
4.0X14MM FIXED SCREW,278,RC,,,,both,1324.99,1192.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,927.49,,,,781.74,1081.19
4.0X14MM FIXED SCREW,278,RC,,,,both,1324.99,1192.49,Cigna,Default,Percent of Total Billed Charges,781.74,,,,781.74,1081.19
4.0X14MM FIXED SCREW,278,RC,,,,both,1324.99,1192.49,United Healthcare,Default,Fee Schedule,1081.19,,,,781.74,1081.19
4.0X14MM VARIABLE SCREW,278,RC,,,,both,1324.99,1192.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,927.49,,,,781.74,1081.19
4.0X14MM VARIABLE SCREW,278,RC,,,,both,1324.99,1192.49,Cigna,Default,Percent of Total Billed Charges,781.74,,,,781.74,1081.19
4.0X14MM VARIABLE SCREW,278,RC,,,,both,1324.99,1192.49,United Healthcare,Default,Fee Schedule,1081.19,,,,781.74,1081.19
10X14X11 CORNERSTONE PSR,278,RC,,,,both,3161.02,2844.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2212.71,,,,1865,2579.39
10X14X11 CORNERSTONE PSR,278,RC,,,,both,3161.02,2844.92,Cigna,Default,Percent of Total Billed Charges,1865,,,,1865,2579.39
10X14X11 CORNERSTONE PSR,278,RC,,,,both,3161.02,2844.92,United Healthcare,Default,Fee Schedule,2579.39,,,,1865,2579.39
OPTEFORM 5CC,278,RC,,,,both,5812.67,5231.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4068.87,,,,3429.48,4743.14
OPTEFORM 5CC,278,RC,,,,both,5812.67,5231.4,Cigna,Default,Percent of Total Billed Charges,3429.48,,,,3429.48,4743.14
OPTEFORM 5CC,278,RC,,,,both,5812.67,5231.4,United Healthcare,Default,Fee Schedule,4743.14,,,,3429.48,4743.14
OPTEFORM  10CC,278,RC,,,,both,9711.18,8740.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6797.83,,,,5729.6,7924.32
OPTEFORM  10CC,278,RC,,,,both,9711.18,8740.06,Cigna,Default,Percent of Total Billed Charges,5729.6,,,,5729.6,7924.32
OPTEFORM  10CC,278,RC,,,,both,9711.18,8740.06,United Healthcare,Default,Fee Schedule,7924.32,,,,5729.6,7924.32
6X14X11 CORNERSTONE PSR,C1889,HCPCS,278,RC,,both,3071.93,2764.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2150.35,,,,1812.44,2506.69
6X14X11 CORNERSTONE PSR,C1889,HCPCS,278,RC,,both,3071.93,2764.74,Cigna,Default,Percent of Total Billed Charges,1812.44,,,,1812.44,2506.69
6X14X11 CORNERSTONE PSR,C1889,HCPCS,278,RC,,both,3071.93,2764.74,United Healthcare,Default,Fee Schedule,2506.69,,,,1812.44,2506.69
XEMPLIFI DBM PUTTY 10 CC,278,RC,,,,both,6146.41,5531.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4302.49,,,,3626.38,5015.47
XEMPLIFI DBM PUTTY 10 CC,278,RC,,,,both,6146.41,5531.77,Cigna,Default,Percent of Total Billed Charges,3626.38,,,,3626.38,5015.47
XEMPLIFI DBM PUTTY 10 CC,278,RC,,,,both,6146.41,5531.77,United Healthcare,Default,Fee Schedule,5015.47,,,,3626.38,5015.47
RISE SPACER 8X22MM 7-13MM,278,RC,,,,both,20801.21,18721.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14560.85,,,,12272.71,16973.79
RISE SPACER 8X22MM 7-13MM,278,RC,,,,both,20801.21,18721.09,Cigna,Default,Percent of Total Billed Charges,12272.71,,,,12272.71,16973.79
RISE SPACER 8X22MM 7-13MM,278,RC,,,,both,20801.21,18721.09,United Healthcare,Default,Fee Schedule,16973.79,,,,12272.71,16973.79
SHEATH INTRODUCER 6F,278,RC,,,,both,203.25,182.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.28,,,,119.92,165.85
SHEATH INTRODUCER 6F,278,RC,,,,both,203.25,182.93,Cigna,Default,Percent of Total Billed Charges,119.92,,,,119.92,165.85
SHEATH INTRODUCER 6F,278,RC,,,,both,203.25,182.93,United Healthcare,Default,Fee Schedule,165.85,,,,119.92,165.85
CREO AMP 6.5X40MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1433.56,,,,1208.29,1671.13
CREO AMP 6.5X40MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Cigna,Default,Percent of Total Billed Charges,1208.29,,,,1208.29,1671.13
CREO AMP 6.5X40MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,United Healthcare,Default,Fee Schedule,1671.13,,,,1208.29,1671.13
CREO AMP 6.5X45MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1433.56,,,,1208.29,1671.13
CREO AMP 6.5X45MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Cigna,Default,Percent of Total Billed Charges,1208.29,,,,1208.29,1671.13
CREO AMP 6.5X45MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,United Healthcare,Default,Fee Schedule,1671.13,,,,1208.29,1671.13
CREO MIS LOCKING CAP,C1776,HCPCS,278,RC,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
CREO MIS LOCKING CAP,C1776,HCPCS,278,RC,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
CREO MIS LOCKING CAP,C1776,HCPCS,278,RC,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
CREO MIS MODULAR POLYAXIAL TULIP 10MM RE,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1433.56,,,,1208.29,1671.13
CREO MIS MODULAR POLYAXIAL TULIP 10MM RE,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Cigna,Default,Percent of Total Billed Charges,1208.29,,,,1208.29,1671.13
CREO MIS MODULAR POLYAXIAL TULIP 10MM RE,C1713,HCPCS,278,RC,,both,2047.95,1843.16,United Healthcare,Default,Fee Schedule,1671.13,,,,1208.29,1671.13
ANCHOR 5.5MM BONE,C1713,HCPCS,278,RC,,both,1348.21,1213.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,943.75,,,,795.44,1100.14
ANCHOR 5.5MM BONE,C1713,HCPCS,278,RC,,both,1348.21,1213.39,Cigna,Default,Percent of Total Billed Charges,795.44,,,,795.44,1100.14
ANCHOR 5.5MM BONE,C1713,HCPCS,278,RC,,both,1348.21,1213.39,United Healthcare,Default,Fee Schedule,1100.14,,,,795.44,1100.14
DRILL 4.5 MM,272,RC,,,,both,878.05,790.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,614.64,,,,518.05,716.49
DRILL 4.5 MM,272,RC,,,,both,878.05,790.25,Cigna,Default,Percent of Total Billed Charges,518.05,,,,518.05,716.49
DRILL 4.5 MM,272,RC,,,,both,878.05,790.25,United Healthcare,Default,Fee Schedule,716.49,,,,518.05,716.49
DRILL 3.5 MM,272,RC,,,,both,878.05,790.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,614.64,,,,518.05,716.49
DRILL 3.5 MM,272,RC,,,,both,878.05,790.25,Cigna,Default,Percent of Total Billed Charges,518.05,,,,518.05,716.49
DRILL 3.5 MM,272,RC,,,,both,878.05,790.25,United Healthcare,Default,Fee Schedule,716.49,,,,518.05,716.49
CREO MIS 5.5MM CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1317.09,1185.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,921.96,,,,777.08,1074.75
CREO MIS 5.5MM CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1317.09,1185.38,Cigna,Default,Percent of Total Billed Charges,777.08,,,,777.08,1074.75
CREO MIS 5.5MM CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1317.09,1185.38,United Healthcare,Default,Fee Schedule,1074.75,,,,777.08,1074.75
"CREO MIS 5.5MM CURVED ROD, TITANIUM ALLO",C1713,HCPCS,278,RC,,both,1248.75,1123.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,874.12,,,,736.76,1018.98
"CREO MIS 5.5MM CURVED ROD, TITANIUM ALLO",C1713,HCPCS,278,RC,,both,1248.75,1123.88,Cigna,Default,Percent of Total Billed Charges,736.76,,,,736.76,1018.98
"CREO MIS 5.5MM CURVED ROD, TITANIUM ALLO",C1713,HCPCS,278,RC,,both,1248.75,1123.88,United Healthcare,Default,Fee Schedule,1018.98,,,,736.76,1018.98
1.6MM K-WIRE 500MM BLUNT TIP,272,RC,,,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
1.6MM K-WIRE 500MM BLUNT TIP,272,RC,,,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
1.6MM K-WIRE 500MM BLUNT TIP,272,RC,,,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
"1.6MM NITINOL K-WIRE, 500MM, BLUNT TIP",L8699,HCPCS,272,RC,,both,511.99,460.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,358.39,,,,302.07,417.78
"1.6MM NITINOL K-WIRE, 500MM, BLUNT TIP",L8699,HCPCS,272,RC,,both,511.99,460.79,Cigna,Default,Percent of Total Billed Charges,302.07,,,,302.07,417.78
"1.6MM NITINOL K-WIRE, 500MM, BLUNT TIP",L8699,HCPCS,272,RC,,both,511.99,460.79,United Healthcare,Default,Fee Schedule,417.78,,,,302.07,417.78
"RISE SPACER, 10X26MM, 8-15MM, 10DEGREE",278,RC,,,,both,20801.21,18721.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14560.85,,,,12272.71,16973.79
"RISE SPACER, 10X26MM, 8-15MM, 10DEGREE",278,RC,,,,both,20801.21,18721.09,Cigna,Default,Percent of Total Billed Charges,12272.71,,,,12272.71,16973.79
"RISE SPACER, 10X26MM, 8-15MM, 10DEGREE",278,RC,,,,both,20801.21,18721.09,United Healthcare,Default,Fee Schedule,16973.79,,,,12272.71,16973.79
XEMPLIFI DBM GEL 1CC,C1713,HCPCS,278,RC,,both,853.31,767.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,597.32,,,,503.45,696.3
XEMPLIFI DBM GEL 1CC,C1713,HCPCS,278,RC,,both,853.31,767.98,Cigna,Default,Percent of Total Billed Charges,503.45,,,,503.45,696.3
XEMPLIFI DBM GEL 1CC,C1713,HCPCS,278,RC,,both,853.31,767.98,United Healthcare,Default,Fee Schedule,696.3,,,,503.45,696.3
XTEND ANTERIOR CERVICAL PLATE 1-LEVEL 12,L8699,HCPCS,278,RC,,both,3413.25,3071.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2389.28,,,,2013.82,2785.21
XTEND ANTERIOR CERVICAL PLATE 1-LEVEL 12,L8699,HCPCS,278,RC,,both,3413.25,3071.93,Cigna,Default,Percent of Total Billed Charges,2013.82,,,,2013.82,2785.21
XTEND ANTERIOR CERVICAL PLATE 1-LEVEL 12,L8699,HCPCS,278,RC,,both,3413.25,3071.93,United Healthcare,Default,Fee Schedule,2785.21,,,,2013.82,2785.21
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1064.91,958.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,745.44,,,,628.3,868.97
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1064.91,958.42,Cigna,Default,Percent of Total Billed Charges,628.3,,,,628.3,868.97
SCREW LAG VHS W/COMP SCREW,C1713,HCPCS,278,RC,,both,1064.91,958.42,United Healthcare,Default,Fee Schedule,868.97,,,,628.3,868.97
"SCREW FEMORAL INTERF. 8MMX20MM,3.5MM",C1713,HCPCS,278,RC,,both,341.32,307.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.92,,,,201.38,278.52
"SCREW FEMORAL INTERF. 8MMX20MM,3.5MM",C1713,HCPCS,278,RC,,both,341.32,307.19,Cigna,Default,Percent of Total Billed Charges,201.38,,,,201.38,278.52
"SCREW FEMORAL INTERF. 8MMX20MM,3.5MM",C1713,HCPCS,278,RC,,both,341.32,307.19,United Healthcare,Default,Fee Schedule,278.52,,,,201.38,278.52
"SCREW FEMORAL INTERF. 9MMX25MM,3.5MM",C1713,HCPCS,278,RC,,both,341.32,307.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.92,,,,201.38,278.52
"SCREW FEMORAL INTERF. 9MMX25MM,3.5MM",C1713,HCPCS,278,RC,,both,341.32,307.19,Cigna,Default,Percent of Total Billed Charges,201.38,,,,201.38,278.52
"SCREW FEMORAL INTERF. 9MMX25MM,3.5MM",C1713,HCPCS,278,RC,,both,341.32,307.19,United Healthcare,Default,Fee Schedule,278.52,,,,201.38,278.52
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.18,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,Cigna,Default,Percent of Total Billed Charges,466.25,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,United Healthcare,Default,Fee Schedule,644.84,,,,466.25,644.84
XTEND ANTERIOR CERVICAL PLATE 2-LEVEL 26,L8699,HCPCS,278,RC,,both,3413.25,3071.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2389.28,,,,2013.82,2785.21
XTEND ANTERIOR CERVICAL PLATE 2-LEVEL 26,L8699,HCPCS,278,RC,,both,3413.25,3071.93,Cigna,Default,Percent of Total Billed Charges,2013.82,,,,2013.82,2785.21
XTEND ANTERIOR CERVICAL PLATE 2-LEVEL 26,L8699,HCPCS,278,RC,,both,3413.25,3071.93,United Healthcare,Default,Fee Schedule,2785.21,,,,2013.82,2785.21
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.18,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,Cigna,Default,Percent of Total Billed Charges,466.25,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,United Healthcare,Default,Fee Schedule,644.84,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.18,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,Cigna,Default,Percent of Total Billed Charges,466.25,,,,466.25,644.84
"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",278,RC,,,,both,790.25,711.23,United Healthcare,Default,Fee Schedule,644.84,,,,466.25,644.84
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM,C1713,HCPCS,278,RC,,both,1959.21,1763.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1371.45,,,,1155.93,1598.72
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM,C1713,HCPCS,278,RC,,both,1959.21,1763.29,Cigna,Default,Percent of Total Billed Charges,1155.93,,,,1155.93,1598.72
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM,C1713,HCPCS,278,RC,,both,1959.21,1763.29,United Healthcare,Default,Fee Schedule,1598.72,,,,1155.93,1598.72
SCREW CANNULATED COMPRESSION S.S 12MM,C1713,HCPCS,278,RC,,both,1262.14,1135.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,883.5,,,,744.66,1029.91
SCREW CANNULATED COMPRESSION S.S 12MM,C1713,HCPCS,278,RC,,both,1262.14,1135.93,Cigna,Default,Percent of Total Billed Charges,744.66,,,,744.66,1029.91
SCREW CANNULATED COMPRESSION S.S 12MM,C1713,HCPCS,278,RC,,both,1262.14,1135.93,United Healthcare,Default,Fee Schedule,1029.91,,,,744.66,1029.91
K-WIRE SINGLE TROCAR POINT,C1713,HCPCS,278,RC,,both,179.82,161.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.87,,,,106.09,146.73
K-WIRE SINGLE TROCAR POINT,C1713,HCPCS,278,RC,,both,179.82,161.84,Cigna,Default,Percent of Total Billed Charges,106.09,,,,106.09,146.73
K-WIRE SINGLE TROCAR POINT,C1713,HCPCS,278,RC,,both,179.82,161.84,United Healthcare,Default,Fee Schedule,146.73,,,,106.09,146.73
SCREW 2.7MM  13MM,C1713,HCPCS,278,RC,,both,239.76,215.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,167.83,,,,141.46,195.64
SCREW 2.7MM  13MM,C1713,HCPCS,278,RC,,both,239.76,215.78,Cigna,Default,Percent of Total Billed Charges,141.46,,,,141.46,195.64
SCREW 2.7MM  13MM,C1713,HCPCS,278,RC,,both,239.76,215.78,United Healthcare,Default,Fee Schedule,195.64,,,,141.46,195.64
PLATE VARI-ANGLE 4 HOLE,C1713,HCPCS,278,RC,,both,1440.37,1296.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1008.26,,,,849.82,1175.34
PLATE VARI-ANGLE 4 HOLE,C1713,HCPCS,278,RC,,both,1440.37,1296.33,Cigna,Default,Percent of Total Billed Charges,849.82,,,,849.82,1175.34
PLATE VARI-ANGLE 4 HOLE,C1713,HCPCS,278,RC,,both,1440.37,1296.33,United Healthcare,Default,Fee Schedule,1175.34,,,,849.82,1175.34
SCREW LAG W/COMP 12.7MM X 70MM,C1713,HCPCS,278,RC,,both,596,536.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,417.2,,,,351.64,486.34
SCREW LAG W/COMP 12.7MM X 70MM,C1713,HCPCS,278,RC,,both,596,536.4,Cigna,Default,Percent of Total Billed Charges,351.64,,,,351.64,486.34
SCREW LAG W/COMP 12.7MM X 70MM,C1713,HCPCS,278,RC,,both,596,536.4,United Healthcare,Default,Fee Schedule,486.34,,,,351.64,486.34
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,113.47,102.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.43,,,,66.95,92.59
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,113.47,102.12,Cigna,Default,Percent of Total Billed Charges,66.95,,,,66.95,92.59
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,113.47,102.12,United Healthcare,Default,Fee Schedule,92.59,,,,66.95,92.59
TIBIAL INSERT SIZE 4 15MM,278,RC,,,,both,7270.21,6543.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5089.15,,,,4289.42,5932.49
TIBIAL INSERT SIZE 4 15MM,278,RC,,,,both,7270.21,6543.19,Cigna,Default,Percent of Total Billed Charges,4289.42,,,,4289.42,5932.49
TIBIAL INSERT SIZE 4 15MM,278,RC,,,,both,7270.21,6543.19,United Healthcare,Default,Fee Schedule,5932.49,,,,4289.42,5932.49
"PIN THREADED TIP GD 2.5MM X 9""",C1713,HCPCS,278,RC,,both,174.14,156.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.9,,,,102.74,142.1
"PIN THREADED TIP GD 2.5MM X 9""",C1713,HCPCS,278,RC,,both,174.14,156.73,Cigna,Default,Percent of Total Billed Charges,102.74,,,,102.74,142.1
"PIN THREADED TIP GD 2.5MM X 9""",C1713,HCPCS,278,RC,,both,174.14,156.73,United Healthcare,Default,Fee Schedule,142.1,,,,102.74,142.1
PLATE KEYLESS 4 HOLE,C1713,HCPCS,278,RC,,both,1621.27,1459.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1134.89,,,,956.55,1322.96
PLATE KEYLESS 4 HOLE,C1713,HCPCS,278,RC,,both,1621.27,1459.14,Cigna,Default,Percent of Total Billed Charges,956.55,,,,956.55,1322.96
PLATE KEYLESS 4 HOLE,C1713,HCPCS,278,RC,,both,1621.27,1459.14,United Healthcare,Default,Fee Schedule,1322.96,,,,956.55,1322.96
SCREW LAG W/COMP,C1713,HCPCS,278,RC,,both,959.11,863.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,671.38,,,,565.87,782.63
SCREW LAG W/COMP,C1713,HCPCS,278,RC,,both,959.11,863.2,Cigna,Default,Percent of Total Billed Charges,565.87,,,,565.87,782.63
SCREW LAG W/COMP,C1713,HCPCS,278,RC,,both,959.11,863.2,United Healthcare,Default,Fee Schedule,782.63,,,,565.87,782.63
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,113.47,102.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.43,,,,66.95,92.59
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,113.47,102.12,Cigna,Default,Percent of Total Billed Charges,66.95,,,,66.95,92.59
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,113.47,102.12,United Healthcare,Default,Fee Schedule,92.59,,,,66.95,92.59
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,134.48,121.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.14,,,,79.34,109.74
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,134.48,121.03,Cigna,Default,Percent of Total Billed Charges,79.34,,,,79.34,109.74
SCREW CORTIAL SCREW 4.5SS,C1713,HCPCS,278,RC,,both,134.48,121.03,United Healthcare,Default,Fee Schedule,109.74,,,,79.34,109.74
PLATE 4 HOLE 8 HOLE HEAD,C1713,HCPCS,278,RC,,both,2867.09,2580.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2006.96,,,,1691.58,2339.55
PLATE 4 HOLE 8 HOLE HEAD,C1713,HCPCS,278,RC,,both,2867.09,2580.38,Cigna,Default,Percent of Total Billed Charges,1691.58,,,,1691.58,2339.55
PLATE 4 HOLE 8 HOLE HEAD,C1713,HCPCS,278,RC,,both,2867.09,2580.38,United Healthcare,Default,Fee Schedule,2339.55,,,,1691.58,2339.55
PLATE 5 HOLE,C1713,HCPCS,278,RC,,both,2952.42,2657.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2066.69,,,,1741.93,2409.17
PLATE 5 HOLE,C1713,HCPCS,278,RC,,both,2952.42,2657.18,Cigna,Default,Percent of Total Billed Charges,1741.93,,,,1741.93,2409.17
PLATE 5 HOLE,C1713,HCPCS,278,RC,,both,2952.42,2657.18,United Healthcare,Default,Fee Schedule,2409.17,,,,1741.93,2409.17
PLATE 3 HOLE 3.5 LCP,C1713,HCPCS,278,RC,,both,5000.34,4500.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3500.24,,,,2950.2,4080.28
PLATE 3 HOLE 3.5 LCP,C1713,HCPCS,278,RC,,both,5000.34,4500.31,Cigna,Default,Percent of Total Billed Charges,2950.2,,,,2950.2,4080.28
PLATE 3 HOLE 3.5 LCP,C1713,HCPCS,278,RC,,both,5000.34,4500.31,United Healthcare,Default,Fee Schedule,4080.28,,,,2950.2,4080.28
PLATE 6 HOLE VHS VARI-ANGLE,C1713,HCPCS,278,RC,,both,1621.27,1459.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1134.89,,,,956.55,1322.96
PLATE 6 HOLE VHS VARI-ANGLE,C1713,HCPCS,278,RC,,both,1621.27,1459.14,Cigna,Default,Percent of Total Billed Charges,956.55,,,,956.55,1322.96
PLATE 6 HOLE VHS VARI-ANGLE,C1713,HCPCS,278,RC,,both,1621.27,1459.14,United Healthcare,Default,Fee Schedule,1322.96,,,,956.55,1322.96
PLATE 4 HOLE VHS VARI-ANGLE,C1713,HCPCS,278,RC,,both,1911.39,1720.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1337.97,,,,1127.72,1559.69
PLATE 4 HOLE VHS VARI-ANGLE,C1713,HCPCS,278,RC,,both,1911.39,1720.25,Cigna,Default,Percent of Total Billed Charges,1127.72,,,,1127.72,1559.69
PLATE 4 HOLE VHS VARI-ANGLE,C1713,HCPCS,278,RC,,both,1911.39,1720.25,United Healthcare,Default,Fee Schedule,1559.69,,,,1127.72,1559.69
PLATE 7 HOLE 3.5 LCP,C1713,HCPCS,278,RC,,both,648.51,583.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,453.96,,,,382.62,529.18
PLATE 7 HOLE 3.5 LCP,C1713,HCPCS,278,RC,,both,648.51,583.66,Cigna,Default,Percent of Total Billed Charges,382.62,,,,382.62,529.18
PLATE 7 HOLE 3.5 LCP,C1713,HCPCS,278,RC,,both,648.51,583.66,United Healthcare,Default,Fee Schedule,529.18,,,,382.62,529.18
PLATE 2 HOLE 56MM,C1713,HCPCS,278,RC,,both,1911.39,1720.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1337.97,,,,1127.72,1559.69
PLATE 2 HOLE 56MM,C1713,HCPCS,278,RC,,both,1911.39,1720.25,Cigna,Default,Percent of Total Billed Charges,1127.72,,,,1127.72,1559.69
PLATE 2 HOLE 56MM,C1713,HCPCS,278,RC,,both,1911.39,1720.25,United Healthcare,Default,Fee Schedule,1559.69,,,,1127.72,1559.69
TIBIAL INSERT,278,RC,,,,both,7551.18,6796.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5285.83,,,,4455.2,6161.76
TIBIAL INSERT,278,RC,,,,both,7551.18,6796.06,Cigna,Default,Percent of Total Billed Charges,4455.2,,,,4455.2,6161.76
TIBIAL INSERT,278,RC,,,,both,7551.18,6796.06,United Healthcare,Default,Fee Schedule,6161.76,,,,4455.2,6161.76
TIBIAL INSERT,278,RC,,,,both,4908.28,4417.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3435.8,,,,2895.89,4005.16
TIBIAL INSERT,278,RC,,,,both,4908.28,4417.45,Cigna,Default,Percent of Total Billed Charges,2895.89,,,,2895.89,4005.16
TIBIAL INSERT,278,RC,,,,both,4908.28,4417.45,United Healthcare,Default,Fee Schedule,4005.16,,,,2895.89,4005.16
TIBIAL INSERT,278,RC,,,,both,7621.43,6859.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5335,,,,4496.64,6219.09
TIBIAL INSERT,278,RC,,,,both,7621.43,6859.29,Cigna,Default,Percent of Total Billed Charges,4496.64,,,,4496.64,6219.09
TIBIAL INSERT,278,RC,,,,both,7621.43,6859.29,United Healthcare,Default,Fee Schedule,6219.09,,,,4496.64,6219.09
"PLATE STANDARD TUBE135MM DIA.,4 HOLE",278,RC,,,,both,1521.3,1369.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1064.91,,,,897.57,1241.38
"PLATE STANDARD TUBE135MM DIA.,4 HOLE",278,RC,,,,both,1521.3,1369.17,Cigna,Default,Percent of Total Billed Charges,897.57,,,,897.57,1241.38
"PLATE STANDARD TUBE135MM DIA.,4 HOLE",278,RC,,,,both,1521.3,1369.17,United Healthcare,Default,Fee Schedule,1241.38,,,,897.57,1241.38
SCREW- 44MM,C1713,HCPCS,278,RC,,both,90.73,81.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.51,,,,53.53,74.04
SCREW- 44MM,C1713,HCPCS,278,RC,,both,90.73,81.66,Cigna,Default,Percent of Total Billed Charges,53.53,,,,53.53,74.04
SCREW- 44MM,C1713,HCPCS,278,RC,,both,90.73,81.66,United Healthcare,Default,Fee Schedule,74.04,,,,53.53,74.04
SCREW - 46MM,278,RC,,,,both,90.73,81.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.51,,,,53.53,74.04
SCREW - 46MM,278,RC,,,,both,90.73,81.66,Cigna,Default,Percent of Total Billed Charges,53.53,,,,53.53,74.04
SCREW - 46MM,278,RC,,,,both,90.73,81.66,United Healthcare,Default,Fee Schedule,74.04,,,,53.53,74.04
SCREW - 90MM,278,RC,,,,both,965.12,868.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,675.58,,,,569.42,787.54
SCREW - 90MM,278,RC,,,,both,965.12,868.61,Cigna,Default,Percent of Total Billed Charges,569.42,,,,569.42,787.54
SCREW - 90MM,278,RC,,,,both,965.12,868.61,United Healthcare,Default,Fee Schedule,787.54,,,,569.42,787.54
"SCREW COMPRESSION 1""",278,RC,,,,both,206.18,185.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.33,,,,121.65,168.24
"SCREW COMPRESSION 1""",278,RC,,,,both,206.18,185.56,Cigna,Default,Percent of Total Billed Charges,121.65,,,,121.65,168.24
"SCREW COMPRESSION 1""",278,RC,,,,both,206.18,185.56,United Healthcare,Default,Fee Schedule,168.24,,,,121.65,168.24
SCREW 2.2MM  14MM,C1713,HCPCS,278,RC,,both,432.28,389.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.6,,,,255.05,352.74
SCREW 2.2MM  14MM,C1713,HCPCS,278,RC,,both,432.28,389.05,Cigna,Default,Percent of Total Billed Charges,255.05,,,,255.05,352.74
SCREW 2.2MM  14MM,C1713,HCPCS,278,RC,,both,432.28,389.05,United Healthcare,Default,Fee Schedule,352.74,,,,255.05,352.74
SCREW LOCKING 2.7MM 13MM,C1713,HCPCS,278,RC,,both,411.19,370.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.83,,,,242.6,335.53
SCREW LOCKING 2.7MM 13MM,C1713,HCPCS,278,RC,,both,411.19,370.07,Cigna,Default,Percent of Total Billed Charges,242.6,,,,242.6,335.53
SCREW LOCKING 2.7MM 13MM,C1713,HCPCS,278,RC,,both,411.19,370.07,United Healthcare,Default,Fee Schedule,335.53,,,,242.6,335.53
SCREW LOCKING 2.7MM 15MM,C1713,HCPCS,278,RC,,both,411.19,370.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.83,,,,242.6,335.53
SCREW LOCKING 2.7MM 15MM,C1713,HCPCS,278,RC,,both,411.19,370.07,Cigna,Default,Percent of Total Billed Charges,242.6,,,,242.6,335.53
SCREW LOCKING 2.7MM 15MM,C1713,HCPCS,278,RC,,both,411.19,370.07,United Healthcare,Default,Fee Schedule,335.53,,,,242.6,335.53
"3.5MM ULS ONE-THIRD TUBULAR PLT 8H, 107M",C1713,HCPCS,278,RC,,both,620.18,558.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,434.13,,,,365.91,506.07
"3.5MM ULS ONE-THIRD TUBULAR PLT 8H, 107M",C1713,HCPCS,278,RC,,both,620.18,558.16,Cigna,Default,Percent of Total Billed Charges,365.91,,,,365.91,506.07
"3.5MM ULS ONE-THIRD TUBULAR PLT 8H, 107M",C1713,HCPCS,278,RC,,both,620.18,558.16,United Healthcare,Default,Fee Schedule,506.07,,,,365.91,506.07
"3.5MM ULS ONE-THIRD TUBULAR PLT 10H, 133",C1713,HCPCS,278,RC,,both,632.8,569.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.96,,,,373.35,516.36
"3.5MM ULS ONE-THIRD TUBULAR PLT 10H, 133",C1713,HCPCS,278,RC,,both,632.8,569.52,Cigna,Default,Percent of Total Billed Charges,373.35,,,,373.35,516.36
"3.5MM ULS ONE-THIRD TUBULAR PLT 10H, 133",C1713,HCPCS,278,RC,,both,632.8,569.52,United Healthcare,Default,Fee Schedule,516.36,,,,373.35,516.36
PLATE 10MM 46MM RIB,278,RC,,,,both,3143.41,2829.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2200.39,,,,1854.61,2565.02
PLATE 10MM 46MM RIB,278,RC,,,,both,3143.41,2829.07,Cigna,Default,Percent of Total Billed Charges,1854.61,,,,1854.61,2565.02
PLATE 10MM 46MM RIB,278,RC,,,,both,3143.41,2829.07,United Healthcare,Default,Fee Schedule,2565.02,,,,1854.61,2565.02
SCREW RIB 10MM,272,RC,,,,both,333.66,300.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.56,,,,196.86,272.27
SCREW RIB 10MM,272,RC,,,,both,333.66,300.29,Cigna,Default,Percent of Total Billed Charges,196.86,,,,196.86,272.27
SCREW RIB 10MM,272,RC,,,,both,333.66,300.29,United Healthcare,Default,Fee Schedule,272.27,,,,196.86,272.27
DRILL BIT 2.2MM,272,RC,,,,both,312.79,281.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,218.95,,,,184.55,255.24
DRILL BIT 2.2MM,272,RC,,,,both,312.79,281.51,Cigna,Default,Percent of Total Billed Charges,184.55,,,,184.55,255.24
DRILL BIT 2.2MM,272,RC,,,,both,312.79,281.51,United Healthcare,Default,Fee Schedule,255.24,,,,184.55,255.24
***SCREW 2.4 LOCKING 2.7MM 20MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,258.97,,,,218.28,301.89
***SCREW 2.4 LOCKING 2.7MM 20MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Cigna,Default,Percent of Total Billed Charges,218.28,,,,218.28,301.89
***SCREW 2.4 LOCKING 2.7MM 20MM,C1713,HCPCS,278,RC,,both,369.96,332.96,United Healthcare,Default,Fee Schedule,301.89,,,,218.28,301.89
SCREW 2.4 LOCKING 2.7MM  18MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,258.97,,,,218.28,301.89
SCREW 2.4 LOCKING 2.7MM  18MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Cigna,Default,Percent of Total Billed Charges,218.28,,,,218.28,301.89
SCREW 2.4 LOCKING 2.7MM  18MM,C1713,HCPCS,278,RC,,both,369.96,332.96,United Healthcare,Default,Fee Schedule,301.89,,,,218.28,301.89
SCREW 2.4 LOCKING 2.7MM   16MM,C1713,HCPCS,278,RC,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SCREW 2.4 LOCKING 2.7MM   16MM,C1713,HCPCS,278,RC,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SCREW 2.4 LOCKING 2.7MM   16MM,C1713,HCPCS,278,RC,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
SCREW 2.4 LOCKING 2.7MM 12MM,C1713,HCPCS,278,RC,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SCREW 2.4 LOCKING 2.7MM 12MM,C1713,HCPCS,278,RC,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SCREW 2.4 LOCKING 2.7MM 12MM,C1713,HCPCS,278,RC,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
SCREW 2.7MM  16MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.39,,,,130.97,181.14
SCREW 2.7MM  16MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Cigna,Default,Percent of Total Billed Charges,130.97,,,,130.97,181.14
SCREW 2.7MM  16MM,C1713,HCPCS,278,RC,,both,221.98,199.78,United Healthcare,Default,Fee Schedule,181.14,,,,130.97,181.14
SCREW 2.7MM  14MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.39,,,,130.97,181.14
SCREW 2.7MM  14MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Cigna,Default,Percent of Total Billed Charges,130.97,,,,130.97,181.14
SCREW 2.7MM  14MM,C1713,HCPCS,278,RC,,both,221.98,199.78,United Healthcare,Default,Fee Schedule,181.14,,,,130.97,181.14
SCREW 2.7MM  12MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.39,,,,130.97,181.14
SCREW 2.7MM  12MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Cigna,Default,Percent of Total Billed Charges,130.97,,,,130.97,181.14
SCREW 2.7MM  12MM,C1713,HCPCS,278,RC,,both,221.98,199.78,United Healthcare,Default,Fee Schedule,181.14,,,,130.97,181.14
TOPAZ MICRO DEDRIDER,272,RC,,,,both,1274.92,1147.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,892.44,,,,752.2,1040.33
TOPAZ MICRO DEDRIDER,272,RC,,,,both,1274.92,1147.43,Cigna,Default,Percent of Total Billed Charges,752.2,,,,752.2,1040.33
TOPAZ MICRO DEDRIDER,272,RC,,,,both,1274.92,1147.43,United Healthcare,Default,Fee Schedule,1040.33,,,,752.2,1040.33
DVR CROSSLOCK PLATE LEFT,C1713,HCPCS,278,RC,,both,2977.02,2679.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2083.91,,,,1756.44,2429.25
DVR CROSSLOCK PLATE LEFT,C1713,HCPCS,278,RC,,both,2977.02,2679.32,Cigna,Default,Percent of Total Billed Charges,1756.44,,,,1756.44,2429.25
DVR CROSSLOCK PLATE LEFT,C1713,HCPCS,278,RC,,both,2977.02,2679.32,United Healthcare,Default,Fee Schedule,2429.25,,,,1756.44,2429.25
LP NON LOCK 2.7MM X 10MM,C1713,HCPCS,278,RC,,both,217.6,195.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.32,,,,128.38,177.56
LP NON LOCK 2.7MM X 10MM,C1713,HCPCS,278,RC,,both,217.6,195.84,Cigna,Default,Percent of Total Billed Charges,128.38,,,,128.38,177.56
LP NON LOCK 2.7MM X 10MM,C1713,HCPCS,278,RC,,both,217.6,195.84,United Healthcare,Default,Fee Schedule,177.56,,,,128.38,177.56
DVR CROSSLOCK PLATE RIGHT,C1713,HCPCS,278,RC,,both,2977.02,2679.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2083.91,,,,1756.44,2429.25
DVR CROSSLOCK PLATE RIGHT,C1713,HCPCS,278,RC,,both,2977.02,2679.32,Cigna,Default,Percent of Total Billed Charges,1756.44,,,,1756.44,2429.25
DVR CROSSLOCK PLATE RIGHT,C1713,HCPCS,278,RC,,both,2977.02,2679.32,United Healthcare,Default,Fee Schedule,2429.25,,,,1756.44,2429.25
DNU PATELLA,278,RC,,,,both,2507.7,2256.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1755.39,,,,1479.54,2046.28
DNU PATELLA,278,RC,,,,both,2507.7,2256.93,Cigna,Default,Percent of Total Billed Charges,1479.54,,,,1479.54,2046.28
DNU PATELLA,278,RC,,,,both,2507.7,2256.93,United Healthcare,Default,Fee Schedule,2046.28,,,,1479.54,2046.28
TIBIAL INSERT,278,RC,,,,both,7621.43,6859.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5335,,,,4496.64,6219.09
TIBIAL INSERT,278,RC,,,,both,7621.43,6859.29,Cigna,Default,Percent of Total Billed Charges,4496.64,,,,4496.64,6219.09
TIBIAL INSERT,278,RC,,,,both,7621.43,6859.29,United Healthcare,Default,Fee Schedule,6219.09,,,,4496.64,6219.09
STEM FLUTED EXTENSION,278,RC,,,,both,4225.68,3803.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2957.98,,,,2493.15,3448.15
STEM FLUTED EXTENSION,278,RC,,,,both,4225.68,3803.11,Cigna,Default,Percent of Total Billed Charges,2493.15,,,,2493.15,3448.15
STEM FLUTED EXTENSION,278,RC,,,,both,4225.68,3803.11,United Healthcare,Default,Fee Schedule,3448.15,,,,2493.15,3448.15
TIBIAL AUG. BLK,278,RC,,,,both,5566.81,5010.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3896.77,,,,3284.42,4542.52
TIBIAL AUG. BLK,278,RC,,,,both,5566.81,5010.13,Cigna,Default,Percent of Total Billed Charges,3284.42,,,,3284.42,4542.52
TIBIAL AUG. BLK,278,RC,,,,both,5566.81,5010.13,United Healthcare,Default,Fee Schedule,4542.52,,,,3284.42,4542.52
TIBIAL INSERT CR SLOPE,278,RC,,,,both,5275.83,4748.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3693.08,,,,3112.74,4305.08
TIBIAL INSERT CR SLOPE,278,RC,,,,both,5275.83,4748.25,Cigna,Default,Percent of Total Billed Charges,3112.74,,,,3112.74,4305.08
TIBIAL INSERT CR SLOPE,278,RC,,,,both,5275.83,4748.25,United Healthcare,Default,Fee Schedule,4305.08,,,,3112.74,4305.08
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7919.98,7127.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5543.99,,,,4672.79,6462.7
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7919.98,7127.98,Cigna,Default,Percent of Total Billed Charges,4672.79,,,,4672.79,6462.7
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7919.98,7127.98,United Healthcare,Default,Fee Schedule,6462.7,,,,4672.79,6462.7
ACETABULAR CUP,278,RC,,,,both,20503.5,18453.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14352.45,,,,12097.06,16730.86
ACETABULAR CUP,278,RC,,,,both,20503.5,18453.15,Cigna,Default,Percent of Total Billed Charges,12097.06,,,,12097.06,16730.86
ACETABULAR CUP,278,RC,,,,both,20503.5,18453.15,United Healthcare,Default,Fee Schedule,16730.86,,,,12097.06,16730.86
SUMMIT STEW SIZE 2 HI-OFF SET,278,RC,,,,both,21776.36,19598.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15243.45,,,,12848.05,17769.51
SUMMIT STEW SIZE 2 HI-OFF SET,278,RC,,,,both,21776.36,19598.72,Cigna,Default,Percent of Total Billed Charges,12848.05,,,,12848.05,17769.51
SUMMIT STEW SIZE 2 HI-OFF SET,278,RC,,,,both,21776.36,19598.72,United Healthcare,Default,Fee Schedule,17769.51,,,,12848.05,17769.51
SLEEVE ADAPTOR T2,272,RC,,,,both,1422.44,1280.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,995.71,,,,839.24,1160.71
SLEEVE ADAPTOR T2,272,RC,,,,both,1422.44,1280.2,Cigna,Default,Percent of Total Billed Charges,839.24,,,,839.24,1160.71
SLEEVE ADAPTOR T2,272,RC,,,,both,1422.44,1280.2,United Healthcare,Default,Fee Schedule,1160.71,,,,839.24,1160.71
STEM EXTENSION,278,RC,,,,both,6251.68,5626.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4376.18,,,,3688.49,5101.37
STEM EXTENSION,278,RC,,,,both,6251.68,5626.51,Cigna,Default,Percent of Total Billed Charges,3688.49,,,,3688.49,5101.37
STEM EXTENSION,278,RC,,,,both,6251.68,5626.51,United Healthcare,Default,Fee Schedule,5101.37,,,,3688.49,5101.37
DRILL BIT QUICK RELEASE,272,RC,,,,both,730.54,657.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,511.38,,,,431.02,596.12
DRILL BIT QUICK RELEASE,272,RC,,,,both,730.54,657.49,Cigna,Default,Percent of Total Billed Charges,431.02,,,,431.02,596.12
DRILL BIT QUICK RELEASE,272,RC,,,,both,730.54,657.49,United Healthcare,Default,Fee Schedule,596.12,,,,431.02,596.12
TIBIAL INSERT CR SLOPE,278,RC,,,,both,4869.99,4382.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3408.99,,,,2873.29,3973.91
TIBIAL INSERT CR SLOPE,278,RC,,,,both,4869.99,4382.99,Cigna,Default,Percent of Total Billed Charges,2873.29,,,,2873.29,3973.91
TIBIAL INSERT CR SLOPE,278,RC,,,,both,4869.99,4382.99,United Healthcare,Default,Fee Schedule,3973.91,,,,2873.29,3973.91
LP NON LOCK 2.7MMX 18MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.39,,,,130.97,181.14
LP NON LOCK 2.7MMX 18MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Cigna,Default,Percent of Total Billed Charges,130.97,,,,130.97,181.14
LP NON LOCK 2.7MMX 18MM,C1713,HCPCS,278,RC,,both,221.98,199.78,United Healthcare,Default,Fee Schedule,181.14,,,,130.97,181.14
SCREW LOCKING 2.7MM 14MM,C1713,HCPCS,278,RC,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SCREW LOCKING 2.7MM 14MM,C1713,HCPCS,278,RC,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SCREW LOCKING 2.7MM 14MM,C1713,HCPCS,278,RC,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
DVR LOCK NARROW MINI L,C1713,HCPCS,278,RC,,both,2987.64,2688.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2091.35,,,,1762.71,2437.91
DVR LOCK NARROW MINI L,C1713,HCPCS,278,RC,,both,2987.64,2688.88,Cigna,Default,Percent of Total Billed Charges,1762.71,,,,1762.71,2437.91
DVR LOCK NARROW MINI L,C1713,HCPCS,278,RC,,both,2987.64,2688.88,United Healthcare,Default,Fee Schedule,2437.91,,,,1762.71,2437.91
LOCK SCREW SQUARE 2.7MMX14MM,C1713,HCPCS,278,RC,,both,432.28,389.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.6,,,,255.05,352.74
LOCK SCREW SQUARE 2.7MMX14MM,C1713,HCPCS,278,RC,,both,432.28,389.05,Cigna,Default,Percent of Total Billed Charges,255.05,,,,255.05,352.74
LOCK SCREW SQUARE 2.7MMX14MM,C1713,HCPCS,278,RC,,both,432.28,389.05,United Healthcare,Default,Fee Schedule,352.74,,,,255.05,352.74
FEMORAL UNI INPLANT,278,RC,,,,both,8014.94,7213.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5610.46,,,,4728.81,6540.19
FEMORAL UNI INPLANT,278,RC,,,,both,8014.94,7213.45,Cigna,Default,Percent of Total Billed Charges,4728.81,,,,4728.81,6540.19
FEMORAL UNI INPLANT,278,RC,,,,both,8014.94,7213.45,United Healthcare,Default,Fee Schedule,6540.19,,,,4728.81,6540.19
DVR LOCK NARROW L,C1713,HCPCS,278,RC,,both,3664.23,3297.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2564.96,,,,2161.9,2990.01
DVR LOCK NARROW L,C1713,HCPCS,278,RC,,both,3664.23,3297.81,Cigna,Default,Percent of Total Billed Charges,2161.9,,,,2161.9,2990.01
DVR LOCK NARROW L,C1713,HCPCS,278,RC,,both,3664.23,3297.81,United Healthcare,Default,Fee Schedule,2990.01,,,,2161.9,2990.01
SCREW LOCKING 2.7MM 8MM,C1713,HCPCS,278,RC,,both,432.28,389.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.6,,,,255.05,352.74
SCREW LOCKING 2.7MM 8MM,C1713,HCPCS,278,RC,,both,432.28,389.05,Cigna,Default,Percent of Total Billed Charges,255.05,,,,255.05,352.74
SCREW LOCKING 2.7MM 8MM,C1713,HCPCS,278,RC,,both,432.28,389.05,United Healthcare,Default,Fee Schedule,352.74,,,,255.05,352.74
GUIDE WIRE .91MMX80MM SS,C1769,HCPCS,278,RC,,both,197.52,177.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,138.26,,,,116.54,161.18
GUIDE WIRE .91MMX80MM SS,C1769,HCPCS,278,RC,,both,197.52,177.77,Cigna,Default,Percent of Total Billed Charges,116.54,,,,116.54,161.18
GUIDE WIRE .91MMX80MM SS,C1769,HCPCS,278,RC,,both,197.52,177.77,United Healthcare,Default,Fee Schedule,161.18,,,,116.54,161.18
CREO AMP 6.5X35MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1433.56,,,,1208.29,1671.13
CREO AMP 6.5X35MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,Cigna,Default,Percent of Total Billed Charges,1208.29,,,,1208.29,1671.13
CREO AMP 6.5X35MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2047.95,1843.16,United Healthcare,Default,Fee Schedule,1671.13,,,,1208.29,1671.13
ADAPTOR TAPER SLEEVE,278,RC,,,,both,1422.44,1280.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,995.71,,,,839.24,1160.71
ADAPTOR TAPER SLEEVE,278,RC,,,,both,1422.44,1280.2,Cigna,Default,Percent of Total Billed Charges,839.24,,,,839.24,1160.71
ADAPTOR TAPER SLEEVE,278,RC,,,,both,1422.44,1280.2,United Healthcare,Default,Fee Schedule,1160.71,,,,839.24,1160.71
PUTTY 1CC,278,RC,,,,both,709.47,638.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,496.63,,,,418.59,578.93
PUTTY 1CC,278,RC,,,,both,709.47,638.52,Cigna,Default,Percent of Total Billed Charges,418.59,,,,418.59,578.93
PUTTY 1CC,278,RC,,,,both,709.47,638.52,United Healthcare,Default,Fee Schedule,578.93,,,,418.59,578.93
15MM 4.0 VARIABLE SCREW/MEDTRONIC,C1713,HCPCS,278,RC,,both,1287.65,1158.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,901.36,,,,759.71,1050.72
15MM 4.0 VARIABLE SCREW/MEDTRONIC,C1713,HCPCS,278,RC,,both,1287.65,1158.89,Cigna,Default,Percent of Total Billed Charges,759.71,,,,759.71,1050.72
15MM 4.0 VARIABLE SCREW/MEDTRONIC,C1713,HCPCS,278,RC,,both,1287.65,1158.89,United Healthcare,Default,Fee Schedule,1050.72,,,,759.71,1050.72
PLATE 35MM 21LV ATLANTIS,278,RC,,,,both,3775.65,3398.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2642.96,,,,2227.63,3080.93
PLATE 35MM 21LV ATLANTIS,278,RC,,,,both,3775.65,3398.09,Cigna,Default,Percent of Total Billed Charges,2227.63,,,,2227.63,3080.93
PLATE 35MM 21LV ATLANTIS,278,RC,,,,both,3775.65,3398.09,United Healthcare,Default,Fee Schedule,3080.93,,,,2227.63,3080.93
TICRON 2 BLUE 30 T-56/HGS-21,272,RC,,,,both,34.91,31.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.44,,,,20.6,28.49
TICRON 2 BLUE 30 T-56/HGS-21,272,RC,,,,both,34.91,31.42,Cigna,Default,Percent of Total Billed Charges,20.6,,,,20.6,28.49
TICRON 2 BLUE 30 T-56/HGS-21,272,RC,,,,both,34.91,31.42,United Healthcare,Default,Fee Schedule,28.49,,,,20.6,28.49
HIP STEM TAPERED W/POROCOAT,278,RC,,,,both,21776.36,19598.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15243.45,,,,12848.05,17769.51
HIP STEM TAPERED W/POROCOAT,278,RC,,,,both,21776.36,19598.72,Cigna,Default,Percent of Total Billed Charges,12848.05,,,,12848.05,17769.51
HIP STEM TAPERED W/POROCOAT,278,RC,,,,both,21776.36,19598.72,United Healthcare,Default,Fee Schedule,17769.51,,,,12848.05,17769.51
CREO MIS 5.5X50mm CURVED ROD TITANIUM AL,C1713,HCPCS,278,RC,,both,1248.75,1123.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,874.12,,,,736.76,1018.98
CREO MIS 5.5X50mm CURVED ROD TITANIUM AL,C1713,HCPCS,278,RC,,both,1248.75,1123.88,Cigna,Default,Percent of Total Billed Charges,736.76,,,,736.76,1018.98
CREO MIS 5.5X50mm CURVED ROD TITANIUM AL,C1713,HCPCS,278,RC,,both,1248.75,1123.88,United Healthcare,Default,Fee Schedule,1018.98,,,,736.76,1018.98
5X14X11 CORNERSTONE PSR,C1713,HCPCS,278,RC,,both,2630.7,2367.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1841.49,,,,1552.11,2146.65
5X14X11 CORNERSTONE PSR,C1713,HCPCS,278,RC,,both,2630.7,2367.63,Cigna,Default,Percent of Total Billed Charges,1552.11,,,,1552.11,2146.65
5X14X11 CORNERSTONE PSR,C1713,HCPCS,278,RC,,both,2630.7,2367.63,United Healthcare,Default,Fee Schedule,2146.65,,,,1552.11,2146.65
PLATE 19MM,C1713,HCPCS,278,RC,,both,3424.43,3081.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2397.1,,,,2020.41,2794.33
PLATE 19MM,C1713,HCPCS,278,RC,,both,3424.43,3081.99,Cigna,Default,Percent of Total Billed Charges,2020.41,,,,2020.41,2794.33
PLATE 19MM,C1713,HCPCS,278,RC,,both,3424.43,3081.99,United Healthcare,Default,Fee Schedule,2794.33,,,,2020.41,2794.33
4X15MM SCREW,C1713,HCPCS,278,RC,,both,1324.99,1192.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,927.49,,,,781.74,1081.19
4X15MM SCREW,C1713,HCPCS,278,RC,,both,1324.99,1192.49,Cigna,Default,Percent of Total Billed Charges,781.74,,,,781.74,1081.19
4X15MM SCREW,C1713,HCPCS,278,RC,,both,1324.99,1192.49,United Healthcare,Default,Fee Schedule,1081.19,,,,781.74,1081.19
TISSUE SPINAL GRAFT,C1762,HCPCS,278,RC,,both,709.47,638.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,496.63,,,,418.59,578.93
TISSUE SPINAL GRAFT,C1762,HCPCS,278,RC,,both,709.47,638.52,Cigna,Default,Percent of Total Billed Charges,418.59,,,,418.59,578.93
TISSUE SPINAL GRAFT,C1762,HCPCS,278,RC,,both,709.47,638.52,United Healthcare,Default,Fee Schedule,578.93,,,,418.59,578.93
"RISE SPACER, 10X26MM, 7-14MM",C1889,HCPCS,278,RC,,both,20214.98,18193.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14150.49,,,,11926.84,16495.42
"RISE SPACER, 10X26MM, 7-14MM",C1889,HCPCS,278,RC,,both,20214.98,18193.48,Cigna,Default,Percent of Total Billed Charges,11926.84,,,,11926.84,16495.42
"RISE SPACER, 10X26MM, 7-14MM",C1889,HCPCS,278,RC,,both,20214.98,18193.48,United Healthcare,Default,Fee Schedule,16495.42,,,,11926.84,16495.42
RISE SPACER 10X30MM 8-15MM 10 DEGREE,C1889,HCPCS,278,RC,,both,20214.98,18193.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14150.49,,,,11926.84,16495.42
RISE SPACER 10X30MM 8-15MM 10 DEGREE,C1889,HCPCS,278,RC,,both,20214.98,18193.48,Cigna,Default,Percent of Total Billed Charges,11926.84,,,,11926.84,16495.42
RISE SPACER 10X30MM 8-15MM 10 DEGREE,C1889,HCPCS,278,RC,,both,20214.98,18193.48,United Healthcare,Default,Fee Schedule,16495.42,,,,11926.84,16495.42
OVERTUBEGUARDUS 8.6-10.0 25CM,272,RC,,,,both,668.18,601.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.73,,,,394.23,545.23
OVERTUBEGUARDUS 8.6-10.0 25CM,272,RC,,,,both,668.18,601.36,Cigna,Default,Percent of Total Billed Charges,394.23,,,,394.23,545.23
OVERTUBEGUARDUS 8.6-10.0 25CM,272,RC,,,,both,668.18,601.36,United Healthcare,Default,Fee Schedule,545.23,,,,394.23,545.23
GRAFTON 3CC,C1713,HCPCS,278,RC,,both,2477.52,2229.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1734.26,,,,1461.74,2021.66
GRAFTON 3CC,C1713,HCPCS,278,RC,,both,2477.52,2229.77,Cigna,Default,Percent of Total Billed Charges,1461.74,,,,1461.74,2021.66
GRAFTON 3CC,C1713,HCPCS,278,RC,,both,2477.52,2229.77,United Healthcare,Default,Fee Schedule,2021.66,,,,1461.74,2021.66
TIP SUCTION ORTHO,272,RC,,,,both,103.78,93.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.65,,,,61.23,84.68
TIP SUCTION ORTHO,272,RC,,,,both,103.78,93.4,Cigna,Default,Percent of Total Billed Charges,61.23,,,,61.23,84.68
TIP SUCTION ORTHO,272,RC,,,,both,103.78,93.4,United Healthcare,Default,Fee Schedule,84.68,,,,61.23,84.68
PERI SCREW  3.55X14MM,C1713,HCPCS,278,RC,,both,162.09,145.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.46,,,,95.63,132.27
PERI SCREW  3.55X14MM,C1713,HCPCS,278,RC,,both,162.09,145.88,Cigna,Default,Percent of Total Billed Charges,95.63,,,,95.63,132.27
PERI SCREW  3.55X14MM,C1713,HCPCS,278,RC,,both,162.09,145.88,United Healthcare,Default,Fee Schedule,132.27,,,,95.63,132.27
3.5 MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,663.52,597.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,464.46,,,,391.48,541.43
3.5 MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,663.52,597.17,Cigna,Default,Percent of Total Billed Charges,391.48,,,,391.48,541.43
3.5 MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,663.52,597.17,United Healthcare,Default,Fee Schedule,541.43,,,,391.48,541.43
PERI SCREW 3.5X MM X 26 W/ 2.7 MM,C1713,HCPCS,278,RC,,both,162.09,145.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.46,,,,95.63,132.27
PERI SCREW 3.5X MM X 26 W/ 2.7 MM,C1713,HCPCS,278,RC,,both,162.09,145.88,Cigna,Default,Percent of Total Billed Charges,95.63,,,,95.63,132.27
PERI SCREW 3.5X MM X 26 W/ 2.7 MM,C1713,HCPCS,278,RC,,both,162.09,145.88,United Healthcare,Default,Fee Schedule,132.27,,,,95.63,132.27
DISTAL LATERAL FIBULA LOCKING PLATE,C1713,HCPCS,278,RC,,both,2366.71,2130.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1656.7,,,,1396.36,1931.24
DISTAL LATERAL FIBULA LOCKING PLATE,C1713,HCPCS,278,RC,,both,2366.71,2130.04,Cigna,Default,Percent of Total Billed Charges,1396.36,,,,1396.36,1931.24
DISTAL LATERAL FIBULA LOCKING PLATE,C1713,HCPCS,278,RC,,both,2366.71,2130.04,United Healthcare,Default,Fee Schedule,1931.24,,,,1396.36,1931.24
2.7MM CORTICAL SCREW 16MM,C1713,HCPCS,278,RC,,both,97.33,87.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.13,,,,57.42,79.42
2.7MM CORTICAL SCREW 16MM,C1713,HCPCS,278,RC,,both,97.33,87.6,Cigna,Default,Percent of Total Billed Charges,57.42,,,,57.42,79.42
2.7MM CORTICAL SCREW 16MM,C1713,HCPCS,278,RC,,both,97.33,87.6,United Healthcare,Default,Fee Schedule,79.42,,,,57.42,79.42
2.7MM CORTICAL SCREW 18MM,C1713,HCPCS,278,RC,,both,97.33,87.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.13,,,,57.42,79.42
2.7MM CORTICAL SCREW 18MM,C1713,HCPCS,278,RC,,both,97.33,87.6,Cigna,Default,Percent of Total Billed Charges,57.42,,,,57.42,79.42
2.7MM CORTICAL SCREW 18MM,C1713,HCPCS,278,RC,,both,97.33,87.6,United Healthcare,Default,Fee Schedule,79.42,,,,57.42,79.42
DISTAL LATERAL FIBULA LOCKING PLATE 4H 8,C1713,HCPCS,278,RC,,both,2308.99,2078.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1616.29,,,,1362.3,1884.14
DISTAL LATERAL FIBULA LOCKING PLATE 4H 8,C1713,HCPCS,278,RC,,both,2308.99,2078.09,Cigna,Default,Percent of Total Billed Charges,1362.3,,,,1362.3,1884.14
DISTAL LATERAL FIBULA LOCKING PLATE 4H 8,C1713,HCPCS,278,RC,,both,2308.99,2078.09,United Healthcare,Default,Fee Schedule,1884.14,,,,1362.3,1884.14
SCREW FORTE CANCELLOUS 4.0MMX10MM FULL T,272,RC,,,,both,239.62,215.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,167.73,,,,141.38,195.53
SCREW FORTE CANCELLOUS 4.0MMX10MM FULL T,272,RC,,,,both,239.62,215.66,Cigna,Default,Percent of Total Billed Charges,141.38,,,,141.38,195.53
SCREW FORTE CANCELLOUS 4.0MMX10MM FULL T,272,RC,,,,both,239.62,215.66,United Healthcare,Default,Fee Schedule,195.53,,,,141.38,195.53
SCREW 3.5 CORTEX 14MM,C1713,HCPCS,278,RC,,both,111.37,100.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.96,,,,65.71,90.88
SCREW 3.5 CORTEX 14MM,C1713,HCPCS,278,RC,,both,111.37,100.23,Cigna,Default,Percent of Total Billed Charges,65.71,,,,65.71,90.88
SCREW 3.5 CORTEX 14MM,C1713,HCPCS,278,RC,,both,111.37,100.23,United Healthcare,Default,Fee Schedule,90.88,,,,65.71,90.88
SCREW 3.5 CORTEX 16MM,C1713,HCPCS,278,RC,,both,108.65,97.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.06,,,,64.1,88.66
SCREW 3.5 CORTEX 16MM,C1713,HCPCS,278,RC,,both,108.65,97.79,Cigna,Default,Percent of Total Billed Charges,64.1,,,,64.1,88.66
SCREW 3.5 CORTEX 16MM,C1713,HCPCS,278,RC,,both,108.65,97.79,United Healthcare,Default,Fee Schedule,88.66,,,,64.1,88.66
SCREW 3.5 CORTEX 18MM,C1713,HCPCS,278,RC,,both,111.37,100.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.96,,,,65.71,90.88
SCREW 3.5 CORTEX 18MM,C1713,HCPCS,278,RC,,both,111.37,100.23,Cigna,Default,Percent of Total Billed Charges,65.71,,,,65.71,90.88
SCREW 3.5 CORTEX 18MM,C1713,HCPCS,278,RC,,both,111.37,100.23,United Healthcare,Default,Fee Schedule,90.88,,,,65.71,90.88
SCREW EXT. STEM,C1713,HCPCS,278,RC,,both,238.1,214.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.67,,,,140.48,194.29
SCREW EXT. STEM,C1713,HCPCS,278,RC,,both,238.1,214.29,Cigna,Default,Percent of Total Billed Charges,140.48,,,,140.48,194.29
SCREW EXT. STEM,C1713,HCPCS,278,RC,,both,238.1,214.29,United Healthcare,Default,Fee Schedule,194.29,,,,140.48,194.29
2.7MM STANDARD DRILL,272,RC,,,,both,481.87,433.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,337.31,,,,284.3,393.21
2.7MM STANDARD DRILL,272,RC,,,,both,481.87,433.68,Cigna,Default,Percent of Total Billed Charges,284.3,,,,284.3,393.21
2.7MM STANDARD DRILL,272,RC,,,,both,481.87,433.68,United Healthcare,Default,Fee Schedule,393.21,,,,284.3,393.21
TAO Q-C FOR 3.5MM SCREWS 110MM,C1713,HCPCS,278,RC,,both,321.04,288.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,224.73,,,,189.41,261.97
TAO Q-C FOR 3.5MM SCREWS 110MM,C1713,HCPCS,278,RC,,both,321.04,288.94,Cigna,Default,Percent of Total Billed Charges,189.41,,,,189.41,261.97
TAO Q-C FOR 3.5MM SCREWS 110MM,C1713,HCPCS,278,RC,,both,321.04,288.94,United Healthcare,Default,Fee Schedule,261.97,,,,189.41,261.97
SCREW FORTE CANCELLOUS 4.0MMX14MM FULL T,C1713,HCPCS,278,RC,,both,227.19,204.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.03,,,,134.04,185.39
SCREW FORTE CANCELLOUS 4.0MMX14MM FULL T,C1713,HCPCS,278,RC,,both,227.19,204.47,Cigna,Default,Percent of Total Billed Charges,134.04,,,,134.04,185.39
SCREW FORTE CANCELLOUS 4.0MMX14MM FULL T,C1713,HCPCS,278,RC,,both,227.19,204.47,United Healthcare,Default,Fee Schedule,185.39,,,,134.04,185.39
DISTAL LATERAL FIBULA LOCKING PLATE 6H 1,C1713,HCPCS,278,RC,,both,2469.52,2222.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1728.66,,,,1457.02,2015.13
DISTAL LATERAL FIBULA LOCKING PLATE 6H 1,C1713,HCPCS,278,RC,,both,2469.52,2222.57,Cigna,Default,Percent of Total Billed Charges,1457.02,,,,1457.02,2015.13
DISTAL LATERAL FIBULA LOCKING PLATE 6H 1,C1713,HCPCS,278,RC,,both,2469.52,2222.57,United Healthcare,Default,Fee Schedule,2015.13,,,,1457.02,2015.13
CREO AMP 6.5X50MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,1998,1798.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1398.6,,,,1178.82,1630.37
CREO AMP 6.5X50MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,1998,1798.2,Cigna,Default,Percent of Total Billed Charges,1178.82,,,,1178.82,1630.37
CREO AMP 6.5X50MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,1998,1798.2,United Healthcare,Default,Fee Schedule,1630.37,,,,1178.82,1630.37
SCREW FORTE CANCELLOUS 4.0MMX16MM FULL T,C1713,HCPCS,278,RC,,both,227.19,204.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.03,,,,134.04,185.39
SCREW FORTE CANCELLOUS 4.0MMX16MM FULL T,C1713,HCPCS,278,RC,,both,227.19,204.47,Cigna,Default,Percent of Total Billed Charges,134.04,,,,134.04,185.39
SCREW FORTE CANCELLOUS 4.0MMX16MM FULL T,C1713,HCPCS,278,RC,,both,227.19,204.47,United Healthcare,Default,Fee Schedule,185.39,,,,134.04,185.39
TRAY TIBIAL TRAPEZOID,278,RC,,,,both,13030.19,11727.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9121.13,,,,7687.81,10632.64
TRAY TIBIAL TRAPEZOID,278,RC,,,,both,13030.19,11727.17,Cigna,Default,Percent of Total Billed Charges,7687.81,,,,7687.81,10632.64
TRAY TIBIAL TRAPEZOID,278,RC,,,,both,13030.19,11727.17,United Healthcare,Default,Fee Schedule,10632.64,,,,7687.81,10632.64
TRAY TIBIAL TRAPEZOID,272,RC,,,,both,9033.51,8130.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6323.46,,,,5329.77,7371.34
TRAY TIBIAL TRAPEZOID,272,RC,,,,both,9033.51,8130.16,Cigna,Default,Percent of Total Billed Charges,5329.77,,,,5329.77,7371.34
TRAY TIBIAL TRAPEZOID,272,RC,,,,both,9033.51,8130.16,United Healthcare,Default,Fee Schedule,7371.34,,,,5329.77,7371.34
TRAY TIBIAL TRAP,272,RC,,,,both,9033.51,8130.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6323.46,,,,5329.77,7371.34
TRAY TIBIAL TRAP,272,RC,,,,both,9033.51,8130.16,Cigna,Default,Percent of Total Billed Charges,5329.77,,,,5329.77,7371.34
TRAY TIBIAL TRAP,272,RC,,,,both,9033.51,8130.16,United Healthcare,Default,Fee Schedule,7371.34,,,,5329.77,7371.34
TIBIAL INSERT,278,RC,,,,both,6919,6227.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4843.3,,,,4082.21,5645.9
TIBIAL INSERT,278,RC,,,,both,6919,6227.1,Cigna,Default,Percent of Total Billed Charges,4082.21,,,,4082.21,5645.9
TIBIAL INSERT,278,RC,,,,both,6919,6227.1,United Healthcare,Default,Fee Schedule,5645.9,,,,4082.21,5645.9
TRAY TIBIAL TRAP,272,RC,,,,both,12187.27,10968.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8531.09,,,,7190.49,9944.81
TRAY TIBIAL TRAP,272,RC,,,,both,12187.27,10968.54,Cigna,Default,Percent of Total Billed Charges,7190.49,,,,7190.49,9944.81
TRAY TIBIAL TRAP,272,RC,,,,both,12187.27,10968.54,United Healthcare,Default,Fee Schedule,9944.81,,,,7190.49,9944.81
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7270.21,6543.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5089.15,,,,4289.42,5932.49
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7270.21,6543.19,Cigna,Default,Percent of Total Billed Charges,4289.42,,,,4289.42,5932.49
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7270.21,6543.19,United Healthcare,Default,Fee Schedule,5932.49,,,,4289.42,5932.49
TRAY TIBIAL TRAPEZOID,278,RC,,,,both,13030.19,11727.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9121.13,,,,7687.81,10632.64
TRAY TIBIAL TRAPEZOID,278,RC,,,,both,13030.19,11727.17,Cigna,Default,Percent of Total Billed Charges,7687.81,,,,7687.81,10632.64
TRAY TIBIAL TRAPEZOID,278,RC,,,,both,13030.19,11727.17,United Healthcare,Default,Fee Schedule,10632.64,,,,7687.81,10632.64
TRAY TIBIAL TRAPEZOID,272,RC,,,,both,13557.02,12201.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9489.91,,,,7998.64,11062.53
TRAY TIBIAL TRAPEZOID,272,RC,,,,both,13557.02,12201.32,Cigna,Default,Percent of Total Billed Charges,7998.64,,,,7998.64,11062.53
TRAY TIBIAL TRAPEZOID,272,RC,,,,both,13557.02,12201.32,United Healthcare,Default,Fee Schedule,11062.53,,,,7998.64,11062.53
TIBIAL INSERT SIZE 4 15MM,278,RC,,,,both,8116.65,7304.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5681.66,,,,4788.82,6623.19
TIBIAL INSERT SIZE 4 15MM,278,RC,,,,both,8116.65,7304.99,Cigna,Default,Percent of Total Billed Charges,4788.82,,,,4788.82,6623.19
TIBIAL INSERT SIZE 4 15MM,278,RC,,,,both,8116.65,7304.99,United Healthcare,Default,Fee Schedule,6623.19,,,,4788.82,6623.19
4.0 MM CANNULATED SCREW 1/3 THD 48MM,C1713,HCPCS,278,RC,,both,708.58,637.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,496.01,,,,418.06,578.2
4.0 MM CANNULATED SCREW 1/3 THD 48MM,C1713,HCPCS,278,RC,,both,708.58,637.72,Cigna,Default,Percent of Total Billed Charges,418.06,,,,418.06,578.2
4.0 MM CANNULATED SCREW 1/3 THD 48MM,C1713,HCPCS,278,RC,,both,708.58,637.72,United Healthcare,Default,Fee Schedule,578.2,,,,418.06,578.2
TIBIAL INSERT SIZE 4 9MM,278,RC,,,,both,4644.52,4180.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3251.16,,,,2740.27,3789.93
TIBIAL INSERT SIZE 4 9MM,278,RC,,,,both,4644.52,4180.07,Cigna,Default,Percent of Total Billed Charges,2740.27,,,,2740.27,3789.93
TIBIAL INSERT SIZE 4 9MM,278,RC,,,,both,4644.52,4180.07,United Healthcare,Default,Fee Schedule,3789.93,,,,2740.27,3789.93
TIBIAL INSERT SIZE 3 11MM SLOPE,278,RC,,,,both,7270.21,6543.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5089.15,,,,4289.42,5932.49
TIBIAL INSERT SIZE 3 11MM SLOPE,278,RC,,,,both,7270.21,6543.19,Cigna,Default,Percent of Total Billed Charges,4289.42,,,,4289.42,5932.49
TIBIAL INSERT SIZE 3 11MM SLOPE,278,RC,,,,both,7270.21,6543.19,United Healthcare,Default,Fee Schedule,5932.49,,,,4289.42,5932.49
TIBIAL INSERT SIZE 3 13MM SLOPE,278,RC,,,,both,7270.21,6543.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5089.15,,,,4289.42,5932.49
TIBIAL INSERT SIZE 3 13MM SLOPE,278,RC,,,,both,7270.21,6543.19,Cigna,Default,Percent of Total Billed Charges,4289.42,,,,4289.42,5932.49
TIBIAL INSERT SIZE 3 13MM SLOPE,278,RC,,,,both,7270.21,6543.19,United Healthcare,Default,Fee Schedule,5932.49,,,,4289.42,5932.49
4.0MM CANNULATED SCREW 1/3 THD 4MM,C1713,HCPCS,278,RC,,both,674.7,607.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,472.29,,,,398.07,550.56
4.0MM CANNULATED SCREW 1/3 THD 4MM,C1713,HCPCS,278,RC,,both,674.7,607.23,Cigna,Default,Percent of Total Billed Charges,398.07,,,,398.07,550.56
4.0MM CANNULATED SCREW 1/3 THD 4MM,C1713,HCPCS,278,RC,,both,674.7,607.23,United Healthcare,Default,Fee Schedule,550.56,,,,398.07,550.56
35MM ECLIF PLATE,C1889,HCPCS,278,RC,,both,3669.24,3302.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2568.47,,,,2164.85,2994.1
35MM ECLIF PLATE,C1889,HCPCS,278,RC,,both,3669.24,3302.32,Cigna,Default,Percent of Total Billed Charges,2164.85,,,,2164.85,2994.1
35MM ECLIF PLATE,C1889,HCPCS,278,RC,,both,3669.24,3302.32,United Healthcare,Default,Fee Schedule,2994.1,,,,2164.85,2994.1
4.0 X 15MM FIXED SCREW,C1713,HCPCS,278,RC,,both,1256.24,1130.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,879.37,,,,741.18,1025.09
4.0 X 15MM FIXED SCREW,C1713,HCPCS,278,RC,,both,1256.24,1130.62,Cigna,Default,Percent of Total Billed Charges,741.18,,,,741.18,1025.09
4.0 X 15MM FIXED SCREW,C1713,HCPCS,278,RC,,both,1256.24,1130.62,United Healthcare,Default,Fee Schedule,1025.09,,,,741.18,1025.09
CREO AMP 7.5X40MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1998,1798.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1398.6,,,,1178.82,1630.37
CREO AMP 7.5X40MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1998,1798.2,Cigna,Default,Percent of Total Billed Charges,1178.82,,,,1178.82,1630.37
CREO AMP 7.5X40MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1998,1798.2,United Healthcare,Default,Fee Schedule,1630.37,,,,1178.82,1630.37
CREO AMP 7.5X45MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1998,1798.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1398.6,,,,1178.82,1630.37
CREO AMP 7.5X45MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1998,1798.2,Cigna,Default,Percent of Total Billed Charges,1178.82,,,,1178.82,1630.37
CREO AMP 7.5X45MM CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1998,1798.2,United Healthcare,Default,Fee Schedule,1630.37,,,,1178.82,1630.37
CREO AMP 7.5x55mm MOD CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1980,1782,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1386,,,,1168.2,1615.68
CREO AMP 7.5x55mm MOD CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1980,1782,Cigna,Default,Percent of Total Billed Charges,1168.2,,,,1168.2,1615.68
CREO AMP 7.5x55mm MOD CANNULATED SCREW,C1713,HCPCS,278,RC,,both,1980,1782,United Healthcare,Default,Fee Schedule,1615.68,,,,1168.2,1615.68
FEMORAL POROUS SIZE 4 LEFT,278,RC,,,,both,14425.76,12983.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10098.03,,,,8511.2,11771.42
FEMORAL POROUS SIZE 4 LEFT,278,RC,,,,both,14425.76,12983.18,Cigna,Default,Percent of Total Billed Charges,8511.2,,,,8511.2,11771.42
FEMORAL POROUS SIZE 4 LEFT,278,RC,,,,both,14425.76,12983.18,United Healthcare,Default,Fee Schedule,11771.42,,,,8511.2,11771.42
FEMORAL HEAD 28MM +10,278,RC,,,,both,4326.13,3893.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3028.29,,,,2552.42,3530.12
FEMORAL HEAD 28MM +10,278,RC,,,,both,4326.13,3893.52,Cigna,Default,Percent of Total Billed Charges,2552.42,,,,2552.42,3530.12
FEMORAL HEAD 28MM +10,278,RC,,,,both,4326.13,3893.52,United Healthcare,Default,Fee Schedule,3530.12,,,,2552.42,3530.12
FEMORAL POROUS,278,RC,,,,both,14074.19,12666.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9851.93,,,,8303.77,11484.54
FEMORAL POROUS,278,RC,,,,both,14074.19,12666.77,Cigna,Default,Percent of Total Billed Charges,8303.77,,,,8303.77,11484.54
FEMORAL POROUS,278,RC,,,,both,14074.19,12666.77,United Healthcare,Default,Fee Schedule,11484.54,,,,8303.77,11484.54
"QCKFIX SCREW, TI, CANC, PT, 3.0X28MM",C1713,HCPCS,278,RC,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
"QCKFIX SCREW, TI, CANC, PT, 3.0X28MM",C1713,HCPCS,278,RC,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
"QCKFIX SCREW, TI, CANC, PT, 3.0X28MM",C1713,HCPCS,278,RC,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
"QCKFIX SCREW, TI, CANC, PT, 3.0X30MM",C1713,HCPCS,278,RC,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
"QCKFIX SCREW, TI, CANC, PT, 3.0X30MM",C1713,HCPCS,278,RC,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
"QCKFIX SCREW, TI, CANC, PT, 3.0X30MM",C1713,HCPCS,278,RC,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
"THD GDWIRE W TRCR TIP, .45"" W/LASER",A4649,HCPCS,272,RC,,both,86.49,77.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.54,,,,51.03,70.58
"THD GDWIRE W TRCR TIP, .45"" W/LASER",A4649,HCPCS,272,RC,,both,86.49,77.84,Cigna,Default,Percent of Total Billed Charges,51.03,,,,51.03,70.58
"THD GDWIRE W TRCR TIP, .45"" W/LASER",A4649,HCPCS,272,RC,,both,86.49,77.84,United Healthcare,Default,Fee Schedule,70.58,,,,51.03,70.58
"COUNTERSINK, 3.0MM, CANNULATED",A4649,HCPCS,272,RC,,both,614.64,553.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.25,,,,362.64,501.55
"COUNTERSINK, 3.0MM, CANNULATED",A4649,HCPCS,272,RC,,both,614.64,553.18,Cigna,Default,Percent of Total Billed Charges,362.64,,,,362.64,501.55
"COUNTERSINK, 3.0MM, CANNULATED",A4649,HCPCS,272,RC,,both,614.64,553.18,United Healthcare,Default,Fee Schedule,501.55,,,,362.64,501.55
FEMORAL POROUS,278,RC,,,,both,22302.18,20071.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15611.53,,,,13158.29,18198.58
FEMORAL POROUS,278,RC,,,,both,22302.18,20071.96,Cigna,Default,Percent of Total Billed Charges,13158.29,,,,13158.29,18198.58
FEMORAL POROUS,278,RC,,,,both,22302.18,20071.96,United Healthcare,Default,Fee Schedule,18198.58,,,,13158.29,18198.58
PLATE 19MM ZEVO,C1713,HCPCS,278,RC,,both,3246.75,2922.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2272.72,,,,1915.58,2649.35
PLATE 19MM ZEVO,C1713,HCPCS,278,RC,,both,3246.75,2922.08,Cigna,Default,Percent of Total Billed Charges,1915.58,,,,1915.58,2649.35
PLATE 19MM ZEVO,C1713,HCPCS,278,RC,,both,3246.75,2922.08,United Healthcare,Default,Fee Schedule,2649.35,,,,1915.58,2649.35
3.15X15MM FIXED SCREW,C1713,HCPCS,278,RC,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
3.15X15MM FIXED SCREW,C1713,HCPCS,278,RC,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
3.15X15MM FIXED SCREW,C1713,HCPCS,278,RC,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
HEAD RESURFACING 50X19,278,RC,,,,both,23637.05,21273.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16545.94,,,,13945.86,19287.83
HEAD RESURFACING 50X19,278,RC,,,,both,23637.05,21273.35,Cigna,Default,Percent of Total Billed Charges,13945.86,,,,13945.86,19287.83
HEAD RESURFACING 50X19,278,RC,,,,both,23637.05,21273.35,United Healthcare,Default,Fee Schedule,19287.83,,,,13945.86,19287.83
CLIP OTSC SYSTEM SET 12/6GC 165CM,272,RC,,,,both,2068.7,1861.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1448.09,,,,1220.53,1688.06
CLIP OTSC SYSTEM SET 12/6GC 165CM,272,RC,,,,both,2068.7,1861.83,Cigna,Default,Percent of Total Billed Charges,1220.53,,,,1220.53,1688.06
CLIP OTSC SYSTEM SET 12/6GC 165CM,272,RC,,,,both,2068.7,1861.83,United Healthcare,Default,Fee Schedule,1688.06,,,,1220.53,1688.06
CLIP OTSC SYSTEM SET 12/6T 220CM,272,RC,,,,both,1945.78,1751.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1362.05,,,,1148.01,1587.76
CLIP OTSC SYSTEM SET 12/6T 220CM,272,RC,,,,both,1945.78,1751.2,Cigna,Default,Percent of Total Billed Charges,1148.01,,,,1148.01,1587.76
CLIP OTSC SYSTEM SET 12/6T 220CM,272,RC,,,,both,1945.78,1751.2,United Healthcare,Default,Fee Schedule,1587.76,,,,1148.01,1587.76
CLIP OTSC SYSTEM SET 11/6T 165CM,272,RC,,,,both,1538.36,1384.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1076.85,,,,907.63,1255.3
CLIP OTSC SYSTEM SET 11/6T 165CM,272,RC,,,,both,1538.36,1384.52,Cigna,Default,Percent of Total Billed Charges,907.63,,,,907.63,1255.3
CLIP OTSC SYSTEM SET 11/6T 165CM,272,RC,,,,both,1538.36,1384.52,United Healthcare,Default,Fee Schedule,1255.3,,,,907.63,1255.3
ANCHOR OTSC 165CM,278,RC,,,,both,1548.89,1394,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1084.22,,,,913.85,1263.89
ANCHOR OTSC 165CM,278,RC,,,,both,1548.89,1394,Cigna,Default,Percent of Total Billed Charges,913.85,,,,913.85,1263.89
ANCHOR OTSC 165CM,278,RC,,,,both,1548.89,1394,United Healthcare,Default,Fee Schedule,1263.89,,,,913.85,1263.89
MESH VENTRALIGHT ST 30.5X35.6CM,C1781,HCPCS,278,RC,,both,9927.4,8934.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6949.18,,,,5857.17,8100.76
MESH VENTRALIGHT ST 30.5X35.6CM,C1781,HCPCS,278,RC,,both,9927.4,8934.66,Cigna,Default,Percent of Total Billed Charges,5857.17,,,,5857.17,8100.76
MESH VENTRALIGHT ST 30.5X35.6CM,C1781,HCPCS,278,RC,,both,9927.4,8934.66,United Healthcare,Default,Fee Schedule,8100.76,,,,5857.17,8100.76
MESH VENTRALIGHT 4.5X11.4CM,C1781,HCPCS,278,RC,,both,1541.96,1387.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1079.37,,,,909.76,1258.24
MESH VENTRALIGHT 4.5X11.4CM,C1781,HCPCS,278,RC,,both,1541.96,1387.76,Cigna,Default,Percent of Total Billed Charges,909.76,,,,909.76,1258.24
MESH VENTRALIGHT 4.5X11.4CM,C1781,HCPCS,278,RC,,both,1541.96,1387.76,United Healthcare,Default,Fee Schedule,1258.24,,,,909.76,1258.24
PLATE 35MM ZEVO,C1713,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
PLATE 35MM ZEVO,C1713,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
PLATE 35MM ZEVO,C1713,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
3.5 X 17MM FIXED SCREW,C1713,HCPCS,278,RC,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
3.5 X 17MM FIXED SCREW,C1713,HCPCS,278,RC,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
3.5 X 17MM FIXED SCREW,C1713,HCPCS,278,RC,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
FEMORAL HEAD,C1776,HCPCS,278,RC,,both,1356.96,1221.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,949.87,,,,800.61,1107.28
FEMORAL HEAD,C1776,HCPCS,278,RC,,both,1356.96,1221.26,Cigna,Default,Percent of Total Billed Charges,800.61,,,,800.61,1107.28
FEMORAL HEAD,C1776,HCPCS,278,RC,,both,1356.96,1221.26,United Healthcare,Default,Fee Schedule,1107.28,,,,800.61,1107.28
PEDICLE ACCESSS KIT,C1713,HCPCS,278,RC,,both,1665,1498.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1165.5,,,,982.35,1358.64
PEDICLE ACCESSS KIT,C1713,HCPCS,278,RC,,both,1665,1498.5,Cigna,Default,Percent of Total Billed Charges,982.35,,,,982.35,1358.64
PEDICLE ACCESSS KIT,C1713,HCPCS,278,RC,,both,1665,1498.5,United Healthcare,Default,Fee Schedule,1358.64,,,,982.35,1358.64
MESH OVAL 6X9IN,C1781,HCPCS,278,RC,,both,2059.04,1853.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1441.33,,,,1214.83,1680.18
MESH OVAL 6X9IN,C1781,HCPCS,278,RC,,both,2059.04,1853.14,Cigna,Default,Percent of Total Billed Charges,1214.83,,,,1214.83,1680.18
MESH OVAL 6X9IN,C1781,HCPCS,278,RC,,both,2059.04,1853.14,United Healthcare,Default,Fee Schedule,1680.18,,,,1214.83,1680.18
CREO MIS 5.5MM CURVED ROD 75MM,C1713,HCPCS,278,RC,,both,1248.75,1123.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,874.12,,,,736.76,1018.98
CREO MIS 5.5MM CURVED ROD 75MM,C1713,HCPCS,278,RC,,both,1248.75,1123.88,Cigna,Default,Percent of Total Billed Charges,736.76,,,,736.76,1018.98
CREO MIS 5.5MM CURVED ROD 75MM,C1713,HCPCS,278,RC,,both,1248.75,1123.88,United Healthcare,Default,Fee Schedule,1018.98,,,,736.76,1018.98
SABLE SPACER 10 X 26 6-12MM 8 DEGREE,C1889,HCPCS,278,RC,,both,21436.88,19293.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15005.82,,,,12647.76,17492.49
SABLE SPACER 10 X 26 6-12MM 8 DEGREE,C1889,HCPCS,278,RC,,both,21436.88,19293.19,Cigna,Default,Percent of Total Billed Charges,12647.76,,,,12647.76,17492.49
SABLE SPACER 10 X 26 6-12MM 8 DEGREE,C1889,HCPCS,278,RC,,both,21436.88,19293.19,United Healthcare,Default,Fee Schedule,17492.49,,,,12647.76,17492.49
ULTRAVERSE 130 3X40MM,C1725,HCPCS,278,RC,,both,749.25,674.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,524.48,,,,442.06,611.39
ULTRAVERSE 130 3X40MM,C1725,HCPCS,278,RC,,both,749.25,674.33,Cigna,Default,Percent of Total Billed Charges,442.06,,,,442.06,611.39
ULTRAVERSE 130 3X40MM,C1725,HCPCS,278,RC,,both,749.25,674.33,United Healthcare,Default,Fee Schedule,611.39,,,,442.06,611.39
ULTRAVERSE 130CM 6X40MM,C1725,HCPCS,278,RC,,both,1202.13,1081.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,841.49,,,,709.26,980.94
ULTRAVERSE 130CM 6X40MM,C1725,HCPCS,278,RC,,both,1202.13,1081.92,Cigna,Default,Percent of Total Billed Charges,709.26,,,,709.26,980.94
ULTRAVERSE 130CM 6X40MM,C1725,HCPCS,278,RC,,both,1202.13,1081.92,United Healthcare,Default,Fee Schedule,980.94,,,,709.26,980.94
ULTRAVERSE 130 4X40MM,C1725,HCPCS,278,RC,,both,632.7,569.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.89,,,,373.29,516.28
ULTRAVERSE 130 4X40MM,C1725,HCPCS,278,RC,,both,632.7,569.43,Cigna,Default,Percent of Total Billed Charges,373.29,,,,373.29,516.28
ULTRAVERSE 130 4X40MM,C1725,HCPCS,278,RC,,both,632.7,569.43,United Healthcare,Default,Fee Schedule,516.28,,,,373.29,516.28
PLATE 3-HOLE DVR,C1713,HCPCS,278,RC,,both,2653.97,2388.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1857.78,,,,1565.84,2165.64
PLATE 3-HOLE DVR,C1713,HCPCS,278,RC,,both,2653.97,2388.57,Cigna,Default,Percent of Total Billed Charges,1565.84,,,,1565.84,2165.64
PLATE 3-HOLE DVR,C1713,HCPCS,278,RC,,both,2653.97,2388.57,United Healthcare,Default,Fee Schedule,2165.64,,,,1565.84,2165.64
CERVICAL CAGE CIF 6 DEG -07,L8699,HCPCS,278,RC,,both,9973.2,8975.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6981.24,,,,5884.19,8138.13
CERVICAL CAGE CIF 6 DEG -07,L8699,HCPCS,278,RC,,both,9973.2,8975.88,Cigna,Default,Percent of Total Billed Charges,5884.19,,,,5884.19,8138.13
CERVICAL CAGE CIF 6 DEG -07,L8699,HCPCS,278,RC,,both,9973.2,8975.88,United Healthcare,Default,Fee Schedule,8138.13,,,,5884.19,8138.13
CERVICAL CAGE CIF 6 DEG -08,L8699,HCPCS,278,RC,,both,9973.2,8975.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6981.24,,,,5884.19,8138.13
CERVICAL CAGE CIF 6 DEG -08,L8699,HCPCS,278,RC,,both,9973.2,8975.88,Cigna,Default,Percent of Total Billed Charges,5884.19,,,,5884.19,8138.13
CERVICAL CAGE CIF 6 DEG -08,L8699,HCPCS,278,RC,,both,9973.2,8975.88,United Healthcare,Default,Fee Schedule,8138.13,,,,5884.19,8138.13
CERVICAL PLATE 10MM,L8699,HCPCS,278,RC,,both,8533,7679.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5973.1,,,,5034.47,6962.93
CERVICAL PLATE 10MM,L8699,HCPCS,278,RC,,both,8533,7679.7,Cigna,Default,Percent of Total Billed Charges,5034.47,,,,5034.47,6962.93
CERVICAL PLATE 10MM,L8699,HCPCS,278,RC,,both,8533,7679.7,United Healthcare,Default,Fee Schedule,6962.93,,,,5034.47,6962.93
CERVICAL PLATE 14 MM,L8699,HCPCS,278,RC,,both,8324.88,7492.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5827.42,,,,4911.68,6793.1
CERVICAL PLATE 14 MM,L8699,HCPCS,278,RC,,both,8324.88,7492.39,Cigna,Default,Percent of Total Billed Charges,4911.68,,,,4911.68,6793.1
CERVICAL PLATE 14 MM,L8699,HCPCS,278,RC,,both,8324.88,7492.39,United Healthcare,Default,Fee Schedule,6793.1,,,,4911.68,6793.1
K-WIRE 1.6,C1769,HCPCS,278,RC,,both,136.65,122.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.66,,,,80.62,111.51
K-WIRE 1.6,C1769,HCPCS,278,RC,,both,136.65,122.99,Cigna,Default,Percent of Total Billed Charges,80.62,,,,80.62,111.51
K-WIRE 1.6,C1769,HCPCS,278,RC,,both,136.65,122.99,United Healthcare,Default,Fee Schedule,111.51,,,,80.62,111.51
K-WIRE,C1769,HCPCS,278,RC,,both,539.45,485.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,377.62,,,,318.28,440.19
K-WIRE,C1769,HCPCS,278,RC,,both,539.45,485.51,Cigna,Default,Percent of Total Billed Charges,318.28,,,,318.28,440.19
K-WIRE,C1769,HCPCS,278,RC,,both,539.45,485.51,United Healthcare,Default,Fee Schedule,440.19,,,,318.28,440.19
DRILL BIT 12MM,272,RC,,,,both,702.44,632.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,491.71,,,,414.44,573.19
DRILL BIT 12MM,272,RC,,,,both,702.44,632.2,Cigna,Default,Percent of Total Billed Charges,414.44,,,,414.44,573.19
DRILL BIT 12MM,272,RC,,,,both,702.44,632.2,United Healthcare,Default,Fee Schedule,573.19,,,,414.44,573.19
SCREW SELF DRILLING 4.0X14MM,278,RC,,,,both,1404.87,1264.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,983.41,,,,828.87,1146.37
SCREW SELF DRILLING 4.0X14MM,278,RC,,,,both,1404.87,1264.38,Cigna,Default,Percent of Total Billed Charges,828.87,,,,828.87,1146.37
SCREW SELF DRILLING 4.0X14MM,278,RC,,,,both,1404.87,1264.38,United Healthcare,Default,Fee Schedule,1146.37,,,,828.87,1146.37
BONE GRAFT I FACTOR 2.5CC,20930,HCPCS,360,RC,,both,5200,4680,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3640,,,,3068,4243.2
BONE GRAFT I FACTOR 2.5CC,20930,HCPCS,360,RC,,both,5200,4680,Cigna,Default,Percent of Total Billed Charges,3068,,,,3068,4243.2
BONE GRAFT I FACTOR 2.5CC,20930,HCPCS,360,RC,,both,5200,4680,United Healthcare,Default,Fee Schedule,4243.2,,,,3068,4243.2
SCREW SELF DRILLING 4.0X12MM,278,RC,,,,both,1404.87,1264.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,983.41,,,,828.87,1146.37
SCREW SELF DRILLING 4.0X12MM,278,RC,,,,both,1404.87,1264.38,Cigna,Default,Percent of Total Billed Charges,828.87,,,,828.87,1146.37
SCREW SELF DRILLING 4.0X12MM,278,RC,,,,both,1404.87,1264.38,United Healthcare,Default,Fee Schedule,1146.37,,,,828.87,1146.37
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,832.49,749.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,582.74,,,,491.17,679.31
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,832.49,749.24,Cigna,Default,Percent of Total Billed Charges,491.17,,,,491.17,679.31
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,832.49,749.24,United Healthcare,Default,Fee Schedule,679.31,,,,491.17,679.31
CERVICAL PLATE,L8699,HCPCS,278,RC,,both,1535.94,1382.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1075.16,,,,906.2,1253.33
CERVICAL PLATE,L8699,HCPCS,278,RC,,both,1535.94,1382.35,Cigna,Default,Percent of Total Billed Charges,906.2,,,,906.2,1253.33
CERVICAL PLATE,L8699,HCPCS,278,RC,,both,1535.94,1382.35,United Healthcare,Default,Fee Schedule,1253.33,,,,906.2,1253.33
"CERVICAL 3.5MM SELF DRILLING SCREW, 12MM",278,RC,,,,both,1141.46,1027.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,799.02,,,,673.46,931.43
"CERVICAL 3.5MM SELF DRILLING SCREW, 12MM",278,RC,,,,both,1141.46,1027.31,Cigna,Default,Percent of Total Billed Charges,673.46,,,,673.46,931.43
"CERVICAL 3.5MM SELF DRILLING SCREW, 12MM",278,RC,,,,both,1141.46,1027.31,United Healthcare,Default,Fee Schedule,931.43,,,,673.46,931.43
"CERVICAL 3.5MM SELF DRILLING SCREW, 14MM",278,RC,,,,both,1141.46,1027.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,799.02,,,,673.46,931.43
"CERVICAL 3.5MM SELF DRILLING SCREW, 14MM",278,RC,,,,both,1141.46,1027.31,Cigna,Default,Percent of Total Billed Charges,673.46,,,,673.46,931.43
"CERVICAL 3.5MM SELF DRILLING SCREW, 14MM",278,RC,,,,both,1141.46,1027.31,United Healthcare,Default,Fee Schedule,931.43,,,,673.46,931.43
SCREW MULTI DIRECTIONAL 24MM,C1713,HCPCS,278,RC,,both,492.83,443.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.98,,,,290.77,402.15
SCREW MULTI DIRECTIONAL 24MM,C1713,HCPCS,278,RC,,both,492.83,443.55,Cigna,Default,Percent of Total Billed Charges,290.77,,,,290.77,402.15
SCREW MULTI DIRECTIONAL 24MM,C1713,HCPCS,278,RC,,both,492.83,443.55,United Healthcare,Default,Fee Schedule,402.15,,,,290.77,402.15
SCREW 2.5 LOCKING 24MM,C1713,HCPCS,278,RC,,both,266.4,239.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.48,,,,157.18,217.38
SCREW 2.5 LOCKING 24MM,C1713,HCPCS,278,RC,,both,266.4,239.76,Cigna,Default,Percent of Total Billed Charges,157.18,,,,157.18,217.38
SCREW 2.5 LOCKING 24MM,C1713,HCPCS,278,RC,,both,266.4,239.76,United Healthcare,Default,Fee Schedule,217.38,,,,157.18,217.38
SCREW 3.5 LOCKING 12MM,C1713,HCPCS,278,RC,,both,266.4,239.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.48,,,,157.18,217.38
SCREW 3.5 LOCKING 12MM,C1713,HCPCS,278,RC,,both,266.4,239.76,Cigna,Default,Percent of Total Billed Charges,157.18,,,,157.18,217.38
SCREW 3.5 LOCKING 12MM,C1713,HCPCS,278,RC,,both,266.4,239.76,United Healthcare,Default,Fee Schedule,217.38,,,,157.18,217.38
"CERVICAL 4.0MM SELF DRILLING SCREW, 12MM",278,RC,,,,both,1141.46,1027.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,799.02,,,,673.46,931.43
"CERVICAL 4.0MM SELF DRILLING SCREW, 12MM",278,RC,,,,both,1141.46,1027.31,Cigna,Default,Percent of Total Billed Charges,673.46,,,,673.46,931.43
"CERVICAL 4.0MM SELF DRILLING SCREW, 12MM",278,RC,,,,both,1141.46,1027.31,United Healthcare,Default,Fee Schedule,931.43,,,,673.46,931.43
"TESERA SC CAGE, 16MMX13.5MMX6MM, 7",L8699,HCPCS,278,RC,,both,16383.35,14745.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11468.34,,,,9666.18,13368.81
"TESERA SC CAGE, 16MMX13.5MMX6MM, 7",L8699,HCPCS,278,RC,,both,16383.35,14745.02,Cigna,Default,Percent of Total Billed Charges,9666.18,,,,9666.18,13368.81
"TESERA SC CAGE, 16MMX13.5MMX6MM, 7",L8699,HCPCS,278,RC,,both,16383.35,14745.02,United Healthcare,Default,Fee Schedule,13368.81,,,,9666.18,13368.81
INSERTS MULTI 2.0,272,RC,,,,both,231.8,208.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.26,,,,136.76,189.15
INSERTS MULTI 2.0,272,RC,,,,both,231.8,208.62,Cigna,Default,Percent of Total Billed Charges,136.76,,,,136.76,189.15
INSERTS MULTI 2.0,272,RC,,,,both,231.8,208.62,United Healthcare,Default,Fee Schedule,189.15,,,,136.76,189.15
"CERVICAL CAGE CIF, 6 DEG, -06",L8699,HCPCS,278,RC,,both,9973.2,8975.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6981.24,,,,5884.19,8138.13
"CERVICAL CAGE CIF, 6 DEG, -06",L8699,HCPCS,278,RC,,both,9973.2,8975.88,Cigna,Default,Percent of Total Billed Charges,5884.19,,,,5884.19,8138.13
"CERVICAL CAGE CIF, 6 DEG, -06",L8699,HCPCS,278,RC,,both,9973.2,8975.88,United Healthcare,Default,Fee Schedule,8138.13,,,,5884.19,8138.13
"1-LEVEL, 12MM CERVICAL PLATE",L8699,HCPCS,278,RC,,both,8324.88,7492.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5827.42,,,,4911.68,6793.1
"1-LEVEL, 12MM CERVICAL PLATE",L8699,HCPCS,278,RC,,both,8324.88,7492.39,Cigna,Default,Percent of Total Billed Charges,4911.68,,,,4911.68,6793.1
"1-LEVEL, 12MM CERVICAL PLATE",L8699,HCPCS,278,RC,,both,8324.88,7492.39,United Healthcare,Default,Fee Schedule,6793.1,,,,4911.68,6793.1
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,853.3,767.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,597.31,,,,503.45,696.29
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,853.3,767.97,Cigna,Default,Percent of Total Billed Charges,503.45,,,,503.45,696.29
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,853.3,767.97,United Healthcare,Default,Fee Schedule,696.29,,,,503.45,696.29
7MM 4 HOLE ANTERIOR PLATE,C1713,HCPCS,278,RC,,both,8324.88,7492.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5827.42,,,,4911.68,6793.1
7MM 4 HOLE ANTERIOR PLATE,C1713,HCPCS,278,RC,,both,8324.88,7492.39,Cigna,Default,Percent of Total Billed Charges,4911.68,,,,4911.68,6793.1
7MM 4 HOLE ANTERIOR PLATE,C1713,HCPCS,278,RC,,both,8324.88,7492.39,United Healthcare,Default,Fee Schedule,6793.1,,,,4911.68,6793.1
7MM LOCKING COVER,C1713,HCPCS,278,RC,,both,832.49,749.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,582.74,,,,491.17,679.31
7MM LOCKING COVER,C1713,HCPCS,278,RC,,both,832.49,749.24,Cigna,Default,Percent of Total Billed Charges,491.17,,,,491.17,679.31
7MM LOCKING COVER,C1713,HCPCS,278,RC,,both,832.49,749.24,United Healthcare,Default,Fee Schedule,679.31,,,,491.17,679.31
3.5MM VARIABLE SCREW SELF DRILLING 14MM,C1713,HCPCS,278,RC,,both,1365.28,1228.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,955.7,,,,805.52,1114.07
3.5MM VARIABLE SCREW SELF DRILLING 14MM,C1713,HCPCS,278,RC,,both,1365.28,1228.75,Cigna,Default,Percent of Total Billed Charges,805.52,,,,805.52,1114.07
3.5MM VARIABLE SCREW SELF DRILLING 14MM,C1713,HCPCS,278,RC,,both,1365.28,1228.75,United Healthcare,Default,Fee Schedule,1114.07,,,,805.52,1114.07
"DRILL, 12MM",272,RC,,,,both,702.44,632.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,491.71,,,,414.44,573.19
"DRILL, 12MM",272,RC,,,,both,702.44,632.2,Cigna,Default,Percent of Total Billed Charges,414.44,,,,414.44,573.19
"DRILL, 12MM",272,RC,,,,both,702.44,632.2,United Healthcare,Default,Fee Schedule,573.19,,,,414.44,573.19
"INTERBODY, 16X14X7MM 7 DEGREE STERILE",C1713,HCPCS,278,RC,,both,9973.2,8975.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6981.24,,,,5884.19,8138.13
"INTERBODY, 16X14X7MM 7 DEGREE STERILE",C1713,HCPCS,278,RC,,both,9973.2,8975.88,Cigna,Default,Percent of Total Billed Charges,5884.19,,,,5884.19,8138.13
"INTERBODY, 16X14X7MM 7 DEGREE STERILE",C1713,HCPCS,278,RC,,both,9973.2,8975.88,United Healthcare,Default,Fee Schedule,8138.13,,,,5884.19,8138.13
MOBI-C CERVICAL DISC PROSTHESIS 15X 15,L8699,HCPCS,278,RC,,both,14851.8,13366.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10396.26,,,,8762.56,12119.07
MOBI-C CERVICAL DISC PROSTHESIS 15X 15,L8699,HCPCS,278,RC,,both,14851.8,13366.62,Cigna,Default,Percent of Total Billed Charges,8762.56,,,,8762.56,12119.07
MOBI-C CERVICAL DISC PROSTHESIS 15X 15,L8699,HCPCS,278,RC,,both,14851.8,13366.62,United Healthcare,Default,Fee Schedule,12119.07,,,,8762.56,12119.07
CANNULATED DRILL Q-C,272,RC,,,,both,1901.56,1711.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1331.09,,,,1121.92,1551.67
CANNULATED DRILL Q-C,272,RC,,,,both,1901.56,1711.4,Cigna,Default,Percent of Total Billed Charges,1121.92,,,,1121.92,1551.67
CANNULATED DRILL Q-C,272,RC,,,,both,1901.56,1711.4,United Healthcare,Default,Fee Schedule,1551.67,,,,1121.92,1551.67
PIN GUIDE 1.6MM X 9IN PARTIAL THREAD,278,RC,,,,both,288.01,259.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.61,,,,169.93,235.02
PIN GUIDE 1.6MM X 9IN PARTIAL THREAD,278,RC,,,,both,288.01,259.21,Cigna,Default,Percent of Total Billed Charges,169.93,,,,169.93,235.02
PIN GUIDE 1.6MM X 9IN PARTIAL THREAD,278,RC,,,,both,288.01,259.21,United Healthcare,Default,Fee Schedule,235.02,,,,169.93,235.02
WASHER 3. AND 4.0 SCREW,278,RC,,,,both,159.83,143.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.88,,,,94.3,130.42
WASHER 3. AND 4.0 SCREW,278,RC,,,,both,159.83,143.85,Cigna,Default,Percent of Total Billed Charges,94.3,,,,94.3,130.42
WASHER 3. AND 4.0 SCREW,278,RC,,,,both,159.83,143.85,United Healthcare,Default,Fee Schedule,130.42,,,,94.3,130.42
SCREW CANNULATED 4.0X60MM 1/2 THREAD,C1713,HCPCS,278,RC,,both,656.15,590.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,459.3,,,,387.13,535.42
SCREW CANNULATED 4.0X60MM 1/2 THREAD,C1713,HCPCS,278,RC,,both,656.15,590.54,Cigna,Default,Percent of Total Billed Charges,387.13,,,,387.13,535.42
SCREW CANNULATED 4.0X60MM 1/2 THREAD,C1713,HCPCS,278,RC,,both,656.15,590.54,United Healthcare,Default,Fee Schedule,535.42,,,,387.13,535.42
CANNULATED DRILL Q-C 4.5MM,272,RC,,,,both,1707.19,1536.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1195.03,,,,1007.24,1393.07
CANNULATED DRILL Q-C 4.5MM,272,RC,,,,both,1707.19,1536.47,Cigna,Default,Percent of Total Billed Charges,1007.24,,,,1007.24,1393.07
CANNULATED DRILL Q-C 4.5MM,272,RC,,,,both,1707.19,1536.47,United Healthcare,Default,Fee Schedule,1393.07,,,,1007.24,1393.07
6.5MM CANNULATED SCREW 16MM THD 80MM,C1713,HCPCS,278,RC,,both,721.08,648.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.76,,,,425.44,588.4
6.5MM CANNULATED SCREW 16MM THD 80MM,C1713,HCPCS,278,RC,,both,721.08,648.97,Cigna,Default,Percent of Total Billed Charges,425.44,,,,425.44,588.4
6.5MM CANNULATED SCREW 16MM THD 80MM,C1713,HCPCS,278,RC,,both,721.08,648.97,United Healthcare,Default,Fee Schedule,588.4,,,,425.44,588.4
6.5MM CANNULATED SCREW 16MM THD 85MM,C1713,HCPCS,278,RC,,both,721.08,648.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.76,,,,425.44,588.4
6.5MM CANNULATED SCREW 16MM THD 85MM,C1713,HCPCS,278,RC,,both,721.08,648.97,Cigna,Default,Percent of Total Billed Charges,425.44,,,,425.44,588.4
6.5MM CANNULATED SCREW 16MM THD 85MM,C1713,HCPCS,278,RC,,both,721.08,648.97,United Healthcare,Default,Fee Schedule,588.4,,,,425.44,588.4
3.2MM X 9IN PARTIAL THD TROCAR TIP GDE P,272,RC,,,,both,325.75,293.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.02,,,,192.19,265.81
3.2MM X 9IN PARTIAL THD TROCAR TIP GDE P,272,RC,,,,both,325.75,293.18,Cigna,Default,Percent of Total Billed Charges,192.19,,,,192.19,265.81
3.2MM X 9IN PARTIAL THD TROCAR TIP GDE P,272,RC,,,,both,325.75,293.18,United Healthcare,Default,Fee Schedule,265.81,,,,192.19,265.81
"1.6MM X 6IN SMOOTH TROCARTIP GDE PIN, 5/",272,RC,,,,both,208.48,187.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.94,,,,123,170.12
"1.6MM X 6IN SMOOTH TROCARTIP GDE PIN, 5/",272,RC,,,,both,208.48,187.63,Cigna,Default,Percent of Total Billed Charges,123,,,,123,170.12
"1.6MM X 6IN SMOOTH TROCARTIP GDE PIN, 5/",272,RC,,,,both,208.48,187.63,United Healthcare,Default,Fee Schedule,170.12,,,,123,170.12
6.5MM CANNULATED SCREW 16MM THD 70MM,C1713,HCPCS,278,RC,,both,805.18,724.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,563.63,,,,475.06,657.03
6.5MM CANNULATED SCREW 16MM THD 70MM,C1713,HCPCS,278,RC,,both,805.18,724.66,Cigna,Default,Percent of Total Billed Charges,475.06,,,,475.06,657.03
6.5MM CANNULATED SCREW 16MM THD 70MM,C1713,HCPCS,278,RC,,both,805.18,724.66,United Healthcare,Default,Fee Schedule,657.03,,,,475.06,657.03
"CABLE CERCLAGE 1.8MMX22"" GRIP",278,RC,,,,both,1300.94,1170.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,910.66,,,,767.55,1061.57
"CABLE CERCLAGE 1.8MMX22"" GRIP",278,RC,,,,both,1300.94,1170.85,Cigna,Default,Percent of Total Billed Charges,767.55,,,,767.55,1061.57
"CABLE CERCLAGE 1.8MMX22"" GRIP",278,RC,,,,both,1300.94,1170.85,United Healthcare,Default,Fee Schedule,1061.57,,,,767.55,1061.57
CABLE CERCLAGE 1.8MMX635MM  COCR,278,RC,,,,both,1308.86,1177.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,916.2,,,,772.23,1068.03
CABLE CERCLAGE 1.8MMX635MM  COCR,278,RC,,,,both,1308.86,1177.97,Cigna,Default,Percent of Total Billed Charges,772.23,,,,772.23,1068.03
CABLE CERCLAGE 1.8MMX635MM  COCR,278,RC,,,,both,1308.86,1177.97,United Healthcare,Default,Fee Schedule,1068.03,,,,772.23,1068.03
GTR 5 HOLE EXTENDED W/4 CABLES,278,RC,,,,both,14206.6,12785.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9944.62,,,,8381.89,11592.59
GTR 5 HOLE EXTENDED W/4 CABLES,278,RC,,,,both,14206.6,12785.94,Cigna,Default,Percent of Total Billed Charges,8381.89,,,,8381.89,11592.59
GTR 5 HOLE EXTENDED W/4 CABLES,278,RC,,,,both,14206.6,12785.94,United Healthcare,Default,Fee Schedule,11592.59,,,,8381.89,11592.59
6.5MM CANNULATED SCREW 16MM THD 75MM,C1713,HCPCS,278,RC,,both,805.18,724.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,563.63,,,,475.06,657.03
6.5MM CANNULATED SCREW 16MM THD 75MM,C1713,HCPCS,278,RC,,both,805.18,724.66,Cigna,Default,Percent of Total Billed Charges,475.06,,,,475.06,657.03
6.5MM CANNULATED SCREW 16MM THD 75MM,C1713,HCPCS,278,RC,,both,805.18,724.66,United Healthcare,Default,Fee Schedule,657.03,,,,475.06,657.03
WIRE K 2.0X150MM,278,RC,,,,both,269.34,242.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,188.54,,,,158.91,219.78
WIRE K 2.0X150MM,278,RC,,,,both,269.34,242.41,Cigna,Default,Percent of Total Billed Charges,158.91,,,,158.91,219.78
WIRE K 2.0X150MM,278,RC,,,,both,269.34,242.41,United Healthcare,Default,Fee Schedule,219.78,,,,158.91,219.78
SUTURE ORTHOCORD,272,RC,,,,both,103.04,92.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.13,,,,60.79,84.08
SUTURE ORTHOCORD,272,RC,,,,both,103.04,92.74,Cigna,Default,Percent of Total Billed Charges,60.79,,,,60.79,84.08
SUTURE ORTHOCORD,272,RC,,,,both,103.04,92.74,United Healthcare,Default,Fee Schedule,84.08,,,,60.79,84.08
ANCHOR HEALIX 4.5MM,278,RC,,,,both,1197.65,1077.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,838.36,,,,706.61,977.28
ANCHOR HEALIX 4.5MM,278,RC,,,,both,1197.65,1077.89,Cigna,Default,Percent of Total Billed Charges,706.61,,,,706.61,977.28
ANCHOR HEALIX 4.5MM,278,RC,,,,both,1197.65,1077.89,United Healthcare,Default,Fee Schedule,977.28,,,,706.61,977.28
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,239.86,215.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,167.9,,,,141.52,195.73
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,239.86,215.87,Cigna,Default,Percent of Total Billed Charges,141.52,,,,141.52,195.73
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,239.86,215.87,United Healthcare,Default,Fee Schedule,195.73,,,,141.52,195.73
MOBI-C CERVICAL DISC PROSTHESIS 17X17,L8699,HCPCS,278,RC,,both,15282.5,13754.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10697.75,,,,9016.68,12470.52
MOBI-C CERVICAL DISC PROSTHESIS 17X17,L8699,HCPCS,278,RC,,both,15282.5,13754.25,Cigna,Default,Percent of Total Billed Charges,9016.68,,,,9016.68,12470.52
MOBI-C CERVICAL DISC PROSTHESIS 17X17,L8699,HCPCS,278,RC,,both,15282.5,13754.25,United Healthcare,Default,Fee Schedule,12470.52,,,,9016.68,12470.52
CARBOJET TUBE,272,RC,,,,both,544.38,489.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,381.07,,,,321.18,444.21
CARBOJET TUBE,272,RC,,,,both,544.38,489.94,Cigna,Default,Percent of Total Billed Charges,321.18,,,,321.18,444.21
CARBOJET TUBE,272,RC,,,,both,544.38,489.94,United Healthcare,Default,Fee Schedule,444.21,,,,321.18,444.21
SCREW- 40MM,278,RC,,,,both,90.73,81.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.51,,,,53.53,74.04
SCREW- 40MM,278,RC,,,,both,90.73,81.66,Cigna,Default,Percent of Total Billed Charges,53.53,,,,53.53,74.04
SCREW- 40MM,278,RC,,,,both,90.73,81.66,United Healthcare,Default,Fee Schedule,74.04,,,,53.53,74.04
FEMORAL FIXATION 4 HOLE 135 DEGREE,278,RC,,,,both,1521.3,1369.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1064.91,,,,897.57,1241.38
FEMORAL FIXATION 4 HOLE 135 DEGREE,278,RC,,,,both,1521.3,1369.17,Cigna,Default,Percent of Total Billed Charges,897.57,,,,897.57,1241.38
FEMORAL FIXATION 4 HOLE 135 DEGREE,278,RC,,,,both,1521.3,1369.17,United Healthcare,Default,Fee Schedule,1241.38,,,,897.57,1241.38
SCREW LAG 70MM 12.7 MM,C1713,HCPCS,278,RC,,both,965.12,868.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,675.58,,,,569.42,787.54
SCREW LAG 70MM 12.7 MM,C1713,HCPCS,278,RC,,both,965.12,868.61,Cigna,Default,Percent of Total Billed Charges,569.42,,,,569.42,787.54
SCREW LAG 70MM 12.7 MM,C1713,HCPCS,278,RC,,both,965.12,868.61,United Healthcare,Default,Fee Schedule,787.54,,,,569.42,787.54
GUIDE WIRE 3.2X230MM,272,RC,,,,both,585,526.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,409.5,,,,345.15,477.36
GUIDE WIRE 3.2X230MM,272,RC,,,,both,585,526.5,Cigna,Default,Percent of Total Billed Charges,345.15,,,,345.15,477.36
GUIDE WIRE 3.2X230MM,272,RC,,,,both,585,526.5,United Healthcare,Default,Fee Schedule,477.36,,,,345.15,477.36
IMPACTOR HEAD,272,RC,,,,both,498.73,448.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.11,,,,294.25,406.96
IMPACTOR HEAD,272,RC,,,,both,498.73,448.86,Cigna,Default,Percent of Total Billed Charges,294.25,,,,294.25,406.96
IMPACTOR HEAD,272,RC,,,,both,498.73,448.86,United Healthcare,Default,Fee Schedule,406.96,,,,294.25,406.96
SCREW COMPRESSION 1/2 IN,278,RC,,,,both,241.75,217.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.22,,,,142.63,197.27
SCREW COMPRESSION 1/2 IN,278,RC,,,,both,241.75,217.58,Cigna,Default,Percent of Total Billed Charges,142.63,,,,142.63,197.27
SCREW COMPRESSION 1/2 IN,278,RC,,,,both,241.75,217.58,United Healthcare,Default,Fee Schedule,197.27,,,,142.63,197.27
SCREW- 42MM,278,RC,,,,both,90.73,81.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.51,,,,53.53,74.04
SCREW- 42MM,278,RC,,,,both,90.73,81.66,Cigna,Default,Percent of Total Billed Charges,53.53,,,,53.53,74.04
SCREW- 42MM,278,RC,,,,both,90.73,81.66,United Healthcare,Default,Fee Schedule,74.04,,,,53.53,74.04
DVR LOCK NARROW R,C1713,HCPCS,278,RC,,both,3063.35,2757.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2144.34,,,,1807.38,2499.69
DVR LOCK NARROW R,C1713,HCPCS,278,RC,,both,3063.35,2757.02,Cigna,Default,Percent of Total Billed Charges,1807.38,,,,1807.38,2499.69
DVR LOCK NARROW R,C1713,HCPCS,278,RC,,both,3063.35,2757.02,United Healthcare,Default,Fee Schedule,2499.69,,,,1807.38,2499.69
SCREW 2.7MM  15MM,C1713,HCPCS,278,RC,,both,246.71,222.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.7,,,,145.56,201.32
SCREW 2.7MM  15MM,C1713,HCPCS,278,RC,,both,246.71,222.04,Cigna,Default,Percent of Total Billed Charges,145.56,,,,145.56,201.32
SCREW 2.7MM  15MM,C1713,HCPCS,278,RC,,both,246.71,222.04,United Healthcare,Default,Fee Schedule,201.32,,,,145.56,201.32
SHEATH 18FR,272,RC,,,,both,439.02,395.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.31,,,,259.02,358.24
SHEATH 18FR,272,RC,,,,both,439.02,395.12,Cigna,Default,Percent of Total Billed Charges,259.02,,,,259.02,358.24
SHEATH 18FR,272,RC,,,,both,439.02,395.12,United Healthcare,Default,Fee Schedule,358.24,,,,259.02,358.24
SHEATH 12FR,272,RC,,,,both,277.47,249.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,194.23,,,,163.71,226.42
SHEATH 12FR,272,RC,,,,both,277.47,249.72,Cigna,Default,Percent of Total Billed Charges,163.71,,,,163.71,226.42
SHEATH 12FR,272,RC,,,,both,277.47,249.72,United Healthcare,Default,Fee Schedule,226.42,,,,163.71,226.42
GRAFT,C1768,HCPCS,278,RC,,both,26880.79,24192.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18816.55,,,,15859.67,21934.72
GRAFT,C1768,HCPCS,278,RC,,both,26880.79,24192.71,Cigna,Default,Percent of Total Billed Charges,15859.67,,,,15859.67,21934.72
GRAFT,C1768,HCPCS,278,RC,,both,26880.79,24192.71,United Healthcare,Default,Fee Schedule,21934.72,,,,15859.67,21934.72
GRAFT - LINE EXTENDER,C1768,HCPCS,278,RC,,both,10572.59,9515.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7400.81,,,,6237.83,8627.23
GRAFT - LINE EXTENDER,C1768,HCPCS,278,RC,,both,10572.59,9515.33,Cigna,Default,Percent of Total Billed Charges,6237.83,,,,6237.83,8627.23
GRAFT - LINE EXTENDER,C1768,HCPCS,278,RC,,both,10572.59,9515.33,United Healthcare,Default,Fee Schedule,8627.23,,,,6237.83,8627.23
GRAFT 10 10,278,RC,,,,both,12643.86,11379.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8850.7,,,,7459.88,10317.39
GRAFT 10 10,278,RC,,,,both,12643.86,11379.47,Cigna,Default,Percent of Total Billed Charges,7459.88,,,,7459.88,10317.39
GRAFT 10 10,278,RC,,,,both,12643.86,11379.47,United Healthcare,Default,Fee Schedule,10317.39,,,,7459.88,10317.39
FEMUR POROUS,278,RC,,,,both,22302.18,20071.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15611.53,,,,13158.29,18198.58
FEMUR POROUS,278,RC,,,,both,22302.18,20071.96,Cigna,Default,Percent of Total Billed Charges,13158.29,,,,13158.29,18198.58
FEMUR POROUS,278,RC,,,,both,22302.18,20071.96,United Healthcare,Default,Fee Schedule,18198.58,,,,13158.29,18198.58
TRAY TIBIAL TRAP,272,RC,,,,both,13557.02,12201.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9489.91,,,,7998.64,11062.53
TRAY TIBIAL TRAP,272,RC,,,,both,13557.02,12201.32,Cigna,Default,Percent of Total Billed Charges,7998.64,,,,7998.64,11062.53
TRAY TIBIAL TRAP,272,RC,,,,both,13557.02,12201.32,United Healthcare,Default,Fee Schedule,11062.53,,,,7998.64,11062.53
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7919.98,7127.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5543.99,,,,4672.79,6462.7
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7919.98,7127.98,Cigna,Default,Percent of Total Billed Charges,4672.79,,,,4672.79,6462.7
TIBIAL INSERT CR SLOPE,278,RC,,,,both,7919.98,7127.98,United Healthcare,Default,Fee Schedule,6462.7,,,,4672.79,6462.7
DNU DRILL BIT,C1713,HCPCS,272,RC,,both,1277.25,1149.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,894.08,,,,753.58,1042.24
DNU DRILL BIT,C1713,HCPCS,272,RC,,both,1277.25,1149.53,Cigna,Default,Percent of Total Billed Charges,753.58,,,,753.58,1042.24
DNU DRILL BIT,C1713,HCPCS,272,RC,,both,1277.25,1149.53,United Healthcare,Default,Fee Schedule,1042.24,,,,753.58,1042.24
PROXIMAL TIBIAL SPACER,278,RC,,,,both,5759.98,5183.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4031.99,,,,3398.39,4700.14
PROXIMAL TIBIAL SPACER,278,RC,,,,both,5759.98,5183.98,Cigna,Default,Percent of Total Billed Charges,3398.39,,,,3398.39,4700.14
PROXIMAL TIBIAL SPACER,278,RC,,,,both,5759.98,5183.98,United Healthcare,Default,Fee Schedule,4700.14,,,,3398.39,4700.14
CREO MIS 5.5MM 80MM CURVED ROD TITANIUM,C1713,HCPCS,278,RC,,both,1248.75,1123.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,874.12,,,,736.76,1018.98
CREO MIS 5.5MM 80MM CURVED ROD TITANIUM,C1713,HCPCS,278,RC,,both,1248.75,1123.88,Cigna,Default,Percent of Total Billed Charges,736.76,,,,736.76,1018.98
CREO MIS 5.5MM 80MM CURVED ROD TITANIUM,C1713,HCPCS,278,RC,,both,1248.75,1123.88,United Healthcare,Default,Fee Schedule,1018.98,,,,736.76,1018.98
SCREW 4.0MM - 40 MM LENGTH,278,RC,,,,both,491.7,442.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.19,,,,290.1,401.23
SCREW 4.0MM - 40 MM LENGTH,278,RC,,,,both,491.7,442.53,Cigna,Default,Percent of Total Billed Charges,290.1,,,,290.1,401.23
SCREW 4.0MM - 40 MM LENGTH,278,RC,,,,both,491.7,442.53,United Healthcare,Default,Fee Schedule,401.23,,,,290.1,401.23
SCREW 4.0MM - 44 MM LENGTH,278,RC,,,,both,491.7,442.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.19,,,,290.1,401.23
SCREW 4.0MM - 44 MM LENGTH,278,RC,,,,both,491.7,442.53,Cigna,Default,Percent of Total Billed Charges,290.1,,,,290.1,401.23
SCREW 4.0MM - 44 MM LENGTH,278,RC,,,,both,491.7,442.53,United Healthcare,Default,Fee Schedule,401.23,,,,290.1,401.23
SCREW 4.0MM - 48 MM LENGTH,278,RC,,,,both,491.7,442.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.19,,,,290.1,401.23
SCREW 4.0MM - 48 MM LENGTH,278,RC,,,,both,491.7,442.53,Cigna,Default,Percent of Total Billed Charges,290.1,,,,290.1,401.23
SCREW 4.0MM - 48 MM LENGTH,278,RC,,,,both,491.7,442.53,United Healthcare,Default,Fee Schedule,401.23,,,,290.1,401.23
SCREW 4.0MM - 50 MM LENGTH,278,RC,,,,both,491.7,442.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.19,,,,290.1,401.23
SCREW 4.0MM - 50 MM LENGTH,278,RC,,,,both,491.7,442.53,Cigna,Default,Percent of Total Billed Charges,290.1,,,,290.1,401.23
SCREW 4.0MM - 50 MM LENGTH,278,RC,,,,both,491.7,442.53,United Healthcare,Default,Fee Schedule,401.23,,,,290.1,401.23
BONE SCREW 6.5x35,C1713,HCPCS,278,RC,,both,236.46,212.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.52,,,,139.51,192.95
BONE SCREW 6.5x35,C1713,HCPCS,278,RC,,both,236.46,212.81,Cigna,Default,Percent of Total Billed Charges,139.51,,,,139.51,192.95
BONE SCREW 6.5x35,C1713,HCPCS,278,RC,,both,236.46,212.81,United Healthcare,Default,Fee Schedule,192.95,,,,139.51,192.95
K-WIRE .35X6 DBL TRO 6PK NS,272,RC,,,,both,301.52,271.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.06,,,,177.9,246.04
K-WIRE .35X6 DBL TRO 6PK NS,272,RC,,,,both,301.52,271.37,Cigna,Default,Percent of Total Billed Charges,177.9,,,,177.9,246.04
K-WIRE .35X6 DBL TRO 6PK NS,272,RC,,,,both,301.52,271.37,United Healthcare,Default,Fee Schedule,246.04,,,,177.9,246.04
K-WIRE .045X6 DBL TRO 6PK NS,272,RC,,,,both,301.52,271.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.06,,,,177.9,246.04
K-WIRE .045X6 DBL TRO 6PK NS,272,RC,,,,both,301.52,271.37,Cigna,Default,Percent of Total Billed Charges,177.9,,,,177.9,246.04
K-WIRE .045X6 DBL TRO 6PK NS,272,RC,,,,both,301.52,271.37,United Healthcare,Default,Fee Schedule,246.04,,,,177.9,246.04
Z NAIL 5.0X30 CORT SCREW FA,C1713,HCPCS,278,RC,,both,691.46,622.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,484.02,,,,407.96,564.23
Z NAIL 5.0X30 CORT SCREW FA,C1713,HCPCS,278,RC,,both,691.46,622.31,Cigna,Default,Percent of Total Billed Charges,407.96,,,,407.96,564.23
Z NAIL 5.0X30 CORT SCREW FA,C1713,HCPCS,278,RC,,both,691.46,622.31,United Healthcare,Default,Fee Schedule,564.23,,,,407.96,564.23
CONTINUUM MULTI-HOLE SHELL 64 OO,C1776,HCPCS,278,RC,,both,8909.61,8018.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6236.73,,,,5256.67,7270.24
CONTINUUM MULTI-HOLE SHELL 64 OO,C1776,HCPCS,278,RC,,both,8909.61,8018.65,Cigna,Default,Percent of Total Billed Charges,5256.67,,,,5256.67,7270.24
CONTINUUM MULTI-HOLE SHELL 64 OO,C1776,HCPCS,278,RC,,both,8909.61,8018.65,United Healthcare,Default,Fee Schedule,7270.24,,,,5256.67,7270.24
CONTINUUM MULTI-HOLE SHELL 62NN,C1776,HCPCS,278,RC,,both,7326,6593.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5128.2,,,,4322.34,5978.02
CONTINUUM MULTI-HOLE SHELL 62NN,C1776,HCPCS,278,RC,,both,7326,6593.4,Cigna,Default,Percent of Total Billed Charges,4322.34,,,,4322.34,5978.02
CONTINUUM MULTI-HOLE SHELL 62NN,C1776,HCPCS,278,RC,,both,7326,6593.4,United Healthcare,Default,Fee Schedule,5978.02,,,,4322.34,5978.02
SCREW LOCKING CAP NCB,C1713,HCPCS,278,RC,,both,720,648,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504,,,,424.8,587.52
SCREW LOCKING CAP NCB,C1713,HCPCS,278,RC,,both,720,648,Cigna,Default,Percent of Total Billed Charges,424.8,,,,424.8,587.52
SCREW LOCKING CAP NCB,C1713,HCPCS,278,RC,,both,720,648,United Healthcare,Default,Fee Schedule,587.52,,,,424.8,587.52
SCREW 5.0 CANCELLOUS 65MM,278,RC,,,,both,667.32,600.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.12,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 65MM,278,RC,,,,both,667.32,600.59,Cigna,Default,Percent of Total Billed Charges,393.72,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 65MM,278,RC,,,,both,667.32,600.59,United Healthcare,Default,Fee Schedule,544.53,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 80MM,278,RC,,,,both,667.32,600.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.12,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 80MM,278,RC,,,,both,667.32,600.59,Cigna,Default,Percent of Total Billed Charges,393.72,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 80MM,278,RC,,,,both,667.32,600.59,United Healthcare,Default,Fee Schedule,544.53,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 85MM,278,RC,,,,both,667.32,600.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.12,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 85MM,278,RC,,,,both,667.32,600.59,Cigna,Default,Percent of Total Billed Charges,393.72,,,,393.72,544.53
SCREW 5.0 CANCELLOUS 85MM,278,RC,,,,both,667.32,600.59,United Healthcare,Default,Fee Schedule,544.53,,,,393.72,544.53
"SCREW NCB 5.0,L. 34MM",278,RC,,,,both,790.24,711.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.17,,,,466.24,644.84
"SCREW NCB 5.0,L. 34MM",278,RC,,,,both,790.24,711.22,Cigna,Default,Percent of Total Billed Charges,466.24,,,,466.24,644.84
"SCREW NCB 5.0,L. 34MM",278,RC,,,,both,790.24,711.22,United Healthcare,Default,Fee Schedule,644.84,,,,466.24,644.84
Z NAIL 5.0X32.5 CORT SCREW,C1713,HCPCS,278,RC,,both,708.75,637.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,496.12,,,,418.16,578.34
Z NAIL 5.0X32.5 CORT SCREW,C1713,HCPCS,278,RC,,both,708.75,637.88,Cigna,Default,Percent of Total Billed Charges,418.16,,,,418.16,578.34
Z NAIL 5.0X32.5 CORT SCREW,C1713,HCPCS,278,RC,,both,708.75,637.88,United Healthcare,Default,Fee Schedule,578.34,,,,418.16,578.34
"NCB DRILL BIT 4.3MM,L. 195MM",272,RC,,,,both,540.87,486.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,378.61,,,,319.11,441.35
"NCB DRILL BIT 4.3MM,L. 195MM",272,RC,,,,both,540.87,486.78,Cigna,Default,Percent of Total Billed Charges,319.11,,,,319.11,441.35
"NCB DRILL BIT 4.3MM,L. 195MM",272,RC,,,,both,540.87,486.78,United Healthcare,Default,Fee Schedule,441.35,,,,319.11,441.35
Z NAIL 5.0X27.5 CORT SCREW,C1713,HCPCS,278,RC,,both,691.46,622.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,484.02,,,,407.96,564.23
Z NAIL 5.0X27.5 CORT SCREW,C1713,HCPCS,278,RC,,both,691.46,622.31,Cigna,Default,Percent of Total Billed Charges,407.96,,,,407.96,564.23
Z NAIL 5.0X27.5 CORT SCREW,C1713,HCPCS,278,RC,,both,691.46,622.31,United Healthcare,Default,Fee Schedule,564.23,,,,407.96,564.23
CALIBRATED DRILL 4.3MM LONG,271,RC,,,,both,382.78,344.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.95,,,,225.84,312.35
CALIBRATED DRILL 4.3MM LONG,271,RC,,,,both,382.78,344.5,Cigna,Default,Percent of Total Billed Charges,225.84,,,,225.84,312.35
CALIBRATED DRILL 4.3MM LONG,271,RC,,,,both,382.78,344.5,United Healthcare,Default,Fee Schedule,312.35,,,,225.84,312.35
"CONTINUUM LONGEVITY NEUTRAL LINER, II 32",C1776,HCPCS,278,RC,,both,3172.31,2855.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2220.62,,,,1871.66,2588.6
"CONTINUUM LONGEVITY NEUTRAL LINER, II 32",C1776,HCPCS,278,RC,,both,3172.31,2855.08,Cigna,Default,Percent of Total Billed Charges,1871.66,,,,1871.66,2588.6
"CONTINUUM LONGEVITY NEUTRAL LINER, II 32",C1776,HCPCS,278,RC,,both,3172.31,2855.08,United Healthcare,Default,Fee Schedule,2588.6,,,,1871.66,2588.6
PLATE TIBIA NCB PROXIMAL,C1713,HCPCS,278,RC,,both,2708.44,2437.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1895.91,,,,1597.98,2210.09
PLATE TIBIA NCB PROXIMAL,C1713,HCPCS,278,RC,,both,2708.44,2437.6,Cigna,Default,Percent of Total Billed Charges,1597.98,,,,1597.98,2210.09
PLATE TIBIA NCB PROXIMAL,C1713,HCPCS,278,RC,,both,2708.44,2437.6,United Healthcare,Default,Fee Schedule,2210.09,,,,1597.98,2210.09
PERI SCREW 3.5MMX10MM W2.7MM HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MMX10MM W2.7MM HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MMX10MM W2.7MM HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
PERI SCREW 3.5MM X 24MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MM X 24MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MM X 24MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
BONE SCREW 6.5 X 30MM,278,RC,,,,both,513.66,462.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,359.56,,,,303.06,419.15
BONE SCREW 6.5 X 30MM,278,RC,,,,both,513.66,462.29,Cigna,Default,Percent of Total Billed Charges,303.06,,,,303.06,419.15
BONE SCREW 6.5 X 30MM,278,RC,,,,both,513.66,462.29,United Healthcare,Default,Fee Schedule,419.15,,,,303.06,419.15
PERI SCREW 3.5MM X 40MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MM X 40MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MM X 40MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
LOCKING SCREW 3.5MM X 20MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,358.1,322.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,250.67,,,,211.28,292.21
LOCKING SCREW 3.5MM X 20MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,358.1,322.29,Cigna,Default,Percent of Total Billed Charges,211.28,,,,211.28,292.21
LOCKING SCREW 3.5MM X 20MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,358.1,322.29,United Healthcare,Default,Fee Schedule,292.21,,,,211.28,292.21
"FEMORAL STEM SZ 11, 145MM",278,RC,,,,both,20290.28,18261.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14203.2,,,,11971.27,16556.87
"FEMORAL STEM SZ 11, 145MM",278,RC,,,,both,20290.28,18261.25,Cigna,Default,Percent of Total Billed Charges,11971.27,,,,11971.27,16556.87
"FEMORAL STEM SZ 11, 145MM",278,RC,,,,both,20290.28,18261.25,United Healthcare,Default,Fee Schedule,16556.87,,,,11971.27,16556.87
BONE SCREW,C1713,HCPCS,278,RC,,both,233.1,209.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.17,,,,137.53,190.21
BONE SCREW,C1713,HCPCS,278,RC,,both,233.1,209.79,Cigna,Default,Percent of Total Billed Charges,137.53,,,,137.53,190.21
BONE SCREW,C1713,HCPCS,278,RC,,both,233.1,209.79,United Healthcare,Default,Fee Schedule,190.21,,,,137.53,190.21
NCB  QC 3.3MM X 195MM,272,RC,,,,both,597.07,537.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,417.95,,,,352.27,487.21
NCB  QC 3.3MM X 195MM,272,RC,,,,both,597.07,537.36,Cigna,Default,Percent of Total Billed Charges,352.27,,,,352.27,487.21
NCB  QC 3.3MM X 195MM,272,RC,,,,both,597.07,537.36,United Healthcare,Default,Fee Schedule,487.21,,,,352.27,487.21
2.5MM QC 180MM BIT,272,RC,,,,both,449.56,404.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.69,,,,265.24,366.84
2.5MM QC 180MM BIT,272,RC,,,,both,449.56,404.6,Cigna,Default,Percent of Total Billed Charges,265.24,,,,265.24,366.84
2.5MM QC 180MM BIT,272,RC,,,,both,449.56,404.6,United Healthcare,Default,Fee Schedule,366.84,,,,265.24,366.84
GUIDE WIRE NCB-PH,278,RC,,,,both,86.5,77.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.55,,,,51.04,70.58
GUIDE WIRE NCB-PH,278,RC,,,,both,86.5,77.85,Cigna,Default,Percent of Total Billed Charges,51.04,,,,51.04,70.58
GUIDE WIRE NCB-PH,278,RC,,,,both,86.5,77.85,United Healthcare,Default,Fee Schedule,70.58,,,,51.04,70.58
"FEMORAL STEM SZ 14, 160MM",278,RC,,,,both,18263.34,16437.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12784.34,,,,10775.37,14902.89
"FEMORAL STEM SZ 14, 160MM",278,RC,,,,both,18263.34,16437.01,Cigna,Default,Percent of Total Billed Charges,10775.37,,,,10775.37,14902.89
"FEMORAL STEM SZ 14, 160MM",278,RC,,,,both,18263.34,16437.01,United Healthcare,Default,Fee Schedule,14902.89,,,,10775.37,14902.89
FEMORAL HEAD 36MM O.D.,278,RC,,,,both,4280.48,3852.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2996.34,,,,2525.48,3492.87
FEMORAL HEAD 36MM O.D.,278,RC,,,,both,4280.48,3852.43,Cigna,Default,Percent of Total Billed Charges,2525.48,,,,2525.48,3492.87
FEMORAL HEAD 36MM O.D.,278,RC,,,,both,4280.48,3852.43,United Healthcare,Default,Fee Schedule,3492.87,,,,2525.48,3492.87
"CROWN CUP 2, 36MM I.D.",278,RC,,,,both,6311.39,5680.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4417.97,,,,3723.72,5150.09
"CROWN CUP 2, 36MM I.D.",278,RC,,,,both,6311.39,5680.25,Cigna,Default,Percent of Total Billed Charges,3723.72,,,,3723.72,5150.09
"CROWN CUP 2, 36MM I.D.",278,RC,,,,both,6311.39,5680.25,United Healthcare,Default,Fee Schedule,5150.09,,,,3723.72,5150.09
DRILL BIT 20MM 4.5 NOVATION,278,RC,,,,both,242.34,218.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.64,,,,142.98,197.75
DRILL BIT 20MM 4.5 NOVATION,278,RC,,,,both,242.34,218.11,Cigna,Default,Percent of Total Billed Charges,142.98,,,,142.98,197.75
DRILL BIT 20MM 4.5 NOVATION,278,RC,,,,both,242.34,218.11,United Healthcare,Default,Fee Schedule,197.75,,,,142.98,197.75
BONE SCREW 6.5 X 20,C1713,HCPCS,278,RC,,both,236.46,212.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.52,,,,139.51,192.95
BONE SCREW 6.5 X 20,C1713,HCPCS,278,RC,,both,236.46,212.81,Cigna,Default,Percent of Total Billed Charges,139.51,,,,139.51,192.95
BONE SCREW 6.5 X 20,C1713,HCPCS,278,RC,,both,236.46,212.81,United Healthcare,Default,Fee Schedule,192.95,,,,139.51,192.95
CUP CLUSTER-HOLE SHELL,278,RC,,,,both,7759.64,6983.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5431.75,,,,4578.19,6331.87
CUP CLUSTER-HOLE SHELL,278,RC,,,,both,7759.64,6983.68,Cigna,Default,Percent of Total Billed Charges,4578.19,,,,4578.19,6331.87
CUP CLUSTER-HOLE SHELL,278,RC,,,,both,7759.64,6983.68,United Healthcare,Default,Fee Schedule,6331.87,,,,4578.19,6331.87
CUP CROWN CLUSTER-HOLE,278,RC,,,,both,7551.27,6796.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5285.89,,,,4455.25,6161.84
CUP CROWN CLUSTER-HOLE,278,RC,,,,both,7551.27,6796.14,Cigna,Default,Percent of Total Billed Charges,4455.25,,,,4455.25,6161.84
CUP CROWN CLUSTER-HOLE,278,RC,,,,both,7551.27,6796.14,United Healthcare,Default,Fee Schedule,6161.84,,,,4455.25,6161.84
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,2913.4,2622.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2039.38,,,,1718.91,2377.33
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,2913.4,2622.06,Cigna,Default,Percent of Total Billed Charges,1718.91,,,,1718.91,2377.33
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,2913.4,2622.06,United Healthcare,Default,Fee Schedule,2377.33,,,,1718.91,2377.33
PERIARTICULAR LOCKING PEG,278,RC,,,,both,227.52,204.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.26,,,,134.24,185.66
PERIARTICULAR LOCKING PEG,278,RC,,,,both,227.52,204.77,Cigna,Default,Percent of Total Billed Charges,134.24,,,,134.24,185.66
PERIARTICULAR LOCKING PEG,278,RC,,,,both,227.52,204.77,United Healthcare,Default,Fee Schedule,185.66,,,,134.24,185.66
PERIARTICULAR LOCKING SCREW 2.4MMX20MM,278,RC,,,,both,377.93,340.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.55,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX20MM,278,RC,,,,both,377.93,340.14,Cigna,Default,Percent of Total Billed Charges,222.98,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX20MM,278,RC,,,,both,377.93,340.14,United Healthcare,Default,Fee Schedule,308.39,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX22MM,278,RC,,,,both,377.93,340.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.55,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX22MM,278,RC,,,,both,377.93,340.14,Cigna,Default,Percent of Total Billed Charges,222.98,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX22MM,278,RC,,,,both,377.93,340.14,United Healthcare,Default,Fee Schedule,308.39,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX14MM,278,RC,,,,both,300.86,270.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.6,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX14MM,278,RC,,,,both,300.86,270.77,Cigna,Default,Percent of Total Billed Charges,177.51,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX14MM,278,RC,,,,both,300.86,270.77,United Healthcare,Default,Fee Schedule,245.5,,,,177.51,245.5
BIT 1.8MM,272,RC,,,,both,1049.1,944.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,734.37,,,,618.97,856.07
BIT 1.8MM,272,RC,,,,both,1049.1,944.19,Cigna,Default,Percent of Total Billed Charges,618.97,,,,618.97,856.07
BIT 1.8MM,272,RC,,,,both,1049.1,944.19,United Healthcare,Default,Fee Schedule,856.07,,,,618.97,856.07
K-WIRES 1.6MMX150MM,278,RC,,,,both,277.42,249.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,194.19,,,,163.68,226.37
K-WIRES 1.6MMX150MM,278,RC,,,,both,277.42,249.68,Cigna,Default,Percent of Total Billed Charges,163.68,,,,163.68,226.37
K-WIRES 1.6MMX150MM,278,RC,,,,both,277.42,249.68,United Healthcare,Default,Fee Schedule,226.37,,,,163.68,226.37
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,3052.85,2747.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2137,,,,1801.18,2491.13
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,3052.85,2747.57,Cigna,Default,Percent of Total Billed Charges,1801.18,,,,1801.18,2491.13
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,3052.85,2747.57,United Healthcare,Default,Fee Schedule,2491.13,,,,1801.18,2491.13
PERIARTICULAR LOCKING SCREW 2.4MMX18MM,278,RC,,,,both,377.93,340.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.55,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX18MM,278,RC,,,,both,377.93,340.14,Cigna,Default,Percent of Total Billed Charges,222.98,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX18MM,278,RC,,,,both,377.93,340.14,United Healthcare,Default,Fee Schedule,308.39,,,,222.98,308.39
PERIARTICULAR LOCKING SCREW 2.4MMX16MM,278,RC,,,,both,300.86,270.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.6,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX16MM,278,RC,,,,both,300.86,270.77,Cigna,Default,Percent of Total Billed Charges,177.51,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX16MM,278,RC,,,,both,300.86,270.77,United Healthcare,Default,Fee Schedule,245.5,,,,177.51,245.5
SCREW CORTICAL 2.7X22MM,C1713,HCPCS,278,RC,,both,89.38,80.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.57,,,,52.73,72.93
SCREW CORTICAL 2.7X22MM,C1713,HCPCS,278,RC,,both,89.38,80.44,Cigna,Default,Percent of Total Billed Charges,52.73,,,,52.73,72.93
SCREW CORTICAL 2.7X22MM,C1713,HCPCS,278,RC,,both,89.38,80.44,United Healthcare,Default,Fee Schedule,72.93,,,,52.73,72.93
SCREW CORTICAL 2.7X14MM,C1713,HCPCS,278,RC,,both,87.2,78.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.04,,,,51.45,71.16
SCREW CORTICAL 2.7X14MM,C1713,HCPCS,278,RC,,both,87.2,78.48,Cigna,Default,Percent of Total Billed Charges,51.45,,,,51.45,71.16
SCREW CORTICAL 2.7X14MM,C1713,HCPCS,278,RC,,both,87.2,78.48,United Healthcare,Default,Fee Schedule,71.16,,,,51.45,71.16
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,2913.4,2622.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2039.38,,,,1718.91,2377.33
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,2913.4,2622.06,Cigna,Default,Percent of Total Billed Charges,1718.91,,,,1718.91,2377.33
DISTAL VOTAR RADIAL LOCKING PLATE,278,RC,,,,both,2913.4,2622.06,United Healthcare,Default,Fee Schedule,2377.33,,,,1718.91,2377.33
K-WIRES TROCAR POINT 1.25MM X 150MM,278,RC,,,,both,277.42,249.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,194.19,,,,163.68,226.37
K-WIRES TROCAR POINT 1.25MM X 150MM,278,RC,,,,both,277.42,249.68,Cigna,Default,Percent of Total Billed Charges,163.68,,,,163.68,226.37
K-WIRES TROCAR POINT 1.25MM X 150MM,278,RC,,,,both,277.42,249.68,United Healthcare,Default,Fee Schedule,226.37,,,,163.68,226.37
ELEMENT STEM,278,RC,,,,both,18729.48,16856.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13110.64,,,,11050.39,15283.26
ELEMENT STEM,278,RC,,,,both,18729.48,16856.53,Cigna,Default,Percent of Total Billed Charges,11050.39,,,,11050.39,15283.26
ELEMENT STEM,278,RC,,,,both,18729.48,16856.53,United Healthcare,Default,Fee Schedule,15283.26,,,,11050.39,15283.26
DRILL BIT Q-C 2.5MM DIA 110MM,272,RC,,,,both,267.09,240.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.96,,,,157.58,217.95
DRILL BIT Q-C 2.5MM DIA 110MM,272,RC,,,,both,267.09,240.38,Cigna,Default,Percent of Total Billed Charges,157.58,,,,157.58,217.95
DRILL BIT Q-C 2.5MM DIA 110MM,272,RC,,,,both,267.09,240.38,United Healthcare,Default,Fee Schedule,217.95,,,,157.58,217.95
FEMORAL HEAD 36MM O.D.,278,RC,,,,both,6505.08,5854.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4553.56,,,,3838,5308.15
FEMORAL HEAD 36MM O.D.,278,RC,,,,both,6505.08,5854.57,Cigna,Default,Percent of Total Billed Charges,3838,,,,3838,5308.15
FEMORAL HEAD 36MM O.D.,278,RC,,,,both,6505.08,5854.57,United Healthcare,Default,Fee Schedule,5308.15,,,,3838,5308.15
PERIARTICULAR LOCKING SCREW 2.4MMX12MM,278,RC,,,,both,300.86,270.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.6,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX12MM,278,RC,,,,both,300.86,270.77,Cigna,Default,Percent of Total Billed Charges,177.51,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX12MM,278,RC,,,,both,300.86,270.77,United Healthcare,Default,Fee Schedule,245.5,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX18MM,278,RC,,,,both,300.86,270.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.6,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX18MM,278,RC,,,,both,300.86,270.77,Cigna,Default,Percent of Total Billed Charges,177.51,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX18MM,278,RC,,,,both,300.86,270.77,United Healthcare,Default,Fee Schedule,245.5,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX22MM,278,RC,,,,both,300.86,270.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.6,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX22MM,278,RC,,,,both,300.86,270.77,Cigna,Default,Percent of Total Billed Charges,177.51,,,,177.51,245.5
PERIARTICULAR LOCKING SCREW 2.4MMX22MM,278,RC,,,,both,300.86,270.77,United Healthcare,Default,Fee Schedule,245.5,,,,177.51,245.5
PERIARTICULAR CORTICAL SCREW 16MMX3.5MM,C1713,HCPCS,278,RC,,both,162.88,146.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.02,,,,96.1,132.91
PERIARTICULAR CORTICAL SCREW 16MMX3.5MM,C1713,HCPCS,278,RC,,both,162.88,146.59,Cigna,Default,Percent of Total Billed Charges,96.1,,,,96.1,132.91
PERIARTICULAR CORTICAL SCREW 16MMX3.5MM,C1713,HCPCS,278,RC,,both,162.88,146.59,United Healthcare,Default,Fee Schedule,132.91,,,,96.1,132.91
LOCKING SCREW,278,RC,,,,both,373.47,336.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.43,,,,220.35,304.75
LOCKING SCREW,278,RC,,,,both,373.47,336.12,Cigna,Default,Percent of Total Billed Charges,220.35,,,,220.35,304.75
LOCKING SCREW,278,RC,,,,both,373.47,336.12,United Healthcare,Default,Fee Schedule,304.75,,,,220.35,304.75
2.0 STANDARD DRILL QC 175MM LONG,272,RC,,,,both,2682.81,2414.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1877.97,,,,1582.86,2189.17
2.0 STANDARD DRILL QC 175MM LONG,272,RC,,,,both,2682.81,2414.53,Cigna,Default,Percent of Total Billed Charges,1582.86,,,,1582.86,2189.17
2.0 STANDARD DRILL QC 175MM LONG,272,RC,,,,both,2682.81,2414.53,United Healthcare,Default,Fee Schedule,2189.17,,,,1582.86,2189.17
2.0 STANDARD DRILL QC 100MM LONG,272,RC,,,,both,241.89,217.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.32,,,,142.72,197.38
2.0 STANDARD DRILL QC 100MM LONG,272,RC,,,,both,241.89,217.7,Cigna,Default,Percent of Total Billed Charges,142.72,,,,142.72,197.38
2.0 STANDARD DRILL QC 100MM LONG,272,RC,,,,both,241.89,217.7,United Healthcare,Default,Fee Schedule,197.38,,,,142.72,197.38
2.5 STANDARD DRILL QC 110MM LONG,272,RC,,,,both,241.89,217.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.32,,,,142.72,197.38
2.5 STANDARD DRILL QC 110MM LONG,272,RC,,,,both,241.89,217.7,Cigna,Default,Percent of Total Billed Charges,142.72,,,,142.72,197.38
2.5 STANDARD DRILL QC 110MM LONG,272,RC,,,,both,241.89,217.7,United Healthcare,Default,Fee Schedule,197.38,,,,142.72,197.38
K-WIRE,272,RC,,,,both,277.42,249.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,194.19,,,,163.68,226.37
K-WIRE,272,RC,,,,both,277.42,249.68,Cigna,Default,Percent of Total Billed Charges,163.68,,,,163.68,226.37
K-WIRE,272,RC,,,,both,277.42,249.68,United Healthcare,Default,Fee Schedule,226.37,,,,163.68,226.37
PLATE PERIARTICULAR DISTAL LATERAL FIBUL,272,RC,,,,both,2543.62,2289.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1780.53,,,,1500.74,2075.59
PLATE PERIARTICULAR DISTAL LATERAL FIBUL,272,RC,,,,both,2543.62,2289.26,Cigna,Default,Percent of Total Billed Charges,1500.74,,,,1500.74,2075.59
PLATE PERIARTICULAR DISTAL LATERAL FIBUL,272,RC,,,,both,2543.62,2289.26,United Healthcare,Default,Fee Schedule,2075.59,,,,1500.74,2075.59
SCREW FORTE CANCELLOUS 4.0MMX18MM,272,RC,,,,both,234.03,210.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.82,,,,138.08,190.97
SCREW FORTE CANCELLOUS 4.0MMX18MM,272,RC,,,,both,234.03,210.63,Cigna,Default,Percent of Total Billed Charges,138.08,,,,138.08,190.97
SCREW FORTE CANCELLOUS 4.0MMX18MM,272,RC,,,,both,234.03,210.63,United Healthcare,Default,Fee Schedule,190.97,,,,138.08,190.97
SCREW FORTE CANCELLOUS 4.0MMX20MM,272,RC,,,,both,209.92,188.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.94,,,,123.85,171.29
SCREW FORTE CANCELLOUS 4.0MMX20MM,272,RC,,,,both,209.92,188.93,Cigna,Default,Percent of Total Billed Charges,123.85,,,,123.85,171.29
SCREW FORTE CANCELLOUS 4.0MMX20MM,272,RC,,,,both,209.92,188.93,United Healthcare,Default,Fee Schedule,171.29,,,,123.85,171.29
SCREW FORTE CANCELLOUS 4.0MMX22MM,272,RC,,,,both,209.92,188.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.94,,,,123.85,171.29
SCREW FORTE CANCELLOUS 4.0MMX22MM,272,RC,,,,both,209.92,188.93,Cigna,Default,Percent of Total Billed Charges,123.85,,,,123.85,171.29
SCREW FORTE CANCELLOUS 4.0MMX22MM,272,RC,,,,both,209.92,188.93,United Healthcare,Default,Fee Schedule,171.29,,,,123.85,171.29
GUIDE WIRE 1.6,C1769,HCPCS,278,RC,,both,152.03,136.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.42,,,,89.7,124.06
GUIDE WIRE 1.6,C1769,HCPCS,278,RC,,both,152.03,136.83,Cigna,Default,Percent of Total Billed Charges,89.7,,,,89.7,124.06
GUIDE WIRE 1.6,C1769,HCPCS,278,RC,,both,152.03,136.83,United Healthcare,Default,Fee Schedule,124.06,,,,89.7,124.06
DRILL BIT 30MM 4.5,278,RC,,,,both,249.61,224.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.73,,,,147.27,203.68
DRILL BIT 30MM 4.5,278,RC,,,,both,249.61,224.65,Cigna,Default,Percent of Total Billed Charges,147.27,,,,147.27,203.68
DRILL BIT 30MM 4.5,278,RC,,,,both,249.61,224.65,United Healthcare,Default,Fee Schedule,203.68,,,,147.27,203.68
"CONTINUUM LONGEVITY NEUTRAL LINER, JJ 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, JJ 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, JJ 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
CONTINUUM MULTI-HOLE SHELL,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5282.05,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Cigna,Default,Percent of Total Billed Charges,4452.01,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL,C1776,HCPCS,278,RC,,both,7545.78,6791.2,United Healthcare,Default,Fee Schedule,6157.36,,,,4452.01,6157.36
"CONTINUUM LONGEVITY NEUTRAL LINER, HH 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, HH 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, HH 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
PERI SCREW 3.5MM X 24MM W/2.7MM HEAD SEL,278,RC,,,,both,162.62,146.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.83,,,,95.95,132.7
PERI SCREW 3.5MM X 24MM W/2.7MM HEAD SEL,278,RC,,,,both,162.62,146.36,Cigna,Default,Percent of Total Billed Charges,95.95,,,,95.95,132.7
PERI SCREW 3.5MM X 24MM W/2.7MM HEAD SEL,278,RC,,,,both,162.62,146.36,United Healthcare,Default,Fee Schedule,132.7,,,,95.95,132.7
ELEMENT STEM,278,RC,,,,both,20290.28,18261.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14203.2,,,,11971.27,16556.87
ELEMENT STEM,278,RC,,,,both,20290.28,18261.25,Cigna,Default,Percent of Total Billed Charges,11971.27,,,,11971.27,16556.87
ELEMENT STEM,278,RC,,,,both,20290.28,18261.25,United Healthcare,Default,Fee Schedule,16556.87,,,,11971.27,16556.87
FEMORAL HEAD BIOLOX,278,RC,,,,both,8547.55,7692.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5983.28,,,,5043.05,6974.8
FEMORAL HEAD BIOLOX,278,RC,,,,both,8547.55,7692.8,Cigna,Default,Percent of Total Billed Charges,5043.05,,,,5043.05,6974.8
FEMORAL HEAD BIOLOX,278,RC,,,,both,8547.55,7692.8,United Healthcare,Default,Fee Schedule,6974.8,,,,5043.05,6974.8
CROWN CUP NOVATION,278,RC,,,,both,7551.27,6796.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5285.89,,,,4455.25,6161.84
CROWN CUP NOVATION,278,RC,,,,both,7551.27,6796.14,Cigna,Default,Percent of Total Billed Charges,4455.25,,,,4455.25,6161.84
CROWN CUP NOVATION,278,RC,,,,both,7551.27,6796.14,United Healthcare,Default,Fee Schedule,6161.84,,,,4455.25,6161.84
CROWN CUP NOVATION LINER,278,RC,,,,both,7042.45,6338.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4929.72,,,,4155.05,5746.64
CROWN CUP NOVATION LINER,278,RC,,,,both,7042.45,6338.21,Cigna,Default,Percent of Total Billed Charges,4155.05,,,,4155.05,5746.64
CROWN CUP NOVATION LINER,278,RC,,,,both,7042.45,6338.21,United Healthcare,Default,Fee Schedule,5746.64,,,,4155.05,5746.64
CANNULATED DRILL TRINKLE END,272,RC,,,,both,1758.14,1582.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1230.7,,,,1037.3,1434.64
CANNULATED DRILL TRINKLE END,272,RC,,,,both,1758.14,1582.33,Cigna,Default,Percent of Total Billed Charges,1037.3,,,,1037.3,1434.64
CANNULATED DRILL TRINKLE END,272,RC,,,,both,1758.14,1582.33,United Healthcare,Default,Fee Schedule,1434.64,,,,1037.3,1434.64
GUIDE PIN 2.4MMX9IN PARTIAL THREAD TRO,272,RC,,,,both,448.76,403.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.13,,,,264.77,366.19
GUIDE PIN 2.4MMX9IN PARTIAL THREAD TRO,272,RC,,,,both,448.76,403.88,Cigna,Default,Percent of Total Billed Charges,264.77,,,,264.77,366.19
GUIDE PIN 2.4MMX9IN PARTIAL THREAD TRO,272,RC,,,,both,448.76,403.88,United Healthcare,Default,Fee Schedule,366.19,,,,264.77,366.19
WASHER FOR 4.5MM SCREW,272,RC,,,,both,164.62,148.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.23,,,,97.13,134.33
WASHER FOR 4.5MM SCREW,272,RC,,,,both,164.62,148.16,Cigna,Default,Percent of Total Billed Charges,97.13,,,,97.13,134.33
WASHER FOR 4.5MM SCREW,272,RC,,,,both,164.62,148.16,United Healthcare,Default,Fee Schedule,134.33,,,,97.13,134.33
CANNULATED SCREW 4.5MMX70MM 1/3 THREAD,272,RC,,,,both,725.61,653.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,507.93,,,,428.11,592.1
CANNULATED SCREW 4.5MMX70MM 1/3 THREAD,272,RC,,,,both,725.61,653.05,Cigna,Default,Percent of Total Billed Charges,428.11,,,,428.11,592.1
CANNULATED SCREW 4.5MMX70MM 1/3 THREAD,272,RC,,,,both,725.61,653.05,United Healthcare,Default,Fee Schedule,592.1,,,,428.11,592.1
GUIDE PIN 1.6MM X 9IN PARTIAL THREAD TIP,272,RC,,,,both,426.86,384.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,298.8,,,,251.85,348.32
GUIDE PIN 1.6MM X 9IN PARTIAL THREAD TIP,272,RC,,,,both,426.86,384.17,Cigna,Default,Percent of Total Billed Charges,251.85,,,,251.85,348.32
GUIDE PIN 1.6MM X 9IN PARTIAL THREAD TIP,272,RC,,,,both,426.86,384.17,United Healthcare,Default,Fee Schedule,348.32,,,,251.85,348.32
WASHER FOR 5.5 THRU 7.5 SCREWS,272,RC,,,,both,164.62,148.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.23,,,,97.13,134.33
WASHER FOR 5.5 THRU 7.5 SCREWS,272,RC,,,,both,164.62,148.16,Cigna,Default,Percent of Total Billed Charges,97.13,,,,97.13,134.33
WASHER FOR 5.5 THRU 7.5 SCREWS,272,RC,,,,both,164.62,148.16,United Healthcare,Default,Fee Schedule,134.33,,,,97.13,134.33
GUIDE PIN 3.2MM X 12IN PARTIAL THRD TIP,272,RC,,,,both,448.56,403.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,313.99,,,,264.65,366.02
GUIDE PIN 3.2MM X 12IN PARTIAL THRD TIP,272,RC,,,,both,448.56,403.7,Cigna,Default,Percent of Total Billed Charges,264.65,,,,264.65,366.02
GUIDE PIN 3.2MM X 12IN PARTIAL THRD TIP,272,RC,,,,both,448.56,403.7,United Healthcare,Default,Fee Schedule,366.02,,,,264.65,366.02
FEMORAL COMPONENT SIZE E,C1776,HCPCS,278,RC,,both,14336.77,12903.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10035.74,,,,8458.69,11698.8
FEMORAL COMPONENT SIZE E,C1776,HCPCS,278,RC,,both,14336.77,12903.09,Cigna,Default,Percent of Total Billed Charges,8458.69,,,,8458.69,11698.8
FEMORAL COMPONENT SIZE E,C1776,HCPCS,278,RC,,both,14336.77,12903.09,United Healthcare,Default,Fee Schedule,11698.8,,,,8458.69,11698.8
SCREW CANNULATED 4.0MMX46MM 1/2 THREAD,278,RC,,,,both,675.83,608.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,473.08,,,,398.74,551.48
SCREW CANNULATED 4.0MMX46MM 1/2 THREAD,278,RC,,,,both,675.83,608.25,Cigna,Default,Percent of Total Billed Charges,398.74,,,,398.74,551.48
SCREW CANNULATED 4.0MMX46MM 1/2 THREAD,278,RC,,,,both,675.83,608.25,United Healthcare,Default,Fee Schedule,551.48,,,,398.74,551.48
CONTINUUM MULTI-HOLE SHELL 56 KK,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5282.05,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 56 KK,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Cigna,Default,Percent of Total Billed Charges,4452.01,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 56 KK,C1776,HCPCS,278,RC,,both,7545.78,6791.2,United Healthcare,Default,Fee Schedule,6157.36,,,,4452.01,6157.36
SCREW CANNULATED 6.5MMX80MMX16MM THREAD,C1713,HCPCS,278,RC,,both,818.12,736.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,572.68,,,,482.69,667.59
SCREW CANNULATED 6.5MMX80MMX16MM THREAD,C1713,HCPCS,278,RC,,both,818.12,736.31,Cigna,Default,Percent of Total Billed Charges,482.69,,,,482.69,667.59
SCREW CANNULATED 6.5MMX80MMX16MM THREAD,C1713,HCPCS,278,RC,,both,818.12,736.31,United Healthcare,Default,Fee Schedule,667.59,,,,482.69,667.59
SCREW CANNULATED 6.5MMX85MMX16MM THREAD,278,RC,,,,both,818.12,736.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,572.68,,,,482.69,667.59
SCREW CANNULATED 6.5MMX85MMX16MM THREAD,278,RC,,,,both,818.12,736.31,Cigna,Default,Percent of Total Billed Charges,482.69,,,,482.69,667.59
SCREW CANNULATED 6.5MMX85MMX16MM THREAD,278,RC,,,,both,818.12,736.31,United Healthcare,Default,Fee Schedule,667.59,,,,482.69,667.59
SCREW CANNULATED 6.5MMX100MMX16MM THREAD,278,RC,,,,both,818.12,736.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,572.68,,,,482.69,667.59
SCREW CANNULATED 6.5MMX100MMX16MM THREAD,278,RC,,,,both,818.12,736.31,Cigna,Default,Percent of Total Billed Charges,482.69,,,,482.69,667.59
SCREW CANNULATED 6.5MMX100MMX16MM THREAD,278,RC,,,,both,818.12,736.31,United Healthcare,Default,Fee Schedule,667.59,,,,482.69,667.59
FEMORAL COMPONENT SIZE G,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
FEMORAL COMPONENT SIZE G,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
FEMORAL COMPONENT SIZE G,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
LEGACY KNEE POSTERIOR STABILIZED SIZE G,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE G,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE G,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
STEMMED TIBIAL COMPONENT PRECOAT SIZE 7,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.95,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 7,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Cigna,Default,Percent of Total Billed Charges,1976.46,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 7,C1776,HCPCS,278,RC,,both,3349.93,3014.94,United Healthcare,Default,Fee Schedule,2733.54,,,,1976.46,2733.54
"LPS-FLEX GSF OPTION FEMORAL, SIZE C-LT",C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
"LPS-FLEX GSF OPTION FEMORAL, SIZE C-LT",C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
"LPS-FLEX GSF OPTION FEMORAL, SIZE C-LT",C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
Z NAIL 10.5X110 LAG SCREW,C1713,HCPCS,278,RC,,both,2033.6,1830.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1423.52,,,,1199.82,1659.42
Z NAIL 10.5X110 LAG SCREW,C1713,HCPCS,278,RC,,both,2033.6,1830.24,Cigna,Default,Percent of Total Billed Charges,1199.82,,,,1199.82,1659.42
Z NAIL 10.5X110 LAG SCREW,C1713,HCPCS,278,RC,,both,2033.6,1830.24,United Healthcare,Default,Fee Schedule,1659.42,,,,1199.82,1659.42
"CONTINUUM LONGEVITY NEUTRAL LINER, KK 32",C1776,HCPCS,278,RC,,both,3172.31,2855.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2220.62,,,,1871.66,2588.6
"CONTINUUM LONGEVITY NEUTRAL LINER, KK 32",C1776,HCPCS,278,RC,,both,3172.31,2855.08,Cigna,Default,Percent of Total Billed Charges,1871.66,,,,1871.66,2588.6
"CONTINUUM LONGEVITY NEUTRAL LINER, KK 32",C1776,HCPCS,278,RC,,both,3172.31,2855.08,United Healthcare,Default,Fee Schedule,2588.6,,,,1871.66,2588.6
LEGACY KNEE POSTERIOR STABILIZED SIZE EF,C1776,HCPCS,278,RC,,both,4072.94,3665.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2851.06,,,,2403.03,3323.52
LEGACY KNEE POSTERIOR STABILIZED SIZE EF,C1776,HCPCS,278,RC,,both,4072.94,3665.65,Cigna,Default,Percent of Total Billed Charges,2403.03,,,,2403.03,3323.52
LEGACY KNEE POSTERIOR STABILIZED SIZE EF,C1776,HCPCS,278,RC,,both,4072.94,3665.65,United Healthcare,Default,Fee Schedule,3323.52,,,,2403.03,3323.52
SCREW CANNULATED 4.5 40MM,C1713,HCPCS,278,RC,,both,685.97,617.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,480.18,,,,404.72,559.75
SCREW CANNULATED 4.5 40MM,C1713,HCPCS,278,RC,,both,685.97,617.37,Cigna,Default,Percent of Total Billed Charges,404.72,,,,404.72,559.75
SCREW CANNULATED 4.5 40MM,C1713,HCPCS,278,RC,,both,685.97,617.37,United Healthcare,Default,Fee Schedule,559.75,,,,404.72,559.75
SCREW CANNULATED 4.5  52MM,C1713,HCPCS,278,RC,,both,878.04,790.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,614.63,,,,518.04,716.48
SCREW CANNULATED 4.5  52MM,C1713,HCPCS,278,RC,,both,878.04,790.24,Cigna,Default,Percent of Total Billed Charges,518.04,,,,518.04,716.48
SCREW CANNULATED 4.5  52MM,C1713,HCPCS,278,RC,,both,878.04,790.24,United Healthcare,Default,Fee Schedule,716.48,,,,518.04,716.48
WASHER 10 MM,278,RC,,,,both,126.94,114.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.86,,,,74.89,103.58
WASHER 10 MM,278,RC,,,,both,126.94,114.25,Cigna,Default,Percent of Total Billed Charges,74.89,,,,74.89,103.58
WASHER 10 MM,278,RC,,,,both,126.94,114.25,United Healthcare,Default,Fee Schedule,103.58,,,,74.89,103.58
SCREW CANNULATED 7.3MM  100MM,C1713,HCPCS,278,RC,,both,878.04,790.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,614.63,,,,518.04,716.48
SCREW CANNULATED 7.3MM  100MM,C1713,HCPCS,278,RC,,both,878.04,790.24,Cigna,Default,Percent of Total Billed Charges,518.04,,,,518.04,716.48
SCREW CANNULATED 7.3MM  100MM,C1713,HCPCS,278,RC,,both,878.04,790.24,United Healthcare,Default,Fee Schedule,716.48,,,,518.04,716.48
SCREW CANNULATED 7.3MM  115MM,C1713,HCPCS,278,RC,,both,899.99,809.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,629.99,,,,530.99,734.39
SCREW CANNULATED 7.3MM  115MM,C1713,HCPCS,278,RC,,both,899.99,809.99,Cigna,Default,Percent of Total Billed Charges,530.99,,,,530.99,734.39
SCREW CANNULATED 7.3MM  115MM,C1713,HCPCS,278,RC,,both,899.99,809.99,United Healthcare,Default,Fee Schedule,734.39,,,,530.99,734.39
SCREW CANNULATED7.3  95MM,C1713,HCPCS,278,RC,,both,878.04,790.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,614.63,,,,518.04,716.48
SCREW CANNULATED7.3  95MM,C1713,HCPCS,278,RC,,both,878.04,790.24,Cigna,Default,Percent of Total Billed Charges,518.04,,,,518.04,716.48
SCREW CANNULATED7.3  95MM,C1713,HCPCS,278,RC,,both,878.04,790.24,United Healthcare,Default,Fee Schedule,716.48,,,,518.04,716.48
SCREW CANNULATED 4.5 52MM,C1713,HCPCS,278,RC,,both,798.04,718.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,558.63,,,,470.84,651.2
SCREW CANNULATED 4.5 52MM,C1713,HCPCS,278,RC,,both,798.04,718.24,Cigna,Default,Percent of Total Billed Charges,470.84,,,,470.84,651.2
SCREW CANNULATED 4.5 52MM,C1713,HCPCS,278,RC,,both,798.04,718.24,United Healthcare,Default,Fee Schedule,651.2,,,,470.84,651.2
FEMORAL COMPONENT SIZE E-LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
FEMORAL COMPONENT SIZE E-LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
FEMORAL COMPONENT SIZE E-LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
ALL-POLY PATELLA 38MM,C1776,HCPCS,278,RC,,both,1978.48,1780.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1384.94,,,,1167.3,1614.44
ALL-POLY PATELLA 38MM,C1776,HCPCS,278,RC,,both,1978.48,1780.63,Cigna,Default,Percent of Total Billed Charges,1167.3,,,,1167.3,1614.44
ALL-POLY PATELLA 38MM,C1776,HCPCS,278,RC,,both,1978.48,1780.63,United Healthcare,Default,Fee Schedule,1614.44,,,,1167.3,1614.44
PATELLA REAMER BLADE SIZE 46,272,RC,,,,both,509.35,458.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,356.54,,,,300.52,415.63
PATELLA REAMER BLADE SIZE 46,272,RC,,,,both,509.35,458.42,Cigna,Default,Percent of Total Billed Charges,300.52,,,,300.52,415.63
PATELLA REAMER BLADE SIZE 46,272,RC,,,,both,509.35,458.42,United Healthcare,Default,Fee Schedule,415.63,,,,300.52,415.63
FEMORAL COMPONENT SIZE D LEFT,C1776,HCPCS,278,RC,,both,11730.28,10557.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8211.2,,,,6920.87,9571.91
FEMORAL COMPONENT SIZE D LEFT,C1776,HCPCS,278,RC,,both,11730.28,10557.25,Cigna,Default,Percent of Total Billed Charges,6920.87,,,,6920.87,9571.91
FEMORAL COMPONENT SIZE D LEFT,C1776,HCPCS,278,RC,,both,11730.28,10557.25,United Healthcare,Default,Fee Schedule,9571.91,,,,6920.87,9571.91
FEMORAL HEAD 32MM-3.5,C1776,HCPCS,278,RC,,both,2117.93,1906.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1482.55,,,,1249.58,1728.23
FEMORAL HEAD 32MM-3.5,C1776,HCPCS,278,RC,,both,2117.93,1906.14,Cigna,Default,Percent of Total Billed Charges,1249.58,,,,1249.58,1728.23
FEMORAL HEAD 32MM-3.5,C1776,HCPCS,278,RC,,both,2117.93,1906.14,United Healthcare,Default,Fee Schedule,1728.23,,,,1249.58,1728.23
VERSYS FM MC CLR 15X160MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8667.22,,,,7305.23,10103.51
VERSYS FM MC CLR 15X160MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,Cigna,Default,Percent of Total Billed Charges,7305.23,,,,7305.23,10103.51
VERSYS FM MC CLR 15X160MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,United Healthcare,Default,Fee Schedule,10103.51,,,,7305.23,10103.51
PERIARTICULAR LOCKING SCREW 2.4MMX14MM,C1713,HCPCS,278,RC,,both,381.53,343.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.07,,,,225.1,311.33
PERIARTICULAR LOCKING SCREW 2.4MMX14MM,C1713,HCPCS,278,RC,,both,381.53,343.38,Cigna,Default,Percent of Total Billed Charges,225.1,,,,225.1,311.33
PERIARTICULAR LOCKING SCREW 2.4MMX14MM,C1713,HCPCS,278,RC,,both,381.53,343.38,United Healthcare,Default,Fee Schedule,311.33,,,,225.1,311.33
PERI LOCKING SCREW 3.5MMX16MM,C1713,HCPCS,278,RC,,both,381.53,343.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.07,,,,225.1,311.33
PERI LOCKING SCREW 3.5MMX16MM,C1713,HCPCS,278,RC,,both,381.53,343.38,Cigna,Default,Percent of Total Billed Charges,225.1,,,,225.1,311.33
PERI LOCKING SCREW 3.5MMX16MM,C1713,HCPCS,278,RC,,both,381.53,343.38,United Healthcare,Default,Fee Schedule,311.33,,,,225.1,311.33
SCREW CANNULATED 3.5MMX50MM 1/2 THREAD,C1713,HCPCS,278,RC,,both,666.76,600.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,466.73,,,,393.39,544.08
SCREW CANNULATED 3.5MMX50MM 1/2 THREAD,C1713,HCPCS,278,RC,,both,666.76,600.08,Cigna,Default,Percent of Total Billed Charges,393.39,,,,393.39,544.08
SCREW CANNULATED 3.5MMX50MM 1/2 THREAD,C1713,HCPCS,278,RC,,both,666.76,600.08,United Healthcare,Default,Fee Schedule,544.08,,,,393.39,544.08
GUIDE PIN 1.6MM X 6IN PARTIAL THREAD TIP,272,RC,,,,both,317.95,286.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,222.56,,,,187.59,259.45
GUIDE PIN 1.6MM X 6IN PARTIAL THREAD TIP,272,RC,,,,both,317.95,286.16,Cigna,Default,Percent of Total Billed Charges,187.59,,,,187.59,259.45
GUIDE PIN 1.6MM X 6IN PARTIAL THREAD TIP,272,RC,,,,both,317.95,286.16,United Healthcare,Default,Fee Schedule,259.45,,,,187.59,259.45
DRILL BIT Q-C 3.5MM DIA 110MM,272,RC,,,,both,267.09,240.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.96,,,,157.58,217.95
DRILL BIT Q-C 3.5MM DIA 110MM,272,RC,,,,both,267.09,240.38,Cigna,Default,Percent of Total Billed Charges,157.58,,,,157.58,217.95
DRILL BIT Q-C 3.5MM DIA 110MM,272,RC,,,,both,267.09,240.38,United Healthcare,Default,Fee Schedule,217.95,,,,157.58,217.95
FEMORAL HEAD 32MM+0,C1776,HCPCS,278,RC,,both,1397.66,1257.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,978.36,,,,824.62,1140.49
FEMORAL HEAD 32MM+0,C1776,HCPCS,278,RC,,both,1397.66,1257.89,Cigna,Default,Percent of Total Billed Charges,824.62,,,,824.62,1140.49
FEMORAL HEAD 32MM+0,C1776,HCPCS,278,RC,,both,1397.66,1257.89,United Healthcare,Default,Fee Schedule,1140.49,,,,824.62,1140.49
VERSYS 6 INCH BEADED FC 14X160MM STD NEC,C1776,HCPCS,278,RC,,both,8554.65,7699.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5988.26,,,,5047.24,6980.59
VERSYS 6 INCH BEADED FC 14X160MM STD NEC,C1776,HCPCS,278,RC,,both,8554.65,7699.19,Cigna,Default,Percent of Total Billed Charges,5047.24,,,,5047.24,6980.59
VERSYS 6 INCH BEADED FC 14X160MM STD NEC,C1776,HCPCS,278,RC,,both,8554.65,7699.19,United Healthcare,Default,Fee Schedule,6980.59,,,,5047.24,6980.59
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.05,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,Cigna,Default,Percent of Total Billed Charges,98.65,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,United Healthcare,Default,Fee Schedule,136.44,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.05,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,Cigna,Default,Percent of Total Billed Charges,98.65,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,United Healthcare,Default,Fee Schedule,136.44,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.05,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,Cigna,Default,Percent of Total Billed Charges,98.65,,,,98.65,136.44
SUTURE PASS THROUGH,272,RC,,,,both,167.21,150.49,United Healthcare,Default,Fee Schedule,136.44,,,,98.65,136.44
"CONTINUUM LONGEVITY NEUTRAL LINER, NN 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, NN 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, NN 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
VERSYS 6 INCH BEADED FC 15X160MM STD BOD,C1776,HCPCS,278,RC,,both,8554.65,7699.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5988.26,,,,5047.24,6980.59
VERSYS 6 INCH BEADED FC 15X160MM STD BOD,C1776,HCPCS,278,RC,,both,8554.65,7699.19,Cigna,Default,Percent of Total Billed Charges,5047.24,,,,5047.24,6980.59
VERSYS 6 INCH BEADED FC 15X160MM STD BOD,C1776,HCPCS,278,RC,,both,8554.65,7699.19,United Healthcare,Default,Fee Schedule,6980.59,,,,5047.24,6980.59
"CONTINUUM LONGEVITY NEUTRAL LINER, OO 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, OO 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, OO 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
CONTINUUM LONGEVITY NEUTRAL LINER II 36X,C1776,HCPCS,278,RC,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
CONTINUUM LONGEVITY NEUTRAL LINER II 36X,C1776,HCPCS,278,RC,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
CONTINUUM LONGEVITY NEUTRAL LINER II 36X,C1776,HCPCS,278,RC,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
CONTINUUM CLUSTER-HOLE SHELL 52 II,C1776,HCPCS,278,RC,,both,5440.8,4896.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3808.56,,,,3210.07,4439.69
CONTINUUM CLUSTER-HOLE SHELL 52 II,C1776,HCPCS,278,RC,,both,5440.8,4896.72,Cigna,Default,Percent of Total Billed Charges,3210.07,,,,3210.07,4439.69
CONTINUUM CLUSTER-HOLE SHELL 52 II,C1776,HCPCS,278,RC,,both,5440.8,4896.72,United Healthcare,Default,Fee Schedule,4439.69,,,,3210.07,4439.69
Z NAIL 5.0X100 LAG SREW,C1713,HCPCS,278,RC,,both,1984,1785.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1388.8,,,,1170.56,1618.94
Z NAIL 5.0X100 LAG SREW,C1713,HCPCS,278,RC,,both,1984,1785.6,Cigna,Default,Percent of Total Billed Charges,1170.56,,,,1170.56,1618.94
Z NAIL 5.0X100 LAG SREW,C1713,HCPCS,278,RC,,both,1984,1785.6,United Healthcare,Default,Fee Schedule,1618.94,,,,1170.56,1618.94
PASSER TWO PIN,272,RC,,,,both,797.68,717.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,558.38,,,,470.63,650.91
PASSER TWO PIN,272,RC,,,,both,797.68,717.91,Cigna,Default,Percent of Total Billed Charges,470.63,,,,470.63,650.91
PASSER TWO PIN,272,RC,,,,both,797.68,717.91,United Healthcare,Default,Fee Schedule,650.91,,,,470.63,650.91
CONTINUUM MULTI-HOLE SHELL 52 II,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5282.05,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 52 II,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Cigna,Default,Percent of Total Billed Charges,4452.01,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 52 II,C1776,HCPCS,278,RC,,both,7545.78,6791.2,United Healthcare,Default,Fee Schedule,6157.36,,,,4452.01,6157.36
NEXGEN LPS-FLEX OPTION FEMORAL SIZE G-LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
NEXGEN LPS-FLEX OPTION FEMORAL SIZE G-LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
NEXGEN LPS-FLEX OPTION FEMORAL SIZE G-LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
MODULAR HEAD 32MM+3MM NECK,C1776,HCPCS,278,RC,,both,1397.66,1257.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,978.36,,,,824.62,1140.49
MODULAR HEAD 32MM+3MM NECK,C1776,HCPCS,278,RC,,both,1397.66,1257.89,Cigna,Default,Percent of Total Billed Charges,824.62,,,,824.62,1140.49
MODULAR HEAD 32MM+3MM NECK,C1776,HCPCS,278,RC,,both,1397.66,1257.89,United Healthcare,Default,Fee Schedule,1140.49,,,,824.62,1140.49
Z NAIL 10.5X105 LAG SCREW,C1713,HCPCS,278,RC,,both,1984,1785.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1388.8,,,,1170.56,1618.94
Z NAIL 10.5X105 LAG SCREW,C1713,HCPCS,278,RC,,both,1984,1785.6,Cigna,Default,Percent of Total Billed Charges,1170.56,,,,1170.56,1618.94
Z NAIL 10.5X105 LAG SCREW,C1713,HCPCS,278,RC,,both,1984,1785.6,United Healthcare,Default,Fee Schedule,1618.94,,,,1170.56,1618.94
Z NAIL CPM 11.5MMX21.5CM 130R,278,RC,,,,both,5468.77,4921.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3828.14,,,,3226.57,4462.52
Z NAIL CPM 11.5MMX21.5CM 130R,278,RC,,,,both,5468.77,4921.89,Cigna,Default,Percent of Total Billed Charges,3226.57,,,,3226.57,4462.52
Z NAIL CPM 11.5MMX21.5CM 130R,278,RC,,,,both,5468.77,4921.89,United Healthcare,Default,Fee Schedule,4462.52,,,,3226.57,4462.52
CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
GDE PIN 3.2MM X 12IN PARTIAL THD TROCAR,272,RC,,,,both,277.12,249.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,193.98,,,,163.5,226.13
GDE PIN 3.2MM X 12IN PARTIAL THD TROCAR,272,RC,,,,both,277.12,249.41,Cigna,Default,Percent of Total Billed Charges,163.5,,,,163.5,226.13
GDE PIN 3.2MM X 12IN PARTIAL THD TROCAR,272,RC,,,,both,277.12,249.41,United Healthcare,Default,Fee Schedule,226.13,,,,163.5,226.13
CONTINUUM CLUSTER-HOLE SHELL 50 HH,C1776,HCPCS,278,RC,,both,7326,6593.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5128.2,,,,4322.34,5978.02
CONTINUUM CLUSTER-HOLE SHELL 50 HH,C1776,HCPCS,278,RC,,both,7326,6593.4,Cigna,Default,Percent of Total Billed Charges,4322.34,,,,4322.34,5978.02
CONTINUUM CLUSTER-HOLE SHELL 50 HH,C1776,HCPCS,278,RC,,both,7326,6593.4,United Healthcare,Default,Fee Schedule,5978.02,,,,4322.34,5978.02
SCREW FORTE CANCELLOUS 4.0MMX22MM FULL T,272,RC,,,,both,246.81,222.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.77,,,,145.62,201.4
SCREW FORTE CANCELLOUS 4.0MMX22MM FULL T,272,RC,,,,both,246.81,222.13,Cigna,Default,Percent of Total Billed Charges,145.62,,,,145.62,201.4
SCREW FORTE CANCELLOUS 4.0MMX22MM FULL T,272,RC,,,,both,246.81,222.13,United Healthcare,Default,Fee Schedule,201.4,,,,145.62,201.4
ACL KIT CAYENNE,272,RC,,,,both,1808.76,1627.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1266.13,,,,1067.17,1475.95
ACL KIT CAYENNE,272,RC,,,,both,1808.76,1627.88,Cigna,Default,Percent of Total Billed Charges,1067.17,,,,1067.17,1475.95
ACL KIT CAYENNE,272,RC,,,,both,1808.76,1627.88,United Healthcare,Default,Fee Schedule,1475.95,,,,1067.17,1475.95
SCREW 9 MM X 25MM,278,RC,,,,both,1428.93,1286.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1000.25,,,,843.07,1166.01
SCREW 9 MM X 25MM,278,RC,,,,both,1428.93,1286.04,Cigna,Default,Percent of Total Billed Charges,843.07,,,,843.07,1166.01
SCREW 9 MM X 25MM,278,RC,,,,both,1428.93,1286.04,United Healthcare,Default,Fee Schedule,1166.01,,,,843.07,1166.01
SCREW 8 MM X 25MM,278,RC,,,,both,1428.93,1286.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1000.25,,,,843.07,1166.01
SCREW 8 MM X 25MM,278,RC,,,,both,1428.93,1286.04,Cigna,Default,Percent of Total Billed Charges,843.07,,,,843.07,1166.01
SCREW 8 MM X 25MM,278,RC,,,,both,1428.93,1286.04,United Healthcare,Default,Fee Schedule,1166.01,,,,843.07,1166.01
BLADE CONMED,272,RC,,,,both,288.68,259.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,202.08,,,,170.32,235.56
BLADE CONMED,272,RC,,,,both,288.68,259.81,Cigna,Default,Percent of Total Billed Charges,170.32,,,,170.32,235.56
BLADE CONMED,272,RC,,,,both,288.68,259.81,United Healthcare,Default,Fee Schedule,235.56,,,,170.32,235.56
KNIFE ACL GRAFT DEPUY,272,RC,,,,both,562.16,505.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,393.51,,,,331.67,458.72
KNIFE ACL GRAFT DEPUY,272,RC,,,,both,562.16,505.94,Cigna,Default,Percent of Total Billed Charges,331.67,,,,331.67,458.72
KNIFE ACL GRAFT DEPUY,272,RC,,,,both,562.16,505.94,United Healthcare,Default,Fee Schedule,458.72,,,,331.67,458.72
SCREW 8 MM X 25MM,278,RC,,,,both,1428.93,1286.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1000.25,,,,843.07,1166.01
SCREW 8 MM X 25MM,278,RC,,,,both,1428.93,1286.04,Cigna,Default,Percent of Total Billed Charges,843.07,,,,843.07,1166.01
SCREW 8 MM X 25MM,278,RC,,,,both,1428.93,1286.04,United Healthcare,Default,Fee Schedule,1166.01,,,,843.07,1166.01
NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
PERI SCREW 3.5MM X 20MM W/2.7MM HEAD SEL,C1713,HCPCS,278,RC,,both,162.88,146.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.02,,,,96.1,132.91
PERI SCREW 3.5MM X 20MM W/2.7MM HEAD SEL,C1713,HCPCS,278,RC,,both,162.88,146.59,Cigna,Default,Percent of Total Billed Charges,96.1,,,,96.1,132.91
PERI SCREW 3.5MM X 20MM W/2.7MM HEAD SEL,C1713,HCPCS,278,RC,,both,162.88,146.59,United Healthcare,Default,Fee Schedule,132.91,,,,96.1,132.91
6.5MM CANNULATED SCREW 16MM THD 100MM,272,RC,,,,both,827.3,744.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,579.11,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 100MM,272,RC,,,,both,827.3,744.57,Cigna,Default,Percent of Total Billed Charges,488.11,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 100MM,272,RC,,,,both,827.3,744.57,United Healthcare,Default,Fee Schedule,675.08,,,,488.11,675.08
CONTINUUM MULTI-HOLE SHELL 48 GG,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5282.05,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 48 GG,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Cigna,Default,Percent of Total Billed Charges,4452.01,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 48 GG,C1776,HCPCS,278,RC,,both,7545.78,6791.2,United Healthcare,Default,Fee Schedule,6157.36,,,,4452.01,6157.36
SCREW SPEED,278,RC,,,,both,1266.14,1139.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,886.3,,,,747.02,1033.17
SCREW SPEED,278,RC,,,,both,1266.14,1139.53,Cigna,Default,Percent of Total Billed Charges,747.02,,,,747.02,1033.17
SCREW SPEED,278,RC,,,,both,1266.14,1139.53,United Healthcare,Default,Fee Schedule,1033.17,,,,747.02,1033.17
PATELLA REAMER BLADE SIZE 51,272,RC,,,,both,509.35,458.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,356.54,,,,300.52,415.63
PATELLA REAMER BLADE SIZE 51,272,RC,,,,both,509.35,458.42,Cigna,Default,Percent of Total Billed Charges,300.52,,,,300.52,415.63
PATELLA REAMER BLADE SIZE 51,272,RC,,,,both,509.35,458.42,United Healthcare,Default,Fee Schedule,415.63,,,,300.52,415.63
6.5MM CANNULATED SCREW 16MM THD 105MM,C1713,HCPCS,278,RC,,both,827.29,744.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,579.1,,,,488.1,675.07
6.5MM CANNULATED SCREW 16MM THD 105MM,C1713,HCPCS,278,RC,,both,827.29,744.56,Cigna,Default,Percent of Total Billed Charges,488.1,,,,488.1,675.07
6.5MM CANNULATED SCREW 16MM THD 105MM,C1713,HCPCS,278,RC,,both,827.29,744.56,United Healthcare,Default,Fee Schedule,675.07,,,,488.1,675.07
6.5MM CANNULATED SCREW 16MM THD 110MM,C1713,HCPCS,278,RC,,both,827.29,744.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,579.1,,,,488.1,675.07
6.5MM CANNULATED SCREW 16MM THD 110MM,C1713,HCPCS,278,RC,,both,827.29,744.56,Cigna,Default,Percent of Total Billed Charges,488.1,,,,488.1,675.07
6.5MM CANNULATED SCREW 16MM THD 110MM,C1713,HCPCS,278,RC,,both,827.29,744.56,United Healthcare,Default,Fee Schedule,675.07,,,,488.1,675.07
WIRE MAGNUM,278,RC,,,,both,111.35,100.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.94,,,,65.7,90.86
WIRE MAGNUM,278,RC,,,,both,111.35,100.22,Cigna,Default,Percent of Total Billed Charges,65.7,,,,65.7,90.86
WIRE MAGNUM,278,RC,,,,both,111.35,100.22,United Healthcare,Default,Fee Schedule,90.86,,,,65.7,90.86
DISTAL LATERAL FIBULA RADIAL LOCKING 10H,278,RC,,,,both,3085.24,2776.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2159.67,,,,1820.29,2517.56
DISTAL LATERAL FIBULA RADIAL LOCKING 10H,278,RC,,,,both,3085.24,2776.72,Cigna,Default,Percent of Total Billed Charges,1820.29,,,,1820.29,2517.56
DISTAL LATERAL FIBULA RADIAL LOCKING 10H,278,RC,,,,both,3085.24,2776.72,United Healthcare,Default,Fee Schedule,2517.56,,,,1820.29,2517.56
PIN GUIDE 1.6MM X 6IN PARTIAL THREAD,278,RC,,,,both,335.36,301.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,234.75,,,,197.86,273.65
PIN GUIDE 1.6MM X 6IN PARTIAL THREAD,278,RC,,,,both,335.36,301.82,Cigna,Default,Percent of Total Billed Charges,197.86,,,,197.86,273.65
PIN GUIDE 1.6MM X 6IN PARTIAL THREAD,278,RC,,,,both,335.36,301.82,United Healthcare,Default,Fee Schedule,273.65,,,,197.86,273.65
4.0MM CANNULATED SCREW 1/3 THD 46MM,C1713,HCPCS,278,RC,,both,708.75,637.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,496.12,,,,418.16,578.34
4.0MM CANNULATED SCREW 1/3 THD 46MM,C1713,HCPCS,278,RC,,both,708.75,637.88,Cigna,Default,Percent of Total Billed Charges,418.16,,,,418.16,578.34
4.0MM CANNULATED SCREW 1/3 THD 46MM,C1713,HCPCS,278,RC,,both,708.75,637.88,United Healthcare,Default,Fee Schedule,578.34,,,,418.16,578.34
DRILL HAND FREE 4.3MM 152.5MM,272,RC,,,,both,368.85,331.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,258.2,,,,217.62,300.98
DRILL HAND FREE 4.3MM 152.5MM,272,RC,,,,both,368.85,331.97,Cigna,Default,Percent of Total Billed Charges,217.62,,,,217.62,300.98
DRILL HAND FREE 4.3MM 152.5MM,272,RC,,,,both,368.85,331.97,United Healthcare,Default,Fee Schedule,300.98,,,,217.62,300.98
Z NAIL 5.0X40 CORT SCREW FA,C1713,HCPCS,278,RC,,both,712.2,640.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,498.54,,,,420.2,581.16
Z NAIL 5.0X40 CORT SCREW FA,C1713,HCPCS,278,RC,,both,712.2,640.98,Cigna,Default,Percent of Total Billed Charges,420.2,,,,420.2,581.16
Z NAIL 5.0X40 CORT SCREW FA,C1713,HCPCS,278,RC,,both,712.2,640.98,United Healthcare,Default,Fee Schedule,581.16,,,,420.2,581.16
Z NAIL 5.0X42.5 CORT SCREW,C1713,HCPCS,278,RC,,both,730.01,657.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,511.01,,,,430.71,595.69
Z NAIL 5.0X42.5 CORT SCREW,C1713,HCPCS,278,RC,,both,730.01,657.01,Cigna,Default,Percent of Total Billed Charges,430.71,,,,430.71,595.69
Z NAIL 5.0X42.5 CORT SCREW,C1713,HCPCS,278,RC,,both,730.01,657.01,United Healthcare,Default,Fee Schedule,595.69,,,,430.71,595.69
Z NAIL CPM 11.5MMX36CM,C1713,HCPCS,278,RC,,both,8215.88,7394.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5751.12,,,,4847.37,6704.16
Z NAIL CPM 11.5MMX36CM,C1713,HCPCS,278,RC,,both,8215.88,7394.29,Cigna,Default,Percent of Total Billed Charges,4847.37,,,,4847.37,6704.16
Z NAIL CPM 11.5MMX36CM,C1713,HCPCS,278,RC,,both,8215.88,7394.29,United Healthcare,Default,Fee Schedule,6704.16,,,,4847.37,6704.16
DRILL HAND FREE 3.3MM,272,RC,,,,both,684.13,615.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,478.89,,,,403.64,558.25
DRILL HAND FREE 3.3MM,272,RC,,,,both,684.13,615.72,Cigna,Default,Percent of Total Billed Charges,403.64,,,,403.64,558.25
DRILL HAND FREE 3.3MM,272,RC,,,,both,684.13,615.72,United Healthcare,Default,Fee Schedule,558.25,,,,403.64,558.25
DRILL CALIB HUM AFFIXUS,272,RC,,,,both,1823.28,1640.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1276.3,,,,1075.74,1487.8
DRILL CALIB HUM AFFIXUS,272,RC,,,,both,1823.28,1640.95,Cigna,Default,Percent of Total Billed Charges,1075.74,,,,1075.74,1487.8
DRILL CALIB HUM AFFIXUS,272,RC,,,,both,1823.28,1640.95,United Healthcare,Default,Fee Schedule,1487.8,,,,1075.74,1487.8
AFFIXUS HUM BALL NOSE GW ST,C1713,HCPCS,272,RC,,both,1440.56,1296.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1008.39,,,,849.93,1175.5
AFFIXUS HUM BALL NOSE GW ST,C1713,HCPCS,272,RC,,both,1440.56,1296.5,Cigna,Default,Percent of Total Billed Charges,849.93,,,,849.93,1175.5
AFFIXUS HUM BALL NOSE GW ST,C1713,HCPCS,272,RC,,both,1440.56,1296.5,United Healthcare,Default,Fee Schedule,1175.5,,,,849.93,1175.5
WIRE AIRSCH W/TROCAR 2.5MM,C1769,HCPCS,272,RC,,both,177.37,159.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.16,,,,104.65,144.73
WIRE AIRSCH W/TROCAR 2.5MM,C1769,HCPCS,272,RC,,both,177.37,159.63,Cigna,Default,Percent of Total Billed Charges,104.65,,,,104.65,144.73
WIRE AIRSCH W/TROCAR 2.5MM,C1769,HCPCS,272,RC,,both,177.37,159.63,United Healthcare,Default,Fee Schedule,144.73,,,,104.65,144.73
SCREW BLUNT TIP AFFIXUS 4X56MM,C1713,HCPCS,272,RC,,both,768.3,691.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,537.81,,,,453.3,626.93
SCREW BLUNT TIP AFFIXUS 4X56MM,C1713,HCPCS,272,RC,,both,768.3,691.47,Cigna,Default,Percent of Total Billed Charges,453.3,,,,453.3,626.93
SCREW BLUNT TIP AFFIXUS 4X56MM,C1713,HCPCS,272,RC,,both,768.3,691.47,United Healthcare,Default,Fee Schedule,626.93,,,,453.3,626.93
SCREW BONE ANN CORT 4X30MM,C1713,HCPCS,272,RC,,both,744.29,669.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,521,,,,439.13,607.34
SCREW BONE ANN CORT 4X30MM,C1713,HCPCS,272,RC,,both,744.29,669.86,Cigna,Default,Percent of Total Billed Charges,439.13,,,,439.13,607.34
SCREW BONE ANN CORT 4X30MM,C1713,HCPCS,272,RC,,both,744.29,669.86,United Healthcare,Default,Fee Schedule,607.34,,,,439.13,607.34
NAIL PROXIMAL HUMERUS RT LONG AFFIXUS 8.,C1713,HCPCS,272,RC,,both,7490.9,6741.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5243.63,,,,4419.63,6112.57
NAIL PROXIMAL HUMERUS RT LONG AFFIXUS 8.,C1713,HCPCS,272,RC,,both,7490.9,6741.81,Cigna,Default,Percent of Total Billed Charges,4419.63,,,,4419.63,6112.57
NAIL PROXIMAL HUMERUS RT LONG AFFIXUS 8.,C1713,HCPCS,272,RC,,both,7490.9,6741.81,United Healthcare,Default,Fee Schedule,6112.57,,,,4419.63,6112.57
CEMEX GENTA,278,RC,,,,both,1953.47,1758.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1367.43,,,,1152.55,1594.03
CEMEX GENTA,278,RC,,,,both,1953.47,1758.12,Cigna,Default,Percent of Total Billed Charges,1152.55,,,,1152.55,1594.03
CEMEX GENTA,278,RC,,,,both,1953.47,1758.12,United Healthcare,Default,Fee Schedule,1594.03,,,,1152.55,1594.03
PASTE BONE 10 CC,278,RC,,,,both,7596.84,6837.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5317.79,,,,4482.14,6199.02
PASTE BONE 10 CC,278,RC,,,,both,7596.84,6837.16,Cigna,Default,Percent of Total Billed Charges,4482.14,,,,4482.14,6199.02
PASTE BONE 10 CC,278,RC,,,,both,7596.84,6837.16,United Healthcare,Default,Fee Schedule,6199.02,,,,4482.14,6199.02
PASTE BONE OPTECURE,278,RC,,,,both,4775.16,4297.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3342.61,,,,2817.34,3896.53
PASTE BONE OPTECURE,278,RC,,,,both,4775.16,4297.64,Cigna,Default,Percent of Total Billed Charges,2817.34,,,,2817.34,3896.53
PASTE BONE OPTECURE,278,RC,,,,both,4775.16,4297.64,United Healthcare,Default,Fee Schedule,3896.53,,,,2817.34,3896.53
5CC BEAT-BSM KIT,C1713,HCPCS,278,RC,,both,4888.17,4399.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3421.72,,,,2884.02,3988.75
5CC BEAT-BSM KIT,C1713,HCPCS,278,RC,,both,4888.17,4399.35,Cigna,Default,Percent of Total Billed Charges,2884.02,,,,2884.02,3988.75
5CC BEAT-BSM KIT,C1713,HCPCS,278,RC,,both,4888.17,4399.35,United Healthcare,Default,Fee Schedule,3988.75,,,,2884.02,3988.75
CONTINUUM VIVACIT-E NEUTRAL LINER LL 36M,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER LL 36M,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER LL 36M,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
"FEMORAL STEM SZ 16, 170MM",278,RC,,,,both,20290.28,18261.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14203.2,,,,11971.27,16556.87
"FEMORAL STEM SZ 16, 170MM",278,RC,,,,both,20290.28,18261.25,Cigna,Default,Percent of Total Billed Charges,11971.27,,,,11971.27,16556.87
"FEMORAL STEM SZ 16, 170MM",278,RC,,,,both,20290.28,18261.25,United Healthcare,Default,Fee Schedule,16556.87,,,,11971.27,16556.87
MODULAR HEAD 36MM +3MM NECK,C1776,HCPCS,278,RC,,both,2772.9,2495.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1941.03,,,,1636.01,2262.69
MODULAR HEAD 36MM +3MM NECK,C1776,HCPCS,278,RC,,both,2772.9,2495.61,Cigna,Default,Percent of Total Billed Charges,1636.01,,,,1636.01,2262.69
MODULAR HEAD 36MM +3MM NECK,C1776,HCPCS,278,RC,,both,2772.9,2495.61,United Healthcare,Default,Fee Schedule,2262.69,,,,1636.01,2262.69
Z NAIL 10.5X85 LAG SCREW,C1713,HCPCS,278,RC,,both,1984.03,1785.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1388.82,,,,1170.58,1618.97
Z NAIL 10.5X85 LAG SCREW,C1713,HCPCS,278,RC,,both,1984.03,1785.63,Cigna,Default,Percent of Total Billed Charges,1170.58,,,,1170.58,1618.97
Z NAIL 10.5X85 LAG SCREW,C1713,HCPCS,278,RC,,both,1984.03,1785.63,United Healthcare,Default,Fee Schedule,1618.97,,,,1170.58,1618.97
LOFT PFJ SIZE 3,278,RC,,,,both,20692.36,18623.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14484.65,,,,12208.49,16884.97
LOFT PFJ SIZE 3,278,RC,,,,both,20692.36,18623.12,Cigna,Default,Percent of Total Billed Charges,12208.49,,,,12208.49,16884.97
LOFT PFJ SIZE 3,278,RC,,,,both,20692.36,18623.12,United Healthcare,Default,Fee Schedule,16884.97,,,,12208.49,16884.97
BIPOLAR LINER 42/43 OD X 22MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,480.19,,,,404.73,559.76
BIPOLAR LINER 42/43 OD X 22MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,Cigna,Default,Percent of Total Billed Charges,404.73,,,,404.73,559.76
BIPOLAR LINER 42/43 OD X 22MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,United Healthcare,Default,Fee Schedule,559.76,,,,404.73,559.76
6.5MM CANNULATED SCREW 16MM THD 95MM,C1713,HCPCS,278,RC,,both,827.3,744.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,579.11,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 95MM,C1713,HCPCS,278,RC,,both,827.3,744.57,Cigna,Default,Percent of Total Billed Charges,488.11,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 95MM,C1713,HCPCS,278,RC,,both,827.3,744.57,United Healthcare,Default,Fee Schedule,675.08,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 115MM,C1713,HCPCS,278,RC,,both,827.3,744.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,579.11,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 115MM,C1713,HCPCS,278,RC,,both,827.3,744.57,Cigna,Default,Percent of Total Billed Charges,488.11,,,,488.11,675.08
6.5MM CANNULATED SCREW 16MM THD 115MM,C1713,HCPCS,278,RC,,both,827.3,744.57,United Healthcare,Default,Fee Schedule,675.08,,,,488.11,675.08
BIPOLAR SHEL 43MM OD,C1776,HCPCS,278,RC,,both,994.67,895.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,696.27,,,,586.86,811.65
BIPOLAR SHEL 43MM OD,C1776,HCPCS,278,RC,,both,994.67,895.2,Cigna,Default,Percent of Total Billed Charges,586.86,,,,586.86,811.65
BIPOLAR SHEL 43MM OD,C1776,HCPCS,278,RC,,both,994.67,895.2,United Healthcare,Default,Fee Schedule,811.65,,,,586.86,811.65
ARCOS 1PC 9.5X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
ARCOS 1PC 9.5X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
ARCOS 1PC 9.5X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
22.2MM DIA COCR MOD HD - 5 NK,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
22.2MM DIA COCR MOD HD - 5 NK,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
22.2MM DIA COCR MOD HD - 5 NK,C1776,HCPCS,278,RC,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
PACEMAKER LV GENERATOR,C1785,HCPCS,275,RC,,both,15434.31,13890.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10804.02,,,,9106.24,12594.4
PACEMAKER LV GENERATOR,C1785,HCPCS,275,RC,,both,15434.31,13890.88,Cigna,Default,Percent of Total Billed Charges,9106.24,,,,9106.24,12594.4
PACEMAKER LV GENERATOR,C1785,HCPCS,275,RC,,both,15434.31,13890.88,United Healthcare,Default,Fee Schedule,12594.4,,,,9106.24,12594.4
PACEMAKER DUAL CHAMBER WITHOUT LEADS,C1785,HCPCS,275,RC,,both,18864.16,16977.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13204.91,,,,11129.85,15393.15
PACEMAKER DUAL CHAMBER WITHOUT LEADS,C1785,HCPCS,275,RC,,both,18864.16,16977.74,Cigna,Default,Percent of Total Billed Charges,11129.85,,,,11129.85,15393.15
PACEMAKER DUAL CHAMBER WITHOUT LEADS,C1785,HCPCS,275,RC,,both,18864.16,16977.74,United Healthcare,Default,Fee Schedule,15393.15,,,,11129.85,15393.15
PACEMAKER DUAL CHAMBER,C1785,HCPCS,275,RC,,both,14062.38,12656.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9843.67,,,,8296.8,11474.9
PACEMAKER DUAL CHAMBER,C1785,HCPCS,275,RC,,both,14062.38,12656.14,Cigna,Default,Percent of Total Billed Charges,8296.8,,,,8296.8,11474.9
PACEMAKER DUAL CHAMBER,C1785,HCPCS,275,RC,,both,14062.38,12656.14,United Healthcare,Default,Fee Schedule,11474.9,,,,8296.8,11474.9
PACEMAKER LEAD,278,RC,,,,both,2472,2224.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1730.4,,,,1458.48,2017.15
PACEMAKER LEAD,278,RC,,,,both,2472,2224.8,Cigna,Default,Percent of Total Billed Charges,1458.48,,,,1458.48,2017.15
PACEMAKER LEAD,278,RC,,,,both,2472,2224.8,United Healthcare,Default,Fee Schedule,2017.15,,,,1458.48,2017.15
PACEMAKER LEAD,278,RC,,,,both,2472,2224.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1730.4,,,,1458.48,2017.15
PACEMAKER LEAD,278,RC,,,,both,2472,2224.8,Cigna,Default,Percent of Total Billed Charges,1458.48,,,,1458.48,2017.15
PACEMAKER LEAD,278,RC,,,,both,2472,2224.8,United Healthcare,Default,Fee Schedule,2017.15,,,,1458.48,2017.15
FEMORAL HEAD,278,RC,,,,both,4319.36,3887.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3023.55,,,,2548.42,3524.6
FEMORAL HEAD,278,RC,,,,both,4319.36,3887.42,Cigna,Default,Percent of Total Billed Charges,2548.42,,,,2548.42,3524.6
FEMORAL HEAD,278,RC,,,,both,4319.36,3887.42,United Healthcare,Default,Fee Schedule,3524.6,,,,2548.42,3524.6
DNU PEG PETELLA,278,RC,,,,both,2196,1976.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1537.2,,,,1295.64,1791.94
DNU PEG PETELLA,278,RC,,,,both,2196,1976.4,Cigna,Default,Percent of Total Billed Charges,1295.64,,,,1295.64,1791.94
DNU PEG PETELLA,278,RC,,,,both,2196,1976.4,United Healthcare,Default,Fee Schedule,1791.94,,,,1295.64,1791.94
PETELLA POLY 41 MM,278,RC,,,,both,2086.75,1878.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1460.72,,,,1231.18,1702.79
PETELLA POLY 41 MM,278,RC,,,,both,2086.75,1878.08,Cigna,Default,Percent of Total Billed Charges,1231.18,,,,1231.18,1702.79
PETELLA POLY 41 MM,278,RC,,,,both,2086.75,1878.08,United Healthcare,Default,Fee Schedule,1702.79,,,,1231.18,1702.79
PEG PETELLA 23 MM,278,RC,,,,both,3023.92,2721.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2116.74,,,,1784.11,2467.52
PEG PETELLA 23 MM,278,RC,,,,both,3023.92,2721.53,Cigna,Default,Percent of Total Billed Charges,1784.11,,,,1784.11,2467.52
PEG PETELLA 23 MM,278,RC,,,,both,3023.92,2721.53,United Healthcare,Default,Fee Schedule,2467.52,,,,1784.11,2467.52
DNU PEG PETELLA 23 MM,278,RC,,,,both,5170.5,4653.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3619.35,,,,3050.6,4219.13
DNU PEG PETELLA 23 MM,278,RC,,,,both,5170.5,4653.45,Cigna,Default,Percent of Total Billed Charges,3050.6,,,,3050.6,4219.13
DNU PEG PETELLA 23 MM,278,RC,,,,both,5170.5,4653.45,United Healthcare,Default,Fee Schedule,4219.13,,,,3050.6,4219.13
CONGRUENT TIBIAL INSERT,278,RC,,,,both,5267.15,4740.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3687,,,,3107.62,4297.99
CONGRUENT TIBIAL INSERT,278,RC,,,,both,5267.15,4740.44,Cigna,Default,Percent of Total Billed Charges,3107.62,,,,3107.62,4297.99
CONGRUENT TIBIAL INSERT,278,RC,,,,both,5267.15,4740.44,United Healthcare,Default,Fee Schedule,4297.99,,,,3107.62,4297.99
BASEPLATE CCM STEM TIBIAL SIZE 3 RIGHT,278,RC,,,,both,9029.4,8126.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6320.58,,,,5327.35,7367.99
BASEPLATE CCM STEM TIBIAL SIZE 3 RIGHT,278,RC,,,,both,9029.4,8126.46,Cigna,Default,Percent of Total Billed Charges,5327.35,,,,5327.35,7367.99
BASEPLATE CCM STEM TIBIAL SIZE 3 RIGHT,278,RC,,,,both,9029.4,8126.46,United Healthcare,Default,Fee Schedule,7367.99,,,,5327.35,7367.99
FEMORAL COMPONENT SIZE 4 RIGHT,278,RC,,,,both,15045.37,13540.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10531.76,,,,8876.77,12277.02
FEMORAL COMPONENT SIZE 4 RIGHT,278,RC,,,,both,15045.37,13540.83,Cigna,Default,Percent of Total Billed Charges,8876.77,,,,8876.77,12277.02
FEMORAL COMPONENT SIZE 4 RIGHT,278,RC,,,,both,15045.37,13540.83,United Healthcare,Default,Fee Schedule,12277.02,,,,8876.77,12277.02
BLADE LINVATEC/HALL 60X13X1.27,272,RC,,,,both,397.93,358.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,278.55,,,,234.78,324.71
BLADE LINVATEC/HALL 60X13X1.27,272,RC,,,,both,397.93,358.14,Cigna,Default,Percent of Total Billed Charges,234.78,,,,234.78,324.71
BLADE LINVATEC/HALL 60X13X1.27,272,RC,,,,both,397.93,358.14,United Healthcare,Default,Fee Schedule,324.71,,,,234.78,324.71
FEMORAL COMPONENT RLP POROUS SIZE 4,278,RC,,,,both,13395.77,12056.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9377.04,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS SIZE 4,278,RC,,,,both,13395.77,12056.19,Cigna,Default,Percent of Total Billed Charges,7903.5,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS SIZE 4,278,RC,,,,both,13395.77,12056.19,United Healthcare,Default,Fee Schedule,10930.95,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS SIZE 5,278,RC,,,,both,14560.64,13104.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10192.45,,,,8590.78,11881.48
FEMORAL COMPONENT RLP POROUS SIZE 5,278,RC,,,,both,14560.64,13104.58,Cigna,Default,Percent of Total Billed Charges,8590.78,,,,8590.78,11881.48
FEMORAL COMPONENT RLP POROUS SIZE 5,278,RC,,,,both,14560.64,13104.58,United Healthcare,Default,Fee Schedule,11881.48,,,,8590.78,11881.48
BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
CONGRUENT TRIBIAL INSERT 3/4 10MM RT,278,RC,,,,both,4091.44,3682.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2864.01,,,,2413.95,3338.62
CONGRUENT TRIBIAL INSERT 3/4 10MM RT,278,RC,,,,both,4091.44,3682.3,Cigna,Default,Percent of Total Billed Charges,2413.95,,,,2413.95,3338.62
CONGRUENT TRIBIAL INSERT 3/4 10MM RT,278,RC,,,,both,4091.44,3682.3,United Healthcare,Default,Fee Schedule,3338.62,,,,2413.95,3338.62
FEMORAL COMPONENT RLP POROUS SIZE 3,278,RC,,,,both,13395.77,12056.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9377.04,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS SIZE 3,278,RC,,,,both,13395.77,12056.19,Cigna,Default,Percent of Total Billed Charges,7903.5,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS SIZE 3,278,RC,,,,both,13395.77,12056.19,United Healthcare,Default,Fee Schedule,10930.95,,,,7903.5,10930.95
FEMORAL COMPONENT POROUS SIZE 3 LEFT,278,RC,,,,both,15045.37,13540.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10531.76,,,,8876.77,12277.02
FEMORAL COMPONENT POROUS SIZE 3 LEFT,278,RC,,,,both,15045.37,13540.83,Cigna,Default,Percent of Total Billed Charges,8876.77,,,,8876.77,12277.02
FEMORAL COMPONENT POROUS SIZE 3 LEFT,278,RC,,,,both,15045.37,13540.83,United Healthcare,Default,Fee Schedule,12277.02,,,,8876.77,12277.02
CONGRUENT TRIBIAL INSERT,278,RC,,,,both,5267.15,4740.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3687,,,,3107.62,4297.99
CONGRUENT TRIBIAL INSERT,278,RC,,,,both,5267.15,4740.44,Cigna,Default,Percent of Total Billed Charges,3107.62,,,,3107.62,4297.99
CONGRUENT TRIBIAL INSERT,278,RC,,,,both,5267.15,4740.44,United Healthcare,Default,Fee Schedule,4297.99,,,,3107.62,4297.99
FEMORAL COMPONENT SIZE 3,278,RC,,,,both,14560.64,13104.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10192.45,,,,8590.78,11881.48
FEMORAL COMPONENT SIZE 3,278,RC,,,,both,14560.64,13104.58,Cigna,Default,Percent of Total Billed Charges,8590.78,,,,8590.78,11881.48
FEMORAL COMPONENT SIZE 3,278,RC,,,,both,14560.64,13104.58,United Healthcare,Default,Fee Schedule,11881.48,,,,8590.78,11881.48
CONGRUENT TRIBIAL INSERT,278,RC,,,,both,4594.29,4134.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3216,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT,278,RC,,,,both,4594.29,4134.86,Cigna,Default,Percent of Total Billed Charges,2710.63,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT,278,RC,,,,both,4594.29,4134.86,United Healthcare,Default,Fee Schedule,3748.94,,,,2710.63,3748.94
BASEPLATE CCM STEM TIBIAL SIZE 2 RIGHT,278,RC,,,,both,9206.66,8285.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6444.66,,,,5431.93,7512.63
BASEPLATE CCM STEM TIBIAL SIZE 2 RIGHT,278,RC,,,,both,9206.66,8285.99,Cigna,Default,Percent of Total Billed Charges,5431.93,,,,5431.93,7512.63
BASEPLATE CCM STEM TIBIAL SIZE 2 RIGHT,278,RC,,,,both,9206.66,8285.99,United Healthcare,Default,Fee Schedule,7512.63,,,,5431.93,7512.63
BASEPLATE CCM STEM TIBIAL SIZE 1 RIGHT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 1 RIGHT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 1 RIGHT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL 2 LEFT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL 2 LEFT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL 2 LEFT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 5 LEFT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 5 LEFT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 5 LEFT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL 4 LEFT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL 4 LEFT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL 4 LEFT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
STEM P SERIES,278,RC,,,,both,22247.91,20023.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15573.54,,,,13126.27,18154.29
STEM P SERIES,278,RC,,,,both,22247.91,20023.12,Cigna,Default,Percent of Total Billed Charges,13126.27,,,,13126.27,18154.29
STEM P SERIES,278,RC,,,,both,22247.91,20023.12,United Healthcare,Default,Fee Schedule,18154.29,,,,13126.27,18154.29
FEMORAL HEAD,278,RC,,,,both,4114.96,3703.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2880.47,,,,2427.83,3357.81
FEMORAL HEAD,278,RC,,,,both,4114.96,3703.46,Cigna,Default,Percent of Total Billed Charges,2427.83,,,,2427.83,3357.81
FEMORAL HEAD,278,RC,,,,both,4114.96,3703.46,United Healthcare,Default,Fee Schedule,3357.81,,,,2427.83,3357.81
BIPOLAR,278,RC,,,,both,6059.4,5453.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4241.58,,,,3575.05,4944.47
BIPOLAR,278,RC,,,,both,6059.4,5453.46,Cigna,Default,Percent of Total Billed Charges,3575.05,,,,3575.05,4944.47
BIPOLAR,278,RC,,,,both,6059.4,5453.46,United Healthcare,Default,Fee Schedule,4944.47,,,,3575.05,4944.47
CONGRUENT TRIBIAL INSERT 1/2 14MM RT,278,RC,,,,both,4594.29,4134.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3216,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 1/2 14MM RT,278,RC,,,,both,4594.29,4134.86,Cigna,Default,Percent of Total Billed Charges,2710.63,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 1/2 14MM RT,278,RC,,,,both,4594.29,4134.86,United Healthcare,Default,Fee Schedule,3748.94,,,,2710.63,3748.94
FEMORAL HEAD,278,RC,,,,both,5607.2,5046.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3925.04,,,,3308.25,4575.48
FEMORAL HEAD,278,RC,,,,both,5607.2,5046.48,Cigna,Default,Percent of Total Billed Charges,3308.25,,,,3308.25,4575.48
FEMORAL HEAD,278,RC,,,,both,5607.2,5046.48,United Healthcare,Default,Fee Schedule,4575.48,,,,3308.25,4575.48
FEMORAL COMPONENT RLP POROUS SIZE 2 RT,278,RC,,,,both,15045.37,13540.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10531.76,,,,8876.77,12277.02
FEMORAL COMPONENT RLP POROUS SIZE 2 RT,278,RC,,,,both,15045.37,13540.83,Cigna,Default,Percent of Total Billed Charges,8876.77,,,,8876.77,12277.02
FEMORAL COMPONENT RLP POROUS SIZE 2 RT,278,RC,,,,both,15045.37,13540.83,United Healthcare,Default,Fee Schedule,12277.02,,,,8876.77,12277.02
BIPOLAR COMPONENT 28X55,278,RC,,,,both,5050.82,4545.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3535.57,,,,2979.98,4121.47
BIPOLAR COMPONENT 28X55,278,RC,,,,both,5050.82,4545.74,Cigna,Default,Percent of Total Billed Charges,2979.98,,,,2979.98,4121.47
BIPOLAR COMPONENT 28X55,278,RC,,,,both,5050.82,4545.74,United Healthcare,Default,Fee Schedule,4121.47,,,,2979.98,4121.47
BIPOLAR,278,RC,,,,both,6692.47,6023.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4684.73,,,,3948.56,5461.06
BIPOLAR,278,RC,,,,both,6692.47,6023.22,Cigna,Default,Percent of Total Billed Charges,3948.56,,,,3948.56,5461.06
BIPOLAR,278,RC,,,,both,6692.47,6023.22,United Healthcare,Default,Fee Schedule,5461.06,,,,3948.56,5461.06
BIPOLAR,278,RC,,,,both,5050.82,4545.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3535.57,,,,2979.98,4121.47
BIPOLAR,278,RC,,,,both,5050.82,4545.74,Cigna,Default,Percent of Total Billed Charges,2979.98,,,,2979.98,4121.47
BIPOLAR,278,RC,,,,both,5050.82,4545.74,United Healthcare,Default,Fee Schedule,4121.47,,,,2979.98,4121.47
BIPOLAR,278,RC,,,,both,7054.21,6348.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4937.95,,,,4161.98,5756.24
BIPOLAR,278,RC,,,,both,7054.21,6348.79,Cigna,Default,Percent of Total Billed Charges,4161.98,,,,4161.98,5756.24
BIPOLAR,278,RC,,,,both,7054.21,6348.79,United Healthcare,Default,Fee Schedule,5756.24,,,,4161.98,5756.24
PRP KIT PROCEDURE,272,RC,,,,both,452.5,407.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.75,,,,266.98,369.24
PRP KIT PROCEDURE,272,RC,,,,both,452.5,407.25,Cigna,Default,Percent of Total Billed Charges,266.98,,,,266.98,369.24
PRP KIT PROCEDURE,272,RC,,,,both,452.5,407.25,United Healthcare,Default,Fee Schedule,369.24,,,,266.98,369.24
KIT APPLICATOR,272,RC,,,,both,759.69,683.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,531.78,,,,448.22,619.91
KIT APPLICATOR,272,RC,,,,both,759.69,683.72,Cigna,Default,Percent of Total Billed Charges,448.22,,,,448.22,619.91
KIT APPLICATOR,272,RC,,,,both,759.69,683.72,United Healthcare,Default,Fee Schedule,619.91,,,,448.22,619.91
CONGRUENT TRIBIAL INSERT 3/4 10MM LT,278,RC,,,,both,4091.44,3682.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2864.01,,,,2413.95,3338.62
CONGRUENT TRIBIAL INSERT 3/4 10MM LT,278,RC,,,,both,4091.44,3682.3,Cigna,Default,Percent of Total Billed Charges,2413.95,,,,2413.95,3338.62
CONGRUENT TRIBIAL INSERT 3/4 10MM LT,278,RC,,,,both,4091.44,3682.3,United Healthcare,Default,Fee Schedule,3338.62,,,,2413.95,3338.62
BIPOLAR,278,RC,,,,both,7596.84,6837.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5317.79,,,,4482.14,6199.02
BIPOLAR,278,RC,,,,both,7596.84,6837.16,Cigna,Default,Percent of Total Billed Charges,4482.14,,,,4482.14,6199.02
BIPOLAR,278,RC,,,,both,7596.84,6837.16,United Healthcare,Default,Fee Schedule,6199.02,,,,4482.14,6199.02
BIPOLAR,278,RC,,,,both,7054.21,6348.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4937.95,,,,4161.98,5756.24
BIPOLAR,278,RC,,,,both,7054.21,6348.79,Cigna,Default,Percent of Total Billed Charges,4161.98,,,,4161.98,5756.24
BIPOLAR,278,RC,,,,both,7054.21,6348.79,United Healthcare,Default,Fee Schedule,5756.24,,,,4161.98,5756.24
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19751.81,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,Cigna,Default,Percent of Total Billed Charges,16647.95,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,United Healthcare,Default,Fee Schedule,23024.97,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19751.81,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,Cigna,Default,Percent of Total Billed Charges,16647.95,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,United Healthcare,Default,Fee Schedule,23024.97,,,,16647.95,23024.97
FEMORAL HEAD,278,RC,,,,both,4455.91,4010.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3119.14,,,,2628.99,3636.02
FEMORAL HEAD,278,RC,,,,both,4455.91,4010.32,Cigna,Default,Percent of Total Billed Charges,2628.99,,,,2628.99,3636.02
FEMORAL HEAD,278,RC,,,,both,4455.91,4010.32,United Healthcare,Default,Fee Schedule,3636.02,,,,2628.99,3636.02
BIPOLAR,278,RC,,,,both,5050.82,4545.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3535.57,,,,2979.98,4121.47
BIPOLAR,278,RC,,,,both,5050.82,4545.74,Cigna,Default,Percent of Total Billed Charges,2979.98,,,,2979.98,4121.47
BIPOLAR,278,RC,,,,both,5050.82,4545.74,United Healthcare,Default,Fee Schedule,4121.47,,,,2979.98,4121.47
BIPOLAR COMPONENT,278,RC,,,,both,5050.82,4545.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3535.57,,,,2979.98,4121.47
BIPOLAR COMPONENT,278,RC,,,,both,5050.82,4545.74,Cigna,Default,Percent of Total Billed Charges,2979.98,,,,2979.98,4121.47
BIPOLAR COMPONENT,278,RC,,,,both,5050.82,4545.74,United Healthcare,Default,Fee Schedule,4121.47,,,,2979.98,4121.47
FEMORAL COMPONENT RLP POROUS COCR 6,278,RC,,,,both,18362.68,16526.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12853.88,,,,10833.98,14983.95
FEMORAL COMPONENT RLP POROUS COCR 6,278,RC,,,,both,18362.68,16526.41,Cigna,Default,Percent of Total Billed Charges,10833.98,,,,10833.98,14983.95
FEMORAL COMPONENT RLP POROUS COCR 6,278,RC,,,,both,18362.68,16526.41,United Healthcare,Default,Fee Schedule,14983.95,,,,10833.98,14983.95
BASEPLATE CCM STEM TIBIAL SIZE 6 LEFT,278,RC,,,,both,9029.4,8126.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6320.58,,,,5327.35,7367.99
BASEPLATE CCM STEM TIBIAL SIZE 6 LEFT,278,RC,,,,both,9029.4,8126.46,Cigna,Default,Percent of Total Billed Charges,5327.35,,,,5327.35,7367.99
BASEPLATE CCM STEM TIBIAL SIZE 6 LEFT,278,RC,,,,both,9029.4,8126.46,United Healthcare,Default,Fee Schedule,7367.99,,,,5327.35,7367.99
CONGRUENT TRIBIAL INSERT 5/16 10MM LEFT,278,RC,,,,both,4594.29,4134.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3216,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 5/16 10MM LEFT,278,RC,,,,both,4594.29,4134.86,Cigna,Default,Percent of Total Billed Charges,2710.63,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 5/16 10MM LEFT,278,RC,,,,both,4594.29,4134.86,United Healthcare,Default,Fee Schedule,3748.94,,,,2710.63,3748.94
BASEPLATE CCM STEM TIBIAL SIZE 6 RIGHT,278,RC,,,,both,9029.4,8126.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6320.58,,,,5327.35,7367.99
BASEPLATE CCM STEM TIBIAL SIZE 6 RIGHT,278,RC,,,,both,9029.4,8126.46,Cigna,Default,Percent of Total Billed Charges,5327.35,,,,5327.35,7367.99
BASEPLATE CCM STEM TIBIAL SIZE 6 RIGHT,278,RC,,,,both,9029.4,8126.46,United Healthcare,Default,Fee Schedule,7367.99,,,,5327.35,7367.99
FEMORAL COMPONENT RLP POROUS SIZE 6 RT,278,RC,,,,both,18362.68,16526.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12853.88,,,,10833.98,14983.95
FEMORAL COMPONENT RLP POROUS SIZE 6 RT,278,RC,,,,both,18362.68,16526.41,Cigna,Default,Percent of Total Billed Charges,10833.98,,,,10833.98,14983.95
FEMORAL COMPONENT RLP POROUS SIZE 6 RT,278,RC,,,,both,18362.68,16526.41,United Healthcare,Default,Fee Schedule,14983.95,,,,10833.98,14983.95
ELEMENT STEM,278,RC,,,,both,20290.28,18261.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14203.2,,,,11971.27,16556.87
ELEMENT STEM,278,RC,,,,both,20290.28,18261.25,Cigna,Default,Percent of Total Billed Charges,11971.27,,,,11971.27,16556.87
ELEMENT STEM,278,RC,,,,both,20290.28,18261.25,United Healthcare,Default,Fee Schedule,16556.87,,,,11971.27,16556.87
TIBIAL INSERT CR SLOPE,278,RC,,,,both,5302.42,4772.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3711.69,,,,3128.43,4326.77
TIBIAL INSERT CR SLOPE,278,RC,,,,both,5302.42,4772.18,Cigna,Default,Percent of Total Billed Charges,3128.43,,,,3128.43,4326.77
TIBIAL INSERT CR SLOPE,278,RC,,,,both,5302.42,4772.18,United Healthcare,Default,Fee Schedule,4326.77,,,,3128.43,4326.77
FEMUR POROUS SIZE 4,278,RC,,,,both,13395.77,12056.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9377.04,,,,7903.5,10930.95
FEMUR POROUS SIZE 4,278,RC,,,,both,13395.77,12056.19,Cigna,Default,Percent of Total Billed Charges,7903.5,,,,7903.5,10930.95
FEMUR POROUS SIZE 4,278,RC,,,,both,13395.77,12056.19,United Healthcare,Default,Fee Schedule,10930.95,,,,7903.5,10930.95
STEM P SERIES,278,RC,,,,both,27493.36,24744.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19245.35,,,,16221.08,22434.58
STEM P SERIES,278,RC,,,,both,27493.36,24744.02,Cigna,Default,Percent of Total Billed Charges,16221.08,,,,16221.08,22434.58
STEM P SERIES,278,RC,,,,both,27493.36,24744.02,United Healthcare,Default,Fee Schedule,22434.58,,,,16221.08,22434.58
STEM P SERIES,278,RC,,,,both,26046.34,23441.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18232.44,,,,15367.34,21253.81
STEM P SERIES,278,RC,,,,both,26046.34,23441.71,Cigna,Default,Percent of Total Billed Charges,15367.34,,,,15367.34,21253.81
STEM P SERIES,278,RC,,,,both,26046.34,23441.71,United Healthcare,Default,Fee Schedule,21253.81,,,,15367.34,21253.81
STEM P SERIES,278,RC,,,,both,26046.34,23441.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18232.44,,,,15367.34,21253.81
STEM P SERIES,278,RC,,,,both,26046.34,23441.71,Cigna,Default,Percent of Total Billed Charges,15367.34,,,,15367.34,21253.81
STEM P SERIES,278,RC,,,,both,26046.34,23441.71,United Healthcare,Default,Fee Schedule,21253.81,,,,15367.34,21253.81
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19751.81,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,Cigna,Default,Percent of Total Billed Charges,16647.95,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,28216.87,25395.18,United Healthcare,Default,Fee Schedule,23024.97,,,,16647.95,23024.97
STEM P SERIES,278,RC,,,,both,27493.36,24744.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19245.35,,,,16221.08,22434.58
STEM P SERIES,278,RC,,,,both,27493.36,24744.02,Cigna,Default,Percent of Total Billed Charges,16221.08,,,,16221.08,22434.58
STEM P SERIES,278,RC,,,,both,27493.36,24744.02,United Healthcare,Default,Fee Schedule,22434.58,,,,16221.08,22434.58
ELEMENT STEM,278,RC,,,,both,28940.37,26046.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20258.26,,,,17074.82,23615.34
ELEMENT STEM,278,RC,,,,both,28940.37,26046.33,Cigna,Default,Percent of Total Billed Charges,17074.82,,,,17074.82,23615.34
ELEMENT STEM,278,RC,,,,both,28940.37,26046.33,United Healthcare,Default,Fee Schedule,23615.34,,,,17074.82,23615.34
FEMORAL POROUS,278,RC,,,,both,21433.96,19290.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15003.77,,,,12646.04,17490.11
FEMORAL POROUS,278,RC,,,,both,21433.96,19290.56,Cigna,Default,Percent of Total Billed Charges,12646.04,,,,12646.04,17490.11
FEMORAL POROUS,278,RC,,,,both,21433.96,19290.56,United Healthcare,Default,Fee Schedule,17490.11,,,,12646.04,17490.11
TRAY TIBIAL TRAP,278,RC,,,,both,13421.1,12078.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9394.77,,,,7918.45,10951.62
TRAY TIBIAL TRAP,278,RC,,,,both,13421.1,12078.99,Cigna,Default,Percent of Total Billed Charges,7918.45,,,,7918.45,10951.62
TRAY TIBIAL TRAP,278,RC,,,,both,13421.1,12078.99,United Healthcare,Default,Fee Schedule,10951.62,,,,7918.45,10951.62
TIBIAL INSERT,278,RC,,,,both,7488.32,6739.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5241.82,,,,4418.11,6110.47
TIBIAL INSERT,278,RC,,,,both,7488.32,6739.49,Cigna,Default,Percent of Total Billed Charges,4418.11,,,,4418.11,6110.47
TIBIAL INSERT,278,RC,,,,both,7488.32,6739.49,United Healthcare,Default,Fee Schedule,6110.47,,,,4418.11,6110.47
NEXGEN LPS 5-6 12 MM,C1776,HCPCS,278,RC,,both,3098.87,2788.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.21,,,,1828.33,2528.68
NEXGEN LPS 5-6 12 MM,C1776,HCPCS,278,RC,,both,3098.87,2788.98,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.68
NEXGEN LPS 5-6 12 MM,C1776,HCPCS,278,RC,,both,3098.87,2788.98,United Healthcare,Default,Fee Schedule,2528.68,,,,1828.33,2528.68
NEXGEN LPS FEMORAL SIZE E RT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
NEXGEN LPS FEMORAL SIZE E RT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
NEXGEN LPS FEMORAL SIZE E RT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
NEXGEN LPS FEMORAL SIZE F RT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
NEXGEN LPS FEMORAL SIZE F RT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
NEXGEN LPS FEMORAL SIZE F RT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
NEXGEN LPS FLEX FEMORAL SIZE F LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
NEXGEN LPS FLEX FEMORAL SIZE F LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
NEXGEN LPS FLEX FEMORAL SIZE F LT,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
NEXGEN LPS 5-6 17 MM,C1776,HCPCS,278,RC,,both,3024.47,2722.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2117.13,,,,1784.44,2467.97
NEXGEN LPS 5-6 17 MM,C1776,HCPCS,278,RC,,both,3024.47,2722.02,Cigna,Default,Percent of Total Billed Charges,1784.44,,,,1784.44,2467.97
NEXGEN LPS 5-6 17 MM,C1776,HCPCS,278,RC,,both,3024.47,2722.02,United Healthcare,Default,Fee Schedule,2467.97,,,,1784.44,2467.97
DURAT DEG INS,278,RC,,,,both,5151.39,4636.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3605.97,,,,3039.32,4203.53
DURAT DEG INS,278,RC,,,,both,5151.39,4636.25,Cigna,Default,Percent of Total Billed Charges,3039.32,,,,3039.32,4203.53
DURAT DEG INS,278,RC,,,,both,5151.39,4636.25,United Healthcare,Default,Fee Schedule,4203.53,,,,3039.32,4203.53
BONE SCREW 6.5 X 25 SELF TAP,C1713,HCPCS,278,RC,,both,243.55,219.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.48,,,,143.69,198.74
BONE SCREW 6.5 X 25 SELF TAP,C1713,HCPCS,278,RC,,both,243.55,219.2,Cigna,Default,Percent of Total Billed Charges,143.69,,,,143.69,198.74
BONE SCREW 6.5 X 25 SELF TAP,C1713,HCPCS,278,RC,,both,243.55,219.2,United Healthcare,Default,Fee Schedule,198.74,,,,143.69,198.74
M/L TAPER KINECTIV STEM SIZE 15,C1776,HCPCS,278,RC,,both,6711.18,6040.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4697.83,,,,3959.6,5476.32
M/L TAPER KINECTIV STEM SIZE 15,C1776,HCPCS,278,RC,,both,6711.18,6040.06,Cigna,Default,Percent of Total Billed Charges,3959.6,,,,3959.6,5476.32
M/L TAPER KINECTIV STEM SIZE 15,C1776,HCPCS,278,RC,,both,6711.18,6040.06,United Healthcare,Default,Fee Schedule,5476.32,,,,3959.6,5476.32
PSN FEM PS CMT CCR STD SZ7 L,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.32,,,,4103.3,5675.07
PSN FEM PS CMT CCR STD SZ7 L,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Cigna,Default,Percent of Total Billed Charges,4103.3,,,,4103.3,5675.07
PSN FEM PS CMT CCR STD SZ7 L,C1776,HCPCS,278,RC,,both,6954.74,6259.27,United Healthcare,Default,Fee Schedule,5675.07,,,,4103.3,5675.07
PSN TIB STM 5 DEG SIZE F L,C1776,HCPCS,278,RC,,both,3098.92,2789.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.72
PSN TIB STM 5 DEG SIZE F L,C1776,HCPCS,278,RC,,both,3098.92,2789.03,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.72
PSN TIB STM 5 DEG SIZE F L,C1776,HCPCS,278,RC,,both,3098.92,2789.03,United Healthcare,Default,Fee Schedule,2528.72,,,,1828.36,2528.72
ARCOS 16X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,11318.67,10186.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7923.07,,,,6678.02,9236.03
ARCOS 16X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,11318.67,10186.8,Cigna,Default,Percent of Total Billed Charges,6678.02,,,,6678.02,9236.03
ARCOS 16X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,11318.67,10186.8,United Healthcare,Default,Fee Schedule,9236.03,,,,6678.02,9236.03
PSN TIB STM 5 DEG SIZE F R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE F R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE F R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
BASEPLATE CCM STEM TIBIAL SIZE 4 LEFT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 4 LEFT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 4 LEFT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 5 RIGHT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 5 RIGHT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM STEM TIBIAL SIZE 5 RIGHT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
FEMORAL POROUS SIZE 3 LEFT,278,RC,,,,both,14858.53,13372.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10400.97,,,,8766.53,12124.56
FEMORAL POROUS SIZE 3 LEFT,278,RC,,,,both,14858.53,13372.68,Cigna,Default,Percent of Total Billed Charges,8766.53,,,,8766.53,12124.56
FEMORAL POROUS SIZE 3 LEFT,278,RC,,,,both,14858.53,13372.68,United Healthcare,Default,Fee Schedule,12124.56,,,,8766.53,12124.56
PERI SCREW 3.5MM X 22MM W/2.7MM HEAD SEL,C1713,HCPCS,278,RC,,both,162.88,146.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.02,,,,96.1,132.91
PERI SCREW 3.5MM X 22MM W/2.7MM HEAD SEL,C1713,HCPCS,278,RC,,both,162.88,146.59,Cigna,Default,Percent of Total Billed Charges,96.1,,,,96.1,132.91
PERI SCREW 3.5MM X 22MM W/2.7MM HEAD SEL,C1713,HCPCS,278,RC,,both,162.88,146.59,United Healthcare,Default,Fee Schedule,132.91,,,,96.1,132.91
SCREW FORTE CANCELLOUS 4.0MMX20MM FULL T,C1713,HCPCS,278,RC,,both,234.03,210.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.82,,,,138.08,190.97
SCREW FORTE CANCELLOUS 4.0MMX20MM FULL T,C1713,HCPCS,278,RC,,both,234.03,210.63,Cigna,Default,Percent of Total Billed Charges,138.08,,,,138.08,190.97
SCREW FORTE CANCELLOUS 4.0MMX20MM FULL T,C1713,HCPCS,278,RC,,both,234.03,210.63,United Healthcare,Default,Fee Schedule,190.97,,,,138.08,190.97
LOCKING SCREW 3.5 x 14MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1047.52,,,,882.91,1221.11
LOCKING SCREW 3.5 x 14MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Cigna,Default,Percent of Total Billed Charges,882.91,,,,882.91,1221.11
LOCKING SCREW 3.5 x 14MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,United Healthcare,Default,Fee Schedule,1221.11,,,,882.91,1221.11
LOCKING SCREW 3.5 X 16MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1047.52,,,,882.91,1221.11
LOCKING SCREW 3.5 X 16MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Cigna,Default,Percent of Total Billed Charges,882.91,,,,882.91,1221.11
LOCKING SCREW 3.5 X 16MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,United Healthcare,Default,Fee Schedule,1221.11,,,,882.91,1221.11
LOCKING SCREW 3.5MM X 20MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1047.52,,,,882.91,1221.11
LOCKING SCREW 3.5MM X 20MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Cigna,Default,Percent of Total Billed Charges,882.91,,,,882.91,1221.11
LOCKING SCREW 3.5MM X 20MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,United Healthcare,Default,Fee Schedule,1221.11,,,,882.91,1221.11
LOCKING SCREW 3.5 X 22MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1047.52,,,,882.91,1221.11
LOCKING SCREW 3.5 X 22MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,Cigna,Default,Percent of Total Billed Charges,882.91,,,,882.91,1221.11
LOCKING SCREW 3.5 X 22MM,C1713,HCPCS,278,RC,,both,1496.46,1346.81,United Healthcare,Default,Fee Schedule,1221.11,,,,882.91,1221.11
TEMP FIXATION PIN 1.1MM SMALL,C1713,HCPCS,278,RC,,both,504.2,453.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.94,,,,297.48,411.43
TEMP FIXATION PIN 1.1MM SMALL,C1713,HCPCS,278,RC,,both,504.2,453.78,Cigna,Default,Percent of Total Billed Charges,297.48,,,,297.48,411.43
TEMP FIXATION PIN 1.1MM SMALL,C1713,HCPCS,278,RC,,both,504.2,453.78,United Healthcare,Default,Fee Schedule,411.43,,,,297.48,411.43
DRILL BIT 2.5 X 60MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,840.32,,,,708.27,979.58
DRILL BIT 2.5 X 60MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,Cigna,Default,Percent of Total Billed Charges,708.27,,,,708.27,979.58
DRILL BIT 2.5 X 60MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,United Healthcare,Default,Fee Schedule,979.58,,,,708.27,979.58
K-WIRE 1.1 X 150MM BLUNT,C1713,HCPCS,278,RC,,both,117.33,105.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.13,,,,69.22,95.74
K-WIRE 1.1 X 150MM BLUNT,C1713,HCPCS,278,RC,,both,117.33,105.6,Cigna,Default,Percent of Total Billed Charges,69.22,,,,69.22,95.74
K-WIRE 1.1 X 150MM BLUNT,C1713,HCPCS,278,RC,,both,117.33,105.6,United Healthcare,Default,Fee Schedule,95.74,,,,69.22,95.74
MTP PLATE RIGHT,C1713,HCPCS,278,RC,,both,12606.9,11346.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8824.83,,,,7438.07,10287.23
MTP PLATE RIGHT,C1713,HCPCS,278,RC,,both,12606.9,11346.21,Cigna,Default,Percent of Total Billed Charges,7438.07,,,,7438.07,10287.23
MTP PLATE RIGHT,C1713,HCPCS,278,RC,,both,12606.9,11346.21,United Healthcare,Default,Fee Schedule,10287.23,,,,7438.07,10287.23
SCREW LAG 3.5 X 32MM,C1713,HCPCS,278,RC,,both,1697.63,1527.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1188.34,,,,1001.6,1385.27
SCREW LAG 3.5 X 32MM,C1713,HCPCS,278,RC,,both,1697.63,1527.87,Cigna,Default,Percent of Total Billed Charges,1001.6,,,,1001.6,1385.27
SCREW LAG 3.5 X 32MM,C1713,HCPCS,278,RC,,both,1697.63,1527.87,United Healthcare,Default,Fee Schedule,1385.27,,,,1001.6,1385.27
CONGRUENT TRIBIAL INSERT 3/4 14MM LEFT,278,RC,,,,both,4594.29,4134.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3216,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 3/4 14MM LEFT,278,RC,,,,both,4594.29,4134.86,Cigna,Default,Percent of Total Billed Charges,2710.63,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 3/4 14MM LEFT,278,RC,,,,both,4594.29,4134.86,United Healthcare,Default,Fee Schedule,3748.94,,,,2710.63,3748.94
CONGRUENT TRIBIAL INSERT 5/16 12MM LEFT,278,RC,,,,both,4091.44,3682.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2864.01,,,,2413.95,3338.62
CONGRUENT TRIBIAL INSERT 5/16 12MM LEFT,278,RC,,,,both,4091.44,3682.3,Cigna,Default,Percent of Total Billed Charges,2413.95,,,,2413.95,3338.62
CONGRUENT TRIBIAL INSERT 5/16 12MM LEFT,278,RC,,,,both,4091.44,3682.3,United Healthcare,Default,Fee Schedule,3338.62,,,,2413.95,3338.62
LEGACY KNEE POSTERIOR STABILIZED SIZE E,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE E,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE E,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
BASEPLATE CCM TIBIAL COCR 4 LEFT,278,RC,,,,both,8038.19,7234.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5626.73,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL COCR 4 LEFT,278,RC,,,,both,8038.19,7234.37,Cigna,Default,Percent of Total Billed Charges,4742.53,,,,4742.53,6559.16
BASEPLATE CCM TIBIAL COCR 4 LEFT,278,RC,,,,both,8038.19,7234.37,United Healthcare,Default,Fee Schedule,6559.16,,,,4742.53,6559.16
FEMORAL COMPONENT RLP POROUS COCR 5,278,RC,,,,both,13395.77,12056.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9377.04,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS COCR 5,278,RC,,,,both,13395.77,12056.19,Cigna,Default,Percent of Total Billed Charges,7903.5,,,,7903.5,10930.95
FEMORAL COMPONENT RLP POROUS COCR 5,278,RC,,,,both,13395.77,12056.19,United Healthcare,Default,Fee Schedule,10930.95,,,,7903.5,10930.95
PEG PETELLA 26 MM,278,RC,,,,both,4359.14,3923.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3051.4,,,,2571.89,3557.06
PEG PETELLA 26 MM,278,RC,,,,both,4359.14,3923.23,Cigna,Default,Percent of Total Billed Charges,2571.89,,,,2571.89,3557.06
PEG PETELLA 26 MM,278,RC,,,,both,4359.14,3923.23,United Healthcare,Default,Fee Schedule,3557.06,,,,2571.89,3557.06
TIBIAL INSERT PCL SIZE 3/4 10MM,278,RC,,,,both,4091.44,3682.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2864.01,,,,2413.95,3338.62
TIBIAL INSERT PCL SIZE 3/4 10MM,278,RC,,,,both,4091.44,3682.3,Cigna,Default,Percent of Total Billed Charges,2413.95,,,,2413.95,3338.62
TIBIAL INSERT PCL SIZE 3/4 10MM,278,RC,,,,both,4091.44,3682.3,United Healthcare,Default,Fee Schedule,3338.62,,,,2413.95,3338.62
BASEPLATE CCM TIBIAL COCR 3 LEFT,278,RC,,,,both,9029.4,8126.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6320.58,,,,5327.35,7367.99
BASEPLATE CCM TIBIAL COCR 3 LEFT,278,RC,,,,both,9029.4,8126.46,Cigna,Default,Percent of Total Billed Charges,5327.35,,,,5327.35,7367.99
BASEPLATE CCM TIBIAL COCR 3 LEFT,278,RC,,,,both,9029.4,8126.46,United Healthcare,Default,Fee Schedule,7367.99,,,,5327.35,7367.99
FEMORAL POROUS SZ 5 RIGHT,278,RC,,,,both,22302.18,20071.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15611.53,,,,13158.29,18198.58
FEMORAL POROUS SZ 5 RIGHT,278,RC,,,,both,22302.18,20071.96,Cigna,Default,Percent of Total Billed Charges,13158.29,,,,13158.29,18198.58
FEMORAL POROUS SZ 5 RIGHT,278,RC,,,,both,22302.18,20071.96,United Healthcare,Default,Fee Schedule,18198.58,,,,13158.29,18198.58
TRAY TIBIAL TRAP SZ 5F/5T,278,RC,,,,both,13963.73,12567.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9774.61,,,,8238.6,11394.4
TRAY TIBIAL TRAP SZ 5F/5T,278,RC,,,,both,13963.73,12567.36,Cigna,Default,Percent of Total Billed Charges,8238.6,,,,8238.6,11394.4
TRAY TIBIAL TRAP SZ 5F/5T,278,RC,,,,both,13963.73,12567.36,United Healthcare,Default,Fee Schedule,11394.4,,,,8238.6,11394.4
TIBIAL INSERT SIZE 5 15MM,278,RC,,,,both,7126.57,6413.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4988.6,,,,4204.68,5815.28
TIBIAL INSERT SIZE 5 15MM,278,RC,,,,both,7126.57,6413.91,Cigna,Default,Percent of Total Billed Charges,4204.68,,,,4204.68,5815.28
TIBIAL INSERT SIZE 5 15MM,278,RC,,,,both,7126.57,6413.91,United Healthcare,Default,Fee Schedule,5815.28,,,,4204.68,5815.28
FEMORAL POROUS SZ 4 RIGHT,278,RC,,,,both,13715.56,12344,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9600.89,,,,8092.18,11191.9
FEMORAL POROUS SZ 4 RIGHT,278,RC,,,,both,13715.56,12344,Cigna,Default,Percent of Total Billed Charges,8092.18,,,,8092.18,11191.9
FEMORAL POROUS SZ 4 RIGHT,278,RC,,,,both,13715.56,12344,United Healthcare,Default,Fee Schedule,11191.9,,,,8092.18,11191.9
PEG PETELLA,278,RC,,,,both,4359.14,3923.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3051.4,,,,2571.89,3557.06
PEG PETELLA,278,RC,,,,both,4359.14,3923.23,Cigna,Default,Percent of Total Billed Charges,2571.89,,,,2571.89,3557.06
PEG PETELLA,278,RC,,,,both,4359.14,3923.23,United Healthcare,Default,Fee Schedule,3557.06,,,,2571.89,3557.06
PEG PATELLA,278,RC,,,,both,4540.02,4086.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3178.01,,,,2678.61,3704.66
PEG PATELLA,278,RC,,,,both,4540.02,4086.02,Cigna,Default,Percent of Total Billed Charges,2678.61,,,,2678.61,3704.66
PEG PATELLA,278,RC,,,,both,4540.02,4086.02,United Healthcare,Default,Fee Schedule,3704.66,,,,2678.61,3704.66
"FEMORAL STEM SZ 15, 165MM",278,RC,,,,both,18729.48,16856.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13110.64,,,,11050.39,15283.26
"FEMORAL STEM SZ 15, 165MM",278,RC,,,,both,18729.48,16856.53,Cigna,Default,Percent of Total Billed Charges,11050.39,,,,11050.39,15283.26
"FEMORAL STEM SZ 15, 165MM",278,RC,,,,both,18729.48,16856.53,United Healthcare,Default,Fee Schedule,15283.26,,,,11050.39,15283.26
BIPOLAR COMPONENT,278,RC,,,,both,4937.94,4444.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3456.56,,,,2913.38,4029.36
BIPOLAR COMPONENT,278,RC,,,,both,4937.94,4444.15,Cigna,Default,Percent of Total Billed Charges,2913.38,,,,2913.38,4029.36
BIPOLAR COMPONENT,278,RC,,,,both,4937.94,4444.15,United Healthcare,Default,Fee Schedule,4029.36,,,,2913.38,4029.36
PROLONG HIGHLY CROSSLINKED POLYETHYLENE,C1776,HCPCS,278,RC,,both,1978.48,1780.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1384.94,,,,1167.3,1614.44
PROLONG HIGHLY CROSSLINKED POLYETHYLENE,C1776,HCPCS,278,RC,,both,1978.48,1780.63,Cigna,Default,Percent of Total Billed Charges,1167.3,,,,1167.3,1614.44
PROLONG HIGHLY CROSSLINKED POLYETHYLENE,C1776,HCPCS,278,RC,,both,1978.48,1780.63,United Healthcare,Default,Fee Schedule,1614.44,,,,1167.3,1614.44
LEGACY KNEE POSTERIOR STABILIZED,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
TAPER STEM PLUG NEXGEN,C1776,HCPCS,278,RC,,both,1633.73,1470.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1143.61,,,,963.9,1333.12
TAPER STEM PLUG NEXGEN,C1776,HCPCS,278,RC,,both,1633.73,1470.36,Cigna,Default,Percent of Total Billed Charges,963.9,,,,963.9,1333.12
TAPER STEM PLUG NEXGEN,C1776,HCPCS,278,RC,,both,1633.73,1470.36,United Healthcare,Default,Fee Schedule,1333.12,,,,963.9,1333.12
LEGACY KNE POSTERIOR STABILIZED,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
PALACOS R+G 1X40 SINGLE BONE CEMENT,C1713,HCPCS,278,RC,,both,1011.81,910.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,708.27,,,,596.97,825.64
PALACOS R+G 1X40 SINGLE BONE CEMENT,C1713,HCPCS,278,RC,,both,1011.81,910.63,Cigna,Default,Percent of Total Billed Charges,596.97,,,,596.97,825.64
PALACOS R+G 1X40 SINGLE BONE CEMENT,C1713,HCPCS,278,RC,,both,1011.81,910.63,United Healthcare,Default,Fee Schedule,825.64,,,,596.97,825.64
PATELLA REAMING BLADE SIZE 41,272,RC,,,,both,509.35,458.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,356.54,,,,300.52,415.63
PATELLA REAMING BLADE SIZE 41,272,RC,,,,both,509.35,458.42,Cigna,Default,Percent of Total Billed Charges,300.52,,,,300.52,415.63
PATELLA REAMING BLADE SIZE 41,272,RC,,,,both,509.35,458.42,United Healthcare,Default,Fee Schedule,415.63,,,,300.52,415.63
STEMMED TIBIAL COMPONENT PRECOAT SIZE 5,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.95,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 5,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Cigna,Default,Percent of Total Billed Charges,1976.46,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 5,C1776,HCPCS,278,RC,,both,3349.93,3014.94,United Healthcare,Default,Fee Schedule,2733.54,,,,1976.46,2733.54
LEGACY KNEE POSTERIOR STABILIZED SIZE E,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE E,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE E,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
STEMMED TIBIAL COMPONENT PRECOAT SIZE 4,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.95,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 4,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Cigna,Default,Percent of Total Billed Charges,1976.46,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 4,C1776,HCPCS,278,RC,,both,3349.93,3014.94,United Healthcare,Default,Fee Schedule,2733.54,,,,1976.46,2733.54
ALL-POLY PATELLA 32MM,C1776,HCPCS,278,RC,,both,1978.48,1780.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1384.94,,,,1167.3,1614.44
ALL-POLY PATELLA 32MM,C1776,HCPCS,278,RC,,both,1978.48,1780.63,Cigna,Default,Percent of Total Billed Charges,1167.3,,,,1167.3,1614.44
ALL-POLY PATELLA 32MM,C1776,HCPCS,278,RC,,both,1978.48,1780.63,United Healthcare,Default,Fee Schedule,1614.44,,,,1167.3,1614.44
LEGACY KNEE POSTERIOR STABILIZED SIZE C,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE C,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
LEGACY KNEE POSTERIOR STABILIZED SIZE C,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
LEGACY KNE POSTERIOR STABILIZED SIZE D,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED SIZE D,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED SIZE D,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
"NEXGEN PROLONG ALLPOLY PATELLA, 29MM",C1776,HCPCS,278,RC,,both,1978.48,1780.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1384.94,,,,1167.3,1614.44
"NEXGEN PROLONG ALLPOLY PATELLA, 29MM",C1776,HCPCS,278,RC,,both,1978.48,1780.63,Cigna,Default,Percent of Total Billed Charges,1167.3,,,,1167.3,1614.44
"NEXGEN PROLONG ALLPOLY PATELLA, 29MM",C1776,HCPCS,278,RC,,both,1978.48,1780.63,United Healthcare,Default,Fee Schedule,1614.44,,,,1167.3,1614.44
PATELLA REAMER BLADE SIZE 38,272,RC,,,,both,509.35,458.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,356.54,,,,300.52,415.63
PATELLA REAMER BLADE SIZE 38,272,RC,,,,both,509.35,458.42,Cigna,Default,Percent of Total Billed Charges,300.52,,,,300.52,415.63
PATELLA REAMER BLADE SIZE 38,272,RC,,,,both,509.35,458.42,United Healthcare,Default,Fee Schedule,415.63,,,,300.52,415.63
LEGACY KNE POSTERIOR STABILIZED SIZE R-L,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED SIZE R-L,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED SIZE R-L,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
NEXGEN PRECOAT STEMTIBIAL PLATE SZ 4,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.95,,,,1976.46,2733.54
NEXGEN PRECOAT STEMTIBIAL PLATE SZ 4,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Cigna,Default,Percent of Total Billed Charges,1976.46,,,,1976.46,2733.54
NEXGEN PRECOAT STEMTIBIAL PLATE SZ 4,C1776,HCPCS,278,RC,,both,3349.93,3014.94,United Healthcare,Default,Fee Schedule,2733.54,,,,1976.46,2733.54
LEGACY KNEE POSTERIOR STABILIZED SZ CD,C1776,HCPCS,278,RC,,both,4072.94,3665.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2851.06,,,,2403.03,3323.52
LEGACY KNEE POSTERIOR STABILIZED SZ CD,C1776,HCPCS,278,RC,,both,4072.94,3665.65,Cigna,Default,Percent of Total Billed Charges,2403.03,,,,2403.03,3323.52
LEGACY KNEE POSTERIOR STABILIZED SZ CD,C1776,HCPCS,278,RC,,both,4072.94,3665.65,United Healthcare,Default,Fee Schedule,3323.52,,,,2403.03,3323.52
LEGACY KNE POSTERIOR STABILIZED SIZE D-L,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.24,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED SIZE D-L,C1776,HCPCS,278,RC,,both,6954.63,6259.17,Cigna,Default,Percent of Total Billed Charges,4103.23,,,,4103.23,5674.98
LEGACY KNE POSTERIOR STABILIZED SIZE D-L,C1776,HCPCS,278,RC,,both,6954.63,6259.17,United Healthcare,Default,Fee Schedule,5674.98,,,,4103.23,5674.98
STEMMED TIBIAL COMPONENT PRECOAT SIZE 6,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.95,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 6,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Cigna,Default,Percent of Total Billed Charges,1976.46,,,,1976.46,2733.54
STEMMED TIBIAL COMPONENT PRECOAT SIZE 6,C1776,HCPCS,278,RC,,both,3349.93,3014.94,United Healthcare,Default,Fee Schedule,2733.54,,,,1976.46,2733.54
PATELLA REAMER BLADE SIZE 35,272,RC,,,,both,494.51,445.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,346.16,,,,291.76,403.52
PATELLA REAMER BLADE SIZE 35,272,RC,,,,both,494.51,445.06,Cigna,Default,Percent of Total Billed Charges,291.76,,,,291.76,403.52
PATELLA REAMER BLADE SIZE 35,272,RC,,,,both,494.51,445.06,United Healthcare,Default,Fee Schedule,403.52,,,,291.76,403.52
REFOBACIN BONE CEMENT R 1X40 US,C1713,HCPCS,278,RC,,both,617.38,555.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,432.17,,,,364.25,503.78
REFOBACIN BONE CEMENT R 1X40 US,C1713,HCPCS,278,RC,,both,617.38,555.64,Cigna,Default,Percent of Total Billed Charges,364.25,,,,364.25,503.78
REFOBACIN BONE CEMENT R 1X40 US,C1713,HCPCS,278,RC,,both,617.38,555.64,United Healthcare,Default,Fee Schedule,503.78,,,,364.25,503.78
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
HEADLESS TROCAR DRILL PIN75MM,C1713,HCPCS,278,RC,,both,881.48,793.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,617.04,,,,520.07,719.29
HEADLESS TROCAR DRILL PIN75MM,C1713,HCPCS,278,RC,,both,881.48,793.33,Cigna,Default,Percent of Total Billed Charges,520.07,,,,520.07,719.29
HEADLESS TROCAR DRILL PIN75MM,C1713,HCPCS,278,RC,,both,881.48,793.33,United Healthcare,Default,Fee Schedule,719.29,,,,520.07,719.29
NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
CUP MAGNUM 580DX521D,278,RC,,,,both,19947.14,17952.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13963,,,,11768.81,16276.87
CUP MAGNUM 580DX521D,278,RC,,,,both,19947.14,17952.43,Cigna,Default,Percent of Total Billed Charges,11768.81,,,,11768.81,16276.87
CUP MAGNUM 580DX521D,278,RC,,,,both,19947.14,17952.43,United Healthcare,Default,Fee Schedule,16276.87,,,,11768.81,16276.87
CUP MAGNUM PF 480DX42ID,278,RC,,,,both,21046.89,18942.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14732.82,,,,12417.67,17174.26
CUP MAGNUM PF 480DX42ID,278,RC,,,,both,21046.89,18942.2,Cigna,Default,Percent of Total Billed Charges,12417.67,,,,12417.67,17174.26
CUP MAGNUM PF 480DX42ID,278,RC,,,,both,21046.89,18942.2,United Healthcare,Default,Fee Schedule,17174.26,,,,12417.67,17174.26
NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 3,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.95,,,,1976.46,2733.54
NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 3,C1776,HCPCS,278,RC,,both,3349.93,3014.94,Cigna,Default,Percent of Total Billed Charges,1976.46,,,,1976.46,2733.54
NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 3,C1776,HCPCS,278,RC,,both,3349.93,3014.94,United Healthcare,Default,Fee Schedule,2733.54,,,,1976.46,2733.54
CUP MAGNUM PF 500DX44ID,278,RC,,,,both,22204.5,19984.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15543.15,,,,13100.66,18118.87
CUP MAGNUM PF 500DX44ID,278,RC,,,,both,22204.5,19984.05,Cigna,Default,Percent of Total Billed Charges,13100.66,,,,13100.66,18118.87
CUP MAGNUM PF 500DX44ID,278,RC,,,,both,22204.5,19984.05,United Healthcare,Default,Fee Schedule,18118.87,,,,13100.66,18118.87
NEXGEN LPS FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
CUP MAGNUM 620DX561D  M2A,278,RC,,,,both,19947.14,17952.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13963,,,,11768.81,16276.87
CUP MAGNUM 620DX561D  M2A,278,RC,,,,both,19947.14,17952.43,Cigna,Default,Percent of Total Billed Charges,11768.81,,,,11768.81,16276.87
CUP MAGNUM 620DX561D  M2A,278,RC,,,,both,19947.14,17952.43,United Healthcare,Default,Fee Schedule,16276.87,,,,11768.81,16276.87
CUP MAGNUM 50ODX48ID,278,RC,,,,both,20721.3,18649.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14504.91,,,,12225.57,16908.58
CUP MAGNUM 50ODX48ID,278,RC,,,,both,20721.3,18649.17,Cigna,Default,Percent of Total Billed Charges,12225.57,,,,12225.57,16908.58
CUP MAGNUM 50ODX48ID,278,RC,,,,both,20721.3,18649.17,United Healthcare,Default,Fee Schedule,16908.58,,,,12225.57,16908.58
MAGNUM PF CUP 50ODX46ID,278,RC,,,,both,22204.5,19984.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15543.15,,,,13100.66,18118.87
MAGNUM PF CUP 50ODX46ID,278,RC,,,,both,22204.5,19984.05,Cigna,Default,Percent of Total Billed Charges,13100.66,,,,13100.66,18118.87
MAGNUM PF CUP 50ODX46ID,278,RC,,,,both,22204.5,19984.05,United Healthcare,Default,Fee Schedule,18118.87,,,,13100.66,18118.87
CUP MAGNUM 54ODX48ID,278,RC,,,,both,21046.89,18942.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14732.82,,,,12417.67,17174.26
CUP MAGNUM 54ODX48ID,278,RC,,,,both,21046.89,18942.2,Cigna,Default,Percent of Total Billed Charges,12417.67,,,,12417.67,17174.26
CUP MAGNUM 54ODX48ID,278,RC,,,,both,21046.89,18942.2,United Healthcare,Default,Fee Schedule,17174.26,,,,12417.67,17174.26
ACT ARTIC HD ARCOM XL 28X46MM,278,RC,,,,both,9616,8654.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6731.2,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X46MM,278,RC,,,,both,9616,8654.4,Cigna,Default,Percent of Total Billed Charges,5673.44,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X46MM,278,RC,,,,both,9616,8654.4,United Healthcare,Default,Fee Schedule,7846.66,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X44MM,278,RC,,,,both,9616,8654.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6731.2,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X44MM,278,RC,,,,both,9616,8654.4,Cigna,Default,Percent of Total Billed Charges,5673.44,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X44MM,278,RC,,,,both,9616,8654.4,United Healthcare,Default,Fee Schedule,7846.66,,,,5673.44,7846.66
M2A MAGNUM PF CUP 50ODX44ID,278,RC,,,,both,22204.5,19984.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15543.15,,,,13100.66,18118.87
M2A MAGNUM PF CUP 50ODX44ID,278,RC,,,,both,22204.5,19984.05,Cigna,Default,Percent of Total Billed Charges,13100.66,,,,13100.66,18118.87
M2A MAGNUM PF CUP 50ODX44ID,278,RC,,,,both,22204.5,19984.05,United Healthcare,Default,Fee Schedule,18118.87,,,,13100.66,18118.87
ACT ARTIC HD ARCOM XL 28X50MM,278,RC,,,,both,9616,8654.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6731.2,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X50MM,278,RC,,,,both,9616,8654.4,Cigna,Default,Percent of Total Billed Charges,5673.44,,,,5673.44,7846.66
ACT ARTIC HD ARCOM XL 28X50MM,278,RC,,,,both,9616,8654.4,United Healthcare,Default,Fee Schedule,7846.66,,,,5673.44,7846.66
CUP MAGNUS 56ODX50ID,278,RC,,,,both,22204.5,19984.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15543.15,,,,13100.66,18118.87
CUP MAGNUS 56ODX50ID,278,RC,,,,both,22204.5,19984.05,Cigna,Default,Percent of Total Billed Charges,13100.66,,,,13100.66,18118.87
CUP MAGNUS 56ODX50ID,278,RC,,,,both,22204.5,19984.05,United Healthcare,Default,Fee Schedule,18118.87,,,,13100.66,18118.87
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 2,C1776,HCPCS,278,RC,,both,4887.54,4398.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3421.28,,,,2883.65,3988.23
NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 2,C1776,HCPCS,278,RC,,both,4887.54,4398.79,Cigna,Default,Percent of Total Billed Charges,2883.65,,,,2883.65,3988.23
NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 2,C1776,HCPCS,278,RC,,both,4887.54,4398.79,United Healthcare,Default,Fee Schedule,3988.23,,,,2883.65,3988.23
NEXGEN LPS FLEX FIXED PSIZE CD 12MM,C1776,HCPCS,278,RC,,both,3978.2,3580.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2784.74,,,,2347.14,3246.21
NEXGEN LPS FLEX FIXED PSIZE CD 12MM,C1776,HCPCS,278,RC,,both,3978.2,3580.38,Cigna,Default,Percent of Total Billed Charges,2347.14,,,,2347.14,3246.21
NEXGEN LPS FLEX FIXED PSIZE CD 12MM,C1776,HCPCS,278,RC,,both,3978.2,3580.38,United Healthcare,Default,Fee Schedule,3246.21,,,,2347.14,3246.21
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
MAGNUM 12/14 TPR 52-60 STD,278,RC,,,,both,2098.17,1888.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1468.72,,,,1237.92,1712.11
MAGNUM 12/14 TPR 52-60 STD,278,RC,,,,both,2098.17,1888.35,Cigna,Default,Percent of Total Billed Charges,1237.92,,,,1237.92,1712.11
MAGNUM 12/14 TPR 52-60 STD,278,RC,,,,both,2098.17,1888.35,United Healthcare,Default,Fee Schedule,1712.11,,,,1237.92,1712.11
MAGNUM 12/14 TPR 52-60 +9,278,RC,,,,both,2098.17,1888.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1468.72,,,,1237.92,1712.11
MAGNUM 12/14 TPR 52-60 +9,278,RC,,,,both,2098.17,1888.35,Cigna,Default,Percent of Total Billed Charges,1237.92,,,,1237.92,1712.11
MAGNUM 12/14 TPR 52-60 +9,278,RC,,,,both,2098.17,1888.35,United Healthcare,Default,Fee Schedule,1712.11,,,,1237.92,1712.11
ARCOS 13X175M BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
ARCOS 13X175M BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
ARCOS 13X175M BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
ARCOS 12X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
ARCOS 12X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
ARCOS 12X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
ACROS 1PC 14X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
ACROS 1PC 14X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
ACROS 1PC 14X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
28MM MOD HD STD NECK TP1 TAPER,278,RC,,,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
28MM MOD HD STD NECK TP1 TAPER,278,RC,,,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
28MM MOD HD STD NECK TP1 TAPER,278,RC,,,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
PSN 2.5MM FEMALE SCREW 25MM,C1713,HCPCS,278,RC,,both,480.19,432.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,336.13,,,,283.31,391.84
PSN 2.5MM FEMALE SCREW 25MM,C1713,HCPCS,278,RC,,both,480.19,432.17,Cigna,Default,Percent of Total Billed Charges,283.31,,,,283.31,391.84
PSN 2.5MM FEMALE SCREW 25MM,C1713,HCPCS,278,RC,,both,480.19,432.17,United Healthcare,Default,Fee Schedule,391.84,,,,283.31,391.84
PSN FEM PS CMT CCR NRW SIZE 5 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR NRW SIZE 5 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR NRW SIZE 5 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
CER BIOLOXD OPTION HD 28MM,278,RC,,,,both,4801.86,4321.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3361.3,,,,2833.1,3918.32
CER BIOLOXD OPTION HD 28MM,278,RC,,,,both,4801.86,4321.67,Cigna,Default,Percent of Total Billed Charges,2833.1,,,,2833.1,3918.32
CER BIOLOXD OPTION HD 28MM,278,RC,,,,both,4801.86,4321.67,United Healthcare,Default,Fee Schedule,3918.32,,,,2833.1,3918.32
CER OPTION 12/14 TPR SLEEVE +4,278,RC,,,,both,1211.88,1090.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,848.32,,,,715.01,988.89
CER OPTION 12/14 TPR SLEEVE +4,278,RC,,,,both,1211.88,1090.69,Cigna,Default,Percent of Total Billed Charges,715.01,,,,715.01,988.89
CER OPTION 12/14 TPR SLEEVE +4,278,RC,,,,both,1211.88,1090.69,United Healthcare,Default,Fee Schedule,988.89,,,,715.01,988.89
PSN ASF PS 16MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
PSN ASF PS 16MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
PSN ASF PS 16MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
PSN TIB STM 5 DEG SIZE D L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE D L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE D L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
ALL POLY PAT VE 32MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
ALL POLY PAT VE 32MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
ALL POLY PAT VE 32MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
ARCOS 11X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
ARCOS 11X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
ARCOS 11X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
PSN FEM PS CMT CCR STD SZ8 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ8 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ8 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN ASF PS 10MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 10MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 10MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN TIB STM 5 DEG SZ G L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SZ G L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SZ G L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
ALL POLY PAT VE 38 MM DIA,C1776,HCPCS,278,RC,,both,1978.5,1780.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1384.95,,,,1167.32,1614.46
ALL POLY PAT VE 38 MM DIA,C1776,HCPCS,278,RC,,both,1978.5,1780.65,Cigna,Default,Percent of Total Billed Charges,1167.32,,,,1167.32,1614.46
ALL POLY PAT VE 38 MM DIA,C1776,HCPCS,278,RC,,both,1978.5,1780.65,United Healthcare,Default,Fee Schedule,1614.46,,,,1167.32,1614.46
MAGNUM MOD HD SZ 52MM,278,RC,,,,both,7567.91,6811.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5297.54,,,,4465.07,6175.41
MAGNUM MOD HD SZ 52MM,278,RC,,,,both,7567.91,6811.12,Cigna,Default,Percent of Total Billed Charges,4465.07,,,,4465.07,6175.41
MAGNUM MOD HD SZ 52MM,278,RC,,,,both,7567.91,6811.12,United Healthcare,Default,Fee Schedule,6175.41,,,,4465.07,6175.41
MAGNUM MOD HD SZ 56MM,278,RC,,,,both,7567.91,6811.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5297.54,,,,4465.07,6175.41
MAGNUM MOD HD SZ 56MM,278,RC,,,,both,7567.91,6811.12,Cigna,Default,Percent of Total Billed Charges,4465.07,,,,4465.07,6175.41
MAGNUM MOD HD SZ 56MM,278,RC,,,,both,7567.91,6811.12,United Healthcare,Default,Fee Schedule,6175.41,,,,4465.07,6175.41
CUP MAGNUM M2A  12/14 TPR 42-50+3,278,RC,,,,both,2213.94,1992.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1549.76,,,,1306.22,1806.58
CUP MAGNUM M2A  12/14 TPR 42-50+3,278,RC,,,,both,2213.94,1992.55,Cigna,Default,Percent of Total Billed Charges,1306.22,,,,1306.22,1806.58
CUP MAGNUM M2A  12/14 TPR 42-50+3,278,RC,,,,both,2213.94,1992.55,United Healthcare,Default,Fee Schedule,1806.58,,,,1306.22,1806.58
MAGUM M2A MOD HD SZ 48MM,278,RC,,,,both,7987.54,7188.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5591.28,,,,4712.65,6517.83
MAGUM M2A MOD HD SZ 48MM,278,RC,,,,both,7987.54,7188.79,Cigna,Default,Percent of Total Billed Charges,4712.65,,,,4712.65,6517.83
MAGUM M2A MOD HD SZ 48MM,278,RC,,,,both,7987.54,7188.79,United Healthcare,Default,Fee Schedule,6517.83,,,,4712.65,6517.83
PSN FEM PS CMT CCR STD SZ10 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ10 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ10 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN ASF PS 12MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 12MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 12MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
ALL POLY PAT VE 41 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
ALL POLY PAT VE 41 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
ALL POLY PAT VE 41 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
"BIOLOX DELTA FEM HEAD, 32MM, +0MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1740.68,,,,1467.14,2029.13
"BIOLOX DELTA FEM HEAD, 32MM, +0MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,Cigna,Default,Percent of Total Billed Charges,1467.14,,,,1467.14,2029.13
"BIOLOX DELTA FEM HEAD, 32MM, +0MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,United Healthcare,Default,Fee Schedule,2029.13,,,,1467.14,2029.13
PSN FEM PS CMT CRR NRW SZ9 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ9 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ9 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN TIB STM 5 DEG SZ E R,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
PSN TIB STM 5 DEG SZ E R,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
PSN TIB STM 5 DEG SZ E R,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
ACT ARTIC E1 28MM ID X 42MM OD,278,RC,,,,both,10103.81,9093.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7072.67,,,,5961.25,8244.71
ACT ARTIC E1 28MM ID X 42MM OD,278,RC,,,,both,10103.81,9093.43,Cigna,Default,Percent of Total Billed Charges,5961.25,,,,5961.25,8244.71
ACT ARTIC E1 28MM ID X 42MM OD,278,RC,,,,both,10103.81,9093.43,United Healthcare,Default,Fee Schedule,8244.71,,,,5961.25,8244.71
PSN ASF PS 10MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
ALL POLY PAT VE 35 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
ALL POLY PAT VE 35 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
ALL POLY PAT VE 35 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
PSN FEM PS CMT CRR NRW SZ8 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CRR NRW SZ8 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CRR NRW SZ8 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
PSN ASF PS 16MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.2,,,,1828.33,2528.67
PSN ASF PS 16MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,Cigna,Default,Percent of Total Billed Charges,1828.33,,,,1828.33,2528.67
PSN ASF PS 16MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,3098.86,2788.97,United Healthcare,Default,Fee Schedule,2528.67,,,,1828.33,2528.67
PSN ASF PS 11MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 11MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 11MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
PSN FEM PS CMT CCR NRW SIZE 6 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.32,,,,4103.3,5675.07
PSN FEM PS CMT CCR NRW SIZE 6 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Cigna,Default,Percent of Total Billed Charges,4103.3,,,,4103.3,5675.07
PSN FEM PS CMT CCR NRW SIZE 6 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,United Healthcare,Default,Fee Schedule,5675.07,,,,4103.3,5675.07
M/L TAPER KINECTIV STEM SIZE 12.5,C1776,HCPCS,278,RC,,both,6711.18,6040.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4697.83,,,,3959.6,5476.32
M/L TAPER KINECTIV STEM SIZE 12.5,C1776,HCPCS,278,RC,,both,6711.18,6040.06,Cigna,Default,Percent of Total Billed Charges,3959.6,,,,3959.6,5476.32
M/L TAPER KINECTIV STEM SIZE 12.5,C1776,HCPCS,278,RC,,both,6711.18,6040.06,United Healthcare,Default,Fee Schedule,5476.32,,,,3959.6,5476.32
PSN FEM PS CMT CCR STD SZ10 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ10 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ10 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN ASF PS 10MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,3008.65,2707.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2106.06,,,,1775.1,2455.06
PSN ASF PS 10MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,3008.65,2707.79,Cigna,Default,Percent of Total Billed Charges,1775.1,,,,1775.1,2455.06
PSN ASF PS 10MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,3008.65,2707.79,United Healthcare,Default,Fee Schedule,2455.06,,,,1775.1,2455.06
PSN FEM PS CMT CCR STD SZ11 R,C1776,HCPCS,278,RC,,both,6002.34,5402.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.64,,,,3541.38,4897.91
PSN FEM PS CMT CCR STD SZ11 R,C1776,HCPCS,278,RC,,both,6002.34,5402.11,Cigna,Default,Percent of Total Billed Charges,3541.38,,,,3541.38,4897.91
PSN FEM PS CMT CCR STD SZ11 R,C1776,HCPCS,278,RC,,both,6002.34,5402.11,United Healthcare,Default,Fee Schedule,4897.91,,,,3541.38,4897.91
PSN ASF PS 10MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN ASF PS 10MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 10MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 10MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
BF HUMERAL HEAD 15MMX46MM,C1776,HCPCS,278,RC,,both,4503.65,4053.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3152.56,,,,2657.15,3674.98
BF HUMERAL HEAD 15MMX46MM,C1776,HCPCS,278,RC,,both,4503.65,4053.29,Cigna,Default,Percent of Total Billed Charges,2657.15,,,,2657.15,3674.98
BF HUMERAL HEAD 15MMX46MM,C1776,HCPCS,278,RC,,both,4503.65,4053.29,United Healthcare,Default,Fee Schedule,3674.98,,,,2657.15,3674.98
TM HUMERAL STEM 48 DEG 11MMX130MM,C1776,HCPCS,278,RC,,both,11518.7,10366.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8063.09,,,,6796.03,9399.26
TM HUMERAL STEM 48 DEG 11MMX130MM,C1776,HCPCS,278,RC,,both,11518.7,10366.83,Cigna,Default,Percent of Total Billed Charges,6796.03,,,,6796.03,9399.26
TM HUMERAL STEM 48 DEG 11MMX130MM,C1776,HCPCS,278,RC,,both,11518.7,10366.83,United Healthcare,Default,Fee Schedule,9399.26,,,,6796.03,9399.26
PSN FEM PS CMT CCR STD SZ9 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ9 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ9 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN TIB STM 5 DEG SZ G R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SZ G R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SZ G R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
PSN ASF PS 11MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 11MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 11MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN ASF PS 12MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 12MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 12MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN FEM PS CMT CCR STD SZ12 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ12 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ12 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
PSN ASF PS 11MM VE R 10-12 GH,278,RC,,,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 11MM VE R 10-12 GH,278,RC,,,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 11MM VE R 10-12 GH,278,RC,,,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
ALL POLY PAT VE 38 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
ALL POLY PAT VE 38 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
ALL POLY PAT VE 38 MM DIA,C1776,HCPCS,278,RC,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
PSN FEM PS CMT CCR STD SZ11 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ11 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ11 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ7 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ7 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR STD SZ7 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN ASF PS 12MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 12MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 12MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
GEMINUS VOLAR DISTAL RADIUS,C1713,HCPCS,278,RC,,both,3700.86,3330.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2590.6,,,,2183.51,3019.9
GEMINUS VOLAR DISTAL RADIUS,C1713,HCPCS,278,RC,,both,3700.86,3330.77,Cigna,Default,Percent of Total Billed Charges,2183.51,,,,2183.51,3019.9
GEMINUS VOLAR DISTAL RADIUS,C1713,HCPCS,278,RC,,both,3700.86,3330.77,United Healthcare,Default,Fee Schedule,3019.9,,,,2183.51,3019.9
SMOOTH PEG LOCKING 2.00X16MM,C1713,HCPCS,278,RC,,both,380.35,342.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,266.24,,,,224.41,310.37
SMOOTH PEG LOCKING 2.00X16MM,C1713,HCPCS,278,RC,,both,380.35,342.32,Cigna,Default,Percent of Total Billed Charges,224.41,,,,224.41,310.37
SMOOTH PEG LOCKING 2.00X16MM,C1713,HCPCS,278,RC,,both,380.35,342.32,United Healthcare,Default,Fee Schedule,310.37,,,,224.41,310.37
SMOOTH PEG LOCKING 2.0X18MM,C1713,HCPCS,278,RC,,both,380.35,342.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,266.24,,,,224.41,310.37
SMOOTH PEG LOCKING 2.0X18MM,C1713,HCPCS,278,RC,,both,380.35,342.32,Cigna,Default,Percent of Total Billed Charges,224.41,,,,224.41,310.37
SMOOTH PEG LOCKING 2.0X18MM,C1713,HCPCS,278,RC,,both,380.35,342.32,United Healthcare,Default,Fee Schedule,310.37,,,,224.41,310.37
SMOOTH PEG LOCKING 2.7X22MM,C1713,HCPCS,278,RC,,both,408.16,367.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,285.71,,,,240.81,333.06
SMOOTH PEG LOCKING 2.7X22MM,C1713,HCPCS,278,RC,,both,408.16,367.34,Cigna,Default,Percent of Total Billed Charges,240.81,,,,240.81,333.06
SMOOTH PEG LOCKING 2.7X22MM,C1713,HCPCS,278,RC,,both,408.16,367.34,United Healthcare,Default,Fee Schedule,333.06,,,,240.81,333.06
HIGH COMPRESSION LOCKING PEG 2.7X22MM,C1713,HCPCS,278,RC,,both,439.03,395.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.32,,,,259.03,358.25
HIGH COMPRESSION LOCKING PEG 2.7X22MM,C1713,HCPCS,278,RC,,both,439.03,395.13,Cigna,Default,Percent of Total Billed Charges,259.03,,,,259.03,358.25
HIGH COMPRESSION LOCKING PEG 2.7X22MM,C1713,HCPCS,278,RC,,both,439.03,395.13,United Healthcare,Default,Fee Schedule,358.25,,,,259.03,358.25
SCREW CORTICAL LOCKING 3.5X10MM,C1713,HCPCS,278,RC,,both,404.73,364.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,283.31,,,,238.79,330.26
SCREW CORTICAL LOCKING 3.5X10MM,C1713,HCPCS,278,RC,,both,404.73,364.26,Cigna,Default,Percent of Total Billed Charges,238.79,,,,238.79,330.26
SCREW CORTICAL LOCKING 3.5X10MM,C1713,HCPCS,278,RC,,both,404.73,364.26,United Healthcare,Default,Fee Schedule,330.26,,,,238.79,330.26
SCREW CORTICAL LOCKING 3.5X12MM,C1713,HCPCS,278,RC,,both,404.73,364.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,283.31,,,,238.79,330.26
SCREW CORTICAL LOCKING 3.5X12MM,C1713,HCPCS,278,RC,,both,404.73,364.26,Cigna,Default,Percent of Total Billed Charges,238.79,,,,238.79,330.26
SCREW CORTICAL LOCKING 3.5X12MM,C1713,HCPCS,278,RC,,both,404.73,364.26,United Healthcare,Default,Fee Schedule,330.26,,,,238.79,330.26
SCREW CORTICAL NON LOCKING 3.5X10MM,C1713,HCPCS,278,RC,,both,397.87,358.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,278.51,,,,234.74,324.66
SCREW CORTICAL NON LOCKING 3.5X10MM,C1713,HCPCS,278,RC,,both,397.87,358.08,Cigna,Default,Percent of Total Billed Charges,234.74,,,,234.74,324.66
SCREW CORTICAL NON LOCKING 3.5X10MM,C1713,HCPCS,278,RC,,both,397.87,358.08,United Healthcare,Default,Fee Schedule,324.66,,,,234.74,324.66
CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
32MM MOD HEAD COCR +6mm NECK,C1776,HCPCS,278,RC,,both,1396.29,1256.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,977.4,,,,823.81,1139.37
32MM MOD HEAD COCR +6mm NECK,C1776,HCPCS,278,RC,,both,1396.29,1256.66,Cigna,Default,Percent of Total Billed Charges,823.81,,,,823.81,1139.37
32MM MOD HEAD COCR +6mm NECK,C1776,HCPCS,278,RC,,both,1396.29,1256.66,United Healthcare,Default,Fee Schedule,1139.37,,,,823.81,1139.37
ARCOS 12X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,11318.49,10186.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7922.94,,,,6677.91,9235.89
ARCOS 12X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,11318.49,10186.64,Cigna,Default,Percent of Total Billed Charges,6677.91,,,,6677.91,9235.89
ARCOS 12X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,11318.49,10186.64,United Healthcare,Default,Fee Schedule,9235.89,,,,6677.91,9235.89
"CONTINUUM VIVACIT-E NEUTRAL LINER, KK 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM VIVACIT-E NEUTRAL LINER, KK 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM VIVACIT-E NEUTRAL LINER, KK 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
CONTINUUM VIVACIT-E NEUTRAL LINER II 32X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER II 32X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER II 32X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
PSN FEM PS CMT CCR NRW SZ7 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.32,,,,4103.3,5675.07
PSN FEM PS CMT CCR NRW SZ7 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Cigna,Default,Percent of Total Billed Charges,4103.3,,,,4103.3,5675.07
PSN FEM PS CMT CCR NRW SZ7 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,United Healthcare,Default,Fee Schedule,5675.07,,,,4103.3,5675.07
PSN ASF PS 12MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 12MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 12MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
"CABLE GRIP SYS,4X40MM",278,RC,,,,both,2052.38,1847.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1436.67,,,,1210.9,1674.74
"CABLE GRIP SYS,4X40MM",278,RC,,,,both,2052.38,1847.14,Cigna,Default,Percent of Total Billed Charges,1210.9,,,,1210.9,1674.74
"CABLE GRIP SYS,4X40MM",278,RC,,,,both,2052.38,1847.14,United Healthcare,Default,Fee Schedule,1674.74,,,,1210.9,1674.74
CABLE GRIP SYS W/TWO CRIMP 4X35MM,278,RC,,,,both,2052.38,1847.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1436.67,,,,1210.9,1674.74
CABLE GRIP SYS W/TWO CRIMP 4X35MM,278,RC,,,,both,2052.38,1847.14,Cigna,Default,Percent of Total Billed Charges,1210.9,,,,1210.9,1674.74
CABLE GRIP SYS W/TWO CRIMP 4X35MM,278,RC,,,,both,2052.38,1847.14,United Healthcare,Default,Fee Schedule,1674.74,,,,1210.9,1674.74
PSN ASF PS 14MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 14MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 14MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
*PATELLA REAMER BLADE SIZE 41,272,RC,,,,both,368.36,331.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.85,,,,217.33,300.58
*PATELLA REAMER BLADE SIZE 41,272,RC,,,,both,368.36,331.52,Cigna,Default,Percent of Total Billed Charges,217.33,,,,217.33,300.58
*PATELLA REAMER BLADE SIZE 41,272,RC,,,,both,368.36,331.52,United Healthcare,Default,Fee Schedule,300.58,,,,217.33,300.58
*PSN TIB STM 5 DEG SIZE E L,C1776,HCPCS,278,RC,,both,3252.36,2927.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2276.65,,,,1918.89,2653.93
*PSN TIB STM 5 DEG SIZE E L,C1776,HCPCS,278,RC,,both,3252.36,2927.12,Cigna,Default,Percent of Total Billed Charges,1918.89,,,,1918.89,2653.93
*PSN TIB STM 5 DEG SIZE E L,C1776,HCPCS,278,RC,,both,3252.36,2927.12,United Healthcare,Default,Fee Schedule,2653.93,,,,1918.89,2653.93
DRESSING EPIFIX 2X3,Q4186,HCPCS,636,RC,,both,653.79,588.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,457.65,,,,385.74,533.49
DRESSING EPIFIX 2X3,Q4186,HCPCS,636,RC,,both,653.79,588.41,Cigna,Default,Percent of Total Billed Charges,385.74,,,,385.74,533.49
DRESSING EPIFIX 2X3,Q4186,HCPCS,636,RC,,both,653.79,588.41,United Healthcare,Default,Fee Schedule,533.49,,,,385.74,533.49
PIN GUIDE 3.2 MM,C1713,HCPCS,278,RC,,both,658.53,592.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,460.97,,,,388.53,537.36
PIN GUIDE 3.2 MM,C1713,HCPCS,278,RC,,both,658.53,592.68,Cigna,Default,Percent of Total Billed Charges,388.53,,,,388.53,537.36
PIN GUIDE 3.2 MM,C1713,HCPCS,278,RC,,both,658.53,592.68,United Healthcare,Default,Fee Schedule,537.36,,,,388.53,537.36
SCREW LAG 85MM,C1713,HCPCS,278,RC,,both,966.06,869.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,676.24,,,,569.98,788.3
SCREW LAG 85MM,C1713,HCPCS,278,RC,,both,966.06,869.45,Cigna,Default,Percent of Total Billed Charges,569.98,,,,569.98,788.3
SCREW LAG 85MM,C1713,HCPCS,278,RC,,both,966.06,869.45,United Healthcare,Default,Fee Schedule,788.3,,,,569.98,788.3
SCREW 4.7 X 25.4 MM,C1713,HCPCS,278,RC,,both,201.34,181.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.94,,,,118.79,164.29
SCREW 4.7 X 25.4 MM,C1713,HCPCS,278,RC,,both,201.34,181.21,Cigna,Default,Percent of Total Billed Charges,118.79,,,,118.79,164.29
SCREW 4.7 X 25.4 MM,C1713,HCPCS,278,RC,,both,201.34,181.21,United Healthcare,Default,Fee Schedule,164.29,,,,118.79,164.29
SCREW 4.5 X 44MM,278,RC,,,,both,144.59,130.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.21,,,,85.31,117.99
SCREW 4.5 X 44MM,278,RC,,,,both,144.59,130.13,Cigna,Default,Percent of Total Billed Charges,85.31,,,,85.31,117.99
SCREW 4.5 X 44MM,278,RC,,,,both,144.59,130.13,United Healthcare,Default,Fee Schedule,117.99,,,,85.31,117.99
SCREW 4.5 X 38MM,278,RC,,,,both,144.59,130.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.21,,,,85.31,117.99
SCREW 4.5 X 38MM,278,RC,,,,both,144.59,130.13,Cigna,Default,Percent of Total Billed Charges,85.31,,,,85.31,117.99
SCREW 4.5 X 38MM,278,RC,,,,both,144.59,130.13,United Healthcare,Default,Fee Schedule,117.99,,,,85.31,117.99
SCREW 2.4 X 16MM CANNOLATED,278,RC,,,,both,560.71,504.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,392.5,,,,330.82,457.54
SCREW 2.4 X 16MM CANNOLATED,278,RC,,,,both,560.71,504.64,Cigna,Default,Percent of Total Billed Charges,330.82,,,,330.82,457.54
SCREW 2.4 X 16MM CANNOLATED,278,RC,,,,both,560.71,504.64,United Healthcare,Default,Fee Schedule,457.54,,,,330.82,457.54
AFB1115-AVAFLEXBALLOON 11G 15MM,C1889,HCPCS,278,RC,,both,8833.71,7950.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6183.6,,,,5211.89,7208.31
AFB1115-AVAFLEXBALLOON 11G 15MM,C1889,HCPCS,278,RC,,both,8833.71,7950.34,Cigna,Default,Percent of Total Billed Charges,5211.89,,,,5211.89,7208.31
AFB1115-AVAFLEXBALLOON 11G 15MM,C1889,HCPCS,278,RC,,both,8833.71,7950.34,United Healthcare,Default,Fee Schedule,7208.31,,,,5211.89,7208.31
AUTOPLEX W/VERTAPLEX HV,C1713,HCPCS,278,RC,,both,2683.98,2415.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1878.79,,,,1583.55,2190.13
AUTOPLEX W/VERTAPLEX HV,C1713,HCPCS,278,RC,,both,2683.98,2415.58,Cigna,Default,Percent of Total Billed Charges,1583.55,,,,1583.55,2190.13
AUTOPLEX W/VERTAPLEX HV,C1713,HCPCS,278,RC,,both,2683.98,2415.58,United Healthcare,Default,Fee Schedule,2190.13,,,,1583.55,2190.13
IVAS 11G BIOPSY,272,RC,,,,both,266.67,240,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.67,,,,157.34,217.6
IVAS 11G BIOPSY,272,RC,,,,both,266.67,240,Cigna,Default,Percent of Total Billed Charges,157.34,,,,157.34,217.6
IVAS 11G BIOPSY,272,RC,,,,both,266.67,240,United Healthcare,Default,Fee Schedule,217.6,,,,157.34,217.6
CURETTE 11G,C1889,HCPCS,278,RC,,both,2027.86,1825.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1419.5,,,,1196.44,1654.73
CURETTE 11G,C1889,HCPCS,278,RC,,both,2027.86,1825.07,Cigna,Default,Percent of Total Billed Charges,1196.44,,,,1196.44,1654.73
CURETTE 11G,C1889,HCPCS,278,RC,,both,2027.86,1825.07,United Healthcare,Default,Fee Schedule,1654.73,,,,1196.44,1654.73
CONSIGNMENT 11G IVAS ACCESS CANNULA,C1889,HCPCS,278,RC,,both,184.58,166.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.21,,,,108.9,150.62
CONSIGNMENT 11G IVAS ACCESS CANNULA,C1889,HCPCS,278,RC,,both,184.58,166.12,Cigna,Default,Percent of Total Billed Charges,108.9,,,,108.9,150.62
CONSIGNMENT 11G IVAS ACCESS CANNULA,C1889,HCPCS,278,RC,,both,184.58,166.12,United Healthcare,Default,Fee Schedule,150.62,,,,108.9,150.62
11G 20MM AVAFLEX KIT,C1889,HCPCS,278,RC,,both,8833.71,7950.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6183.6,,,,5211.89,7208.31
11G 20MM AVAFLEX KIT,C1889,HCPCS,278,RC,,both,8833.71,7950.34,Cigna,Default,Percent of Total Billed Charges,5211.89,,,,5211.89,7208.31
11G 20MM AVAFLEX KIT,C1889,HCPCS,278,RC,,both,8833.71,7950.34,United Healthcare,Default,Fee Schedule,7208.31,,,,5211.89,7208.31
CONTINUUM VIVACIT-E NEUTRAL LINER GG 32X,C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
CONTINUUM VIVACIT-E NEUTRAL LINER GG 32X,C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
CONTINUUM VIVACIT-E NEUTRAL LINER GG 32X,C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
PSN ASF PS 10MM VE L 10-11 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 10-11 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 10-11 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN TIB STM 5 DEG SIZE F L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE F L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE F L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
PSN ASF PS 14MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 14MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 14MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN TIB STM 5 DEG SZ E L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SZ E L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SZ E L,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
PSN ASF PS 14MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 14MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 14MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
CER BIOLOXD OPTION HD 32MM,C1776,HCPCS,278,RC,,both,4801.86,4321.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3361.3,,,,2833.1,3918.32
CER BIOLOXD OPTION HD 32MM,C1776,HCPCS,278,RC,,both,4801.86,4321.67,Cigna,Default,Percent of Total Billed Charges,2833.1,,,,2833.1,3918.32
CER BIOLOXD OPTION HD 32MM,C1776,HCPCS,278,RC,,both,4801.86,4321.67,United Healthcare,Default,Fee Schedule,3918.32,,,,2833.1,3918.32
CER OPTION TYPE 1 TPR SLEEVE +3,C1889,HCPCS,278,RC,,both,342.99,308.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,240.09,,,,202.36,279.88
CER OPTION TYPE 1 TPR SLEEVE +3,C1889,HCPCS,278,RC,,both,342.99,308.69,Cigna,Default,Percent of Total Billed Charges,202.36,,,,202.36,279.88
CER OPTION TYPE 1 TPR SLEEVE +3,C1889,HCPCS,278,RC,,both,342.99,308.69,United Healthcare,Default,Fee Schedule,279.88,,,,202.36,279.88
"CONTINUUM VIVACIT-E NEUTRAL LINER,  JJ 3",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM VIVACIT-E NEUTRAL LINER,  JJ 3",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM VIVACIT-E NEUTRAL LINER,  JJ 3",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
CER BIOLOXD OPTION HD 36MM,C1776,HCPCS,278,RC,,both,4801.86,4321.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3361.3,,,,2833.1,3918.32
CER BIOLOXD OPTION HD 36MM,C1776,HCPCS,278,RC,,both,4801.86,4321.67,Cigna,Default,Percent of Total Billed Charges,2833.1,,,,2833.1,3918.32
CER BIOLOXD OPTION HD 36MM,C1776,HCPCS,278,RC,,both,4801.86,4321.67,United Healthcare,Default,Fee Schedule,3918.32,,,,2833.1,3918.32
CER OPTION TYPE 1 TPR SLEEVE +6,C1889,HCPCS,278,RC,,both,333,299.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.1,,,,196.47,271.73
CER OPTION TYPE 1 TPR SLEEVE +6,C1889,HCPCS,278,RC,,both,333,299.7,Cigna,Default,Percent of Total Billed Charges,196.47,,,,196.47,271.73
CER OPTION TYPE 1 TPR SLEEVE +6,C1889,HCPCS,278,RC,,both,333,299.7,United Healthcare,Default,Fee Schedule,271.73,,,,196.47,271.73
COMP RVS 2.7 MM DIA DRL,272,RC,,,,both,795.52,715.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.86,,,,469.36,649.14
COMP RVS 2.7 MM DIA DRL,272,RC,,,,both,795.52,715.97,Cigna,Default,Percent of Total Billed Charges,469.36,,,,469.36,649.14
COMP RVS 2.7 MM DIA DRL,272,RC,,,,both,795.52,715.97,United Healthcare,Default,Fee Schedule,649.14,,,,469.36,649.14
COMP REV SHLDR 9 IN STEINMANN,C1713,HCPCS,278,RC,,both,546.11,491.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,382.28,,,,322.2,445.63
COMP REV SHLDR 9 IN STEINMANN,C1713,HCPCS,278,RC,,both,546.11,491.5,Cigna,Default,Percent of Total Billed Charges,322.2,,,,322.2,445.63
COMP REV SHLDR 9 IN STEINMANN,C1713,HCPCS,278,RC,,both,546.11,491.5,United Healthcare,Default,Fee Schedule,445.63,,,,322.2,445.63
COMP RVS 3.2 MM DRL,272,RC,,,,both,580.4,522.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,406.28,,,,342.44,473.61
COMP RVS 3.2 MM DRL,272,RC,,,,both,580.4,522.36,Cigna,Default,Percent of Total Billed Charges,342.44,,,,342.44,473.61
COMP RVS 3.2 MM DRL,272,RC,,,,both,580.4,522.36,United Healthcare,Default,Fee Schedule,473.61,,,,342.44,473.61
COMP RVS 25MM BSPLT HA+ADPTR,C1776,HCPCS,278,RC,,both,5916.58,5324.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4141.61,,,,3490.78,4827.93
COMP RVS 25MM BSPLT HA+ADPTR,C1776,HCPCS,278,RC,,both,5916.58,5324.92,Cigna,Default,Percent of Total Billed Charges,3490.78,,,,3490.78,4827.93
COMP RVS 25MM BSPLT HA+ADPTR,C1776,HCPCS,278,RC,,both,5916.58,5324.92,United Healthcare,Default,Fee Schedule,4827.93,,,,3490.78,4827.93
HMRL BEARING 36 MM + 3 VITE,C1713,HCPCS,278,RC,,both,6311.02,5679.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4417.71,,,,3723.5,5149.79
HMRL BEARING 36 MM + 3 VITE,C1713,HCPCS,278,RC,,both,6311.02,5679.92,Cigna,Default,Percent of Total Billed Charges,3723.5,,,,3723.5,5149.79
HMRL BEARING 36 MM + 3 VITE,C1713,HCPCS,278,RC,,both,6311.02,5679.92,United Healthcare,Default,Fee Schedule,5149.79,,,,3723.5,5149.79
HMRL TRAY +3 STD,C1776,HCPCS,278,RC,,both,5455.09,4909.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3818.56,,,,3218.5,4451.35
HMRL TRAY +3 STD,C1776,HCPCS,278,RC,,both,5455.09,4909.58,Cigna,Default,Percent of Total Billed Charges,3218.5,,,,3218.5,4451.35
HMRL TRAY +3 STD,C1776,HCPCS,278,RC,,both,5455.09,4909.58,United Healthcare,Default,Fee Schedule,4451.35,,,,3218.5,4451.35
COMP NLK SCR 3.5HEX 4.75X25 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.46,,,,294.55,407.37
COMP NLK SCR 3.5HEX 4.75X25 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,Cigna,Default,Percent of Total Billed Charges,294.55,,,,294.55,407.37
COMP NLK SCR 3.5HEX 4.75X25 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,United Healthcare,Default,Fee Schedule,407.37,,,,294.55,407.37
COMP NLK SCR 3.5HEX 4.75X20 ST,C1713,HCPCS,278,RC,,both,485.16,436.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,339.61,,,,286.24,395.89
COMP NLK SCR 3.5HEX 4.75X20 ST,C1713,HCPCS,278,RC,,both,485.16,436.64,Cigna,Default,Percent of Total Billed Charges,286.24,,,,286.24,395.89
COMP NLK SCR 3.5HEX 4.75X20 ST,C1713,HCPCS,278,RC,,both,485.16,436.64,United Healthcare,Default,Fee Schedule,395.89,,,,286.24,395.89
COMP RVRS SHLDR GLNSP STD 36MM,C1776,HCPCS,278,RC,,both,4721.43,4249.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3305,,,,2785.64,3852.69
COMP RVRS SHLDR GLNSP STD 36MM,C1776,HCPCS,278,RC,,both,4721.43,4249.29,Cigna,Default,Percent of Total Billed Charges,2785.64,,,,2785.64,3852.69
COMP RVRS SHLDR GLNSP STD 36MM,C1776,HCPCS,278,RC,,both,4721.43,4249.29,United Healthcare,Default,Fee Schedule,3852.69,,,,2785.64,3852.69
COMP RVS CNTRL 6.5X25MM ST/RST,C1713,HCPCS,278,RC,,both,477.27,429.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,334.09,,,,281.59,389.45
COMP RVS CNTRL 6.5X25MM ST/RST,C1713,HCPCS,278,RC,,both,477.27,429.54,Cigna,Default,Percent of Total Billed Charges,281.59,,,,281.59,389.45
COMP RVS CNTRL 6.5X25MM ST/RST,C1713,HCPCS,278,RC,,both,477.27,429.54,United Healthcare,Default,Fee Schedule,389.45,,,,281.59,389.45
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM,C1713,HCPCS,278,RC,,both,2044.22,1839.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1430.95,,,,1206.09,1668.08
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM,C1713,HCPCS,278,RC,,both,2044.22,1839.8,Cigna,Default,Percent of Total Billed Charges,1206.09,,,,1206.09,1668.08
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM,C1713,HCPCS,278,RC,,both,2044.22,1839.8,United Healthcare,Default,Fee Schedule,1668.08,,,,1206.09,1668.08
CANNULATED COMPRESSION SCREW W/ S.S.,C1713,HCPCS,278,RC,,both,1262.14,1135.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,883.5,,,,744.66,1029.91
CANNULATED COMPRESSION SCREW W/ S.S.,C1713,HCPCS,278,RC,,both,1262.14,1135.93,Cigna,Default,Percent of Total Billed Charges,744.66,,,,744.66,1029.91
CANNULATED COMPRESSION SCREW W/ S.S.,C1713,HCPCS,278,RC,,both,1262.14,1135.93,United Healthcare,Default,Fee Schedule,1029.91,,,,744.66,1029.91
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM,C1713,HCPCS,278,RC,,both,2044.22,1839.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1430.95,,,,1206.09,1668.08
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM,C1713,HCPCS,278,RC,,both,2044.22,1839.8,Cigna,Default,Percent of Total Billed Charges,1206.09,,,,1206.09,1668.08
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM,C1713,HCPCS,278,RC,,both,2044.22,1839.8,United Healthcare,Default,Fee Schedule,1668.08,,,,1206.09,1668.08
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 16MM,C1713,HCPCS,278,RC,,both,2103.51,1893.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1472.46,,,,1241.07,1716.46
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 16MM,C1713,HCPCS,278,RC,,both,2103.51,1893.16,Cigna,Default,Percent of Total Billed Charges,1241.07,,,,1241.07,1716.46
AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 16MM,C1713,HCPCS,278,RC,,both,2103.51,1893.16,United Healthcare,Default,Fee Schedule,1716.46,,,,1241.07,1716.46
COUNTERSINK 2.0 - 2.5MM CANNULATED,A4649,HCPCS,272,RC,,both,1852.92,1667.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1297.04,,,,1093.22,1511.98
COUNTERSINK 2.0 - 2.5MM CANNULATED,A4649,HCPCS,272,RC,,both,1852.92,1667.63,Cigna,Default,Percent of Total Billed Charges,1093.22,,,,1093.22,1511.98
COUNTERSINK 2.0 - 2.5MM CANNULATED,A4649,HCPCS,272,RC,,both,1852.92,1667.63,United Healthcare,Default,Fee Schedule,1511.98,,,,1093.22,1511.98
MRI STERILE SHORT OSTEOTOME BLADE 12MM,272,RC,,,,both,395.29,355.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.7,,,,233.22,322.56
MRI STERILE SHORT OSTEOTOME BLADE 12MM,272,RC,,,,both,395.29,355.76,Cigna,Default,Percent of Total Billed Charges,233.22,,,,233.22,322.56
MRI STERILE SHORT OSTEOTOME BLADE 12MM,272,RC,,,,both,395.29,355.76,United Healthcare,Default,Fee Schedule,322.56,,,,233.22,322.56
COMP RV SHLDR GD AND BN R,C1713,HCPCS,278,RC,,both,4023.48,3621.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2816.44,,,,2373.85,3283.16
COMP RV SHLDR GD AND BN R,C1713,HCPCS,278,RC,,both,4023.48,3621.13,Cigna,Default,Percent of Total Billed Charges,2373.85,,,,2373.85,3283.16
COMP RV SHLDR GD AND BN R,C1713,HCPCS,278,RC,,both,4023.48,3621.13,United Healthcare,Default,Fee Schedule,3283.16,,,,2373.85,3283.16
COMP LK SCR 3.5 HEX 4.75X20 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.46,,,,294.55,407.37
COMP LK SCR 3.5 HEX 4.75X20 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,Cigna,Default,Percent of Total Billed Charges,294.55,,,,294.55,407.37
COMP LK SCR 3.5 HEX 4.75X20 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,United Healthcare,Default,Fee Schedule,407.37,,,,294.55,407.37
COMP PRIMARY STEM 9MM MINI,C1776,HCPCS,278,RC,,both,13977.53,12579.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9784.27,,,,8246.74,11405.66
COMP PRIMARY STEM 9MM MINI,C1776,HCPCS,278,RC,,both,13977.53,12579.78,Cigna,Default,Percent of Total Billed Charges,8246.74,,,,8246.74,11405.66
COMP PRIMARY STEM 9MM MINI,C1776,HCPCS,278,RC,,both,13977.53,12579.78,United Healthcare,Default,Fee Schedule,11405.66,,,,8246.74,11405.66
HMRL BEARING 36MM STD VITE,C1713,HCPCS,278,RC,,both,6494.04,5844.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4545.83,,,,3831.48,5299.14
HMRL BEARING 36MM STD VITE,C1713,HCPCS,278,RC,,both,6494.04,5844.64,Cigna,Default,Percent of Total Billed Charges,3831.48,,,,3831.48,5299.14
HMRL BEARING 36MM STD VITE,C1713,HCPCS,278,RC,,both,6494.04,5844.64,United Healthcare,Default,Fee Schedule,5299.14,,,,3831.48,5299.14
COMP LK SCR 3.5 HEX 4.75X30 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.46,,,,294.55,407.37
COMP LK SCR 3.5 HEX 4.75X30 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,Cigna,Default,Percent of Total Billed Charges,294.55,,,,294.55,407.37
COMP LK SCR 3.5 HEX 4.75X30 ST,C1713,HCPCS,278,RC,,both,499.23,449.31,United Healthcare,Default,Fee Schedule,407.37,,,,294.55,407.37
PSN ASF PS 13MM VE R 10-12 EF,C1776,HCPCS,278,RC,,both,3188.78,2869.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2232.15,,,,1881.38,2602.04
PSN ASF PS 13MM VE R 10-12 EF,C1776,HCPCS,278,RC,,both,3188.78,2869.9,Cigna,Default,Percent of Total Billed Charges,1881.38,,,,1881.38,2602.04
PSN ASF PS 13MM VE R 10-12 EF,C1776,HCPCS,278,RC,,both,3188.78,2869.9,United Healthcare,Default,Fee Schedule,2602.04,,,,1881.38,2602.04
CER OPTION TYPE 1 TPR SLEEVE 0MM,C1889,HCPCS,278,RC,,both,342.99,308.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,240.09,,,,202.36,279.88
CER OPTION TYPE 1 TPR SLEEVE 0MM,C1889,HCPCS,278,RC,,both,342.99,308.69,Cigna,Default,Percent of Total Billed Charges,202.36,,,,202.36,279.88
CER OPTION TYPE 1 TPR SLEEVE 0MM,C1889,HCPCS,278,RC,,both,342.99,308.69,United Healthcare,Default,Fee Schedule,279.88,,,,202.36,279.88
PSN ASF PS 16MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 16MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 16MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN FEM CR POR CCR STD SZ8 R,C1776,HCPCS,278,RC,,both,11044.28,9939.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7731,,,,6516.13,9012.13
PSN FEM CR POR CCR STD SZ8 R,C1776,HCPCS,278,RC,,both,11044.28,9939.85,Cigna,Default,Percent of Total Billed Charges,6516.13,,,,6516.13,9012.13
PSN FEM CR POR CCR STD SZ8 R,C1776,HCPCS,278,RC,,both,11044.28,9939.85,United Healthcare,Default,Fee Schedule,9012.13,,,,6516.13,9012.13
PLATE 135 DEGREE 3 HOLE,C1713,HCPCS,278,RC,,both,1485.64,1337.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1039.95,,,,876.53,1212.28
PLATE 135 DEGREE 3 HOLE,C1713,HCPCS,278,RC,,both,1485.64,1337.08,Cigna,Default,Percent of Total Billed Charges,876.53,,,,876.53,1212.28
PLATE 135 DEGREE 3 HOLE,C1713,HCPCS,278,RC,,both,1485.64,1337.08,United Healthcare,Default,Fee Schedule,1212.28,,,,876.53,1212.28
SCREW CORTICAL NON LOCKING 3.5X12MM,C1713,HCPCS,278,RC,,both,397.87,358.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,278.51,,,,234.74,324.66
SCREW CORTICAL NON LOCKING 3.5X12MM,C1713,HCPCS,278,RC,,both,397.87,358.08,Cigna,Default,Percent of Total Billed Charges,234.74,,,,234.74,324.66
SCREW CORTICAL NON LOCKING 3.5X12MM,C1713,HCPCS,278,RC,,both,397.87,358.08,United Healthcare,Default,Fee Schedule,324.66,,,,234.74,324.66
K-WIRE 1.6X127MM,C1769,HCPCS,278,RC,,both,147.81,133.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.47,,,,87.21,120.61
K-WIRE 1.6X127MM,C1769,HCPCS,278,RC,,both,147.81,133.03,Cigna,Default,Percent of Total Billed Charges,87.21,,,,87.21,120.61
K-WIRE 1.6X127MM,C1769,HCPCS,278,RC,,both,147.81,133.03,United Healthcare,Default,Fee Schedule,120.61,,,,87.21,120.61
DRILL SOLID SIDE CUTTING 2X40MM,C1713,HCPCS,278,RC,,both,473.33,426,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,331.33,,,,279.26,386.24
DRILL SOLID SIDE CUTTING 2X40MM,C1713,HCPCS,278,RC,,both,473.33,426,Cigna,Default,Percent of Total Billed Charges,279.26,,,,279.26,386.24
DRILL SOLID SIDE CUTTING 2X40MM,C1713,HCPCS,278,RC,,both,473.33,426,United Healthcare,Default,Fee Schedule,386.24,,,,279.26,386.24
DRILL SOLID SIDE CUTTING 2.5X40MM,C1713,HCPCS,278,RC,,both,483.62,435.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338.53,,,,285.34,394.63
DRILL SOLID SIDE CUTTING 2.5X40MM,C1713,HCPCS,278,RC,,both,483.62,435.26,Cigna,Default,Percent of Total Billed Charges,285.34,,,,285.34,394.63
DRILL SOLID SIDE CUTTING 2.5X40MM,C1713,HCPCS,278,RC,,both,483.62,435.26,United Healthcare,Default,Fee Schedule,394.63,,,,285.34,394.63
DRIVER PEG TORQUE,C1713,HCPCS,278,RC,,both,476.76,429.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,333.73,,,,281.29,389.04
DRIVER PEG TORQUE,C1713,HCPCS,278,RC,,both,476.76,429.08,Cigna,Default,Percent of Total Billed Charges,281.29,,,,281.29,389.04
DRIVER PEG TORQUE,C1713,HCPCS,278,RC,,both,476.76,429.08,United Healthcare,Default,Fee Schedule,389.04,,,,281.29,389.04
NITINOL SPEED 18X18X15MM,278,RC,,,,both,5408.24,4867.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3785.77,,,,3190.86,4413.12
NITINOL SPEED 18X18X15MM,278,RC,,,,both,5408.24,4867.42,Cigna,Default,Percent of Total Billed Charges,3190.86,,,,3190.86,4413.12
NITINOL SPEED 18X18X15MM,278,RC,,,,both,5408.24,4867.42,United Healthcare,Default,Fee Schedule,4413.12,,,,3190.86,4413.12
GUIDE,272,RC,,,,both,1428.93,1286.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1000.25,,,,843.07,1166.01
GUIDE,272,RC,,,,both,1428.93,1286.04,Cigna,Default,Percent of Total Billed Charges,843.07,,,,843.07,1166.01
GUIDE,272,RC,,,,both,1428.93,1286.04,United Healthcare,Default,Fee Schedule,1166.01,,,,843.07,1166.01
XEMPLIFI DBM PUTTY 5 CC,C1713,HCPCS,278,RC,,both,3529.37,3176.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2470.56,,,,2082.33,2879.97
XEMPLIFI DBM PUTTY 5 CC,C1713,HCPCS,278,RC,,both,3529.37,3176.43,Cigna,Default,Percent of Total Billed Charges,2082.33,,,,2082.33,2879.97
XEMPLIFI DBM PUTTY 5 CC,C1713,HCPCS,278,RC,,both,3529.37,3176.43,United Healthcare,Default,Fee Schedule,2879.97,,,,2082.33,2879.97
CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1356.6,1220.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,949.62,,,,800.39,1106.99
CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1356.6,1220.94,Cigna,Default,Percent of Total Billed Charges,800.39,,,,800.39,1106.99
CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1356.6,1220.94,United Healthcare,Default,Fee Schedule,1106.99,,,,800.39,1106.99
CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1286.21,1157.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,900.35,,,,758.86,1049.55
CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1286.21,1157.59,Cigna,Default,Percent of Total Billed Charges,758.86,,,,758.86,1049.55
CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,C1713,HCPCS,278,RC,,both,1286.21,1157.59,United Healthcare,Default,Fee Schedule,1049.55,,,,758.86,1049.55
CREO MIS 5.5X40MM CURVED ROD TITANIUM AL,C1713,HCPCS,278,RC,,both,1318.37,1186.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,922.86,,,,777.84,1075.79
CREO MIS 5.5X40MM CURVED ROD TITANIUM AL,C1713,HCPCS,278,RC,,both,1318.37,1186.53,Cigna,Default,Percent of Total Billed Charges,777.84,,,,777.84,1075.79
CREO MIS 5.5X40MM CURVED ROD TITANIUM AL,C1713,HCPCS,278,RC,,both,1318.37,1186.53,United Healthcare,Default,Fee Schedule,1075.79,,,,777.84,1075.79
CREO AMP 6.5X45MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2057.94,1852.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1440.56,,,,1214.18,1679.28
CREO AMP 6.5X45MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2057.94,1852.15,Cigna,Default,Percent of Total Billed Charges,1214.18,,,,1214.18,1679.28
CREO AMP 6.5X45MM MODULAR CANNULATED SCR,C1713,HCPCS,278,RC,,both,2057.94,1852.15,United Healthcare,Default,Fee Schedule,1679.28,,,,1214.18,1679.28
SUSTAIN RADIOLUCENT SPACER 8X22 8MM,278,RC,,,,both,20801.21,18721.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14560.85,,,,12272.71,16973.79
SUSTAIN RADIOLUCENT SPACER 8X22 8MM,278,RC,,,,both,20801.21,18721.09,Cigna,Default,Percent of Total Billed Charges,12272.71,,,,12272.71,16973.79
SUSTAIN RADIOLUCENT SPACER 8X22 8MM,278,RC,,,,both,20801.21,18721.09,United Healthcare,Default,Fee Schedule,16973.79,,,,12272.71,16973.79
CREO MIS MODULAR POLYAXIAL TULIP 30MM RE,C1713,HCPCS,278,RC,,both,2057.94,1852.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1440.56,,,,1214.18,1679.28
CREO MIS MODULAR POLYAXIAL TULIP 30MM RE,C1713,HCPCS,278,RC,,both,2057.94,1852.15,Cigna,Default,Percent of Total Billed Charges,1214.18,,,,1214.18,1679.28
CREO MIS MODULAR POLYAXIAL TULIP 30MM RE,C1713,HCPCS,278,RC,,both,2057.94,1852.15,United Healthcare,Default,Fee Schedule,1679.28,,,,1214.18,1679.28
COLONIAL ACDF SPACER 12X14 7DEGREE 7MM,C1889,HCPCS,278,RC,,both,3429.9,3086.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2400.93,,,,2023.64,2798.8
COLONIAL ACDF SPACER 12X14 7DEGREE 7MM,C1889,HCPCS,278,RC,,both,3429.9,3086.91,Cigna,Default,Percent of Total Billed Charges,2023.64,,,,2023.64,2798.8
COLONIAL ACDF SPACER 12X14 7DEGREE 7MM,C1889,HCPCS,278,RC,,both,3429.9,3086.91,United Healthcare,Default,Fee Schedule,2798.8,,,,2023.64,2798.8
XEMPLIFI DBM PUTTY 3 CC,278,RC,,,,both,2441.87,2197.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1709.31,,,,1440.7,1992.57
XEMPLIFI DBM PUTTY 3 CC,278,RC,,,,both,2441.87,2197.68,Cigna,Default,Percent of Total Billed Charges,1440.7,,,,1440.7,1992.57
XEMPLIFI DBM PUTTY 3 CC,278,RC,,,,both,2441.87,2197.68,United Healthcare,Default,Fee Schedule,1992.57,,,,1440.7,1992.57
COLONIAL ACDF SPACER 12X14 7DEGREE 6MM,C1889,HCPCS,278,RC,,both,3529.37,3176.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2470.56,,,,2082.33,2879.97
COLONIAL ACDF SPACER 12X14 7DEGREE 6MM,C1889,HCPCS,278,RC,,both,3529.37,3176.43,Cigna,Default,Percent of Total Billed Charges,2082.33,,,,2082.33,2879.97
COLONIAL ACDF SPACER 12X14 7DEGREE 6MM,C1889,HCPCS,278,RC,,both,3529.37,3176.43,United Healthcare,Default,Fee Schedule,2879.97,,,,2082.33,2879.97
COLONIAL ACDF SPACER 12X14 7DEGREE 10MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2448.3,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 7DEGREE 10MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,Cigna,Default,Percent of Total Billed Charges,2063.57,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 7DEGREE 10MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,United Healthcare,Default,Fee Schedule,2854.02,,,,2063.57,2854.02
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,771.73,694.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,540.21,,,,455.32,629.73
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,771.73,694.56,Cigna,Default,Percent of Total Billed Charges,455.32,,,,455.32,629.73
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,771.73,694.56,United Healthcare,Default,Fee Schedule,629.73,,,,455.32,629.73
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2379.3,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Cigna,Default,Percent of Total Billed Charges,2005.41,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,United Healthcare,Default,Fee Schedule,2773.58,,,,2005.41,2773.58
XEMPLIFI DBM PUTTY 1 CC,C1713,HCPCS,278,RC,,both,857.48,771.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,600.24,,,,505.91,699.7
XEMPLIFI DBM PUTTY 1 CC,C1713,HCPCS,278,RC,,both,857.48,771.73,Cigna,Default,Percent of Total Billed Charges,505.91,,,,505.91,699.7
XEMPLIFI DBM PUTTY 1 CC,C1713,HCPCS,278,RC,,both,857.48,771.73,United Healthcare,Default,Fee Schedule,699.7,,,,505.91,699.7
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2379.3,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Cigna,Default,Percent of Total Billed Charges,2005.41,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,United Healthcare,Default,Fee Schedule,2773.58,,,,2005.41,2773.58
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,771.73,694.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,540.21,,,,455.32,629.73
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,771.73,694.56,Cigna,Default,Percent of Total Billed Charges,455.32,,,,455.32,629.73
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,771.73,694.56,United Healthcare,Default,Fee Schedule,629.73,,,,455.32,629.73
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2379.3,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Cigna,Default,Percent of Total Billed Charges,2005.41,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,United Healthcare,Default,Fee Schedule,2773.58,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2379.3,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,Cigna,Default,Percent of Total Billed Charges,2005.41,,,,2005.41,2773.58
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3399,3059.1,United Healthcare,Default,Fee Schedule,2773.58,,,,2005.41,2773.58
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,176.47,158.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.53,,,,104.12,144
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,176.47,158.82,Cigna,Default,Percent of Total Billed Charges,104.12,,,,104.12,144
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,176.47,158.82,United Healthcare,Default,Fee Schedule,144,,,,104.12,144
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2448.3,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,Cigna,Default,Percent of Total Billed Charges,2063.57,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,United Healthcare,Default,Fee Schedule,2854.02,,,,2063.57,2854.02
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,176.47,158.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.53,,,,104.12,144
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,176.47,158.82,Cigna,Default,Percent of Total Billed Charges,104.12,,,,104.12,144
DISTRACTION PIN 14MM,C1713,HCPCS,278,RC,,both,176.47,158.82,United Healthcare,Default,Fee Schedule,144,,,,104.12,144
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,794.11,714.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,555.88,,,,468.52,647.99
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,794.11,714.7,Cigna,Default,Percent of Total Billed Charges,468.52,,,,468.52,647.99
BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,C1713,HCPCS,278,RC,,both,794.11,714.7,United Healthcare,Default,Fee Schedule,647.99,,,,468.52,647.99
COLONIAL ACDF SPACER 12X14 0DEGREE 6MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2448.3,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 0DEGREE 6MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,Cigna,Default,Percent of Total Billed Charges,2063.57,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 0DEGREE 6MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,United Healthcare,Default,Fee Schedule,2854.02,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 7DEGREE 5MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2448.3,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 7DEGREE 5MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,Cigna,Default,Percent of Total Billed Charges,2063.57,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 7DEGREE 5MM,C1889,HCPCS,278,RC,,both,3497.57,3147.81,United Healthcare,Default,Fee Schedule,2854.02,,,,2063.57,2854.02
COLONIAL ACDF SPACER 12X14 0 DEGREE 5MM,C1889,HCPCS,278,RC,,both,3529.37,3176.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2470.56,,,,2082.33,2879.97
COLONIAL ACDF SPACER 12X14 0 DEGREE 5MM,C1889,HCPCS,278,RC,,both,3529.37,3176.43,Cigna,Default,Percent of Total Billed Charges,2082.33,,,,2082.33,2879.97
COLONIAL ACDF SPACER 12X14 0 DEGREE 5MM,C1889,HCPCS,278,RC,,both,3529.37,3176.43,United Healthcare,Default,Fee Schedule,2879.97,,,,2082.33,2879.97
RESONATE ANTERIOR CERVICAL PLATE 3-LEVEL,L8699,HCPCS,278,RC,,both,3529.37,3176.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2470.56,,,,2082.33,2879.97
RESONATE ANTERIOR CERVICAL PLATE 3-LEVEL,L8699,HCPCS,278,RC,,both,3529.37,3176.43,Cigna,Default,Percent of Total Billed Charges,2082.33,,,,2082.33,2879.97
RESONATE ANTERIOR CERVICAL PLATE 3-LEVEL,L8699,HCPCS,278,RC,,both,3529.37,3176.43,United Healthcare,Default,Fee Schedule,2879.97,,,,2082.33,2879.97
MINI-MONSTER CANNULATED SHORT THREADED S,C1713,HCPCS,278,RC,,both,1137.5,1023.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,796.25,,,,671.12,928.2
MINI-MONSTER CANNULATED SHORT THREADED S,C1713,HCPCS,278,RC,,both,1137.5,1023.75,Cigna,Default,Percent of Total Billed Charges,671.12,,,,671.12,928.2
MINI-MONSTER CANNULATED SHORT THREADED S,C1713,HCPCS,278,RC,,both,1137.5,1023.75,United Healthcare,Default,Fee Schedule,928.2,,,,671.12,928.2
PSN TIB STM 5 DEG SIZE D R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE D R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
PSN TIB STM 5 DEG SIZE D R,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
EPIFIX 2.0x2.0 CM,Q4186,HCPCS,636,RC,,both,845.04,760.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,591.53,,,,498.57,689.55
EPIFIX 2.0x2.0 CM,Q4186,HCPCS,636,RC,,both,845.04,760.54,Cigna,Default,Percent of Total Billed Charges,498.57,,,,498.57,689.55
EPIFIX 2.0x2.0 CM,Q4186,HCPCS,636,RC,,both,845.04,760.54,United Healthcare,Default,Fee Schedule,689.55,,,,498.57,689.55
PSN FEM PS CMT CRR NRW SZ6 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ6 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ6 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ5 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ5 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ5 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ6 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ6 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ6 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN MC VE ASF R 10MM 8-11 GH,C1776,HCPCS,278,RC,,both,3098.92,2789.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.72
PSN MC VE ASF R 10MM 8-11 GH,C1776,HCPCS,278,RC,,both,3098.92,2789.03,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.72
PSN MC VE ASF R 10MM 8-11 GH,C1776,HCPCS,278,RC,,both,3098.92,2789.03,United Healthcare,Default,Fee Schedule,2528.72,,,,1828.36,2528.72
PSN ASF PS 12MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 12MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 12MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN ASF PS 10MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 10MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 10MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN ASF PS 12 MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 12 MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 12 MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
PSN ASF PS 11MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 11MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 11MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
EPIFIX 5.0X6.0 CM,Q4186,HCPCS,636,RC,,both,689.96,620.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,482.97,,,,407.08,563.01
EPIFIX 5.0X6.0 CM,Q4186,HCPCS,636,RC,,both,689.96,620.96,Cigna,Default,Percent of Total Billed Charges,407.08,,,,407.08,563.01
EPIFIX 5.0X6.0 CM,Q4186,HCPCS,636,RC,,both,689.96,620.96,United Healthcare,Default,Fee Schedule,563.01,,,,407.08,563.01
EPIFIX 4.0X4.0 CM,Q4186,HCPCS,636,RC,,both,673.12,605.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,471.18,,,,397.14,549.27
EPIFIX 4.0X4.0 CM,Q4186,HCPCS,636,RC,,both,673.12,605.81,Cigna,Default,Percent of Total Billed Charges,397.14,,,,397.14,549.27
EPIFIX 4.0X4.0 CM,Q4186,HCPCS,636,RC,,both,673.12,605.81,United Healthcare,Default,Fee Schedule,549.27,,,,397.14,549.27
EPIFIX 3.0 X 4.0 CM CONSIGN,Q4186,HCPCS,636,RC,,both,0.01,0.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
EPIFIX 3.0 X 4.0 CM CONSIGN,Q4186,HCPCS,636,RC,,both,0.01,0.01,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
EPIFIX 3.0 X 4.0 CM CONSIGN,Q4186,HCPCS,636,RC,,both,0.01,0.01,United Healthcare,Default,Fee Schedule,0.01,,,,0.01,0.01
DRESSING EPIFIX 18MM DISC,Q4186,HCPCS,636,RC,,both,2282.72,2054.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1597.9,,,,1346.8,1862.7
DRESSING EPIFIX 18MM DISC,Q4186,HCPCS,636,RC,,both,2282.72,2054.45,Cigna,Default,Percent of Total Billed Charges,1346.8,,,,1346.8,1862.7
DRESSING EPIFIX 18MM DISC,Q4186,HCPCS,636,RC,,both,2282.72,2054.45,United Healthcare,Default,Fee Schedule,1862.7,,,,1346.8,1862.7
EPIFIX 2.0x4.0 CM,Q4186,HCPCS,636,RC,,both,610.47,549.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,427.33,,,,360.18,498.14
EPIFIX 2.0x4.0 CM,Q4186,HCPCS,636,RC,,both,610.47,549.42,Cigna,Default,Percent of Total Billed Charges,360.18,,,,360.18,498.14
EPIFIX 2.0x4.0 CM,Q4186,HCPCS,636,RC,,both,610.47,549.42,United Healthcare,Default,Fee Schedule,498.14,,,,360.18,498.14
PSN FEM PS CMT CRR NRW SZ7 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ7 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CRR NRW SZ7 R,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2448.3,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,Cigna,Default,Percent of Total Billed Charges,2063.57,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,United Healthcare,Default,Fee Schedule,2854.02,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2448.3,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,Cigna,Default,Percent of Total Billed Charges,2063.57,,,,2063.57,2854.02
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3497.57,3147.81,United Healthcare,Default,Fee Schedule,2854.02,,,,2063.57,2854.02
DRESSING EPIFIX 14MM DISC,Q4186,HCPCS,636,RC,,both,1075.59,968.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,752.91,,,,634.6,877.68
DRESSING EPIFIX 14MM DISC,Q4186,HCPCS,636,RC,,both,1075.59,968.03,Cigna,Default,Percent of Total Billed Charges,634.6,,,,634.6,877.68
DRESSING EPIFIX 14MM DISC,Q4186,HCPCS,636,RC,,both,1075.59,968.03,United Healthcare,Default,Fee Schedule,877.68,,,,634.6,877.68
PSN ASF PS 13MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 13MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 13MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
6.5MM CANNULATED SCREW 16MM THD 90MM,C1713,HCPCS,272,RC,,both,803.2,722.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,562.24,,,,473.89,655.41
6.5MM CANNULATED SCREW 16MM THD 90MM,C1713,HCPCS,272,RC,,both,803.2,722.88,Cigna,Default,Percent of Total Billed Charges,473.89,,,,473.89,655.41
6.5MM CANNULATED SCREW 16MM THD 90MM,C1713,HCPCS,272,RC,,both,803.2,722.88,United Healthcare,Default,Fee Schedule,655.41,,,,473.89,655.41
FLUID COLLECTION BAG,272,RC,,,,both,61.57,55.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.1,,,,36.33,50.24
FLUID COLLECTION BAG,272,RC,,,,both,61.57,55.41,Cigna,Default,Percent of Total Billed Charges,36.33,,,,36.33,50.24
FLUID COLLECTION BAG,272,RC,,,,both,61.57,55.41,United Healthcare,Default,Fee Schedule,50.24,,,,36.33,50.24
DRILL BIT 3.2,272,RC,,,,both,184.57,166.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.2,,,,108.9,150.61
DRILL BIT 3.2,272,RC,,,,both,184.57,166.11,Cigna,Default,Percent of Total Billed Charges,108.9,,,,108.9,150.61
DRILL BIT 3.2,272,RC,,,,both,184.57,166.11,United Healthcare,Default,Fee Schedule,150.61,,,,108.9,150.61
TIP IMPACTOR,272,RC,,,,both,1787.08,1608.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1250.96,,,,1054.38,1458.26
TIP IMPACTOR,272,RC,,,,both,1787.08,1608.37,Cigna,Default,Percent of Total Billed Charges,1054.38,,,,1054.38,1458.26
TIP IMPACTOR,272,RC,,,,both,1787.08,1608.37,United Healthcare,Default,Fee Schedule,1458.26,,,,1054.38,1458.26
TAP LAG SCREW,272,RC,,,,both,3979.29,3581.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2785.5,,,,2347.78,3247.1
TAP LAG SCREW,272,RC,,,,both,3979.29,3581.36,Cigna,Default,Percent of Total Billed Charges,2347.78,,,,2347.78,3247.1
TAP LAG SCREW,272,RC,,,,both,3979.29,3581.36,United Healthcare,Default,Fee Schedule,3247.1,,,,2347.78,3247.1
DRILL BIT 1.7,278,RC,,,,both,1016.53,914.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,711.57,,,,599.75,829.49
DRILL BIT 1.7,278,RC,,,,both,1016.53,914.88,Cigna,Default,Percent of Total Billed Charges,599.75,,,,599.75,829.49
DRILL BIT 1.7,278,RC,,,,both,1016.53,914.88,United Healthcare,Default,Fee Schedule,829.49,,,,599.75,829.49
HUMERAL STEM,278,RC,,,,both,8559.11,7703.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5991.38,,,,5049.87,6984.23
HUMERAL STEM,278,RC,,,,both,8559.11,7703.2,Cigna,Default,Percent of Total Billed Charges,5049.87,,,,5049.87,6984.23
HUMERAL STEM,278,RC,,,,both,8559.11,7703.2,United Healthcare,Default,Fee Schedule,6984.23,,,,5049.87,6984.23
HUMERAL HEAD,278,RC,,,,both,6513.4,5862.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4559.38,,,,3842.91,5314.93
HUMERAL HEAD,278,RC,,,,both,6513.4,5862.06,Cigna,Default,Percent of Total Billed Charges,3842.91,,,,3842.91,5314.93
HUMERAL HEAD,278,RC,,,,both,6513.4,5862.06,United Healthcare,Default,Fee Schedule,5314.93,,,,3842.91,5314.93
REPLICATOR PLATE TORQUE SCREW DRIVER,278,RC,,,,both,5372.96,4835.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3761.07,,,,3170.05,4384.34
REPLICATOR PLATE TORQUE SCREW DRIVER,278,RC,,,,both,5372.96,4835.66,Cigna,Default,Percent of Total Billed Charges,3170.05,,,,3170.05,4384.34
REPLICATOR PLATE TORQUE SCREW DRIVER,278,RC,,,,both,5372.96,4835.66,United Healthcare,Default,Fee Schedule,4384.34,,,,3170.05,4384.34
HUMERAL STEM,278,RC,,,,both,11503.8,10353.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8052.66,,,,6787.24,9387.1
HUMERAL STEM,278,RC,,,,both,11503.8,10353.42,Cigna,Default,Percent of Total Billed Charges,6787.24,,,,6787.24,9387.1
HUMERAL STEM,278,RC,,,,both,11503.8,10353.42,United Healthcare,Default,Fee Schedule,9387.1,,,,6787.24,9387.1
HUMERAL ADAPTER TRAY,278,RC,,,,both,7924.24,7131.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5546.97,,,,4675.3,6466.18
HUMERAL ADAPTER TRAY,278,RC,,,,both,7924.24,7131.82,Cigna,Default,Percent of Total Billed Charges,4675.3,,,,4675.3,6466.18
HUMERAL ADAPTER TRAY,278,RC,,,,both,7924.24,7131.82,United Healthcare,Default,Fee Schedule,6466.18,,,,4675.3,6466.18
GLENOID PLATE,278,RC,,,,both,6583.94,5925.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4608.76,,,,3884.52,5372.5
GLENOID PLATE,278,RC,,,,both,6583.94,5925.55,Cigna,Default,Percent of Total Billed Charges,3884.52,,,,3884.52,5372.5
GLENOID PLATE,278,RC,,,,both,6583.94,5925.55,United Healthcare,Default,Fee Schedule,5372.5,,,,3884.52,5372.5
GLENOSPHERE,278,RC,,,,both,8790.64,7911.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6153.45,,,,5186.48,7173.16
GLENOSPHERE,278,RC,,,,both,8790.64,7911.58,Cigna,Default,Percent of Total Billed Charges,5186.48,,,,5186.48,7173.16
GLENOSPHERE,278,RC,,,,both,8790.64,7911.58,United Healthcare,Default,Fee Schedule,7173.16,,,,5186.48,7173.16
HUMERAL LINER,278,RC,,,,both,5010.3,4509.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3507.21,,,,2956.08,4088.4
HUMERAL LINER,278,RC,,,,both,5010.3,4509.27,Cigna,Default,Percent of Total Billed Charges,2956.08,,,,2956.08,4088.4
HUMERAL LINER,278,RC,,,,both,5010.3,4509.27,United Healthcare,Default,Fee Schedule,4088.4,,,,2956.08,4088.4
TORQUE DEFINING SCREW,278,RC,,,,both,1093.4,984.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,765.38,,,,645.11,892.21
TORQUE DEFINING SCREW,278,RC,,,,both,1093.4,984.06,Cigna,Default,Percent of Total Billed Charges,645.11,,,,645.11,892.21
TORQUE DEFINING SCREW,278,RC,,,,both,1093.4,984.06,United Healthcare,Default,Fee Schedule,892.21,,,,645.11,892.21
DRILL BITS,272,RC,,,,both,1316.78,1185.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,921.75,,,,776.9,1074.49
DRILL BITS,272,RC,,,,both,1316.78,1185.1,Cigna,Default,Percent of Total Billed Charges,776.9,,,,776.9,1074.49
DRILL BITS,272,RC,,,,both,1316.78,1185.1,United Healthcare,Default,Fee Schedule,1074.49,,,,776.9,1074.49
GLENOSPHERE LOCKING SCREW,278,RC,,,,both,505.54,454.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,353.88,,,,298.27,412.52
GLENOSPHERE LOCKING SCREW,278,RC,,,,both,505.54,454.99,Cigna,Default,Percent of Total Billed Charges,298.27,,,,298.27,412.52
GLENOSPHERE LOCKING SCREW,278,RC,,,,both,505.54,454.99,United Healthcare,Default,Fee Schedule,412.52,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,506.46,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,Cigna,Default,Percent of Total Billed Charges,426.87,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,United Healthcare,Default,Fee Schedule,590.38,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,506.46,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,Cigna,Default,Percent of Total Billed Charges,426.87,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,United Healthcare,Default,Fee Schedule,590.38,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,506.46,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,Cigna,Default,Percent of Total Billed Charges,426.87,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,723.51,651.16,United Healthcare,Default,Fee Schedule,590.38,,,,426.87,590.38
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,353.88,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,Cigna,Default,Percent of Total Billed Charges,298.27,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,United Healthcare,Default,Fee Schedule,412.52,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,353.88,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,Cigna,Default,Percent of Total Billed Charges,298.27,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,United Healthcare,Default,Fee Schedule,412.52,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,353.88,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,Cigna,Default,Percent of Total Billed Charges,298.27,,,,298.27,412.52
COMPRESSION SCREW/LOCKING CAP KIT,278,RC,,,,both,505.54,454.99,United Healthcare,Default,Fee Schedule,412.52,,,,298.27,412.52
HUMERAL STEM,278,RC,,,,both,7994.78,7195.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5596.35,,,,4716.92,6523.74
HUMERAL STEM,278,RC,,,,both,7994.78,7195.3,Cigna,Default,Percent of Total Billed Charges,4716.92,,,,4716.92,6523.74
HUMERAL STEM,278,RC,,,,both,7994.78,7195.3,United Healthcare,Default,Fee Schedule,6523.74,,,,4716.92,6523.74
GLENOSPHERE,278,RC,,,,both,6113.66,5502.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4279.56,,,,3607.06,4988.75
GLENOSPHERE,278,RC,,,,both,6113.66,5502.29,Cigna,Default,Percent of Total Billed Charges,3607.06,,,,3607.06,4988.75
GLENOSPHERE,278,RC,,,,both,6113.66,5502.29,United Healthcare,Default,Fee Schedule,4988.75,,,,3607.06,4988.75
HUMERAL LINER,278,RC,,,,both,3480.08,3132.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2436.06,,,,2053.25,2839.75
HUMERAL LINER,278,RC,,,,both,3480.08,3132.07,Cigna,Default,Percent of Total Billed Charges,2053.25,,,,2053.25,2839.75
HUMERAL LINER,278,RC,,,,both,3480.08,3132.07,United Healthcare,Default,Fee Schedule,2839.75,,,,2053.25,2839.75
3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,C1713,HCPCS,278,RC,,both,106.2,95.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.34,,,,62.66,86.66
3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,C1713,HCPCS,278,RC,,both,106.2,95.58,Cigna,Default,Percent of Total Billed Charges,62.66,,,,62.66,86.66
3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,C1713,HCPCS,278,RC,,both,106.2,95.58,United Healthcare,Default,Fee Schedule,86.66,,,,62.66,86.66
3.5MM ULS T-PLT 4H HEAD 6H SHAFT 85MM,C1713,HCPCS,278,RC,,both,1439.56,1295.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1007.69,,,,849.34,1174.68
3.5MM ULS T-PLT 4H HEAD 6H SHAFT 85MM,C1713,HCPCS,278,RC,,both,1439.56,1295.6,Cigna,Default,Percent of Total Billed Charges,849.34,,,,849.34,1174.68
3.5MM ULS T-PLT 4H HEAD 6H SHAFT 85MM,C1713,HCPCS,278,RC,,both,1439.56,1295.6,United Healthcare,Default,Fee Schedule,1174.68,,,,849.34,1174.68
5CC BETA-BSM KIT,C1713,HCPCS,278,RC,,both,4888.17,4399.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3421.72,,,,2884.02,3988.75
5CC BETA-BSM KIT,C1713,HCPCS,278,RC,,both,4888.17,4399.35,Cigna,Default,Percent of Total Billed Charges,2884.02,,,,2884.02,3988.75
5CC BETA-BSM KIT,C1713,HCPCS,278,RC,,both,4888.17,4399.35,United Healthcare,Default,Fee Schedule,3988.75,,,,2884.02,3988.75
VENOUS OUTFLOW COMPONENT,278,RC,,,,both,8338.45,7504.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5836.92,,,,4919.69,6804.18
VENOUS OUTFLOW COMPONENT,278,RC,,,,both,8338.45,7504.61,Cigna,Default,Percent of Total Billed Charges,4919.69,,,,4919.69,6804.18
VENOUS OUTFLOW COMPONENT,278,RC,,,,both,8338.45,7504.61,United Healthcare,Default,Fee Schedule,6804.18,,,,4919.69,6804.18
ARTERIAL GRAFT COMPONENT,278,RC,,,,both,3653.72,3288.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2557.6,,,,2155.69,2981.44
ARTERIAL GRAFT COMPONENT,278,RC,,,,both,3653.72,3288.35,Cigna,Default,Percent of Total Billed Charges,2155.69,,,,2155.69,2981.44
ARTERIAL GRAFT COMPONENT,278,RC,,,,both,3653.72,3288.35,United Healthcare,Default,Fee Schedule,2981.44,,,,2155.69,2981.44
ACCESSORY COMPONENT KIT,278,RC,,,,both,1844.95,1660.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1291.46,,,,1088.52,1505.48
ACCESSORY COMPONENT KIT,278,RC,,,,both,1844.95,1660.46,Cigna,Default,Percent of Total Billed Charges,1088.52,,,,1088.52,1505.48
ACCESSORY COMPONENT KIT,278,RC,,,,both,1844.95,1660.46,United Healthcare,Default,Fee Schedule,1505.48,,,,1088.52,1505.48
"VIATRAC 14 PLUS 4X20, 135CM",272,RC,,,,both,1067.18,960.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.03,,,,629.64,870.82
"VIATRAC 14 PLUS 4X20, 135CM",272,RC,,,,both,1067.18,960.46,Cigna,Default,Percent of Total Billed Charges,629.64,,,,629.64,870.82
"VIATRAC 14 PLUS 4X20, 135CM",272,RC,,,,both,1067.18,960.46,United Healthcare,Default,Fee Schedule,870.82,,,,629.64,870.82
EMBOSHIELD NAV PROTECT SYSTEM,C1884,HCPCS,278,RC,,both,5813.6,5232.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4069.52,,,,3430.02,4743.9
EMBOSHIELD NAV PROTECT SYSTEM,C1884,HCPCS,278,RC,,both,5813.6,5232.24,Cigna,Default,Percent of Total Billed Charges,3430.02,,,,3430.02,4743.9
EMBOSHIELD NAV PROTECT SYSTEM,C1884,HCPCS,278,RC,,both,5813.6,5232.24,United Healthcare,Default,Fee Schedule,4743.9,,,,3430.02,4743.9
STENT XACT 8-6X30,278,RC,,,,both,8844.9,7960.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6191.43,,,,5218.49,7217.44
STENT XACT 8-6X30,278,RC,,,,both,8844.9,7960.41,Cigna,Default,Percent of Total Billed Charges,5218.49,,,,5218.49,7217.44
STENT XACT 8-6X30,278,RC,,,,both,8844.9,7960.41,United Healthcare,Default,Fee Schedule,7217.44,,,,5218.49,7217.44
"VIATRAC 14 PLUS 4X30, 135CM",272,RC,,,,both,1067.18,960.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.03,,,,629.64,870.82
"VIATRAC 14 PLUS 4X30, 135CM",272,RC,,,,both,1067.18,960.46,Cigna,Default,Percent of Total Billed Charges,629.64,,,,629.64,870.82
"VIATRAC 14 PLUS 4X30, 135CM",272,RC,,,,both,1067.18,960.46,United Healthcare,Default,Fee Schedule,870.82,,,,629.64,870.82
"VIATRAC 14 PLUS 6X30, 135CM",272,RC,,,,both,1067.18,960.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.03,,,,629.64,870.82
"VIATRAC 14 PLUS 6X30, 135CM",272,RC,,,,both,1067.18,960.46,Cigna,Default,Percent of Total Billed Charges,629.64,,,,629.64,870.82
"VIATRAC 14 PLUS 6X30, 135CM",272,RC,,,,both,1067.18,960.46,United Healthcare,Default,Fee Schedule,870.82,,,,629.64,870.82
STENT XACT 10-8MMX40MM,278,RC,,,,both,8844.9,7960.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6191.43,,,,5218.49,7217.44
STENT XACT 10-8MMX40MM,278,RC,,,,both,8844.9,7960.41,Cigna,Default,Percent of Total Billed Charges,5218.49,,,,5218.49,7217.44
STENT XACT 10-8MMX40MM,278,RC,,,,both,8844.9,7960.41,United Healthcare,Default,Fee Schedule,7217.44,,,,5218.49,7217.44
"VIATRAC 14 PLUS 5X30, 135CM",272,RC,,,,both,1067.18,960.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,747.03,,,,629.64,870.82
"VIATRAC 14 PLUS 5X30, 135CM",272,RC,,,,both,1067.18,960.46,Cigna,Default,Percent of Total Billed Charges,629.64,,,,629.64,870.82
"VIATRAC 14 PLUS 5X30, 135CM",272,RC,,,,both,1067.18,960.46,United Healthcare,Default,Fee Schedule,870.82,,,,629.64,870.82
"GUIDE WIRE .035X4"" P/T",278,RC,,,,both,86.5,77.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.55,,,,51.04,70.58
"GUIDE WIRE .035X4"" P/T",278,RC,,,,both,86.5,77.85,Cigna,Default,Percent of Total Billed Charges,51.04,,,,51.04,70.58
"GUIDE WIRE .035X4"" P/T",278,RC,,,,both,86.5,77.85,United Healthcare,Default,Fee Schedule,70.58,,,,51.04,70.58
CROWN CUP CLUSTER HOLE SHELL,278,RC,,,,both,8180.53,7362.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5726.37,,,,4826.51,6675.31
CROWN CUP CLUSTER HOLE SHELL,278,RC,,,,both,8180.53,7362.48,Cigna,Default,Percent of Total Billed Charges,4826.51,,,,4826.51,6675.31
CROWN CUP CLUSTER HOLE SHELL,278,RC,,,,both,8180.53,7362.48,United Healthcare,Default,Fee Schedule,6675.31,,,,4826.51,6675.31
CROWN CUP GXL LINER,278,RC,,,,both,7042.45,6338.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4929.72,,,,4155.05,5746.64
CROWN CUP GXL LINER,278,RC,,,,both,7042.45,6338.21,Cigna,Default,Percent of Total Billed Charges,4155.05,,,,4155.05,5746.64
CROWN CUP GXL LINER,278,RC,,,,both,7042.45,6338.21,United Healthcare,Default,Fee Schedule,5746.64,,,,4155.05,5746.64
FEMORAL STEM ELEMENT,278,RC,,,,both,20290.28,18261.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14203.2,,,,11971.27,16556.87
FEMORAL STEM ELEMENT,278,RC,,,,both,20290.28,18261.25,Cigna,Default,Percent of Total Billed Charges,11971.27,,,,11971.27,16556.87
FEMORAL STEM ELEMENT,278,RC,,,,both,20290.28,18261.25,United Healthcare,Default,Fee Schedule,16556.87,,,,11971.27,16556.87
FEMORAL HEAD COCR 28MM DIA 3MM NK,278,RC,,,,both,1457.71,1311.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1020.4,,,,860.05,1189.49
FEMORAL HEAD COCR 28MM DIA 3MM NK,278,RC,,,,both,1457.71,1311.94,Cigna,Default,Percent of Total Billed Charges,860.05,,,,860.05,1189.49
FEMORAL HEAD COCR 28MM DIA 3MM NK,278,RC,,,,both,1457.71,1311.94,United Healthcare,Default,Fee Schedule,1189.49,,,,860.05,1189.49
FEMORAL HEAD COCR,278,RC,,,,both,4773.36,4296.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3341.35,,,,2816.28,3895.06
FEMORAL HEAD COCR,278,RC,,,,both,4773.36,4296.02,Cigna,Default,Percent of Total Billed Charges,2816.28,,,,2816.28,3895.06
FEMORAL HEAD COCR,278,RC,,,,both,4773.36,4296.02,United Healthcare,Default,Fee Schedule,3895.06,,,,2816.28,3895.06
FEMORAL HEAD COCR,278,RC,,,,both,4773.36,4296.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3341.35,,,,2816.28,3895.06
FEMORAL HEAD COCR,278,RC,,,,both,4773.36,4296.02,Cigna,Default,Percent of Total Billed Charges,2816.28,,,,2816.28,3895.06
FEMORAL HEAD COCR,278,RC,,,,both,4773.36,4296.02,United Healthcare,Default,Fee Schedule,3895.06,,,,2816.28,3895.06
APLIGRAPH PER SQ CM,Q4101,HCPCS,636,RC,,both,4793.24,4313.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3355.27,,,,2828.01,3911.28
APLIGRAPH PER SQ CM,Q4101,HCPCS,636,RC,,both,4793.24,4313.92,Cigna,Default,Percent of Total Billed Charges,2828.01,,,,2828.01,3911.28
APLIGRAPH PER SQ CM,Q4101,HCPCS,636,RC,,both,4793.24,4313.92,United Healthcare,Default,Fee Schedule,3911.28,,,,2828.01,3911.28
BB-TAK,C1713,HCPCS,278,RC,,both,183.15,164.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.2,,,,108.06,149.45
BB-TAK,C1713,HCPCS,278,RC,,both,183.15,164.84,Cigna,Default,Percent of Total Billed Charges,108.06,,,,108.06,149.45
BB-TAK,C1713,HCPCS,278,RC,,both,183.15,164.84,United Healthcare,Default,Fee Schedule,149.45,,,,108.06,149.45
"BB-TAK, THREADED",C1713,HCPCS,278,RC,,both,291.55,262.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,204.08,,,,172.01,237.9
"BB-TAK, THREADED",C1713,HCPCS,278,RC,,both,291.55,262.4,Cigna,Default,Percent of Total Billed Charges,172.01,,,,172.01,237.9
"BB-TAK, THREADED",C1713,HCPCS,278,RC,,both,291.55,262.4,United Healthcare,Default,Fee Schedule,237.9,,,,172.01,237.9
"LO-PRO SCRW,TI,3.0MMX 14MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.7,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 14MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Cigna,Default,Percent of Total Billed Charges,228.16,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 14MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,United Healthcare,Default,Fee Schedule,315.56,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 16MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.7,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 16MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Cigna,Default,Percent of Total Billed Charges,228.16,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 16MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,United Healthcare,Default,Fee Schedule,315.56,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 18MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.7,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 18MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Cigna,Default,Percent of Total Billed Charges,228.16,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 18MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,United Healthcare,Default,Fee Schedule,315.56,,,,228.16,315.56
"CANNULATED DRILL BIT, 2.0MM (AO)",272,RC,,,,both,194.86,175.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.4,,,,114.97,159.01
"CANNULATED DRILL BIT, 2.0MM (AO)",272,RC,,,,both,194.86,175.37,Cigna,Default,Percent of Total Billed Charges,114.97,,,,114.97,159.01
"CANNULATED DRILL BIT, 2.0MM (AO)",272,RC,,,,both,194.86,175.37,United Healthcare,Default,Fee Schedule,159.01,,,,114.97,159.01
"LO-PRO SCRW,TI,3X 28MMCANN,PT THD",C1713,HCPCS,278,RC,,both,421.87,379.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.31,,,,248.9,344.25
"LO-PRO SCRW,TI,3X 28MMCANN,PT THD",C1713,HCPCS,278,RC,,both,421.87,379.68,Cigna,Default,Percent of Total Billed Charges,248.9,,,,248.9,344.25
"LO-PRO SCRW,TI,3X 28MMCANN,PT THD",C1713,HCPCS,278,RC,,both,421.87,379.68,United Healthcare,Default,Fee Schedule,344.25,,,,248.9,344.25
"GUIDEWIRE, .045""X5.91""",C1769,HCPCS,278,RC,,both,30.3,27.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.21,,,,17.88,24.72
"GUIDEWIRE, .045""X5.91""",C1769,HCPCS,278,RC,,both,30.3,27.27,Cigna,Default,Percent of Total Billed Charges,17.88,,,,17.88,24.72
"GUIDEWIRE, .045""X5.91""",C1769,HCPCS,278,RC,,both,30.3,27.27,United Healthcare,Default,Fee Schedule,24.72,,,,17.88,24.72
"LO-PRO LOCK SCRW,TI3.0MMX 14MM",C1713,HCPCS,272,RC,,both,485.15,436.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,339.6,,,,286.24,395.88
"LO-PRO LOCK SCRW,TI3.0MMX 14MM",C1713,HCPCS,272,RC,,both,485.15,436.64,Cigna,Default,Percent of Total Billed Charges,286.24,,,,286.24,395.88
"LO-PRO LOCK SCRW,TI3.0MMX 14MM",C1713,HCPCS,272,RC,,both,485.15,436.64,United Healthcare,Default,Fee Schedule,395.88,,,,286.24,395.88
"LO-PRO LOCK SCRW,TI,3.0MMX 16M",C1713,HCPCS,278,RC,,both,386.71,348.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.7,,,,228.16,315.56
"LO-PRO LOCK SCRW,TI,3.0MMX 16M",C1713,HCPCS,278,RC,,both,386.71,348.04,Cigna,Default,Percent of Total Billed Charges,228.16,,,,228.16,315.56
"LO-PRO LOCK SCRW,TI,3.0MMX 16M",C1713,HCPCS,278,RC,,both,386.71,348.04,United Healthcare,Default,Fee Schedule,315.56,,,,228.16,315.56
".062"" GUIDE WIRE WITH TROCAR TIP",C1769,HCPCS,278,RC,,both,63.34,57.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.34,,,,37.37,51.69
".062"" GUIDE WIRE WITH TROCAR TIP",C1769,HCPCS,278,RC,,both,63.34,57.01,Cigna,Default,Percent of Total Billed Charges,37.37,,,,37.37,51.69
".062"" GUIDE WIRE WITH TROCAR TIP",C1769,HCPCS,278,RC,,both,63.34,57.01,United Healthcare,Default,Fee Schedule,51.69,,,,37.37,51.69
"DRILL BIT, 2.0MM (AO)",272,RC,,,,both,307.5,276.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.25,,,,181.42,250.92
"DRILL BIT, 2.0MM (AO)",272,RC,,,,both,307.5,276.75,Cigna,Default,Percent of Total Billed Charges,181.42,,,,181.42,250.92
"DRILL BIT, 2.0MM (AO)",272,RC,,,,both,307.5,276.75,United Healthcare,Default,Fee Schedule,250.92,,,,181.42,250.92
"LO-PRO MTP PLT TM CONTRD,SHT,L,TI",C1713,HCPCS,278,RC,,both,2812.48,2531.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1968.74,,,,1659.36,2294.98
"LO-PRO MTP PLT TM CONTRD,SHT,L,TI",C1713,HCPCS,278,RC,,both,2812.48,2531.23,Cigna,Default,Percent of Total Billed Charges,1659.36,,,,1659.36,2294.98
"LO-PRO MTP PLT TM CONTRD,SHT,L,TI",C1713,HCPCS,278,RC,,both,2812.48,2531.23,United Healthcare,Default,Fee Schedule,2294.98,,,,1659.36,2294.98
SPEEDBRG IMP SYS W/BIO-COMP SWVLK,C1713,HCPCS,278,RC,,both,5967.93,5371.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4177.55,,,,3521.08,4869.83
SPEEDBRG IMP SYS W/BIO-COMP SWVLK,C1713,HCPCS,278,RC,,both,5967.93,5371.14,Cigna,Default,Percent of Total Billed Charges,3521.08,,,,3521.08,4869.83
SPEEDBRG IMP SYS W/BIO-COMP SWVLK,C1713,HCPCS,278,RC,,both,5967.93,5371.14,United Healthcare,Default,Fee Schedule,4869.83,,,,3521.08,4869.83
CANNULATED DRILL 3.5MM,A4649,HCPCS,272,RC,,both,633.07,569.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.15,,,,373.51,516.59
CANNULATED DRILL 3.5MM,A4649,HCPCS,272,RC,,both,633.07,569.76,Cigna,Default,Percent of Total Billed Charges,373.51,,,,373.51,516.59
CANNULATED DRILL 3.5MM,A4649,HCPCS,272,RC,,both,633.07,569.76,United Healthcare,Default,Fee Schedule,516.59,,,,373.51,516.59
BONE TAP 4.5MM CANNULATED,A4649,HCPCS,272,RC,,both,633.07,569.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.15,,,,373.51,516.59
BONE TAP 4.5MM CANNULATED,A4649,HCPCS,272,RC,,both,633.07,569.76,Cigna,Default,Percent of Total Billed Charges,373.51,,,,373.51,516.59
BONE TAP 4.5MM CANNULATED,A4649,HCPCS,272,RC,,both,633.07,569.76,United Healthcare,Default,Fee Schedule,516.59,,,,373.51,516.59
BONE TAP 5.5MM CANNULATED,A4649,HCPCS,272,RC,,both,633.07,569.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.15,,,,373.51,516.59
BONE TAP 5.5MM CANNULATED,A4649,HCPCS,272,RC,,both,633.07,569.76,Cigna,Default,Percent of Total Billed Charges,373.51,,,,373.51,516.59
BONE TAP 5.5MM CANNULATED,A4649,HCPCS,272,RC,,both,633.07,569.76,United Healthcare,Default,Fee Schedule,516.59,,,,373.51,516.59
BONE TAP 6.0MM,A4649,HCPCS,272,RC,,both,633.07,569.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.15,,,,373.51,516.59
BONE TAP 6.0MM,A4649,HCPCS,272,RC,,both,633.07,569.76,Cigna,Default,Percent of Total Billed Charges,373.51,,,,373.51,516.59
BONE TAP 6.0MM,A4649,HCPCS,272,RC,,both,633.07,569.76,United Healthcare,Default,Fee Schedule,516.59,,,,373.51,516.59
GUIDEWIRE W/TRCR TIP 2MMX200MM,A4649,HCPCS,272,RC,,both,633.07,569.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.15,,,,373.51,516.59
GUIDEWIRE W/TRCR TIP 2MMX200MM,A4649,HCPCS,272,RC,,both,633.07,569.76,Cigna,Default,Percent of Total Billed Charges,373.51,,,,373.51,516.59
GUIDEWIRE W/TRCR TIP 2MMX200MM,A4649,HCPCS,272,RC,,both,633.07,569.76,United Healthcare,Default,Fee Schedule,516.59,,,,373.51,516.59
"LO-PRO SCRW,TI,5.5MMX45MM",C1713,HCPCS,278,RC,,both,2794.89,2515.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1956.42,,,,1648.99,2280.63
"LO-PRO SCRW,TI,5.5MMX45MM",C1713,HCPCS,278,RC,,both,2794.89,2515.4,Cigna,Default,Percent of Total Billed Charges,1648.99,,,,1648.99,2280.63
"LO-PRO SCRW,TI,5.5MMX45MM",C1713,HCPCS,278,RC,,both,2794.89,2515.4,United Healthcare,Default,Fee Schedule,2280.63,,,,1648.99,2280.63
LO-PRO SCREW TI 3.0MMX20CORT,C1713,HCPCS,278,RC,,both,377.28,339.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.1,,,,222.6,307.86
LO-PRO SCREW TI 3.0MMX20CORT,C1713,HCPCS,278,RC,,both,377.28,339.55,Cigna,Default,Percent of Total Billed Charges,222.6,,,,222.6,307.86
LO-PRO SCREW TI 3.0MMX20CORT,C1713,HCPCS,278,RC,,both,377.28,339.55,United Healthcare,Default,Fee Schedule,307.86,,,,222.6,307.86
"LO-PRO SCRW,TI,3.0MMX 22MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,270.7,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 22MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,Cigna,Default,Percent of Total Billed Charges,228.16,,,,228.16,315.56
"LO-PRO SCRW,TI,3.0MMX 22MMCORT",C1713,HCPCS,278,RC,,both,386.71,348.04,United Healthcare,Default,Fee Schedule,315.56,,,,228.16,315.56
3.0X12MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,336.13,,,,283.31,391.83
3.0X12MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,Cigna,Default,Percent of Total Billed Charges,283.31,,,,283.31,391.83
3.0X12MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,United Healthcare,Default,Fee Schedule,391.83,,,,283.31,391.83
3.0X14MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,336.13,,,,283.31,391.83
3.0X14MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,Cigna,Default,Percent of Total Billed Charges,283.31,,,,283.31,391.83
3.0X14MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,United Healthcare,Default,Fee Schedule,391.83,,,,283.31,391.83
3.0X20MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,336.13,,,,283.31,391.83
3.0X20MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,Cigna,Default,Percent of Total Billed Charges,283.31,,,,283.31,391.83
3.0X20MM VAL SCREW TI,C1713,HCPCS,278,RC,,both,480.18,432.16,United Healthcare,Default,Fee Schedule,391.83,,,,283.31,391.83
"LO-PRO MTP PLATE STR, LONG TI",C1713,HCPCS,278,RC,,both,2812.48,2531.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1968.74,,,,1659.36,2294.98
"LO-PRO MTP PLATE STR, LONG TI",C1713,HCPCS,278,RC,,both,2812.48,2531.23,Cigna,Default,Percent of Total Billed Charges,1659.36,,,,1659.36,2294.98
"LO-PRO MTP PLATE STR, LONG TI",C1713,HCPCS,278,RC,,both,2812.48,2531.23,United Healthcare,Default,Fee Schedule,2294.98,,,,1659.36,2294.98
PHALANGEAL REAMER 22MM,C1713,HCPCS,278,RC,,both,1543.43,1389.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1080.4,,,,910.62,1259.44
PHALANGEAL REAMER 22MM,C1713,HCPCS,278,RC,,both,1543.43,1389.09,Cigna,Default,Percent of Total Billed Charges,910.62,,,,910.62,1259.44
PHALANGEAL REAMER 22MM,C1713,HCPCS,278,RC,,both,1543.43,1389.09,United Healthcare,Default,Fee Schedule,1259.44,,,,910.62,1259.44
METATARSAL REAMER 22MM,C1713,HCPCS,278,RC,,both,1543.43,1389.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1080.4,,,,910.62,1259.44
METATARSAL REAMER 22MM,C1713,HCPCS,278,RC,,both,1543.43,1389.09,Cigna,Default,Percent of Total Billed Charges,910.62,,,,910.62,1259.44
METATARSAL REAMER 22MM,C1713,HCPCS,278,RC,,both,1543.43,1389.09,United Healthcare,Default,Fee Schedule,1259.44,,,,910.62,1259.44
DECELLULARIZED DERMIS,278,RC,,,,both,32840.1,29556.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22988.07,,,,19375.66,26797.52
DECELLULARIZED DERMIS,278,RC,,,,both,32840.1,29556.09,Cigna,Default,Percent of Total Billed Charges,19375.66,,,,19375.66,26797.52
DECELLULARIZED DERMIS,278,RC,,,,both,32840.1,29556.09,United Healthcare,Default,Fee Schedule,26797.52,,,,19375.66,26797.52
SPEEDBRG IMP SYS W/BIO-COMP SWVLK,C1713,HCPCS,278,RC,,both,6996.33,6296.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4897.43,,,,4127.83,5709.01
SPEEDBRG IMP SYS W/BIO-COMP SWVLK,C1713,HCPCS,278,RC,,both,6996.33,6296.7,Cigna,Default,Percent of Total Billed Charges,4127.83,,,,4127.83,5709.01
SPEEDBRG IMP SYS W/BIO-COMP SWVLK,C1713,HCPCS,278,RC,,both,6996.33,6296.7,United Healthcare,Default,Fee Schedule,5709.01,,,,4127.83,5709.01
FHL IMPLANT SYSTEM 6.25 MM,C1713,HCPCS,278,RC,,both,5476.19,4928.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3833.33,,,,3230.95,4468.57
FHL IMPLANT SYSTEM 6.25 MM,C1713,HCPCS,278,RC,,both,5476.19,4928.57,Cigna,Default,Percent of Total Billed Charges,3230.95,,,,3230.95,4468.57
FHL IMPLANT SYSTEM 6.25 MM,C1713,HCPCS,278,RC,,both,5476.19,4928.57,United Healthcare,Default,Fee Schedule,4468.57,,,,3230.95,4468.57
TENO SCREW KIT DISP.,C1713,HCPCS,278,RC,,both,668.83,601.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,468.18,,,,394.61,545.77
TENO SCREW KIT DISP.,C1713,HCPCS,278,RC,,both,668.83,601.95,Cigna,Default,Percent of Total Billed Charges,394.61,,,,394.61,545.77
TENO SCREW KIT DISP.,C1713,HCPCS,278,RC,,both,668.83,601.95,United Healthcare,Default,Fee Schedule,545.77,,,,394.61,545.77
COMPR FT SCREW MINI 3.5 X 32MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,840.32,,,,708.27,979.58
COMPR FT SCREW MINI 3.5 X 32MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,Cigna,Default,Percent of Total Billed Charges,708.27,,,,708.27,979.58
COMPR FT SCREW MINI 3.5 X 32MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,United Healthcare,Default,Fee Schedule,979.58,,,,708.27,979.58
COMPR FT SCREW MINI 3.5 X 34MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,840.32,,,,708.27,979.58
COMPR FT SCREW MINI 3.5 X 34MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,Cigna,Default,Percent of Total Billed Charges,708.27,,,,708.27,979.58
COMPR FT SCREW MINI 3.5 X 34MM,C1713,HCPCS,278,RC,,both,1200.46,1080.41,United Healthcare,Default,Fee Schedule,979.58,,,,708.27,979.58
G-WIRE W/TRCR TIP .45 W/ LASER LINE,A4649,HCPCS,272,RC,,both,65.18,58.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.63,,,,38.46,53.19
G-WIRE W/TRCR TIP .45 W/ LASER LINE,A4649,HCPCS,272,RC,,both,65.18,58.66,Cigna,Default,Percent of Total Billed Charges,38.46,,,,38.46,53.19
G-WIRE W/TRCR TIP .45 W/ LASER LINE,A4649,HCPCS,272,RC,,both,65.18,58.66,United Healthcare,Default,Fee Schedule,53.19,,,,38.46,53.19
DRILL BIT2.7MM CMP FT CALIBRATED,272,RC,,,,both,688.23,619.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,481.76,,,,406.06,561.6
DRILL BIT2.7MM CMP FT CALIBRATED,272,RC,,,,both,688.23,619.41,Cigna,Default,Percent of Total Billed Charges,406.06,,,,406.06,561.6
DRILL BIT2.7MM CMP FT CALIBRATED,272,RC,,,,both,688.23,619.41,United Healthcare,Default,Fee Schedule,561.6,,,,406.06,561.6
DRILL PROFILE MINI CMP FT,A4649,HCPCS,272,RC,,both,529.41,476.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,370.59,,,,312.35,432
DRILL PROFILE MINI CMP FT,A4649,HCPCS,272,RC,,both,529.41,476.47,Cigna,Default,Percent of Total Billed Charges,312.35,,,,312.35,432
DRILL PROFILE MINI CMP FT,A4649,HCPCS,272,RC,,both,529.41,476.47,United Healthcare,Default,Fee Schedule,432,,,,312.35,432
DRL BIT 5.0MM CANN,272,RC,,,,both,617.64,555.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,432.35,,,,364.41,503.99
DRL BIT 5.0MM CANN,272,RC,,,,both,617.64,555.88,Cigna,Default,Percent of Total Billed Charges,364.41,,,,364.41,503.99
DRL BIT 5.0MM CANN,272,RC,,,,both,617.64,555.88,United Healthcare,Default,Fee Schedule,503.99,,,,364.41,503.99
COMPR FT SCRE XL 7 X 55MM,C1713,HCPCS,278,RC,,both,2383.78,2145.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1668.65,,,,1406.43,1945.16
COMPR FT SCRE XL 7 X 55MM,C1713,HCPCS,278,RC,,both,2383.78,2145.4,Cigna,Default,Percent of Total Billed Charges,1406.43,,,,1406.43,1945.16
COMPR FT SCRE XL 7 X 55MM,C1713,HCPCS,278,RC,,both,2383.78,2145.4,United Healthcare,Default,Fee Schedule,1945.16,,,,1406.43,1945.16
COMPR FT SCREW XL 7 X 60MM,C1713,HCPCS,278,RC,,both,2383.78,2145.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1668.65,,,,1406.43,1945.16
COMPR FT SCREW XL 7 X 60MM,C1713,HCPCS,278,RC,,both,2383.78,2145.4,Cigna,Default,Percent of Total Billed Charges,1406.43,,,,1406.43,1945.16
COMPR FT SCREW XL 7 X 60MM,C1713,HCPCS,278,RC,,both,2383.78,2145.4,United Healthcare,Default,Fee Schedule,1945.16,,,,1406.43,1945.16
GUIDEWIRE W/TRCR TIP 2.4MMX9.25,A4649,HCPCS,272,RC,,both,65.18,58.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.63,,,,38.46,53.19
GUIDEWIRE W/TRCR TIP 2.4MMX9.25,A4649,HCPCS,272,RC,,both,65.18,58.66,Cigna,Default,Percent of Total Billed Charges,38.46,,,,38.46,53.19
GUIDEWIRE W/TRCR TIP 2.4MMX9.25,A4649,HCPCS,272,RC,,both,65.18,58.66,United Healthcare,Default,Fee Schedule,53.19,,,,38.46,53.19
GUIDEWIRE W/TRCR TIP 2.4MMX9.25,A4649,HCPCS,272,RC,,both,130.37,117.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.26,,,,76.92,106.38
GUIDEWIRE W/TRCR TIP 2.4MMX9.25,A4649,HCPCS,272,RC,,both,130.37,117.33,Cigna,Default,Percent of Total Billed Charges,76.92,,,,76.92,106.38
GUIDEWIRE W/TRCR TIP 2.4MMX9.25,A4649,HCPCS,272,RC,,both,130.37,117.33,United Healthcare,Default,Fee Schedule,106.38,,,,76.92,106.38
MAIN PUMP TUBING,278,RC,,,,both,220.76,198.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.53,,,,130.25,180.14
MAIN PUMP TUBING,278,RC,,,,both,220.76,198.68,Cigna,Default,Percent of Total Billed Charges,130.25,,,,130.25,180.14
MAIN PUMP TUBING,278,RC,,,,both,220.76,198.68,United Healthcare,Default,Fee Schedule,180.14,,,,130.25,180.14
MULTIFIRE SCORPION NEEDLE,272,RC,,,,both,614.98,553.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.49,,,,362.84,501.82
MULTIFIRE SCORPION NEEDLE,272,RC,,,,both,614.98,553.48,Cigna,Default,Percent of Total Billed Charges,362.84,,,,362.84,501.82
MULTIFIRE SCORPION NEEDLE,272,RC,,,,both,614.98,553.48,United Healthcare,Default,Fee Schedule,501.82,,,,362.84,501.82
SUTURE ANCH BIOCOMP SWI-VELOCK C CLD 4.7,272,RC,,,,both,1447.02,1302.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1012.91,,,,853.74,1180.77
SUTURE ANCH BIOCOMP SWI-VELOCK C CLD 4.7,272,RC,,,,both,1447.02,1302.32,Cigna,Default,Percent of Total Billed Charges,853.74,,,,853.74,1180.77
SUTURE ANCH BIOCOMP SWI-VELOCK C CLD 4.7,272,RC,,,,both,1447.02,1302.32,United Healthcare,Default,Fee Schedule,1180.77,,,,853.74,1180.77
CANNULA TWIST-IN NOTCHED,C1713,HCPCS,278,RC,,both,111.35,100.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.94,,,,65.7,90.86
CANNULA TWIST-IN NOTCHED,C1713,HCPCS,278,RC,,both,111.35,100.22,Cigna,Default,Percent of Total Billed Charges,65.7,,,,65.7,90.86
CANNULA TWIST-IN NOTCHED,C1713,HCPCS,278,RC,,both,111.35,100.22,United Healthcare,Default,Fee Schedule,90.86,,,,65.7,90.86
FIBERLINK,272,RC,,,,both,180.94,162.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.66,,,,106.75,147.65
FIBERLINK,272,RC,,,,both,180.94,162.85,Cigna,Default,Percent of Total Billed Charges,106.75,,,,106.75,147.65
FIBERLINK,272,RC,,,,both,180.94,162.85,United Healthcare,Default,Fee Schedule,147.65,,,,106.75,147.65
BONE CUTTER 4.0MMX13CM,278,RC,,,,both,238.75,214.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,167.12,,,,140.86,194.82
BONE CUTTER 4.0MMX13CM,278,RC,,,,both,238.75,214.88,Cigna,Default,Percent of Total Billed Charges,140.86,,,,140.86,194.82
BONE CUTTER 4.0MMX13CM,278,RC,,,,both,238.75,214.88,United Healthcare,Default,Fee Schedule,194.82,,,,140.86,194.82
FIBERTAPE,272,RC,,,,both,180.88,162.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.62,,,,106.72,147.6
FIBERTAPE,272,RC,,,,both,180.88,162.79,Cigna,Default,Percent of Total Billed Charges,106.72,,,,106.72,147.6
FIBERTAPE,272,RC,,,,both,180.88,162.79,United Healthcare,Default,Fee Schedule,147.6,,,,106.72,147.6
SYNDESMOSIS TIGHTROPE XP IMPLANT STAINLE,C1713,HCPCS,278,RC,,both,5127.7,4614.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3589.39,,,,3025.34,4184.2
SYNDESMOSIS TIGHTROPE XP IMPLANT STAINLE,C1713,HCPCS,278,RC,,both,5127.7,4614.93,Cigna,Default,Percent of Total Billed Charges,3025.34,,,,3025.34,4184.2
SYNDESMOSIS TIGHTROPE XP IMPLANT STAINLE,C1713,HCPCS,278,RC,,both,5127.7,4614.93,United Healthcare,Default,Fee Schedule,4184.2,,,,3025.34,4184.2
"FIBERWIRE #2 BLU 38"" W/2 STR DP NDL",272,RC,,,,both,195.98,176.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.19,,,,115.63,159.92
"FIBERWIRE #2 BLU 38"" W/2 STR DP NDL",272,RC,,,,both,195.98,176.38,Cigna,Default,Percent of Total Billed Charges,115.63,,,,115.63,159.92
"FIBERWIRE #2 BLU 38"" W/2 STR DP NDL",272,RC,,,,both,195.98,176.38,United Healthcare,Default,Fee Schedule,159.92,,,,115.63,159.92
TORPEDO 4.0MMX13CM,278,RC,,,,both,365.37,328.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.76,,,,215.57,298.14
TORPEDO 4.0MMX13CM,278,RC,,,,both,365.37,328.83,Cigna,Default,Percent of Total Billed Charges,215.57,,,,215.57,298.14
TORPEDO 4.0MMX13CM,278,RC,,,,both,365.37,328.83,United Healthcare,Default,Fee Schedule,298.14,,,,215.57,298.14
TAPERES CRVD NDL 26MM 1/2 CIRCLEX/LOOP,272,RC,,,,both,80.24,72.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.17,,,,47.34,65.48
TAPERES CRVD NDL 26MM 1/2 CIRCLEX/LOOP,272,RC,,,,both,80.24,72.22,Cigna,Default,Percent of Total Billed Charges,47.34,,,,47.34,65.48
TAPERES CRVD NDL 26MM 1/2 CIRCLEX/LOOP,272,RC,,,,both,80.24,72.22,United Healthcare,Default,Fee Schedule,65.48,,,,47.34,65.48
"PUNCH, DISP CRKSCREW SWVLK ANCHS",272,RC,,,,both,271.31,244.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,189.92,,,,160.07,221.39
"PUNCH, DISP CRKSCREW SWVLK ANCHS",272,RC,,,,both,271.31,244.18,Cigna,Default,Percent of Total Billed Charges,160.07,,,,160.07,221.39
"PUNCH, DISP CRKSCREW SWVLK ANCHS",272,RC,,,,both,271.31,244.18,United Healthcare,Default,Fee Schedule,221.39,,,,160.07,221.39
DBL LOADED 4.75MM BIO-COMP SWVLK,272,RC,,,,both,1508.55,1357.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1055.98,,,,890.04,1230.98
DBL LOADED 4.75MM BIO-COMP SWVLK,272,RC,,,,both,1508.55,1357.7,Cigna,Default,Percent of Total Billed Charges,890.04,,,,890.04,1230.98
DBL LOADED 4.75MM BIO-COMP SWVLK,272,RC,,,,both,1508.55,1357.7,United Healthcare,Default,Fee Schedule,1230.98,,,,890.04,1230.98
"BIO-COMP SWIVELOCK C, FT, 4.75X19.1MM",272,RC,,,,both,1700.27,1530.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1190.19,,,,1003.16,1387.42
"BIO-COMP SWIVELOCK C, FT, 4.75X19.1MM",272,RC,,,,both,1700.27,1530.24,Cigna,Default,Percent of Total Billed Charges,1003.16,,,,1003.16,1387.42
"BIO-COMP SWIVELOCK C, FT, 4.75X19.1MM",272,RC,,,,both,1700.27,1530.24,United Healthcare,Default,Fee Schedule,1387.42,,,,1003.16,1387.42
"BIO-COMP, SWIVELOCK C, TT, 4.75X19.1MM",272,RC,,,,both,1700.27,1530.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1190.19,,,,1003.16,1387.42
"BIO-COMP, SWIVELOCK C, TT, 4.75X19.1MM",272,RC,,,,both,1700.27,1530.24,Cigna,Default,Percent of Total Billed Charges,1003.16,,,,1003.16,1387.42
"BIO-COMP, SWIVELOCK C, TT, 4.75X19.1MM",272,RC,,,,both,1700.27,1530.24,United Healthcare,Default,Fee Schedule,1387.42,,,,1003.16,1387.42
"IMPLANT SYS, BIOC ACHILLES SPEEEDB W JUM",C1713,HCPCS,278,RC,,both,7013.71,6312.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4909.6,,,,4138.09,5723.19
"IMPLANT SYS, BIOC ACHILLES SPEEEDB W JUM",C1713,HCPCS,278,RC,,both,7013.71,6312.34,Cigna,Default,Percent of Total Billed Charges,4138.09,,,,4138.09,5723.19
"IMPLANT SYS, BIOC ACHILLES SPEEEDB W JUM",C1713,HCPCS,278,RC,,both,7013.71,6312.34,United Healthcare,Default,Fee Schedule,5723.19,,,,4138.09,5723.19
"IMPLANT SYS, BIOC ACHILLES SPEEDB W/JUMP",C1713,HCPCS,278,RC,,both,7307.69,6576.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5115.38,,,,4311.54,5963.08
"IMPLANT SYS, BIOC ACHILLES SPEEDB W/JUMP",C1713,HCPCS,278,RC,,both,7307.69,6576.92,Cigna,Default,Percent of Total Billed Charges,4311.54,,,,4311.54,5963.08
"IMPLANT SYS, BIOC ACHILLES SPEEDB W/JUMP",C1713,HCPCS,278,RC,,both,7307.69,6576.92,United Healthcare,Default,Fee Schedule,5963.08,,,,4311.54,5963.08
UROLIFT UL400 DELIVERY DEVICE & IMPLANT,L8699,HCPCS,278,RC,,both,3344.15,3009.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2340.9,,,,1973.05,2728.83
UROLIFT UL400 DELIVERY DEVICE & IMPLANT,L8699,HCPCS,278,RC,,both,3344.15,3009.74,Cigna,Default,Percent of Total Billed Charges,1973.05,,,,1973.05,2728.83
UROLIFT UL400 DELIVERY DEVICE & IMPLANT,L8699,HCPCS,278,RC,,both,3344.15,3009.74,United Healthcare,Default,Fee Schedule,2728.83,,,,1973.05,2728.83
*ABIATOR LIGHTWAVE SUCTION,272,RC,,,,both,337.5,303.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.25,,,,199.12,275.4
*ABIATOR LIGHTWAVE SUCTION,272,RC,,,,both,337.5,303.75,Cigna,Default,Percent of Total Billed Charges,199.12,,,,199.12,275.4
*ABIATOR LIGHTWAVE SUCTION,272,RC,,,,both,337.5,303.75,United Healthcare,Default,Fee Schedule,275.4,,,,199.12,275.4
"3.2MM THREAD PIN, 508MM",C1713,HCPCS,278,RC,,both,444.52,400.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.16,,,,262.27,362.73
"3.2MM THREAD PIN, 508MM",C1713,HCPCS,278,RC,,both,444.52,400.07,Cigna,Default,Percent of Total Billed Charges,262.27,,,,262.27,362.73
"3.2MM THREAD PIN, 508MM",C1713,HCPCS,278,RC,,both,444.52,400.07,United Healthcare,Default,Fee Schedule,362.73,,,,262.27,362.73
CODA SHAVER 4.2MM,272,RC,,,,both,153.48,138.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.44,,,,90.55,125.24
CODA SHAVER 4.2MM,272,RC,,,,both,153.48,138.13,Cigna,Default,Percent of Total Billed Charges,90.55,,,,90.55,125.24
CODA SHAVER 4.2MM,272,RC,,,,both,153.48,138.13,United Healthcare,Default,Fee Schedule,125.24,,,,90.55,125.24
SCREW COMPRESSION LAG,278,RC,,,,both,212.37,191.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,148.66,,,,125.3,173.29
SCREW COMPRESSION LAG,278,RC,,,,both,212.37,191.13,Cigna,Default,Percent of Total Billed Charges,125.3,,,,125.3,173.29
SCREW COMPRESSION LAG,278,RC,,,,both,212.37,191.13,United Healthcare,Default,Fee Schedule,173.29,,,,125.3,173.29
FEMORAL NAIL,278,RC,,,,both,5468.77,4921.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3828.14,,,,3226.57,4462.52
FEMORAL NAIL,278,RC,,,,both,5468.77,4921.89,Cigna,Default,Percent of Total Billed Charges,3226.57,,,,3226.57,4462.52
FEMORAL NAIL,278,RC,,,,both,5468.77,4921.89,United Healthcare,Default,Fee Schedule,4462.52,,,,3226.57,4462.52
LAG SCREW 80MM,C1713,HCPCS,278,RC,,both,2385.74,2147.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1670.02,,,,1407.59,1946.76
LAG SCREW 80MM,C1713,HCPCS,278,RC,,both,2385.74,2147.17,Cigna,Default,Percent of Total Billed Charges,1407.59,,,,1407.59,1946.76
LAG SCREW 80MM,C1713,HCPCS,278,RC,,both,2385.74,2147.17,United Healthcare,Default,Fee Schedule,1946.76,,,,1407.59,1946.76
GUIDE WIRE TEAR DROP,272,RC,,,,both,705,634.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,493.5,,,,415.95,575.28
GUIDE WIRE TEAR DROP,272,RC,,,,both,705,634.5,Cigna,Default,Percent of Total Billed Charges,415.95,,,,415.95,575.28
GUIDE WIRE TEAR DROP,272,RC,,,,both,705,634.5,United Healthcare,Default,Fee Schedule,575.28,,,,415.95,575.28
"3.2MM THREADED PIN, 450MM",272,RC,,,,both,661.35,595.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,462.94,,,,390.2,539.66
"3.2MM THREADED PIN, 450MM",272,RC,,,,both,661.35,595.22,Cigna,Default,Percent of Total Billed Charges,390.2,,,,390.2,539.66
"3.2MM THREADED PIN, 450MM",272,RC,,,,both,661.35,595.22,United Healthcare,Default,Fee Schedule,539.66,,,,390.2,539.66
SCREW LAG 80MM 12.7 MM,278,RC,,,,both,994.07,894.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,695.85,,,,586.5,811.16
SCREW LAG 80MM 12.7 MM,278,RC,,,,both,994.07,894.66,Cigna,Default,Percent of Total Billed Charges,586.5,,,,586.5,811.16
SCREW LAG 80MM 12.7 MM,278,RC,,,,both,994.07,894.66,United Healthcare,Default,Fee Schedule,811.16,,,,586.5,811.16
FEMORAL FIXATION 3 HOLE 135 DEGREE,278,RC,,,,both,1566.94,1410.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1096.86,,,,924.49,1278.62
FEMORAL FIXATION 3 HOLE 135 DEGREE,278,RC,,,,both,1566.94,1410.25,Cigna,Default,Percent of Total Billed Charges,924.49,,,,924.49,1278.62
FEMORAL FIXATION 3 HOLE 135 DEGREE,278,RC,,,,both,1566.94,1410.25,United Healthcare,Default,Fee Schedule,1278.62,,,,924.49,1278.62
SCREW CORTICAL 4.5MM 40MM,278,RC,,,,both,69.97,62.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.98,,,,41.28,57.1
SCREW CORTICAL 4.5MM 40MM,278,RC,,,,both,69.97,62.97,Cigna,Default,Percent of Total Billed Charges,41.28,,,,41.28,57.1
SCREW CORTICAL 4.5MM 40MM,278,RC,,,,both,69.97,62.97,United Healthcare,Default,Fee Schedule,57.1,,,,41.28,57.1
3MMx100CM TEARDROP GD,C1713,HCPCS,278,RC,,both,597.75,537.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,418.42,,,,352.67,487.76
3MMx100CM TEARDROP GD,C1713,HCPCS,278,RC,,both,597.75,537.98,Cigna,Default,Percent of Total Billed Charges,352.67,,,,352.67,487.76
3MMx100CM TEARDROP GD,C1713,HCPCS,278,RC,,both,597.75,537.98,United Healthcare,Default,Fee Schedule,487.76,,,,352.67,487.76
TUBE SET 24K,272,RC,,,,both,161,144.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.7,,,,94.99,131.38
TUBE SET 24K,272,RC,,,,both,161,144.9,Cigna,Default,Percent of Total Billed Charges,94.99,,,,94.99,131.38
TUBE SET 24K,272,RC,,,,both,161,144.9,United Healthcare,Default,Fee Schedule,131.38,,,,94.99,131.38
TUBE SET 24K,272,RC,,,,both,33.25,29.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.28,,,,19.62,27.13
TUBE SET 24K,272,RC,,,,both,33.25,29.93,Cigna,Default,Percent of Total Billed Charges,19.62,,,,19.62,27.13
TUBE SET 24K,272,RC,,,,both,33.25,29.93,United Healthcare,Default,Fee Schedule,27.13,,,,19.62,27.13
Z NAIL 10.5X95 LAG SCREW 75MM,278,RC,,,,both,1984.03,1785.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1388.82,,,,1170.58,1618.97
Z NAIL 10.5X95 LAG SCREW 75MM,278,RC,,,,both,1984.03,1785.63,Cigna,Default,Percent of Total Billed Charges,1170.58,,,,1170.58,1618.97
Z NAIL 10.5X95 LAG SCREW 75MM,278,RC,,,,both,1984.03,1785.63,United Healthcare,Default,Fee Schedule,1618.97,,,,1170.58,1618.97
FEMORAL NAIL 10MMX21.5CM 130 R,C1776,HCPCS,278,RC,,both,5468.69,4921.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3828.08,,,,3226.53,4462.45
FEMORAL NAIL 10MMX21.5CM 130 R,C1776,HCPCS,278,RC,,both,5468.69,4921.82,Cigna,Default,Percent of Total Billed Charges,3226.53,,,,3226.53,4462.45
FEMORAL NAIL 10MMX21.5CM 130 R,C1776,HCPCS,278,RC,,both,5468.69,4921.82,United Healthcare,Default,Fee Schedule,4462.45,,,,3226.53,4462.45
BIPOLAR LINER 53/54/55MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,480.19,,,,404.73,559.76
BIPOLAR LINER 53/54/55MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,Cigna,Default,Percent of Total Billed Charges,404.73,,,,404.73,559.76
BIPOLAR LINER 53/54/55MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,United Healthcare,Default,Fee Schedule,559.76,,,,404.73,559.76
BIPOLAR SHELL 55MM OD,C1776,HCPCS,278,RC,,both,9946.71,8952.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6962.7,,,,5868.56,8116.52
BIPOLAR SHELL 55MM OD,C1776,HCPCS,278,RC,,both,9946.71,8952.04,Cigna,Default,Percent of Total Billed Charges,5868.56,,,,5868.56,8116.52
BIPOLAR SHELL 55MM OD,C1776,HCPCS,278,RC,,both,9946.71,8952.04,United Healthcare,Default,Fee Schedule,8116.52,,,,5868.56,8116.52
Z NAIL CPM 10MMX21.5CM 130L,C1713,HCPCS,278,RC,,both,5468.77,4921.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3828.14,,,,3226.57,4462.52
Z NAIL CPM 10MMX21.5CM 130L,C1713,HCPCS,278,RC,,both,5468.77,4921.89,Cigna,Default,Percent of Total Billed Charges,3226.57,,,,3226.57,4462.52
Z NAIL CPM 10MMX21.5CM 130L,C1713,HCPCS,278,RC,,both,5468.77,4921.89,United Healthcare,Default,Fee Schedule,4462.52,,,,3226.57,4462.52
BALL TIP GUIDE WIRE 3.0MMX100CM,C1713,HCPCS,278,RC,,both,432.44,389.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.71,,,,255.14,352.87
BALL TIP GUIDE WIRE 3.0MMX100CM,C1713,HCPCS,278,RC,,both,432.44,389.2,Cigna,Default,Percent of Total Billed Charges,255.14,,,,255.14,352.87
BALL TIP GUIDE WIRE 3.0MMX100CM,C1713,HCPCS,278,RC,,both,432.44,389.2,United Healthcare,Default,Fee Schedule,352.87,,,,255.14,352.87
LAG SCREW 10.5X90 Z NAIL,278,RC,,,,both,2092.58,1883.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1464.81,,,,1234.62,1707.55
LAG SCREW 10.5X90 Z NAIL,278,RC,,,,both,2092.58,1883.32,Cigna,Default,Percent of Total Billed Charges,1234.62,,,,1234.62,1707.55
LAG SCREW 10.5X90 Z NAIL,278,RC,,,,both,2092.58,1883.32,United Healthcare,Default,Fee Schedule,1707.55,,,,1234.62,1707.55
BALL NOSE GUIDE WIRE 80CM,C1769,HCPCS,272,RC,,both,618.06,556.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,432.64,,,,364.66,504.34
BALL NOSE GUIDE WIRE 80CM,C1769,HCPCS,272,RC,,both,618.06,556.25,Cigna,Default,Percent of Total Billed Charges,364.66,,,,364.66,504.34
BALL NOSE GUIDE WIRE 80CM,C1769,HCPCS,272,RC,,both,618.06,556.25,United Healthcare,Default,Fee Schedule,504.34,,,,364.66,504.34
PIN 2.0MM,C1713,HCPCS,278,RC,,both,343.4,309.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,240.38,,,,202.61,280.21
PIN 2.0MM,C1713,HCPCS,278,RC,,both,343.4,309.06,Cigna,Default,Percent of Total Billed Charges,202.61,,,,202.61,280.21
PIN 2.0MM,C1713,HCPCS,278,RC,,both,343.4,309.06,United Healthcare,Default,Fee Schedule,280.21,,,,202.61,280.21
BALL NOSE GUIDE WIRE 100CM,C1769,HCPCS,272,RC,,both,506.26,455.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,354.38,,,,298.69,413.11
BALL NOSE GUIDE WIRE 100CM,C1769,HCPCS,272,RC,,both,506.26,455.63,Cigna,Default,Percent of Total Billed Charges,298.69,,,,298.69,413.11
BALL NOSE GUIDE WIRE 100CM,C1769,HCPCS,272,RC,,both,506.26,455.63,United Healthcare,Default,Fee Schedule,413.11,,,,298.69,413.11
BIPOLAR SHELL 54MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,675.99,,,,569.76,788.01
BIPOLAR SHELL 54MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Cigna,Default,Percent of Total Billed Charges,569.76,,,,569.76,788.01
BIPOLAR SHELL 54MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,United Healthcare,Default,Fee Schedule,788.01,,,,569.76,788.01
VERSYS 6 INCH BEADED FC 11X160MM STD NEC,C1776,HCPCS,278,RC,,both,8554.65,7699.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5988.26,,,,5047.24,6980.59
VERSYS 6 INCH BEADED FC 11X160MM STD NEC,C1776,HCPCS,278,RC,,both,8554.65,7699.19,Cigna,Default,Percent of Total Billed Charges,5047.24,,,,5047.24,6980.59
VERSYS 6 INCH BEADED FC 11X160MM STD NEC,C1776,HCPCS,278,RC,,both,8554.65,7699.19,United Healthcare,Default,Fee Schedule,6980.59,,,,5047.24,6980.59
M/L TAPER KINECTIV STEM SIZE 10,C1776,HCPCS,278,RC,,both,6711.18,6040.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4697.83,,,,3959.6,5476.32
M/L TAPER KINECTIV STEM SIZE 10,C1776,HCPCS,278,RC,,both,6711.18,6040.06,Cigna,Default,Percent of Total Billed Charges,3959.6,,,,3959.6,5476.32
M/L TAPER KINECTIV STEM SIZE 10,C1776,HCPCS,278,RC,,both,6711.18,6040.06,United Healthcare,Default,Fee Schedule,5476.32,,,,3959.6,5476.32
12/14 COCR FEMORAL HEAD 32MM + 0,C1776,HCPCS,278,RC,,both,1397.69,1257.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,978.38,,,,824.64,1140.52
12/14 COCR FEMORAL HEAD 32MM + 0,C1776,HCPCS,278,RC,,both,1397.69,1257.92,Cigna,Default,Percent of Total Billed Charges,824.64,,,,824.64,1140.52
12/14 COCR FEMORAL HEAD 32MM + 0,C1776,HCPCS,278,RC,,both,1397.69,1257.92,United Healthcare,Default,Fee Schedule,1140.52,,,,824.64,1140.52
CONTINUUM MULTI-HOLE SHELL 50 HH,C1776,HCPCS,278,RC,,both,9177.04,8259.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6423.93,,,,5414.45,7488.46
CONTINUUM MULTI-HOLE SHELL 50 HH,C1776,HCPCS,278,RC,,both,9177.04,8259.34,Cigna,Default,Percent of Total Billed Charges,5414.45,,,,5414.45,7488.46
CONTINUUM MULTI-HOLE SHELL 50 HH,C1776,HCPCS,278,RC,,both,9177.04,8259.34,United Healthcare,Default,Fee Schedule,7488.46,,,,5414.45,7488.46
CONTINUUM VIVACIT-E NEUTRAL LINER HH 32x,C1776,HCPCS,278,RC,,both,3267.53,2940.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.27,,,,1927.84,2666.3
CONTINUUM VIVACIT-E NEUTRAL LINER HH 32x,C1776,HCPCS,278,RC,,both,3267.53,2940.78,Cigna,Default,Percent of Total Billed Charges,1927.84,,,,1927.84,2666.3
CONTINUUM VIVACIT-E NEUTRAL LINER HH 32x,C1776,HCPCS,278,RC,,both,3267.53,2940.78,United Healthcare,Default,Fee Schedule,2666.3,,,,1927.84,2666.3
BIPOLAR SHEL 47MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,675.99,,,,569.76,788.01
BIPOLAR SHEL 47MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Cigna,Default,Percent of Total Billed Charges,569.76,,,,569.76,788.01
BIPOLAR SHEL 47MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,United Healthcare,Default,Fee Schedule,788.01,,,,569.76,788.01
MODULAR NECK 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.34,,,,748.75,1035.55
MODULAR NECK 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Cigna,Default,Percent of Total Billed Charges,748.75,,,,748.75,1035.55
MODULAR NECK 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,United Healthcare,Default,Fee Schedule,1035.55,,,,748.75,1035.55
MODULAR NECK 12/14 TAPER,C1776,HCPCS,278,RC,,both,2435.63,2192.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1704.94,,,,1437.02,1987.47
MODULAR NECK 12/14 TAPER,C1776,HCPCS,278,RC,,both,2435.63,2192.07,Cigna,Default,Percent of Total Billed Charges,1437.02,,,,1437.02,1987.47
MODULAR NECK 12/14 TAPER,C1776,HCPCS,278,RC,,both,2435.63,2192.07,United Healthcare,Default,Fee Schedule,1987.47,,,,1437.02,1987.47
MODULAR NEX C 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.34,,,,748.75,1035.55
MODULAR NEX C 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Cigna,Default,Percent of Total Billed Charges,748.75,,,,748.75,1035.55
MODULAR NEX C 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,United Healthcare,Default,Fee Schedule,1035.55,,,,748.75,1035.55
BIPOLAR LINER 47/48/49MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,480.19,,,,404.73,559.76
BIPOLAR LINER 47/48/49MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,Cigna,Default,Percent of Total Billed Charges,404.73,,,,404.73,559.76
BIPOLAR LINER 47/48/49MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,685.98,617.38,United Healthcare,Default,Fee Schedule,559.76,,,,404.73,559.76
BIPOLAR SHELL 48MM OD,C1776,HCPCS,278,RC,,both,1131.66,1018.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,792.16,,,,667.68,923.43
BIPOLAR SHELL 48MM OD,C1776,HCPCS,278,RC,,both,1131.66,1018.49,Cigna,Default,Percent of Total Billed Charges,667.68,,,,667.68,923.43
BIPOLAR SHELL 48MM OD,C1776,HCPCS,278,RC,,both,1131.66,1018.49,United Healthcare,Default,Fee Schedule,923.43,,,,667.68,923.43
VERSYS PRESS FIT LD/FX SZ 11X120MM,C1776,HCPCS,278,RC,,both,4561.69,4105.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3193.18,,,,2691.4,3722.34
VERSYS PRESS FIT LD/FX SZ 11X120MM,C1776,HCPCS,278,RC,,both,4561.69,4105.52,Cigna,Default,Percent of Total Billed Charges,2691.4,,,,2691.4,3722.34
VERSYS PRESS FIT LD/FX SZ 11X120MM,C1776,HCPCS,278,RC,,both,4561.69,4105.52,United Healthcare,Default,Fee Schedule,3722.34,,,,2691.4,3722.34
12/14 COCE FEMORAL HEAD 28MM,C1776,HCPCS,278,RC,,both,1397.66,1257.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,978.36,,,,824.62,1140.49
12/14 COCE FEMORAL HEAD 28MM,C1776,HCPCS,278,RC,,both,1397.66,1257.89,Cigna,Default,Percent of Total Billed Charges,824.62,,,,824.62,1140.49
12/14 COCE FEMORAL HEAD 28MM,C1776,HCPCS,278,RC,,both,1397.66,1257.89,United Healthcare,Default,Fee Schedule,1140.49,,,,824.62,1140.49
MODULAR NECK E 12/14 TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.34,,,,748.75,1035.55
MODULAR NECK E 12/14 TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Cigna,Default,Percent of Total Billed Charges,748.75,,,,748.75,1035.55
MODULAR NECK E 12/14 TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,United Healthcare,Default,Fee Schedule,1035.55,,,,748.75,1035.55
BIPOLAR SHELL 49MM OD,C1776,HCPCS,278,RC,,both,994.67,895.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,696.27,,,,586.86,811.65
BIPOLAR SHELL 49MM OD,C1776,HCPCS,278,RC,,both,994.67,895.2,Cigna,Default,Percent of Total Billed Charges,586.86,,,,586.86,811.65
BIPOLAR SHELL 49MM OD,C1776,HCPCS,278,RC,,both,994.67,895.2,United Healthcare,Default,Fee Schedule,811.65,,,,586.86,811.65
VERSYS FM MC CLR 13X140MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8667.22,,,,7305.23,10103.51
VERSYS FM MC CLR 13X140MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,Cigna,Default,Percent of Total Billed Charges,7305.23,,,,7305.23,10103.51
VERSYS FM MC CLR 13X140MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,United Healthcare,Default,Fee Schedule,10103.51,,,,7305.23,10103.51
HIP PROSTHESIS TAPER 7.5,278,RC,,,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
HIP PROSTHESIS TAPER 7.5,278,RC,,,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
HIP PROSTHESIS TAPER 7.5,278,RC,,,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
HIP PROSTHESIS TAPER ML,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
HIP PROSTHESIS TAPER ML,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
HIP PROSTHESIS TAPER ML,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
HIP PROSTHESIS TAPER 6,278,RC,,,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
HIP PROSTHESIS TAPER 6,278,RC,,,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
HIP PROSTHESIS TAPER 6,278,RC,,,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
HIP PROSTHESIS TAPER SZ 12.5,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
HIP PROSTHESIS TAPER SZ 12.5,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
HIP PROSTHESIS TAPER SZ 12.5,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
MODULAR NEX G 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.34,,,,748.75,1035.55
MODULAR NEX G 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Cigna,Default,Percent of Total Billed Charges,748.75,,,,748.75,1035.55
MODULAR NEX G 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,United Healthcare,Default,Fee Schedule,1035.55,,,,748.75,1035.55
"CONTINUUM LONGEVITY NEUTRAL LINER, MM 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2287.24,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, MM 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,Cigna,Default,Percent of Total Billed Charges,1927.81,,,,1927.81,2666.26
"CONTINUUM LONGEVITY NEUTRAL LINER, MM 32",C1776,HCPCS,278,RC,,both,3267.48,2940.73,United Healthcare,Default,Fee Schedule,2666.26,,,,1927.81,2666.26
CONTINUUM MULTI-HOLE SHELL 58LL,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5282.05,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 58LL,C1776,HCPCS,278,RC,,both,7545.78,6791.2,Cigna,Default,Percent of Total Billed Charges,4452.01,,,,4452.01,6157.36
CONTINUUM MULTI-HOLE SHELL 58LL,C1776,HCPCS,278,RC,,both,7545.78,6791.2,United Healthcare,Default,Fee Schedule,6157.36,,,,4452.01,6157.36
VERSYS FM MC CLR 12X140MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8667.22,,,,7305.23,10103.51
VERSYS FM MC CLR 12X140MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,Cigna,Default,Percent of Total Billed Charges,7305.23,,,,7305.23,10103.51
VERSYS FM MC CLR 12X140MM STD NECK,C1776,HCPCS,278,RC,,both,12381.75,11143.58,United Healthcare,Default,Fee Schedule,10103.51,,,,7305.23,10103.51
MODULAR NEX B 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.34,,,,748.75,1035.55
MODULAR NEX B 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Cigna,Default,Percent of Total Billed Charges,748.75,,,,748.75,1035.55
MODULAR NEX B 12/14 NECK TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,United Healthcare,Default,Fee Schedule,1035.55,,,,748.75,1035.55
HIP PROSTHESIS TAPER SZ 16.25,C1776,HCPCS,278,RC,,both,6711.08,6039.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4697.76,,,,3959.54,5476.24
HIP PROSTHESIS TAPER SZ 16.25,C1776,HCPCS,278,RC,,both,6711.08,6039.97,Cigna,Default,Percent of Total Billed Charges,3959.54,,,,3959.54,5476.24
HIP PROSTHESIS TAPER SZ 16.25,C1776,HCPCS,278,RC,,both,6711.08,6039.97,United Healthcare,Default,Fee Schedule,5476.24,,,,3959.54,5476.24
HEAD METASUL LDH 44 CODE J TAPER 18/20,278,RC,,,,both,6703.69,6033.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4692.58,,,,3955.18,5470.21
HEAD METASUL LDH 44 CODE J TAPER 18/20,278,RC,,,,both,6703.69,6033.32,Cigna,Default,Percent of Total Billed Charges,3955.18,,,,3955.18,5470.21
HEAD METASUL LDH 44 CODE J TAPER 18/20,278,RC,,,,both,6703.69,6033.32,United Healthcare,Default,Fee Schedule,5470.21,,,,3955.18,5470.21
HEAD METASUL LDH 50 CODE P TAPER 18/20,278,RC,,,,both,7448.54,6703.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5213.98,,,,4394.64,6078.01
HEAD METASUL LDH 50 CODE P TAPER 18/20,278,RC,,,,both,7448.54,6703.69,Cigna,Default,Percent of Total Billed Charges,4394.64,,,,4394.64,6078.01
HEAD METASUL LDH 50 CODE P TAPER 18/20,278,RC,,,,both,7448.54,6703.69,United Healthcare,Default,Fee Schedule,6078.01,,,,4394.64,6078.01
VERSYS ADVOCATE CEMENTED STEM 11X120 STA,C1776,HCPCS,278,RC,,both,5429.54,4886.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3800.68,,,,3203.43,4430.5
VERSYS ADVOCATE CEMENTED STEM 11X120 STA,C1776,HCPCS,278,RC,,both,5429.54,4886.59,Cigna,Default,Percent of Total Billed Charges,3203.43,,,,3203.43,4430.5
VERSYS ADVOCATE CEMENTED STEM 11X120 STA,C1776,HCPCS,278,RC,,both,5429.54,4886.59,United Healthcare,Default,Fee Schedule,4430.5,,,,3203.43,4430.5
VERSYS DISTAL CENTRALIZER 11MM,C1713,HCPCS,278,RC,,both,243.55,219.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,170.48,,,,143.69,198.74
VERSYS DISTAL CENTRALIZER 11MM,C1713,HCPCS,278,RC,,both,243.55,219.2,Cigna,Default,Percent of Total Billed Charges,143.69,,,,143.69,198.74
VERSYS DISTAL CENTRALIZER 11MM,C1713,HCPCS,278,RC,,both,243.55,219.2,United Healthcare,Default,Fee Schedule,198.74,,,,143.69,198.74
12/14 COCR FEMORAL HEAD 36MM +7.0,C1776,HCPCS,278,RC,,both,2772.86,2495.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1941,,,,1635.99,2262.65
12/14 COCR FEMORAL HEAD 36MM +7.0,C1776,HCPCS,278,RC,,both,2772.86,2495.57,Cigna,Default,Percent of Total Billed Charges,1635.99,,,,1635.99,2262.65
12/14 COCR FEMORAL HEAD 36MM +7.0,C1776,HCPCS,278,RC,,both,2772.86,2495.57,United Healthcare,Default,Fee Schedule,2262.65,,,,1635.99,2262.65
HIVAC 7 SINGLE/DOUBLE SINGLE,C1713,HCPCS,278,RC,,both,914.05,822.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,639.84,,,,539.29,745.86
HIVAC 7 SINGLE/DOUBLE SINGLE,C1713,HCPCS,278,RC,,both,914.05,822.65,Cigna,Default,Percent of Total Billed Charges,539.29,,,,539.29,745.86
HIVAC 7 SINGLE/DOUBLE SINGLE,C1713,HCPCS,278,RC,,both,914.05,822.65,United Healthcare,Default,Fee Schedule,745.86,,,,539.29,745.86
BIPOLAR SHELL 53MM OD,C1776,HCPCS,278,RC,,both,1131.64,1018.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,792.15,,,,667.67,923.42
BIPOLAR SHELL 53MM OD,C1776,HCPCS,278,RC,,both,1131.64,1018.48,Cigna,Default,Percent of Total Billed Charges,667.67,,,,667.67,923.42
BIPOLAR SHELL 53MM OD,C1776,HCPCS,278,RC,,both,1131.64,1018.48,United Healthcare,Default,Fee Schedule,923.42,,,,667.67,923.42
VERSYS PRESS FIT LD/FX SZ 15X140MM,C1776,HCPCS,278,RC,,both,3080.14,2772.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2156.1,,,,1817.28,2513.39
VERSYS PRESS FIT LD/FX SZ 15X140MM,C1776,HCPCS,278,RC,,both,3080.14,2772.13,Cigna,Default,Percent of Total Billed Charges,1817.28,,,,1817.28,2513.39
VERSYS PRESS FIT LD/FX SZ 15X140MM,C1776,HCPCS,278,RC,,both,3080.14,2772.13,United Healthcare,Default,Fee Schedule,2513.39,,,,1817.28,2513.39
HIP PROSTHESIS TAPER SZ 11,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
HIP PROSTHESIS TAPER SZ 11,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
HIP PROSTHESIS TAPER SZ 11,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
32MM MOD HEAD COCR STD NECK,C1776,HCPCS,278,RC,,both,1396.29,1256.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,977.4,,,,823.81,1139.37
32MM MOD HEAD COCR STD NECK,C1776,HCPCS,278,RC,,both,1396.29,1256.66,Cigna,Default,Percent of Total Billed Charges,823.81,,,,823.81,1139.37
32MM MOD HEAD COCR STD NECK,C1776,HCPCS,278,RC,,both,1396.29,1256.66,United Healthcare,Default,Fee Schedule,1139.37,,,,823.81,1139.37
ACETABULAR METASUL DUROM 50/044 CODE J,278,RC,,,,both,15497.58,13947.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10848.31,,,,9143.57,12646.03
ACETABULAR METASUL DUROM 50/044 CODE J,278,RC,,,,both,15497.58,13947.82,Cigna,Default,Percent of Total Billed Charges,9143.57,,,,9143.57,12646.03
ACETABULAR METASUL DUROM 50/044 CODE J,278,RC,,,,both,15497.58,13947.82,United Healthcare,Default,Fee Schedule,12646.03,,,,9143.57,12646.03
ACETABULAR METASUL DUROM 56/050 CODE J,278,RC,,,,both,17219.52,15497.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12053.66,,,,10159.52,14051.13
ACETABULAR METASUL DUROM 56/050 CODE J,278,RC,,,,both,17219.52,15497.57,Cigna,Default,Percent of Total Billed Charges,10159.52,,,,10159.52,14051.13
ACETABULAR METASUL DUROM 56/050 CODE J,278,RC,,,,both,17219.52,15497.57,United Healthcare,Default,Fee Schedule,14051.13,,,,10159.52,14051.13
ACETABULAR COMPONENT STD 28MM,278,RC,,,,both,8682.12,7813.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6077.48,,,,5122.45,7084.61
ACETABULAR COMPONENT STD 28MM,278,RC,,,,both,8682.12,7813.91,Cigna,Default,Percent of Total Billed Charges,5122.45,,,,5122.45,7084.61
ACETABULAR COMPONENT STD 28MM,278,RC,,,,both,8682.12,7813.91,United Healthcare,Default,Fee Schedule,7084.61,,,,5122.45,7084.61
ACETABULAR COMPONENT ELEV RM 28MM,278,RC,,,,both,8682.12,7813.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6077.48,,,,5122.45,7084.61
ACETABULAR COMPONENT ELEV RM 28MM,278,RC,,,,both,8682.12,7813.91,Cigna,Default,Percent of Total Billed Charges,5122.45,,,,5122.45,7084.61
ACETABULAR COMPONENT ELEV RM 28MM,278,RC,,,,both,8682.12,7813.91,United Healthcare,Default,Fee Schedule,7084.61,,,,5122.45,7084.61
FEMORAL HEAD 28MM,278,RC,,,,both,4196.35,3776.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2937.44,,,,2475.85,3424.22
FEMORAL HEAD 28MM,278,RC,,,,both,4196.35,3776.72,Cigna,Default,Percent of Total Billed Charges,2475.85,,,,2475.85,3424.22
FEMORAL HEAD 28MM,278,RC,,,,both,4196.35,3776.72,United Healthcare,Default,Fee Schedule,3424.22,,,,2475.85,3424.22
M/L TAPER KINECTIV STEM SIZE 9,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
M/L TAPER KINECTIV STEM SIZE 9,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
M/L TAPER KINECTIV STEM SIZE 9,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
DISPOSABLE FLEXDRILL 15M,272,RC,,,,both,497.34,447.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,348.14,,,,293.43,405.83
DISPOSABLE FLEXDRILL 15M,272,RC,,,,both,497.34,447.61,Cigna,Default,Percent of Total Billed Charges,293.43,,,,293.43,405.83
DISPOSABLE FLEXDRILL 15M,272,RC,,,,both,497.34,447.61,United Healthcare,Default,Fee Schedule,405.83,,,,293.43,405.83
MODULAR NEX R NECK TAPER,C1776,HCPCS,278,RC,,both,2435.63,2192.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1704.94,,,,1437.02,1987.47
MODULAR NEX R NECK TAPER,C1776,HCPCS,278,RC,,both,2435.63,2192.07,Cigna,Default,Percent of Total Billed Charges,1437.02,,,,1437.02,1987.47
MODULAR NEX R NECK TAPER,C1776,HCPCS,278,RC,,both,2435.63,2192.07,United Healthcare,Default,Fee Schedule,1987.47,,,,1437.02,1987.47
MODULAR DRILL BIT 3.2X30,272,RC,,,,both,482.85,434.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,338,,,,284.88,394.01
MODULAR DRILL BIT 3.2X30,272,RC,,,,both,482.85,434.57,Cigna,Default,Percent of Total Billed Charges,284.88,,,,284.88,394.01
MODULAR DRILL BIT 3.2X30,272,RC,,,,both,482.85,434.57,United Healthcare,Default,Fee Schedule,394.01,,,,284.88,394.01
HEAD ADAPTER METASUL TAPER 12/14-18/20,278,RC,,,,both,716.27,644.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.39,,,,422.6,584.48
HEAD ADAPTER METASUL TAPER 12/14-18/20,278,RC,,,,both,716.27,644.64,Cigna,Default,Percent of Total Billed Charges,422.6,,,,422.6,584.48
HEAD ADAPTER METASUL TAPER 12/14-18/20,278,RC,,,,both,716.27,644.64,United Healthcare,Default,Fee Schedule,584.48,,,,422.6,584.48
DNO HIP PACK,272,RC,,,,both,904.39,813.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,633.07,,,,533.59,737.98
DNO HIP PACK,272,RC,,,,both,904.39,813.95,Cigna,Default,Percent of Total Billed Charges,533.59,,,,533.59,737.98
DNO HIP PACK,272,RC,,,,both,904.39,813.95,United Healthcare,Default,Fee Schedule,737.98,,,,533.59,737.98
M/L TAPER KINECTIV STEM SIZE 13.5,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4981.93,,,,4199.05,5807.5
M/L TAPER KINECTIV STEM SIZE 13.5,C1776,HCPCS,278,RC,,both,7117.04,6405.34,Cigna,Default,Percent of Total Billed Charges,4199.05,,,,4199.05,5807.5
M/L TAPER KINECTIV STEM SIZE 13.5,C1776,HCPCS,278,RC,,both,7117.04,6405.34,United Healthcare,Default,Fee Schedule,5807.5,,,,4199.05,5807.5
PSN ASF PS 10MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 10MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN FEM PS CMT CCR NRW SZ4 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4201.62,,,,3541.37,4897.89
PSN FEM PS CMT CCR NRW SZ4 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,Cigna,Default,Percent of Total Billed Charges,3541.37,,,,3541.37,4897.89
PSN FEM PS CMT CCR NRW SZ4 L,C1776,HCPCS,278,RC,,both,6002.32,5402.09,United Healthcare,Default,Fee Schedule,4897.89,,,,3541.37,4897.89
PSN FEM PS CMT CCR NRW SIZE 5 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4868.32,,,,4103.3,5675.07
PSN FEM PS CMT CCR NRW SIZE 5 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,Cigna,Default,Percent of Total Billed Charges,4103.3,,,,4103.3,5675.07
PSN FEM PS CMT CCR NRW SIZE 5 R,C1776,HCPCS,278,RC,,both,6954.74,6259.27,United Healthcare,Default,Fee Schedule,5675.07,,,,4103.3,5675.07
PSN ASF PS 10MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2169.24,,,,1828.36,2528.71
PSN ASF PS 10MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,Cigna,Default,Percent of Total Billed Charges,1828.36,,,,1828.36,2528.71
PSN ASF PS 10MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,3098.91,2789.02,United Healthcare,Default,Fee Schedule,2528.71,,,,1828.36,2528.71
PSN TIB STM 5 DEG SIZE D R,C1776,HCPCS,278,RC,,both,3349.98,3014.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2344.99,,,,1976.49,2733.58
PSN TIB STM 5 DEG SIZE D R,C1776,HCPCS,278,RC,,both,3349.98,3014.98,Cigna,Default,Percent of Total Billed Charges,1976.49,,,,1976.49,2733.58
PSN TIB STM 5 DEG SIZE D R,C1776,HCPCS,278,RC,,both,3349.98,3014.98,United Healthcare,Default,Fee Schedule,2733.58,,,,1976.49,2733.58
4 INCH INSERTION NEEDLE,272,RC,,,,both,484.4,435.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,339.08,,,,285.8,395.27
4 INCH INSERTION NEEDLE,272,RC,,,,both,484.4,435.96,Cigna,Default,Percent of Total Billed Charges,285.8,,,,285.8,395.27
4 INCH INSERTION NEEDLE,272,RC,,,,both,484.4,435.96,United Healthcare,Default,Fee Schedule,395.27,,,,285.8,395.27
CABLE & SLEEVE SET 1.6MM,272,RC,,,,both,1548.31,1393.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1083.82,,,,913.5,1263.42
CABLE & SLEEVE SET 1.6MM,272,RC,,,,both,1548.31,1393.48,Cigna,Default,Percent of Total Billed Charges,913.5,,,,913.5,1263.42
CABLE & SLEEVE SET 1.6MM,272,RC,,,,both,1548.31,1393.48,United Healthcare,Default,Fee Schedule,1263.42,,,,913.5,1263.42
"LEAD, NEUROSTIM TEST KIT",C1897,HCPCS,278,RC,,both,6859.8,6173.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4801.86,,,,4047.28,5597.6
"LEAD, NEUROSTIM TEST KIT",C1897,HCPCS,278,RC,,both,6859.8,6173.82,Cigna,Default,Percent of Total Billed Charges,4047.28,,,,4047.28,5597.6
"LEAD, NEUROSTIM TEST KIT",C1897,HCPCS,278,RC,,both,6859.8,6173.82,United Healthcare,Default,Fee Schedule,5597.6,,,,4047.28,5597.6
NEUROSTIM PATIENT TRIAL KIT,272,RC,,,,both,301.9,271.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.33,,,,178.12,246.35
NEUROSTIM PATIENT TRIAL KIT,272,RC,,,,both,301.9,271.71,Cigna,Default,Percent of Total Billed Charges,178.12,,,,178.12,246.35
NEUROSTIM PATIENT TRIAL KIT,272,RC,,,,both,301.9,271.71,United Healthcare,Default,Fee Schedule,246.35,,,,178.12,246.35
NEUROSTIM OR CABLE AND EXT,272,RC,,,,both,21.2,19.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.84,,,,12.51,17.3
NEUROSTIM OR CABLE AND EXT,272,RC,,,,both,21.2,19.08,Cigna,Default,Percent of Total Billed Charges,12.51,,,,12.51,17.3
NEUROSTIM OR CABLE AND EXT,272,RC,,,,both,21.2,19.08,United Healthcare,Default,Fee Schedule,17.3,,,,12.51,17.3
NEUROSTIM ENHANCED KIT W/T STYLET CAP,272,RC,,,,both,415.06,373.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,290.54,,,,244.89,338.69
NEUROSTIM ENHANCED KIT W/T STYLET CAP,272,RC,,,,both,415.06,373.55,Cigna,Default,Percent of Total Billed Charges,244.89,,,,244.89,338.69
NEUROSTIM ENHANCED KIT W/T STYLET CAP,272,RC,,,,both,415.06,373.55,United Healthcare,Default,Fee Schedule,338.69,,,,244.89,338.69
AFFIXUS HUMERAL PROX HUMEROUS LEFT LONG,C1713,HCPCS,278,RC,,both,7490.9,6741.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5243.63,,,,4419.63,6112.57
AFFIXUS HUMERAL PROX HUMEROUS LEFT LONG,C1713,HCPCS,278,RC,,both,7490.9,6741.81,Cigna,Default,Percent of Total Billed Charges,4419.63,,,,4419.63,6112.57
AFFIXUS HUMERAL PROX HUMEROUS LEFT LONG,C1713,HCPCS,278,RC,,both,7490.9,6741.81,United Healthcare,Default,Fee Schedule,6112.57,,,,4419.63,6112.57
SCREW BLUNT TIP AFFIXUS BLUNT TIP SCREW,C1713,HCPCS,278,RC,,both,761.38,685.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,532.97,,,,449.21,621.29
SCREW BLUNT TIP AFFIXUS BLUNT TIP SCREW,C1713,HCPCS,278,RC,,both,761.38,685.24,Cigna,Default,Percent of Total Billed Charges,449.21,,,,449.21,621.29
SCREW BLUNT TIP AFFIXUS BLUNT TIP SCREW,C1713,HCPCS,278,RC,,both,761.38,685.24,United Healthcare,Default,Fee Schedule,621.29,,,,449.21,621.29
ANN CORT BONE SCREW 4X24MM,C1713,HCPCS,278,RC,,both,737.58,663.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,516.31,,,,435.17,601.87
ANN CORT BONE SCREW 4X24MM,C1713,HCPCS,278,RC,,both,737.58,663.82,Cigna,Default,Percent of Total Billed Charges,435.17,,,,435.17,601.87
ANN CORT BONE SCREW 4X24MM,C1713,HCPCS,278,RC,,both,737.58,663.82,United Healthcare,Default,Fee Schedule,601.87,,,,435.17,601.87
LO-PRO LOCK SCREW SS 2.7 X 16MM,C1713,HCPCS,278,RC,,both,421.25,379.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,294.88,,,,248.54,343.74
LO-PRO LOCK SCREW SS 2.7 X 16MM,C1713,HCPCS,278,RC,,both,421.25,379.13,Cigna,Default,Percent of Total Billed Charges,248.54,,,,248.54,343.74
LO-PRO LOCK SCREW SS 2.7 X 16MM,C1713,HCPCS,278,RC,,both,421.25,379.13,United Healthcare,Default,Fee Schedule,343.74,,,,248.54,343.74
LO PRO LOCK SCRW SS 2.7X18MM,C1713,HCPCS,278,RC,,both,390.88,351.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,273.62,,,,230.62,318.96
LO PRO LOCK SCRW SS 2.7X18MM,C1713,HCPCS,278,RC,,both,390.88,351.79,Cigna,Default,Percent of Total Billed Charges,230.62,,,,230.62,318.96
LO PRO LOCK SCRW SS 2.7X18MM,C1713,HCPCS,278,RC,,both,390.88,351.79,United Healthcare,Default,Fee Schedule,318.96,,,,230.62,318.96
G-WIRE W/TRCT TIP .078X5.91 IN(2MMX150MM,C1769,HCPCS,272,RC,,both,33.99,30.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.79,,,,20.05,27.74
G-WIRE W/TRCT TIP .078X5.91 IN(2MMX150MM,C1769,HCPCS,272,RC,,both,33.99,30.59,Cigna,Default,Percent of Total Billed Charges,20.05,,,,20.05,27.74
G-WIRE W/TRCT TIP .078X5.91 IN(2MMX150MM,C1769,HCPCS,272,RC,,both,33.99,30.59,United Healthcare,Default,Fee Schedule,27.74,,,,20.05,27.74
LO PRO SCRW TM SS 3.5 X 14MMCORT,C1713,HCPCS,278,RC,,both,147.81,133.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.47,,,,87.21,120.61
LO PRO SCRW TM SS 3.5 X 14MMCORT,C1713,HCPCS,278,RC,,both,147.81,133.03,Cigna,Default,Percent of Total Billed Charges,87.21,,,,87.21,120.61
LO PRO SCRW TM SS 3.5 X 14MMCORT,C1713,HCPCS,278,RC,,both,147.81,133.03,United Healthcare,Default,Fee Schedule,120.61,,,,87.21,120.61
LO PRO SCRW TM SS 3.5X16MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.28,,,,70.19,97.08
LO PRO SCRW TM SS 3.5X16MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,Cigna,Default,Percent of Total Billed Charges,70.19,,,,70.19,97.08
LO PRO SCRW TM SS 3.5X16MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,United Healthcare,Default,Fee Schedule,97.08,,,,70.19,97.08
LO PRO SCRW TM SS 3.5X24MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.28,,,,70.19,97.08
LO PRO SCRW TM SS 3.5X24MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,Cigna,Default,Percent of Total Billed Charges,70.19,,,,70.19,97.08
LO PRO SCRW TM SS 3.5X24MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,United Healthcare,Default,Fee Schedule,97.08,,,,70.19,97.08
LOP PRO SCRW TM SS 3.5X50MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LOP PRO SCRW TM SS 3.5X50MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LOP PRO SCRW TM SS 3.5X50MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS  3.5X55MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.28,,,,70.19,97.08
LO PRO SCRW TM SS  3.5X55MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,Cigna,Default,Percent of Total Billed Charges,70.19,,,,70.19,97.08
LO PRO SCRW TM SS  3.5X55MMCORT,C1713,HCPCS,278,RC,,both,118.97,107.07,United Healthcare,Default,Fee Schedule,97.08,,,,70.19,97.08
LOW PROF SCRW SS 4.0X50MMCAN LNG THD,C1713,HCPCS,278,RC,,both,604.4,543.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,423.08,,,,356.6,493.19
LOW PROF SCRW SS 4.0X50MMCAN LNG THD,C1713,HCPCS,278,RC,,both,604.4,543.96,Cigna,Default,Percent of Total Billed Charges,356.6,,,,356.6,493.19
LOW PROF SCRW SS 4.0X50MMCAN LNG THD,C1713,HCPCS,278,RC,,both,604.4,543.96,United Healthcare,Default,Fee Schedule,493.19,,,,356.6,493.19
DRILL BIT 3.5 MM,272,RC,,,,both,270.96,243.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,189.67,,,,159.87,221.1
DRILL BIT 3.5 MM,272,RC,,,,both,270.96,243.86,Cigna,Default,Percent of Total Billed Charges,159.87,,,,159.87,221.1
DRILL BIT 3.5 MM,272,RC,,,,both,270.96,243.86,United Healthcare,Default,Fee Schedule,221.1,,,,159.87,221.1
DRILL BIT Q-C 2.6MM DRILL BIT CANNULATED,272,RC,,,,both,612.08,550.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,428.46,,,,361.13,499.46
DRILL BIT Q-C 2.6MM DRILL BIT CANNULATED,272,RC,,,,both,612.08,550.87,Cigna,Default,Percent of Total Billed Charges,361.13,,,,361.13,499.46
DRILL BIT Q-C 2.6MM DRILL BIT CANNULATED,272,RC,,,,both,612.08,550.87,United Healthcare,Default,Fee Schedule,499.46,,,,361.13,499.46
2.0MM DRILL BIT CALIBRATED,272,RC,,,,both,347.99,313.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.59,,,,205.31,283.96
2.0MM DRILL BIT CALIBRATED,272,RC,,,,both,347.99,313.19,Cigna,Default,Percent of Total Billed Charges,205.31,,,,205.31,283.96
2.0MM DRILL BIT CALIBRATED,272,RC,,,,both,347.99,313.19,United Healthcare,Default,Fee Schedule,283.96,,,,205.31,283.96
2.5MM DRILL BIT,272,RC,,,,both,311.36,280.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,217.95,,,,183.7,254.07
2.5MM DRILL BIT,272,RC,,,,both,311.36,280.22,Cigna,Default,Percent of Total Billed Charges,183.7,,,,183.7,254.07
2.5MM DRILL BIT,272,RC,,,,both,311.36,280.22,United Healthcare,Default,Fee Schedule,254.07,,,,183.7,254.07
2.5 MM DRILL BIT CALIBRATED,272,RC,,,,both,291.54,262.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,204.08,,,,172.01,237.9
2.5 MM DRILL BIT CALIBRATED,272,RC,,,,both,291.54,262.39,Cigna,Default,Percent of Total Billed Charges,172.01,,,,172.01,237.9
2.5 MM DRILL BIT CALIBRATED,272,RC,,,,both,291.54,262.39,United Healthcare,Default,Fee Schedule,237.9,,,,172.01,237.9
GUIDE WIRE TROCAR TIP 1.35MM,C1769,HCPCS,272,RC,,both,90.2,81.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.14,,,,53.22,73.6
GUIDE WIRE TROCAR TIP 1.35MM,C1769,HCPCS,272,RC,,both,90.2,81.18,Cigna,Default,Percent of Total Billed Charges,53.22,,,,53.22,73.6
GUIDE WIRE TROCAR TIP 1.35MM,C1769,HCPCS,272,RC,,both,90.2,81.18,United Healthcare,Default,Fee Schedule,73.6,,,,53.22,73.6
PATIENT TRIAL KIT,272,RC,,,,both,293.4,264.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,205.38,,,,173.11,239.41
PATIENT TRIAL KIT,272,RC,,,,both,293.4,264.06,Cigna,Default,Percent of Total Billed Charges,173.11,,,,173.11,239.41
PATIENT TRIAL KIT,272,RC,,,,both,293.4,264.06,United Healthcare,Default,Fee Schedule,239.41,,,,173.11,239.41
LOCK DISTAL FIBULA PLT SS RT 8H,C1713,HCPCS,278,RC,,both,2702.2,2431.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1891.54,,,,1594.3,2205
LOCK DISTAL FIBULA PLT SS RT 8H,C1713,HCPCS,278,RC,,both,2702.2,2431.98,Cigna,Default,Percent of Total Billed Charges,1594.3,,,,1594.3,2205
LOCK DISTAL FIBULA PLT SS RT 8H,C1713,HCPCS,278,RC,,both,2702.2,2431.98,United Healthcare,Default,Fee Schedule,2205,,,,1594.3,2205
COMP PRIMARY STEM 7MM MINI,C1776,HCPCS,278,RC,,both,13580.52,12222.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9506.36,,,,8012.51,11081.7
COMP PRIMARY STEM 7MM MINI,C1776,HCPCS,278,RC,,both,13580.52,12222.47,Cigna,Default,Percent of Total Billed Charges,8012.51,,,,8012.51,11081.7
COMP PRIMARY STEM 7MM MINI,C1776,HCPCS,278,RC,,both,13580.52,12222.47,United Healthcare,Default,Fee Schedule,11081.7,,,,8012.51,11081.7
Z NAIL10.5X120 LAG SCREW,C1713,HCPCS,278,RC,,both,1984.03,1785.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1388.82,,,,1170.58,1618.97
Z NAIL10.5X120 LAG SCREW,C1713,HCPCS,278,RC,,both,1984.03,1785.63,Cigna,Default,Percent of Total Billed Charges,1170.58,,,,1170.58,1618.97
Z NAIL10.5X120 LAG SCREW,C1713,HCPCS,278,RC,,both,1984.03,1785.63,United Healthcare,Default,Fee Schedule,1618.97,,,,1170.58,1618.97
Z NAIL 5.0 X 35 CORT SCREW FA,C1713,HCPCS,278,RC,,both,712.21,640.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,498.55,,,,420.2,581.16
Z NAIL 5.0 X 35 CORT SCREW FA,C1713,HCPCS,278,RC,,both,712.21,640.99,Cigna,Default,Percent of Total Billed Charges,420.2,,,,420.2,581.16
Z NAIL 5.0 X 35 CORT SCREW FA,C1713,HCPCS,278,RC,,both,712.21,640.99,United Healthcare,Default,Fee Schedule,581.16,,,,420.2,581.16
"CANNULA, TWIST-IN",C1713,HCPCS,278,RC,,both,88.23,79.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.76,,,,52.06,72
"CANNULA, TWIST-IN",C1713,HCPCS,278,RC,,both,88.23,79.41,Cigna,Default,Percent of Total Billed Charges,52.06,,,,52.06,72
"CANNULA, TWIST-IN",C1713,HCPCS,278,RC,,both,88.23,79.41,United Healthcare,Default,Fee Schedule,72,,,,52.06,72
SCOPE DISPOSABLE URETEROSCOPE,272,RC,,,,both,5144.85,4630.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3601.4,,,,3035.46,4198.2
SCOPE DISPOSABLE URETEROSCOPE,272,RC,,,,both,5144.85,4630.37,Cigna,Default,Percent of Total Billed Charges,3035.46,,,,3035.46,4198.2
SCOPE DISPOSABLE URETEROSCOPE,272,RC,,,,both,5144.85,4630.37,United Healthcare,Default,Fee Schedule,4198.2,,,,3035.46,4198.2
PROSTATE BX UROLOGY,272,RC,,,,both,1235.28,1111.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,864.7,,,,728.82,1007.99
PROSTATE BX UROLOGY,272,RC,,,,both,1235.28,1111.75,Cigna,Default,Percent of Total Billed Charges,728.82,,,,728.82,1007.99
PROSTATE BX UROLOGY,272,RC,,,,both,1235.28,1111.75,United Healthcare,Default,Fee Schedule,1007.99,,,,728.82,1007.99
PATHOLOGY KIT UROLOGY,272,RC,,,,both,91.26,82.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.88,,,,53.84,74.47
PATHOLOGY KIT UROLOGY,272,RC,,,,both,91.26,82.13,Cigna,Default,Percent of Total Billed Charges,53.84,,,,53.84,74.47
PATHOLOGY KIT UROLOGY,272,RC,,,,both,91.26,82.13,United Healthcare,Default,Fee Schedule,74.47,,,,53.84,74.47
16 CONTACT IMPLANTABLE PULSE GENERATOR K,C1820,HCPCS,278,RC,,both,72352.02,65116.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50646.41,,,,42687.69,59039.25
16 CONTACT IMPLANTABLE PULSE GENERATOR K,C1820,HCPCS,278,RC,,both,72352.02,65116.82,Cigna,Default,Percent of Total Billed Charges,42687.69,,,,42687.69,59039.25
16 CONTACT IMPLANTABLE PULSE GENERATOR K,C1820,HCPCS,278,RC,,both,72352.02,65116.82,United Healthcare,Default,Fee Schedule,59039.25,,,,42687.69,59039.25
35CM LONG TUNNELING TOOL,272,RC,,,,both,673.44,606.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,471.41,,,,397.33,549.53
35CM LONG TUNNELING TOOL,272,RC,,,,both,673.44,606.1,Cigna,Default,Percent of Total Billed Charges,397.33,,,,397.33,549.53
35CM LONG TUNNELING TOOL,272,RC,,,,both,673.44,606.1,United Healthcare,Default,Fee Schedule,549.53,,,,397.33,549.53
PRECESION PASSING ELEVATOR,272,RC,,,,both,203.67,183.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.57,,,,120.17,166.19
PRECESION PASSING ELEVATOR,272,RC,,,,both,203.67,183.3,Cigna,Default,Percent of Total Billed Charges,120.17,,,,120.17,166.19
PRECESION PASSING ELEVATOR,272,RC,,,,both,203.67,183.3,United Healthcare,Default,Fee Schedule,166.19,,,,120.17,166.19
M/L TAPER KINECTIV STEM SIZE 15,C1776,HCPCS,278,RC,,both,6905.81,6215.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4834.07,,,,4074.43,5635.14
M/L TAPER KINECTIV STEM SIZE 15,C1776,HCPCS,278,RC,,both,6905.81,6215.23,Cigna,Default,Percent of Total Billed Charges,4074.43,,,,4074.43,5635.14
M/L TAPER KINECTIV STEM SIZE 15,C1776,HCPCS,278,RC,,both,6905.81,6215.23,United Healthcare,Default,Fee Schedule,5635.14,,,,4074.43,5635.14
"BIOLOX DELTA FEM HEAD, 36MM, +0MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1740.68,,,,1467.14,2029.13
"BIOLOX DELTA FEM HEAD, 36MM, +0MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,Cigna,Default,Percent of Total Billed Charges,1467.14,,,,1467.14,2029.13
"BIOLOX DELTA FEM HEAD, 36MM, +0MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,United Healthcare,Default,Fee Schedule,2029.13,,,,1467.14,2029.13
CONTINUUM VIVACIT-E NEUTRAL LINER LL 36X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER LL 36X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
CONTINUUM VIVACIT-E NEUTRAL LINER LL 36X,C1776,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
STERLING BALLON 3X40X150,C1725,HCPCS,272,RC,,both,651.68,586.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,456.18,,,,384.49,531.77
STERLING BALLON 3X40X150,C1725,HCPCS,272,RC,,both,651.68,586.51,Cigna,Default,Percent of Total Billed Charges,384.49,,,,384.49,531.77
STERLING BALLON 3X40X150,C1725,HCPCS,272,RC,,both,651.68,586.51,United Healthcare,Default,Fee Schedule,531.77,,,,384.49,531.77
STERLING BALLON 4X40X135,C1725,HCPCS,272,RC,,both,651.68,586.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,456.18,,,,384.49,531.77
STERLING BALLON 4X40X135,C1725,HCPCS,272,RC,,both,651.68,586.51,Cigna,Default,Percent of Total Billed Charges,384.49,,,,384.49,531.77
STERLING BALLON 4X40X135,C1725,HCPCS,272,RC,,both,651.68,586.51,United Healthcare,Default,Fee Schedule,531.77,,,,384.49,531.77
"SABLE SPACER, 10X22,6-12 MM, 8 DEG.",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15005.82,,,,12647.76,17492.49
"SABLE SPACER, 10X22,6-12 MM, 8 DEG.",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Cigna,Default,Percent of Total Billed Charges,12647.76,,,,12647.76,17492.49
"SABLE SPACER, 10X22,6-12 MM, 8 DEG.",C1889,HCPCS,278,RC,,both,21436.88,19293.19,United Healthcare,Default,Fee Schedule,17492.49,,,,12647.76,17492.49
VIABAHN BX BALLON EXP ENDO/6MMX39MM 7FR8,C1874,HCPCS,278,RC,,both,10828.19,9745.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7579.73,,,,6388.63,8835.8
VIABAHN BX BALLON EXP ENDO/6MMX39MM 7FR8,C1874,HCPCS,278,RC,,both,10828.19,9745.37,Cigna,Default,Percent of Total Billed Charges,6388.63,,,,6388.63,8835.8
VIABAHN BX BALLON EXP ENDO/6MMX39MM 7FR8,C1874,HCPCS,278,RC,,both,10828.19,9745.37,United Healthcare,Default,Fee Schedule,8835.8,,,,6388.63,8835.8
"SABLE SPACER 10X26, 7-14MM, 15 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15005.82,,,,12647.76,17492.49
"SABLE SPACER 10X26, 7-14MM, 15 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Cigna,Default,Percent of Total Billed Charges,12647.76,,,,12647.76,17492.49
"SABLE SPACER 10X26, 7-14MM, 15 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,United Healthcare,Default,Fee Schedule,17492.49,,,,12647.76,17492.49
"SABLE SPACER 10X26, 9-16 MM, 8 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15005.82,,,,12647.76,17492.49
"SABLE SPACER 10X26, 9-16 MM, 8 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Cigna,Default,Percent of Total Billed Charges,12647.76,,,,12647.76,17492.49
"SABLE SPACER 10X26, 9-16 MM, 8 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,United Healthcare,Default,Fee Schedule,17492.49,,,,12647.76,17492.49
PSN TIB STM 5 DEG SZ H L,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
PSN TIB STM 5 DEG SZ H L,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
PSN TIB STM 5 DEG SZ H L,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
CABLE READY PIN ASSY 4MMX 40MM,C1713,HCPCS,278,RC,,both,1889.21,1700.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1322.45,,,,1114.63,1541.6
CABLE READY PIN ASSY 4MMX 40MM,C1713,HCPCS,278,RC,,both,1889.21,1700.29,Cigna,Default,Percent of Total Billed Charges,1114.63,,,,1114.63,1541.6
CABLE READY PIN ASSY 4MMX 40MM,C1713,HCPCS,278,RC,,both,1889.21,1700.29,United Healthcare,Default,Fee Schedule,1541.6,,,,1114.63,1541.6
PSN ASF PS 14MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3008.65,2707.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2106.06,,,,1775.1,2455.06
PSN ASF PS 14MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3008.65,2707.79,Cigna,Default,Percent of Total Billed Charges,1775.1,,,,1775.1,2455.06
PSN ASF PS 14MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3008.65,2707.79,United Healthcare,Default,Fee Schedule,2455.06,,,,1775.1,2455.06
*PSN FEM PS CMT CCR NRW SZ6 L,C1776,HCPCS,278,RC,,both,6752.17,6076.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4726.52,,,,3983.78,5509.77
*PSN FEM PS CMT CCR NRW SZ6 L,C1776,HCPCS,278,RC,,both,6752.17,6076.95,Cigna,Default,Percent of Total Billed Charges,3983.78,,,,3983.78,5509.77
*PSN FEM PS CMT CCR NRW SZ6 L,C1776,HCPCS,278,RC,,both,6752.17,6076.95,United Healthcare,Default,Fee Schedule,5509.77,,,,3983.78,5509.77
ARCOS 15X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
ARCOS 15X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
ARCOS 15X175MM BRCH BODY STD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
RF CALIBRATED DRILL 4.3MM,271,RC,,,,both,382.78,344.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.95,,,,225.84,312.35
RF CALIBRATED DRILL 4.3MM,271,RC,,,,both,382.78,344.5,Cigna,Default,Percent of Total Billed Charges,225.84,,,,225.84,312.35
RF CALIBRATED DRILL 4.3MM,271,RC,,,,both,382.78,344.5,United Healthcare,Default,Fee Schedule,312.35,,,,225.84,312.35
RF CALIBRATED DRILL 4.9MM,271,RC,,,,both,1457.04,1311.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1019.93,,,,859.65,1188.94
RF CALIBRATED DRILL 4.9MM,271,RC,,,,both,1457.04,1311.34,Cigna,Default,Percent of Total Billed Charges,859.65,,,,859.65,1188.94
RF CALIBRATED DRILL 4.9MM,271,RC,,,,both,1457.04,1311.34,United Healthcare,Default,Fee Schedule,1188.94,,,,859.65,1188.94
Z NAIL 6.0X40 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.33,,,,422.55,584.4
Z NAIL 6.0X40 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,Cigna,Default,Percent of Total Billed Charges,422.55,,,,422.55,584.4
Z NAIL 6.0X40 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,United Healthcare,Default,Fee Schedule,584.4,,,,422.55,584.4
"SABLE SPACER 10X26, 7-14MM, 15 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15005.82,,,,12647.76,17492.49
"SABLE SPACER 10X26, 7-14MM, 15 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Cigna,Default,Percent of Total Billed Charges,12647.76,,,,12647.76,17492.49
"SABLE SPACER 10X26, 7-14MM, 15 DEGREE",C1889,HCPCS,278,RC,,both,21436.88,19293.19,United Healthcare,Default,Fee Schedule,17492.49,,,,12647.76,17492.49
Z NAIL 6.0X70 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.33,,,,422.55,584.4
Z NAIL 6.0X70 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,Cigna,Default,Percent of Total Billed Charges,422.55,,,,422.55,584.4
Z NAIL 6.0X70 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,United Healthcare,Default,Fee Schedule,584.4,,,,422.55,584.4
Z NAIL 6.0X85 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.33,,,,422.55,584.4
Z NAIL 6.0X85 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,Cigna,Default,Percent of Total Billed Charges,422.55,,,,422.55,584.4
Z NAIL 6.0X85 CANC SCREW FA,C1713,HCPCS,278,RC,,both,716.18,644.56,United Healthcare,Default,Fee Schedule,584.4,,,,422.55,584.4
Z NAIL RF 11.5MMX20CM UNIV,C1776,HCPCS,278,RC,,both,7532.06,6778.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5272.44,,,,4443.92,6146.16
Z NAIL RF 11.5MMX20CM UNIV,C1776,HCPCS,278,RC,,both,7532.06,6778.85,Cigna,Default,Percent of Total Billed Charges,4443.92,,,,4443.92,6146.16
Z NAIL RF 11.5MMX20CM UNIV,C1776,HCPCS,278,RC,,both,7532.06,6778.85,United Healthcare,Default,Fee Schedule,6146.16,,,,4443.92,6146.16
NCB CORT SCREW 5.0X 14MM SELF TAPPING,C1713,HCPCS,278,RC,,both,580.35,522.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,406.24,,,,342.41,473.57
NCB CORT SCREW 5.0X 14MM SELF TAPPING,C1713,HCPCS,278,RC,,both,580.35,522.32,Cigna,Default,Percent of Total Billed Charges,342.41,,,,342.41,473.57
NCB CORT SCREW 5.0X 14MM SELF TAPPING,C1713,HCPCS,278,RC,,both,580.35,522.32,United Healthcare,Default,Fee Schedule,473.57,,,,342.41,473.57
PSN FEM PS CMT CCR NRW SZ9 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CCR NRW SZ9 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CCR NRW SZ9 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
PSN ASF PS 13MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 13MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 13MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
BIOLOAR SHELL 44MM OD,C1776,HCPCS,278,RC,,both,1098.7,988.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,769.09,,,,648.23,896.54
BIOLOAR SHELL 44MM OD,C1776,HCPCS,278,RC,,both,1098.7,988.83,Cigna,Default,Percent of Total Billed Charges,648.23,,,,648.23,896.54
BIOLOAR SHELL 44MM OD,C1776,HCPCS,278,RC,,both,1098.7,988.83,United Healthcare,Default,Fee Schedule,896.54,,,,648.23,896.54
BIPOLAR LINER 44/45/46MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,666,599.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,466.2,,,,392.94,543.46
BIPOLAR LINER 44/45/46MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,666,599.4,Cigna,Default,Percent of Total Billed Charges,392.94,,,,392.94,543.46
BIPOLAR LINER 44/45/46MM OD X 28MM ID,C1776,HCPCS,278,RC,,both,666,599.4,United Healthcare,Default,Fee Schedule,543.46,,,,392.94,543.46
PSN FEM PS CMT CRR NRW SZ8 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CRR NRW SZ8 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CRR NRW SZ8 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
STENT EXPRESS LD ILIAC BIL OTW 5MMX17MM,C1874,HCPCS,278,RC,,both,3837.99,3454.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2686.59,,,,2264.41,3131.8
STENT EXPRESS LD ILIAC BIL OTW 5MMX17MM,C1874,HCPCS,278,RC,,both,3837.99,3454.19,Cigna,Default,Percent of Total Billed Charges,2264.41,,,,2264.41,3131.8
STENT EXPRESS LD ILIAC BIL OTW 5MMX17MM,C1874,HCPCS,278,RC,,both,3837.99,3454.19,United Healthcare,Default,Fee Schedule,3131.8,,,,2264.41,3131.8
PSN FEM PS CMT CCR STD SZ9 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ9 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ9 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
PSN ASF PS 12MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 12MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 12MM VE R 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
"INDEPENDENCE MIS SPACER, 24X30MM 15DEG",C1889,HCPCS,278,RC,,both,27439.2,24695.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19207.44,,,,16189.13,22390.39
"INDEPENDENCE MIS SPACER, 24X30MM 15DEG",C1889,HCPCS,278,RC,,both,27439.2,24695.28,Cigna,Default,Percent of Total Billed Charges,16189.13,,,,16189.13,22390.39
"INDEPENDENCE MIS SPACER, 24X30MM 15DEG",C1889,HCPCS,278,RC,,both,27439.2,24695.28,United Healthcare,Default,Fee Schedule,22390.39,,,,16189.13,22390.39
"LUMBAR ANCHOR, 25MM",C1713,HCPCS,278,RC,,both,1665,1498.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1165.5,,,,982.35,1358.64
"LUMBAR ANCHOR, 25MM",C1713,HCPCS,278,RC,,both,1665,1498.5,Cigna,Default,Percent of Total Billed Charges,982.35,,,,982.35,1358.64
"LUMBAR ANCHOR, 25MM",C1713,HCPCS,278,RC,,both,1665,1498.5,United Healthcare,Default,Fee Schedule,1358.64,,,,982.35,1358.64
PSN ASF PS 12MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 12MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 12MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
PSN ASF PS 12MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 12MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 12MM VE L 3-5 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
"DNO INSULATED EXTENSION BLADE HEX6""",272,RC,,,,both,25.54,22.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.88,,,,15.07,20.84
"DNO INSULATED EXTENSION BLADE HEX6""",272,RC,,,,both,25.54,22.99,Cigna,Default,Percent of Total Billed Charges,15.07,,,,15.07,20.84
"DNO INSULATED EXTENSION BLADE HEX6""",272,RC,,,,both,25.54,22.99,United Healthcare,Default,Fee Schedule,20.84,,,,15.07,20.84
COATED STRAIGHT LAP ELECTORDE 36CM,272,RC,,,,both,144.69,130.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.28,,,,85.37,118.07
COATED STRAIGHT LAP ELECTORDE 36CM,272,RC,,,,both,144.69,130.22,Cigna,Default,Percent of Total Billed Charges,85.37,,,,85.37,118.07
COATED STRAIGHT LAP ELECTORDE 36CM,272,RC,,,,both,144.69,130.22,United Healthcare,Default,Fee Schedule,118.07,,,,85.37,118.07
PACK SPINE CUSTOM,272,RC,,,,both,533.28,479.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,373.3,,,,314.64,435.16
PACK SPINE CUSTOM,272,RC,,,,both,533.28,479.95,Cigna,Default,Percent of Total Billed Charges,314.64,,,,314.64,435.16
PACK SPINE CUSTOM,272,RC,,,,both,533.28,479.95,United Healthcare,Default,Fee Schedule,435.16,,,,314.64,435.16
DNO PACK MINOR SETUP TRAY,272,RC,,,,both,169.66,152.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.76,,,,100.1,138.44
DNO PACK MINOR SETUP TRAY,272,RC,,,,both,169.66,152.69,Cigna,Default,Percent of Total Billed Charges,100.1,,,,100.1,138.44
DNO PACK MINOR SETUP TRAY,272,RC,,,,both,169.66,152.69,United Healthcare,Default,Fee Schedule,138.44,,,,100.1,138.44
LOCKING SCREW 2.7 X  10MM,C1713,HCPCS,278,RC,,both,1461.87,1315.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1023.31,,,,862.5,1192.89
LOCKING SCREW 2.7 X  10MM,C1713,HCPCS,278,RC,,both,1461.87,1315.68,Cigna,Default,Percent of Total Billed Charges,862.5,,,,862.5,1192.89
LOCKING SCREW 2.7 X  10MM,C1713,HCPCS,278,RC,,both,1461.87,1315.68,United Healthcare,Default,Fee Schedule,1192.89,,,,862.5,1192.89
LOCKING SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,1461.87,1315.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1023.31,,,,862.5,1192.89
LOCKING SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,1461.87,1315.68,Cigna,Default,Percent of Total Billed Charges,862.5,,,,862.5,1192.89
LOCKING SCREW 2.7X12MM,C1713,HCPCS,278,RC,,both,1461.87,1315.68,United Healthcare,Default,Fee Schedule,1192.89,,,,862.5,1192.89
DRILL BIT 2.5 X 30MM,C1713,HCPCS,278,RC,,both,1165.5,1048.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,815.85,,,,687.64,951.05
DRILL BIT 2.5 X 30MM,C1713,HCPCS,278,RC,,both,1165.5,1048.95,Cigna,Default,Percent of Total Billed Charges,687.64,,,,687.64,951.05
DRILL BIT 2.5 X 30MM,C1713,HCPCS,278,RC,,both,1165.5,1048.95,United Healthcare,Default,Fee Schedule,951.05,,,,687.64,951.05
K-WIRE 1.4X150MM BLUNT/TROCAR,C1713,HCPCS,278,RC,,both,179.82,161.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.87,,,,106.09,146.73
K-WIRE 1.4X150MM BLUNT/TROCAR,C1713,HCPCS,278,RC,,both,179.82,161.84,Cigna,Default,Percent of Total Billed Charges,106.09,,,,106.09,146.73
K-WIRE 1.4X150MM BLUNT/TROCAR,C1713,HCPCS,278,RC,,both,179.82,161.84,United Healthcare,Default,Fee Schedule,146.73,,,,106.09,146.73
MTP PLATE LEFT,C1713,HCPCS,278,RC,,both,12311.01,11079.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8617.71,,,,7263.5,10045.78
MTP PLATE LEFT,C1713,HCPCS,278,RC,,both,12311.01,11079.91,Cigna,Default,Percent of Total Billed Charges,7263.5,,,,7263.5,10045.78
MTP PLATE LEFT,C1713,HCPCS,278,RC,,both,12311.01,11079.91,United Healthcare,Default,Fee Schedule,10045.78,,,,7263.5,10045.78
SCREW LAG 3.5 X 18MM,C1713,HCPCS,278,RC,,both,1658.34,1492.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1160.84,,,,978.42,1353.21
SCREW LAG 3.5 X 18MM,C1713,HCPCS,278,RC,,both,1658.34,1492.51,Cigna,Default,Percent of Total Billed Charges,978.42,,,,978.42,1353.21
SCREW LAG 3.5 X 18MM,C1713,HCPCS,278,RC,,both,1658.34,1492.51,United Healthcare,Default,Fee Schedule,1353.21,,,,978.42,1353.21
LO-PRO LOCK SCREW SS 2.7X18MM,C1713,HCPCS,278,RC,,both,382.95,344.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.06,,,,225.94,312.49
LO-PRO LOCK SCREW SS 2.7X18MM,C1713,HCPCS,278,RC,,both,382.95,344.66,Cigna,Default,Percent of Total Billed Charges,225.94,,,,225.94,312.49
LO-PRO LOCK SCREW SS 2.7X18MM,C1713,HCPCS,278,RC,,both,382.95,344.66,United Healthcare,Default,Fee Schedule,312.49,,,,225.94,312.49
CACELLOUS SCREW 3.0 X 18MM,C1713,HCPCS,278,RC,,both,143.5,129.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.45,,,,84.66,117.1
CACELLOUS SCREW 3.0 X 18MM,C1713,HCPCS,278,RC,,both,143.5,129.15,Cigna,Default,Percent of Total Billed Charges,84.66,,,,84.66,117.1
CACELLOUS SCREW 3.0 X 18MM,C1713,HCPCS,278,RC,,both,143.5,129.15,United Healthcare,Default,Fee Schedule,117.1,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 18MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.45,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 18MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Cigna,Default,Percent of Total Billed Charges,84.66,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 18MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,United Healthcare,Default,Fee Schedule,117.1,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 26MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.45,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 26MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Cigna,Default,Percent of Total Billed Charges,84.66,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 26MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,United Healthcare,Default,Fee Schedule,117.1,,,,84.66,117.1
5 HOLE LOCKING DISTAL FIB PLATE R,C1713,HCPCS,278,RC,,both,2414.25,2172.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1689.98,,,,1424.41,1970.03
5 HOLE LOCKING DISTAL FIB PLATE R,C1713,HCPCS,278,RC,,both,2414.25,2172.83,Cigna,Default,Percent of Total Billed Charges,1424.41,,,,1424.41,1970.03
5 HOLE LOCKING DISTAL FIB PLATE R,C1713,HCPCS,278,RC,,both,2414.25,2172.83,United Healthcare,Default,Fee Schedule,1970.03,,,,1424.41,1970.03
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,233.1,209.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.17,,,,137.53,190.21
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,233.1,209.79,Cigna,Default,Percent of Total Billed Charges,137.53,,,,137.53,190.21
DISTRACTION PIN 12MM,C1713,HCPCS,278,RC,,both,233.1,209.79,United Healthcare,Default,Fee Schedule,190.21,,,,137.53,190.21
AFB1115-AVAFLEXBALLOON 10G 15MM,C1889,HCPCS,278,RC,,both,8576.42,7718.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6003.49,,,,5060.09,6998.36
AFB1115-AVAFLEXBALLOON 10G 15MM,C1889,HCPCS,278,RC,,both,8576.42,7718.78,Cigna,Default,Percent of Total Billed Charges,5060.09,,,,5060.09,6998.36
AFB1115-AVAFLEXBALLOON 10G 15MM,C1889,HCPCS,278,RC,,both,8576.42,7718.78,United Healthcare,Default,Fee Schedule,6998.36,,,,5060.09,6998.36
"NIKO SPACER 14X16, 3.5/3.5 DEG, 21MM",C1889,HCPCS,278,RC,,both,13320,11988,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9324,,,,7858.8,10869.12
"NIKO SPACER 14X16, 3.5/3.5 DEG, 21MM",C1889,HCPCS,278,RC,,both,13320,11988,Cigna,Default,Percent of Total Billed Charges,7858.8,,,,7858.8,10869.12
"NIKO SPACER 14X16, 3.5/3.5 DEG, 21MM",C1889,HCPCS,278,RC,,both,13320,11988,United Healthcare,Default,Fee Schedule,10869.12,,,,7858.8,10869.12
2-0 FW BLUE W/TPR 3/8CIR NEEDLE,272,RC,,,,both,90.2,81.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.14,,,,53.22,73.6
2-0 FW BLUE W/TPR 3/8CIR NEEDLE,272,RC,,,,both,90.2,81.18,Cigna,Default,Percent of Total Billed Charges,53.22,,,,53.22,73.6
2-0 FW BLUE W/TPR 3/8CIR NEEDLE,272,RC,,,,both,90.2,81.18,United Healthcare,Default,Fee Schedule,73.6,,,,53.22,73.6
"DUAL-FLEX GUIDEWIRE .035""X150CM, ANGLED",272,RC,,,,both,175.88,158.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.12,,,,103.77,143.52
"DUAL-FLEX GUIDEWIRE .035""X150CM, ANGLED",272,RC,,,,both,175.88,158.29,Cigna,Default,Percent of Total Billed Charges,103.77,,,,103.77,143.52
"DUAL-FLEX GUIDEWIRE .035""X150CM, ANGLED",272,RC,,,,both,175.88,158.29,United Healthcare,Default,Fee Schedule,143.52,,,,103.77,143.52
PSN TIB STM 5 DEG SIZE C R,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
PSN TIB STM 5 DEG SIZE C R,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
PSN TIB STM 5 DEG SIZE C R,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
PSN ASF PS 16MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 16MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 16MM VE R 3-5 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
ASSURITY PACEMAKER MRI,C1785,HCPCS,275,RC,,both,14652,13186.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10256.4,,,,8644.68,11956.03
ASSURITY PACEMAKER MRI,C1785,HCPCS,275,RC,,both,14652,13186.8,Cigna,Default,Percent of Total Billed Charges,8644.68,,,,8644.68,11956.03
ASSURITY PACEMAKER MRI,C1785,HCPCS,275,RC,,both,14652,13186.8,United Healthcare,Default,Fee Schedule,11956.03,,,,8644.68,11956.03
"US STR POUCH ASSY, LEAD CAP",272,RC,,,,both,149.85,134.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.9,,,,88.41,122.28
"US STR POUCH ASSY, LEAD CAP",272,RC,,,,both,149.85,134.87,Cigna,Default,Percent of Total Billed Charges,88.41,,,,88.41,122.28
"US STR POUCH ASSY, LEAD CAP",272,RC,,,,both,149.85,134.87,United Healthcare,Default,Fee Schedule,122.28,,,,88.41,122.28
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3300,2970,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2310,,,,1947,2692.8
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3300,2970,Cigna,Default,Percent of Total Billed Charges,1947,,,,1947,2692.8
RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,L8699,HCPCS,278,RC,,both,3300,2970,United Healthcare,Default,Fee Schedule,2692.8,,,,1947,2692.8
PSN ASF PS 12MM VE R 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 12MM VE R 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 12MM VE R 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
SPEEDIE CATH MALE 14FX14,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SPEEDIE CATH MALE 14FX14,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SPEEDIE CATH MALE 14FX14,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
SPEEDIE CATH MALE 16 FRX14,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SPEEDIE CATH MALE 16 FRX14,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SPEEDIE CATH MALE 16 FRX14,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
MOBI-C CERVICAL DISC PROSTHESIS 13 X 15,L8699,HCPCS,278,RC,,both,14851.8,13366.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10396.26,,,,8762.56,12119.07
MOBI-C CERVICAL DISC PROSTHESIS 13 X 15,L8699,HCPCS,278,RC,,both,14851.8,13366.62,Cigna,Default,Percent of Total Billed Charges,8762.56,,,,8762.56,12119.07
MOBI-C CERVICAL DISC PROSTHESIS 13 X 15,L8699,HCPCS,278,RC,,both,14851.8,13366.62,United Healthcare,Default,Fee Schedule,12119.07,,,,8762.56,12119.07
DYNJS0164 MINOR SET UP PACK,272,RC,,,,both,179.99,161.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.99,,,,106.19,146.87
DYNJS0164 MINOR SET UP PACK,272,RC,,,,both,179.99,161.99,Cigna,Default,Percent of Total Billed Charges,106.19,,,,106.19,146.87
DYNJS0164 MINOR SET UP PACK,272,RC,,,,both,179.99,161.99,United Healthcare,Default,Fee Schedule,146.87,,,,106.19,146.87
1200 PSI TUBING,272,RC,,,,both,25.17,22.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.62,,,,14.85,20.54
1200 PSI TUBING,272,RC,,,,both,25.17,22.65,Cigna,Default,Percent of Total Billed Charges,14.85,,,,14.85,20.54
1200 PSI TUBING,272,RC,,,,both,25.17,22.65,United Healthcare,Default,Fee Schedule,20.54,,,,14.85,20.54
SURSEAL ENDOSCOPIC VALVE,272,RC,,,,both,57.4,51.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.18,,,,33.87,46.84
SURSEAL ENDOSCOPIC VALVE,272,RC,,,,both,57.4,51.66,Cigna,Default,Percent of Total Billed Charges,33.87,,,,33.87,46.84
SURSEAL ENDOSCOPIC VALVE,272,RC,,,,both,57.4,51.66,United Healthcare,Default,Fee Schedule,46.84,,,,33.87,46.84
PSN MC VE ASF PS L 13MM VE 10-12 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN MC VE ASF PS L 13MM VE 10-12 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN MC VE ASF PS L 13MM VE 10-12 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
"HEDRON P SPACER 10X26, 8MM 8 DEG",C1889,HCPCS,278,RC,,both,14152.5,12737.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9906.75,,,,8349.98,11548.44
"HEDRON P SPACER 10X26, 8MM 8 DEG",C1889,HCPCS,278,RC,,both,14152.5,12737.25,Cigna,Default,Percent of Total Billed Charges,8349.98,,,,8349.98,11548.44
"HEDRON P SPACER 10X26, 8MM 8 DEG",C1889,HCPCS,278,RC,,both,14152.5,12737.25,United Healthcare,Default,Fee Schedule,11548.44,,,,8349.98,11548.44
PSN ASF PS 11MM VE L 3-5 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 11MM VE L 3-5 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 11MM VE L 3-5 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
ANNULOTOMY KNIFE,272,RC,,,,both,1665,1498.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1165.5,,,,982.35,1358.64
ANNULOTOMY KNIFE,272,RC,,,,both,1665,1498.5,Cigna,Default,Percent of Total Billed Charges,982.35,,,,982.35,1358.64
ANNULOTOMY KNIFE,272,RC,,,,both,1665,1498.5,United Healthcare,Default,Fee Schedule,1358.64,,,,982.35,1358.64
"INDEPENDENCE MIS SPACER, 24X30MM 15DEG 1",C1889,HCPCS,278,RC,,both,27439.2,24695.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19207.44,,,,16189.13,22390.39
"INDEPENDENCE MIS SPACER, 24X30MM 15DEG 1",C1889,HCPCS,278,RC,,both,27439.2,24695.28,Cigna,Default,Percent of Total Billed Charges,16189.13,,,,16189.13,22390.39
"INDEPENDENCE MIS SPACER, 24X30MM 15DEG 1",C1889,HCPCS,278,RC,,both,27439.2,24695.28,United Healthcare,Default,Fee Schedule,22390.39,,,,16189.13,22390.39
K-WIRES,272,RC,,,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
K-WIRES,272,RC,,,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
K-WIRES,272,RC,,,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
BIPOLAR FORCEPS BAYON.STRAIGHT,272,RC,,,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
BIPOLAR FORCEPS BAYON.STRAIGHT,272,RC,,,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
BIPOLAR FORCEPS BAYON.STRAIGHT,272,RC,,,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
ILLUMINATION SYSTEM,C1713,HCPCS,278,RC,,both,3330,2997,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2331,,,,1964.7,2717.28
ILLUMINATION SYSTEM,C1713,HCPCS,278,RC,,both,3330,2997,Cigna,Default,Percent of Total Billed Charges,1964.7,,,,1964.7,2717.28
ILLUMINATION SYSTEM,C1713,HCPCS,278,RC,,both,3330,2997,United Healthcare,Default,Fee Schedule,2717.28,,,,1964.7,2717.28
"RISE SPACER, 18X50MM, 7-14MM, 3-15 DEGRE",C1889,HCPCS,278,RC,,both,27439.2,24695.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19207.44,,,,16189.13,22390.39
"RISE SPACER, 18X50MM, 7-14MM, 3-15 DEGRE",C1889,HCPCS,278,RC,,both,27439.2,24695.28,Cigna,Default,Percent of Total Billed Charges,16189.13,,,,16189.13,22390.39
"RISE SPACER, 18X50MM, 7-14MM, 3-15 DEGRE",C1889,HCPCS,278,RC,,both,27439.2,24695.28,United Healthcare,Default,Fee Schedule,22390.39,,,,16189.13,22390.39
".35"" SIMMONS 1 CATH 4 FR. 65CM",272,RC,,,,both,49.2,44.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.44,,,,29.03,40.15
".35"" SIMMONS 1 CATH 4 FR. 65CM",272,RC,,,,both,49.2,44.28,Cigna,Default,Percent of Total Billed Charges,29.03,,,,29.03,40.15
".35"" SIMMONS 1 CATH 4 FR. 65CM",272,RC,,,,both,49.2,44.28,United Healthcare,Default,Fee Schedule,40.15,,,,29.03,40.15
PSN MC VE ASF L 16MM 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN MC VE ASF L 16MM 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN MC VE ASF L 16MM 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
MINIONE BUTTON 24FR SIZE 2.5 CM,272,RC,,,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 2.5 CM,272,RC,,,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 2.5 CM,272,RC,,,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 3.0CM,272,RC,,,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 3.0CM,272,RC,,,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 3.0CM,272,RC,,,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 3.5CM,272,RC,,,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 3.5CM,272,RC,,,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
MINIONE BUTTON 24FR SIZE 3.5CM,272,RC,,,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
"SABLE SPACER, 10X30,6-12 MM, 8 DEG.",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15005.82,,,,12647.76,17492.49
"SABLE SPACER, 10X30,6-12 MM, 8 DEG.",C1889,HCPCS,278,RC,,both,21436.88,19293.19,Cigna,Default,Percent of Total Billed Charges,12647.76,,,,12647.76,17492.49
"SABLE SPACER, 10X30,6-12 MM, 8 DEG.",C1889,HCPCS,278,RC,,both,21436.88,19293.19,United Healthcare,Default,Fee Schedule,17492.49,,,,12647.76,17492.49
"ELSA SPACER 20 X 55MM, 8-17MM, 5-20 DEG.",C1889,HCPCS,278,RC,,both,35842.46,32258.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25089.72,,,,21147.05,29247.45
"ELSA SPACER 20 X 55MM, 8-17MM, 5-20 DEG.",C1889,HCPCS,278,RC,,both,35842.46,32258.21,Cigna,Default,Percent of Total Billed Charges,21147.05,,,,21147.05,29247.45
"ELSA SPACER 20 X 55MM, 8-17MM, 5-20 DEG.",C1889,HCPCS,278,RC,,both,35842.46,32258.21,United Healthcare,Default,Fee Schedule,29247.45,,,,21147.05,29247.45
"SELF DRILLING SCREW, VARIABLE ANGLE 5.5M",C1713,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
"SELF DRILLING SCREW, VARIABLE ANGLE 5.5M",C1713,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
"SELF DRILLING SCREW, VARIABLE ANGLE 5.5M",C1713,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
"K-WIRES, THREADED, BLUNT",272,RC,,,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
"K-WIRES, THREADED, BLUNT",272,RC,,,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
"K-WIRES, THREADED, BLUNT",272,RC,,,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
LUTONIX 018  4X80 4F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2913.71,,,,2455.84,3396.55
LUTONIX 018  4X80 4F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,Cigna,Default,Percent of Total Billed Charges,2455.84,,,,2455.84,3396.55
LUTONIX 018  4X80 4F,C1725,HCPCS,278,RC,,both,4162.44,3746.2,United Healthcare,Default,Fee Schedule,3396.55,,,,2455.84,3396.55
STERLING BALLON 3X20X150,C1725,HCPCS,272,RC,,both,632.7,569.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.89,,,,373.29,516.28
STERLING BALLON 3X20X150,C1725,HCPCS,272,RC,,both,632.7,569.43,Cigna,Default,Percent of Total Billed Charges,373.29,,,,373.29,516.28
STERLING BALLON 3X20X150,C1725,HCPCS,272,RC,,both,632.7,569.43,United Healthcare,Default,Fee Schedule,516.28,,,,373.29,516.28
3.5MM  SCREW HEX,C1713,HCPCS,278,RC,,both,732.6,659.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,512.82,,,,432.23,597.8
3.5MM  SCREW HEX,C1713,HCPCS,278,RC,,both,732.6,659.34,Cigna,Default,Percent of Total Billed Charges,432.23,,,,432.23,597.8
3.5MM  SCREW HEX,C1713,HCPCS,278,RC,,both,732.6,659.34,United Healthcare,Default,Fee Schedule,597.8,,,,432.23,597.8
PSN ASF PS 13MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 13MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 13MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
SINGLE USE GRASPING FORCEPS,272,RC,,,,both,235.36,211.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.75,,,,138.86,192.05
SINGLE USE GRASPING FORCEPS,272,RC,,,,both,235.36,211.82,Cigna,Default,Percent of Total Billed Charges,138.86,,,,138.86,192.05
SINGLE USE GRASPING FORCEPS,272,RC,,,,both,235.36,211.82,United Healthcare,Default,Fee Schedule,192.05,,,,138.86,192.05
CANNULATED COMPRESSION SCREW W/ S.S. 14M,C1713,HCPCS,278,RC,,both,1884.78,1696.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1319.35,,,,1112.02,1537.98
CANNULATED COMPRESSION SCREW W/ S.S. 14M,C1713,HCPCS,278,RC,,both,1884.78,1696.3,Cigna,Default,Percent of Total Billed Charges,1112.02,,,,1112.02,1537.98
CANNULATED COMPRESSION SCREW W/ S.S. 14M,C1713,HCPCS,278,RC,,both,1884.78,1696.3,United Healthcare,Default,Fee Schedule,1537.98,,,,1112.02,1537.98
LOW PROFILE SCREW TI 4.5X24MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X24MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X24MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X26MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X26MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X26MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
"ANKLE FUSION PLATE, ANT TT, RIGHT",C1713,HCPCS,278,RC,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
"ANKLE FUSION PLATE, ANT TT, RIGHT",C1713,HCPCS,278,RC,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
"ANKLE FUSION PLATE, ANT TT, RIGHT",C1713,HCPCS,278,RC,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
LOW PROFILE SCREW TI 4.5X34MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X34MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X34MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X46MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X46MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X46MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X50MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X50MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X50MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X55MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X55MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X55MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
LOW PROFILE SCREW TI 4.5X30MM,C1713,HCPCS,278,RC,,both,649.35,584.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.54,,,,383.12,529.87
LOW PROFILE SCREW TI 4.5X30MM,C1713,HCPCS,278,RC,,both,649.35,584.42,Cigna,Default,Percent of Total Billed Charges,383.12,,,,383.12,529.87
LOW PROFILE SCREW TI 4.5X30MM,C1713,HCPCS,278,RC,,both,649.35,584.42,United Healthcare,Default,Fee Schedule,529.87,,,,383.12,529.87
LOW PROFILE SCREW TI 5.5X50MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.82,,,,147.35,203.8
LOW PROFILE SCREW TI 5.5X50MM,C1713,HCPCS,278,RC,,both,249.75,224.78,Cigna,Default,Percent of Total Billed Charges,147.35,,,,147.35,203.8
LOW PROFILE SCREW TI 5.5X50MM,C1713,HCPCS,278,RC,,both,249.75,224.78,United Healthcare,Default,Fee Schedule,203.8,,,,147.35,203.8
"PRFL DRL, 7.0MM CMPR FT",272,RC,,,,both,666,599.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,466.2,,,,392.94,543.46
"PRFL DRL, 7.0MM CMPR FT",272,RC,,,,both,666,599.4,Cigna,Default,Percent of Total Billed Charges,392.94,,,,392.94,543.46
"PRFL DRL, 7.0MM CMPR FT",272,RC,,,,both,666,599.4,United Healthcare,Default,Fee Schedule,543.46,,,,392.94,543.46
".062X7"" LONG, GUIDEWIRE",A4649,HCPCS,272,RC,,both,133.2,119.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.24,,,,78.59,108.69
".062X7"" LONG, GUIDEWIRE",A4649,HCPCS,272,RC,,both,133.2,119.88,Cigna,Default,Percent of Total Billed Charges,78.59,,,,78.59,108.69
".062X7"" LONG, GUIDEWIRE",A4649,HCPCS,272,RC,,both,133.2,119.88,United Healthcare,Default,Fee Schedule,108.69,,,,78.59,108.69
"LARGE BB-TAK, THREADED",C1713,HCPCS,278,RC,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
"LARGE BB-TAK, THREADED",C1713,HCPCS,278,RC,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
"LARGE BB-TAK, THREADED",C1713,HCPCS,278,RC,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
"CALIBRATED DRILL BIT, 3.0MM, LONG",272,RC,,,,both,649.35,584.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.54,,,,383.12,529.87
"CALIBRATED DRILL BIT, 3.0MM, LONG",272,RC,,,,both,649.35,584.42,Cigna,Default,Percent of Total Billed Charges,383.12,,,,383.12,529.87
"CALIBRATED DRILL BIT, 3.0MM, LONG",272,RC,,,,both,649.35,584.42,United Healthcare,Default,Fee Schedule,529.87,,,,383.12,529.87
"SOLID DRILL BIT, 5.5MM LONG",272,RC,,,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
"SOLID DRILL BIT, 5.5MM LONG",272,RC,,,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
"SOLID DRILL BIT, 5.5MM LONG",272,RC,,,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
1.65MM K-WIRE 600MM BLUNT THREAD,272,RC,,,,both,499.5,449.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.65,,,,294.7,407.59
1.65MM K-WIRE 600MM BLUNT THREAD,272,RC,,,,both,499.5,449.55,Cigna,Default,Percent of Total Billed Charges,294.7,,,,294.7,407.59
1.65MM K-WIRE 600MM BLUNT THREAD,272,RC,,,,both,499.5,449.55,United Healthcare,Default,Fee Schedule,407.59,,,,294.7,407.59
FIBERGRAFT BG PUTTY XXS 1CC,C1713,HCPCS,278,RC,,both,715.95,644.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,501.16,,,,422.41,584.22
FIBERGRAFT BG PUTTY XXS 1CC,C1713,HCPCS,278,RC,,both,715.95,644.36,Cigna,Default,Percent of Total Billed Charges,422.41,,,,422.41,584.22
FIBERGRAFT BG PUTTY XXS 1CC,C1713,HCPCS,278,RC,,both,715.95,644.36,United Healthcare,Default,Fee Schedule,584.22,,,,422.41,584.22
SKY 2 LEVEL PLTE 28MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
SKY 2 LEVEL PLTE 28MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
SKY 2 LEVEL PLTE 28MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
SKY VARIABLE S-D SCREW 16MM T1,272,RC,,,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SKY VARIABLE S-D SCREW 16MM T1,272,RC,,,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SKY VARIABLE S-D SCREW 16MM T1,272,RC,,,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
DISTRACTOR PIN 12MM,C1713,HCPCS,278,RC,,both,199.8,179.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.86,,,,117.88,163.04
DISTRACTOR PIN 12MM,C1713,HCPCS,278,RC,,both,199.8,179.82,Cigna,Default,Percent of Total Billed Charges,117.88,,,,117.88,163.04
DISTRACTOR PIN 12MM,C1713,HCPCS,278,RC,,both,199.8,179.82,United Healthcare,Default,Fee Schedule,163.04,,,,117.88,163.04
ACIS-STERILE LORDOTIC/STANDARD-5MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
ACIS-STERILE LORDOTIC/STANDARD-5MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
ACIS-STERILE LORDOTIC/STANDARD-5MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-6MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-6MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-6MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-7MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-7MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-7MM HT,L8699,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
FIBERGRAFT BG PUTTY XXS 2CC,C1713,HCPCS,278,RC,,both,1435.9,1292.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1005.13,,,,847.18,1171.69
FIBERGRAFT BG PUTTY XXS 2CC,C1713,HCPCS,278,RC,,both,1435.9,1292.31,Cigna,Default,Percent of Total Billed Charges,847.18,,,,847.18,1171.69
FIBERGRAFT BG PUTTY XXS 2CC,C1713,HCPCS,278,RC,,both,1435.9,1292.31,United Healthcare,Default,Fee Schedule,1171.69,,,,847.18,1171.69
SKY 1 LEVEL PLTE 12MM T1,L8699,HCPCS,278,RC,,both,2247.75,2022.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1573.42,,,,1326.17,1834.16
SKY 1 LEVEL PLTE 12MM T1,L8699,HCPCS,278,RC,,both,2247.75,2022.98,Cigna,Default,Percent of Total Billed Charges,1326.17,,,,1326.17,1834.16
SKY 1 LEVEL PLTE 12MM T1,L8699,HCPCS,278,RC,,both,2247.75,2022.98,United Healthcare,Default,Fee Schedule,1834.16,,,,1326.17,1834.16
SKY VARIABLE S-D SCREW 18MM T1,272,RC,,,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SKY VARIABLE S-D SCREW 18MM T1,272,RC,,,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SKY VARIABLE S-D SCREW 18MM T1,272,RC,,,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
SKY VARIABLE S-D SCREW 16MM T1(52016),272,RC,,,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SKY VARIABLE S-D SCREW 16MM T1(52016),272,RC,,,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SKY VARIABLE S-D SCREW 16MM T1(52016),272,RC,,,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
"CONF INTRO NEEDLE, 11G 6""",C1713,HCPCS,278,RC,,both,529.47,476.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,370.63,,,,312.39,432.05
"CONF INTRO NEEDLE, 11G 6""",C1713,HCPCS,278,RC,,both,529.47,476.52,Cigna,Default,Percent of Total Billed Charges,312.39,,,,312.39,432.05
"CONF INTRO NEEDLE, 11G 6""",C1713,HCPCS,278,RC,,both,529.47,476.52,United Healthcare,Default,Fee Schedule,432.05,,,,312.39,432.05
1.6 MM KIRSCHER WIRE BLNT TIP 480MM,272,RC,,,,both,166.5,149.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.55,,,,98.24,135.86
1.6 MM KIRSCHER WIRE BLNT TIP 480MM,272,RC,,,,both,166.5,149.85,Cigna,Default,Percent of Total Billed Charges,98.24,,,,98.24,135.86
1.6 MM KIRSCHER WIRE BLNT TIP 480MM,272,RC,,,,both,166.5,149.85,United Healthcare,Default,Fee Schedule,135.86,,,,98.24,135.86
5.0 MM TI CAN MTRZ PLYAX 45MM SCREW,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2179.48,,,,1836.99,2540.66
5.0 MM TI CAN MTRZ PLYAX 45MM SCREW,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Cigna,Default,Percent of Total Billed Charges,1836.99,,,,1836.99,2540.66
5.0 MM TI CAN MTRZ PLYAX 45MM SCREW,C1713,HCPCS,278,RC,,both,3113.55,2802.2,United Healthcare,Default,Fee Schedule,2540.66,,,,1836.99,2540.66
7.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2179.48,,,,1836.99,2540.66
7.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Cigna,Default,Percent of Total Billed Charges,1836.99,,,,1836.99,2540.66
7.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,United Healthcare,Default,Fee Schedule,2540.66,,,,1836.99,2540.66
FIBERGRAFT BG PUTTY GPD M 6CC,C1713,HCPCS,278,RC,,both,4279.05,3851.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2995.34,,,,2524.64,3491.7
FIBERGRAFT BG PUTTY GPD M 6CC,C1713,HCPCS,278,RC,,both,4279.05,3851.15,Cigna,Default,Percent of Total Billed Charges,2524.64,,,,2524.64,3491.7
FIBERGRAFT BG PUTTY GPD M 6CC,C1713,HCPCS,278,RC,,both,4279.05,3851.15,United Healthcare,Default,Fee Schedule,3491.7,,,,2524.64,3491.7
200 MM FIBERGRAFT GPS CANNULA,272,RC,,,,both,599.4,539.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.58,,,,353.65,489.11
200 MM FIBERGRAFT GPS CANNULA,272,RC,,,,both,599.4,539.46,Cigna,Default,Percent of Total Billed Charges,353.65,,,,353.65,489.11
200 MM FIBERGRAFT GPS CANNULA,272,RC,,,,both,599.4,539.46,United Healthcare,Default,Fee Schedule,489.11,,,,353.65,489.11
VIPER 2 LORDOTIC ROD 40MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 40MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 40MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
X-PAC 10X28MM LORDOTIC,C1776,HCPCS,278,RC,,both,17898.75,16108.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12529.12,,,,10560.26,14605.38
X-PAC 10X28MM LORDOTIC,C1776,HCPCS,278,RC,,both,17898.75,16108.88,Cigna,Default,Percent of Total Billed Charges,10560.26,,,,10560.26,14605.38
X-PAC 10X28MM LORDOTIC,C1776,HCPCS,278,RC,,both,17898.75,16108.88,United Healthcare,Default,Fee Schedule,14605.38,,,,10560.26,14605.38
MATRIX LOCKING CAP W/O SADDLE,C1776,HCPCS,278,RC,,both,183.15,164.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.2,,,,108.06,149.45
MATRIX LOCKING CAP W/O SADDLE,C1776,HCPCS,278,RC,,both,183.15,164.84,Cigna,Default,Percent of Total Billed Charges,108.06,,,,108.06,149.45
MATRIX LOCKING CAP W/O SADDLE,C1776,HCPCS,278,RC,,both,183.15,164.84,United Healthcare,Default,Fee Schedule,149.45,,,,108.06,149.45
FIBERGRAFT GPS CANNULA 100 MM,272,RC,,,,both,599.4,539.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.58,,,,353.65,489.11
FIBERGRAFT GPS CANNULA 100 MM,272,RC,,,,both,599.4,539.46,Cigna,Default,Percent of Total Billed Charges,353.65,,,,353.65,489.11
FIBERGRAFT GPS CANNULA 100 MM,272,RC,,,,both,599.4,539.46,United Healthcare,Default,Fee Schedule,489.11,,,,353.65,489.11
480MM FLX GUIDE WIRE W/ CONICAL TIP,A4649,HCPCS,272,RC,,both,166.5,149.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.55,,,,98.24,135.86
480MM FLX GUIDE WIRE W/ CONICAL TIP,A4649,HCPCS,272,RC,,both,166.5,149.85,Cigna,Default,Percent of Total Billed Charges,98.24,,,,98.24,135.86
480MM FLX GUIDE WIRE W/ CONICAL TIP,A4649,HCPCS,272,RC,,both,166.5,149.85,United Healthcare,Default,Fee Schedule,135.86,,,,98.24,135.86
PSN ASF PS 10MM VE R 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 10MM VE R 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 10MM VE R 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
CONTINUUM MULTI-HOLE SHELL 60MM,C1776,HCPCS,278,RC,,both,7326,6593.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5128.2,,,,4322.34,5978.02
CONTINUUM MULTI-HOLE SHELL 60MM,C1776,HCPCS,278,RC,,both,7326,6593.4,Cigna,Default,Percent of Total Billed Charges,4322.34,,,,4322.34,5978.02
CONTINUUM MULTI-HOLE SHELL 60MM,C1776,HCPCS,278,RC,,both,7326,6593.4,United Healthcare,Default,Fee Schedule,5978.02,,,,4322.34,5978.02
CONTINUUM VIVACIT-E NEUTRAL LINER 36X60,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
CONTINUUM VIVACIT-E NEUTRAL LINER 36X60,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
CONTINUUM VIVACIT-E NEUTRAL LINER 36X60,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
FIBERGRAFT BG PUTTY XXS 4CC,C1713,HCPCS,278,RC,,both,2814.35,2532.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1970.04,,,,1660.47,2296.51
FIBERGRAFT BG PUTTY XXS 4CC,C1713,HCPCS,278,RC,,both,2814.35,2532.92,Cigna,Default,Percent of Total Billed Charges,1660.47,,,,1660.47,2296.51
FIBERGRAFT BG PUTTY XXS 4CC,C1713,HCPCS,278,RC,,both,2814.35,2532.92,United Healthcare,Default,Fee Schedule,2296.51,,,,1660.47,2296.51
PSN FEM PS CMT CCR STD SZ8 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ8 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ8 R,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
PSN ASF CPS 14MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3546.45,3191.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2482.52,,,,2092.41,2893.9
PSN ASF CPS 14MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3546.45,3191.81,Cigna,Default,Percent of Total Billed Charges,2092.41,,,,2092.41,2893.9
PSN ASF CPS 14MM VE R 10-12 GH,C1776,HCPCS,278,RC,,both,3546.45,3191.81,United Healthcare,Default,Fee Schedule,2893.9,,,,2092.41,2893.9
PEDICLE ACCESS TROCAR,C1713,HCPCS,278,RC,,both,10076.58,9068.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7053.61,,,,5945.18,8222.49
PEDICLE ACCESS TROCAR,C1713,HCPCS,278,RC,,both,10076.58,9068.92,Cigna,Default,Percent of Total Billed Charges,5945.18,,,,5945.18,8222.49
PEDICLE ACCESS TROCAR,C1713,HCPCS,278,RC,,both,10076.58,9068.92,United Healthcare,Default,Fee Schedule,8222.49,,,,5945.18,8222.49
VIPER 2 LORDOTIC ROD 60MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 60MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 60MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
"8MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.88,,,,5157.34,7132.86
"8MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Cigna,Default,Percent of Total Billed Charges,5157.34,,,,5157.34,7132.86
"8MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,United Healthcare,Default,Fee Schedule,7132.86,,,,5157.34,7132.86
VIPER 2 LORDOTIC ROD 65MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 65MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 65MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
TI POLYAXIAL REDUCTION HEAD FOR TI MATRI,C1713,HCPCS,278,RC,,both,1665,1498.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1165.5,,,,982.35,1358.64
TI POLYAXIAL REDUCTION HEAD FOR TI MATRI,C1713,HCPCS,278,RC,,both,1665,1498.5,Cigna,Default,Percent of Total Billed Charges,982.35,,,,982.35,1358.64
TI POLYAXIAL REDUCTION HEAD FOR TI MATRI,C1713,HCPCS,278,RC,,both,1665,1498.5,United Healthcare,Default,Fee Schedule,1358.64,,,,982.35,1358.64
PSN ASF PS 11MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 11MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 11MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
VIPER 2 LORDOTIC ROD 35MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 35MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 35MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
"7MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.88,,,,5157.34,7132.86
"7MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Cigna,Default,Percent of Total Billed Charges,5157.34,,,,5157.34,7132.86
"7MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,United Healthcare,Default,Fee Schedule,7132.86,,,,5157.34,7132.86
VIPER 2 LORDOTIC ROD 45MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 45MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 45MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
"10MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.88,,,,5157.34,7132.86
"10MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Cigna,Default,Percent of Total Billed Charges,5157.34,,,,5157.34,7132.86
"10MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,United Healthcare,Default,Fee Schedule,7132.86,,,,5157.34,7132.86
"CONTINUUM LONGEVITY NEUTRAL LINER, GG 28",C1776,HCPCS,278,RC,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
"CONTINUUM LONGEVITY NEUTRAL LINER, GG 28",C1776,HCPCS,278,RC,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
"CONTINUUM LONGEVITY NEUTRAL LINER, GG 28",C1776,HCPCS,278,RC,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
JGRLOC SS SLD DRL KIT,272,RC,,,,both,2471.03,2223.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1729.72,,,,1457.91,2016.36
JGRLOC SS SLD DRL KIT,272,RC,,,,both,2471.03,2223.93,Cigna,Default,Percent of Total Billed Charges,1457.91,,,,1457.91,2016.36
JGRLOC SS SLD DRL KIT,272,RC,,,,both,2471.03,2223.93,United Healthcare,Default,Fee Schedule,2016.36,,,,1457.91,2016.36
PERI SCREW 3.5MM X 30MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MM X 30MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MM X 30MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,Cigna,Default,Percent of Total Billed Charges,93.3,,,,93.3,129.04
PERI SCREW 3.5MM X 12MM W/2.7 HEAD,C1713,HCPCS,278,RC,,both,158.14,142.33,United Healthcare,Default,Fee Schedule,129.04,,,,93.3,129.04
SKY VARIABLE S-D SCREW 14MM T1,272,RC,,,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SKY VARIABLE S-D SCREW 14MM T1,272,RC,,,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SKY VARIABLE S-D SCREW 14MM T1,272,RC,,,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
SKY 2 LEVEL PLTE 26MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
SKY 2 LEVEL PLTE 26MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
SKY 2 LEVEL PLTE 26MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
SKY 3 LEVEL PLTE 45MM T1,L8699,HCPCS,278,RC,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
SKY 3 LEVEL PLTE 45MM T1,L8699,HCPCS,278,RC,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
SKY 3 LEVEL PLTE 45MM T1,L8699,HCPCS,278,RC,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
LO-PRO LOCK SCREW SS 2.7 X 14MM,C1713,HCPCS,278,RC,,both,382.95,344.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.06,,,,225.94,312.49
LO-PRO LOCK SCREW SS 2.7 X 14MM,C1713,HCPCS,278,RC,,both,382.95,344.66,Cigna,Default,Percent of Total Billed Charges,225.94,,,,225.94,312.49
LO-PRO LOCK SCREW SS 2.7 X 14MM,C1713,HCPCS,278,RC,,both,382.95,344.66,United Healthcare,Default,Fee Schedule,312.49,,,,225.94,312.49
LO PRO SCRW TM SS 3.5 X 22MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.45,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 22MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Cigna,Default,Percent of Total Billed Charges,84.66,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 22MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,United Healthcare,Default,Fee Schedule,117.1,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 35MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.45,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 35MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,Cigna,Default,Percent of Total Billed Charges,84.66,,,,84.66,117.1
LO PRO SCRW TM SS 3.5 X 35MMCORT,C1713,HCPCS,278,RC,,both,143.5,129.15,United Healthcare,Default,Fee Schedule,117.1,,,,84.66,117.1
LOW PROF SCRW SS 4.0X45MMCAN LNG THD,C1713,HCPCS,278,RC,,both,544.5,490.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,381.15,,,,321.26,444.31
LOW PROF SCRW SS 4.0X45MMCAN LNG THD,C1713,HCPCS,278,RC,,both,544.5,490.05,Cigna,Default,Percent of Total Billed Charges,321.26,,,,321.26,444.31
LOW PROF SCRW SS 4.0X45MMCAN LNG THD,C1713,HCPCS,278,RC,,both,544.5,490.05,United Healthcare,Default,Fee Schedule,444.31,,,,321.26,444.31
2.5MM DRILL BIT CALIBRATED,272,RC,,,,both,283.05,254.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.14,,,,167,230.97
2.5MM DRILL BIT CALIBRATED,272,RC,,,,both,283.05,254.75,Cigna,Default,Percent of Total Billed Charges,167,,,,167,230.97
2.5MM DRILL BIT CALIBRATED,272,RC,,,,both,283.05,254.75,United Healthcare,Default,Fee Schedule,230.97,,,,167,230.97
LOCK DISTAL FIBULA PLT SS RT 6H,C1713,HCPCS,278,RC,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
LOCK DISTAL FIBULA PLT SS RT 6H,C1713,HCPCS,278,RC,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
LOCK DISTAL FIBULA PLT SS RT 6H,C1713,HCPCS,278,RC,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
"G-WIRE W/TRCR TIP .94""X8""",C1769,HCPCS,272,RC,,both,61.5,55.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.05,,,,36.28,50.18
"G-WIRE W/TRCR TIP .94""X8""",C1769,HCPCS,272,RC,,both,61.5,55.35,Cigna,Default,Percent of Total Billed Charges,36.28,,,,36.28,50.18
"G-WIRE W/TRCR TIP .94""X8""",C1769,HCPCS,272,RC,,both,61.5,55.35,United Healthcare,Default,Fee Schedule,50.18,,,,36.28,50.18
CANNULATED DRILL BIT 4.0MM,272,RC,,,,both,649.35,584.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.54,,,,383.12,529.87
CANNULATED DRILL BIT 4.0MM,272,RC,,,,both,649.35,584.42,Cigna,Default,Percent of Total Billed Charges,383.12,,,,383.12,529.87
CANNULATED DRILL BIT 4.0MM,272,RC,,,,both,649.35,584.42,United Healthcare,Default,Fee Schedule,529.87,,,,383.12,529.87
"LOW PRO SCREW TI 6.7X40MMCANN, 18MM THD",272,RC,,,,both,832.5,749.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,582.75,,,,491.18,679.32
"LOW PRO SCREW TI 6.7X40MMCANN, 18MM THD",272,RC,,,,both,832.5,749.25,Cigna,Default,Percent of Total Billed Charges,491.18,,,,491.18,679.32
"LOW PRO SCREW TI 6.7X40MMCANN, 18MM THD",272,RC,,,,both,832.5,749.25,United Healthcare,Default,Fee Schedule,679.32,,,,491.18,679.32
HEMOSTATIC PEEL AWAY 9FRX 13CM SYSTEM,C1982,HCPCS,272,RC,,both,216.45,194.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.52,,,,127.71,176.62
HEMOSTATIC PEEL AWAY 9FRX 13CM SYSTEM,C1982,HCPCS,272,RC,,both,216.45,194.81,Cigna,Default,Percent of Total Billed Charges,127.71,,,,127.71,176.62
HEMOSTATIC PEEL AWAY 9FRX 13CM SYSTEM,C1982,HCPCS,272,RC,,both,216.45,194.81,United Healthcare,Default,Fee Schedule,176.62,,,,127.71,176.62
SKY 3 LEVEL PLTE 48MM T1,L8699,HCPCS,278,RC,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
SKY 3 LEVEL PLTE 48MM T1,L8699,HCPCS,278,RC,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
SKY 3 LEVEL PLTE 48MM T1,L8699,HCPCS,278,RC,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
SKY 2 LEVEL PLTE 30MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
SKY 2 LEVEL PLTE 30MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
SKY 2 LEVEL PLTE 30MM T1,L8699,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
VIPER 2 LORDOTIC ROD 70MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 70MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 70MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
7.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2179.48,,,,1836.99,2540.66
7.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Cigna,Default,Percent of Total Billed Charges,1836.99,,,,1836.99,2540.66
7.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,United Healthcare,Default,Fee Schedule,2540.66,,,,1836.99,2540.66
Z NAIL 5.0X47.5 CORT SCREW FA,C1713,HCPCS,278,RC,,both,708.75,637.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,496.12,,,,418.16,578.34
Z NAIL 5.0X47.5 CORT SCREW FA,C1713,HCPCS,278,RC,,both,708.75,637.88,Cigna,Default,Percent of Total Billed Charges,418.16,,,,418.16,578.34
Z NAIL 5.0X47.5 CORT SCREW FA,C1713,HCPCS,278,RC,,both,708.75,637.88,United Healthcare,Default,Fee Schedule,578.34,,,,418.16,578.34
Z NAIL CPM  11.5MM X 38CM 130R,C1713,HCPCS,278,RC,,both,7976.58,7178.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5583.61,,,,4706.18,6508.89
Z NAIL CPM  11.5MM X 38CM 130R,C1713,HCPCS,278,RC,,both,7976.58,7178.92,Cigna,Default,Percent of Total Billed Charges,4706.18,,,,4706.18,6508.89
Z NAIL CPM  11.5MM X 38CM 130R,C1713,HCPCS,278,RC,,both,7976.58,7178.92,United Healthcare,Default,Fee Schedule,6508.89,,,,4706.18,6508.89
"11MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.88,,,,5157.34,7132.86
"11MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Cigna,Default,Percent of Total Billed Charges,5157.34,,,,5157.34,7132.86
"11MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,United Healthcare,Default,Fee Schedule,7132.86,,,,5157.34,7132.86
ACIS STERILE LORDOTIC/STANDARD-8MM HT,C1889,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-8MM HT,C1889,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
ACIS STERILE LORDOTIC/STANDARD-8MM HT,C1889,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
BONE SCREW 6.5X20 SELF TAP,C1713,HCPCS,278,RC,,both,233.1,209.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.17,,,,137.53,190.21
BONE SCREW 6.5X20 SELF TAP,C1713,HCPCS,278,RC,,both,233.1,209.79,Cigna,Default,Percent of Total Billed Charges,137.53,,,,137.53,190.21
BONE SCREW 6.5X20 SELF TAP,C1713,HCPCS,278,RC,,both,233.1,209.79,United Healthcare,Default,Fee Schedule,190.21,,,,137.53,190.21
8.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2179.48,,,,1836.99,2540.66
8.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Cigna,Default,Percent of Total Billed Charges,1836.99,,,,1836.99,2540.66
8.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,United Healthcare,Default,Fee Schedule,2540.66,,,,1836.99,2540.66
"9MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.88,,,,5157.34,7132.86
"9MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Cigna,Default,Percent of Total Billed Charges,5157.34,,,,5157.34,7132.86
"9MM,4DEG, 26/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,United Healthcare,Default,Fee Schedule,7132.86,,,,5157.34,7132.86
PSN TIB STM 5 DEG SZ H R,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
PSN TIB STM 5 DEG SZ H R,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
PSN TIB STM 5 DEG SZ H R,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
SKY VARIABLE LRG-D SCREW 18MM T1,272,RC,,,,both,399.6,359.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.72,,,,235.76,326.07
SKY VARIABLE LRG-D SCREW 18MM T1,272,RC,,,,both,399.6,359.64,Cigna,Default,Percent of Total Billed Charges,235.76,,,,235.76,326.07
SKY VARIABLE LRG-D SCREW 18MM T1,272,RC,,,,both,399.6,359.64,United Healthcare,Default,Fee Schedule,326.07,,,,235.76,326.07
"8MM,4DEG, 30/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6118.88,,,,5157.34,7132.86
"8MM,4DEG, 30/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,Cigna,Default,Percent of Total Billed Charges,5157.34,,,,5157.34,7132.86
"8MM,4DEG, 30/9 IBF",C1776,HCPCS,278,RC,,both,8741.25,7867.13,United Healthcare,Default,Fee Schedule,7132.86,,,,5157.34,7132.86
STAPLER INTRALUMINAL CIRCUlLAR 29 MM,272,RC,,,,both,805.88,725.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,564.12,,,,475.47,657.6
STAPLER INTRALUMINAL CIRCUlLAR 29 MM,272,RC,,,,both,805.88,725.29,Cigna,Default,Percent of Total Billed Charges,475.47,,,,475.47,657.6
STAPLER INTRALUMINAL CIRCUlLAR 29 MM,272,RC,,,,both,805.88,725.29,United Healthcare,Default,Fee Schedule,657.6,,,,475.47,657.6
PRESTIGE LP CERVICAL DISC  5 X16,L8699,HCPCS,278,RC,,both,15297.35,13767.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10708.14,,,,9025.44,12482.64
PRESTIGE LP CERVICAL DISC  5 X16,L8699,HCPCS,278,RC,,both,15297.35,13767.62,Cigna,Default,Percent of Total Billed Charges,9025.44,,,,9025.44,12482.64
PRESTIGE LP CERVICAL DISC  5 X16,L8699,HCPCS,278,RC,,both,15297.35,13767.62,United Healthcare,Default,Fee Schedule,12482.64,,,,9025.44,12482.64
RAIL CUTTER,C1713,HCPCS,278,RC,,both,416.25,374.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,291.38,,,,245.59,339.66
RAIL CUTTER,C1713,HCPCS,278,RC,,both,416.25,374.63,Cigna,Default,Percent of Total Billed Charges,245.59,,,,245.59,339.66
RAIL CUTTER,C1713,HCPCS,278,RC,,both,416.25,374.63,United Healthcare,Default,Fee Schedule,339.66,,,,245.59,339.66
8.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2179.48,,,,1836.99,2540.66
8.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,Cigna,Default,Percent of Total Billed Charges,1836.99,,,,1836.99,2540.66
8.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3113.55,2802.2,United Healthcare,Default,Fee Schedule,2540.66,,,,1836.99,2540.66
CANN HEAD DRILL FOR 3.0MM SCREW,A4649,HCPCS,272,RC,,both,1465.2,1318.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1025.64,,,,864.47,1195.6
CANN HEAD DRILL FOR 3.0MM SCREW,A4649,HCPCS,272,RC,,both,1465.2,1318.68,Cigna,Default,Percent of Total Billed Charges,864.47,,,,864.47,1195.6
CANN HEAD DRILL FOR 3.0MM SCREW,A4649,HCPCS,272,RC,,both,1465.2,1318.68,United Healthcare,Default,Fee Schedule,1195.6,,,,864.47,1195.6
CHARLOTTE 3.0MMX20 MM SCREW,C1713,HCPCS,278,RC,,both,2034.63,1831.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1424.24,,,,1200.43,1660.26
CHARLOTTE 3.0MMX20 MM SCREW,C1713,HCPCS,278,RC,,both,2034.63,1831.17,Cigna,Default,Percent of Total Billed Charges,1200.43,,,,1200.43,1660.26
CHARLOTTE 3.0MMX20 MM SCREW,C1713,HCPCS,278,RC,,both,2034.63,1831.17,United Healthcare,Default,Fee Schedule,1660.26,,,,1200.43,1660.26
K-WIRE 1.0X150MM,C1713,HCPCS,278,RC,,both,216.08,194.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.26,,,,127.49,176.32
K-WIRE 1.0X150MM,C1713,HCPCS,278,RC,,both,216.08,194.47,Cigna,Default,Percent of Total Billed Charges,127.49,,,,127.49,176.32
K-WIRE 1.0X150MM,C1713,HCPCS,278,RC,,both,216.08,194.47,United Healthcare,Default,Fee Schedule,176.32,,,,127.49,176.32
BIPOLAR SHEL 46MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,675.99,,,,569.76,788.01
BIPOLAR SHEL 46MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Cigna,Default,Percent of Total Billed Charges,569.76,,,,569.76,788.01
BIPOLAR SHEL 46MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,United Healthcare,Default,Fee Schedule,788.01,,,,569.76,788.01
Z NAIL CMN  11.5MM X 38CM 130L,C1713,HCPCS,278,RC,,both,8215.88,7394.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5751.12,,,,4847.37,6704.16
Z NAIL CMN  11.5MM X 38CM 130L,C1713,HCPCS,278,RC,,both,8215.88,7394.29,Cigna,Default,Percent of Total Billed Charges,4847.37,,,,4847.37,6704.16
Z NAIL CMN  11.5MM X 38CM 130L,C1713,HCPCS,278,RC,,both,8215.88,7394.29,United Healthcare,Default,Fee Schedule,6704.16,,,,4847.37,6704.16
G01290 CATH BENTSON WIRE .035X180 CM TSF,C1769,HCPCS,272,RC,,both,68.45,61.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.92,,,,40.39,55.86
G01290 CATH BENTSON WIRE .035X180 CM TSF,C1769,HCPCS,272,RC,,both,68.45,61.61,Cigna,Default,Percent of Total Billed Charges,40.39,,,,40.39,55.86
G01290 CATH BENTSON WIRE .035X180 CM TSF,C1769,HCPCS,272,RC,,both,68.45,61.61,United Healthcare,Default,Fee Schedule,55.86,,,,40.39,55.86
CATH 100CM 4 FR BERNSTEIN,C1769,HCPCS,272,RC,,both,55.97,50.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.18,,,,33.02,45.67
CATH 100CM 4 FR BERNSTEIN,C1769,HCPCS,272,RC,,both,55.97,50.37,Cigna,Default,Percent of Total Billed Charges,33.02,,,,33.02,45.67
CATH 100CM 4 FR BERNSTEIN,C1769,HCPCS,272,RC,,both,55.97,50.37,United Healthcare,Default,Fee Schedule,45.67,,,,33.02,45.67
ALL POLY PAT CEMENTED 38 MM DIA,C1776,HCPCS,278,RC,,both,1082.25,974.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,757.58,,,,638.53,883.12
ALL POLY PAT CEMENTED 38 MM DIA,C1776,HCPCS,278,RC,,both,1082.25,974.03,Cigna,Default,Percent of Total Billed Charges,638.53,,,,638.53,883.12
ALL POLY PAT CEMENTED 38 MM DIA,C1776,HCPCS,278,RC,,both,1082.25,974.03,United Healthcare,Default,Fee Schedule,883.12,,,,638.53,883.12
PSN ASF PS 11MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 11MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 11MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
6.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2244.87,,,,1892.11,2616.88
6.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Cigna,Default,Percent of Total Billed Charges,1892.11,,,,1892.11,2616.88
6.0 MM T1 CAN MTRX PLYAX SCRW 45MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,United Healthcare,Default,Fee Schedule,2616.88,,,,1892.11,2616.88
PSN ASF PS 10MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 10MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 10MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
MR8 15 CM MATCH HEAD 3MM,272,RC,,,,both,446.54,401.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,312.58,,,,263.46,364.38
MR8 15 CM MATCH HEAD 3MM,272,RC,,,,both,446.54,401.89,Cigna,Default,Percent of Total Billed Charges,263.46,,,,263.46,364.38
MR8 15 CM MATCH HEAD 3MM,272,RC,,,,both,446.54,401.89,United Healthcare,Default,Fee Schedule,364.38,,,,263.46,364.38
MR8 F2/7 CM TAPER 2.3 MM,272,RC,,,,both,306.29,275.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,214.4,,,,180.71,249.93
MR8 F2/7 CM TAPER 2.3 MM,272,RC,,,,both,306.29,275.66,Cigna,Default,Percent of Total Billed Charges,180.71,,,,180.71,249.93
MR8 F2/7 CM TAPER 2.3 MM,272,RC,,,,both,306.29,275.66,United Healthcare,Default,Fee Schedule,249.93,,,,180.71,249.93
MR8 9CM MTL CUT 3MM,272,RC,,,,both,535.2,481.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,374.64,,,,315.77,436.72
MR8 9CM MTL CUT 3MM,272,RC,,,,both,535.2,481.68,Cigna,Default,Percent of Total Billed Charges,315.77,,,,315.77,436.72
MR8 9CM MTL CUT 3MM,272,RC,,,,both,535.2,481.68,United Healthcare,Default,Fee Schedule,436.72,,,,315.77,436.72
VIPER 2 LORDOTIC ROD 55MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 55MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 55MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 75MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 75MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 75MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
7.0 MM T1 CAN MTRX PLYAX SCRW 40MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2244.87,,,,1892.11,2616.88
7.0 MM T1 CAN MTRX PLYAX SCRW 40MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Cigna,Default,Percent of Total Billed Charges,1892.11,,,,1892.11,2616.88
7.0 MM T1 CAN MTRX PLYAX SCRW 40MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,United Healthcare,Default,Fee Schedule,2616.88,,,,1892.11,2616.88
OMNICURVE 11 G 15MM FRACTURE KIT,272,RC,,,,both,7888.77,7099.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5522.14,,,,4654.37,6437.24
OMNICURVE 11 G 15MM FRACTURE KIT,272,RC,,,,both,7888.77,7099.89,Cigna,Default,Percent of Total Billed Charges,4654.37,,,,4654.37,6437.24
OMNICURVE 11 G 15MM FRACTURE KIT,272,RC,,,,both,7888.77,7099.89,United Healthcare,Default,Fee Schedule,6437.24,,,,4654.37,6437.24
OSTEOAUGER BONE GRAFT HARVERSTER,272,RC,,,,both,1937.89,1744.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1356.52,,,,1143.36,1581.32
OSTEOAUGER BONE GRAFT HARVERSTER,272,RC,,,,both,1937.89,1744.1,Cigna,Default,Percent of Total Billed Charges,1143.36,,,,1143.36,1581.32
OSTEOAUGER BONE GRAFT HARVERSTER,272,RC,,,,both,1937.89,1744.1,United Healthcare,Default,Fee Schedule,1581.32,,,,1143.36,1581.32
LO PRO SCRW TI  3.5 X 14MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.05,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 14MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Cigna,Default,Percent of Total Billed Charges,121.42,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 14MM,C1713,HCPCS,278,RC,,both,205.79,185.21,United Healthcare,Default,Fee Schedule,167.92,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 16MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.05,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 16MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Cigna,Default,Percent of Total Billed Charges,121.42,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 16MM,C1713,HCPCS,278,RC,,both,205.79,185.21,United Healthcare,Default,Fee Schedule,167.92,,,,121.42,167.92
LO PRO SCRW TI  3.5 X  20MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.05,,,,121.42,167.92
LO PRO SCRW TI  3.5 X  20MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Cigna,Default,Percent of Total Billed Charges,121.42,,,,121.42,167.92
LO PRO SCRW TI  3.5 X  20MM,C1713,HCPCS,278,RC,,both,205.79,185.21,United Healthcare,Default,Fee Schedule,167.92,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 22MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.05,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 22MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Cigna,Default,Percent of Total Billed Charges,121.42,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 22MM,C1713,HCPCS,278,RC,,both,205.79,185.21,United Healthcare,Default,Fee Schedule,167.92,,,,121.42,167.92
LO PRO SCRW TI 3.5 X 34MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.05,,,,121.42,167.92
LO PRO SCRW TI 3.5 X 34MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Cigna,Default,Percent of Total Billed Charges,121.42,,,,121.42,167.92
LO PRO SCRW TI 3.5 X 34MM,C1713,HCPCS,278,RC,,both,205.79,185.21,United Healthcare,Default,Fee Schedule,167.92,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 40MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.05,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 40MM,C1713,HCPCS,278,RC,,both,205.79,185.21,Cigna,Default,Percent of Total Billed Charges,121.42,,,,121.42,167.92
LO PRO SCRW TI  3.5 X 40MM,C1713,HCPCS,278,RC,,both,205.79,185.21,United Healthcare,Default,Fee Schedule,167.92,,,,121.42,167.92
"BONE TAP, 4.0MM",C1713,HCPCS,272,RC,,both,514.49,463.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,360.14,,,,303.55,419.82
"BONE TAP, 4.0MM",C1713,HCPCS,272,RC,,both,514.49,463.04,Cigna,Default,Percent of Total Billed Charges,303.55,,,,303.55,419.82
"BONE TAP, 4.0MM",C1713,HCPCS,272,RC,,both,514.49,463.04,United Healthcare,Default,Fee Schedule,419.82,,,,303.55,419.82
"LOW PROFILE LAPIDUS PLATE, TITA.",C1713,HCPCS,278,RC,,both,3069.76,2762.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2148.83,,,,1811.16,2504.92
"LOW PROFILE LAPIDUS PLATE, TITA.",C1713,HCPCS,278,RC,,both,3069.76,2762.78,Cigna,Default,Percent of Total Billed Charges,1811.16,,,,1811.16,2504.92
"LOW PROFILE LAPIDUS PLATE, TITA.",C1713,HCPCS,278,RC,,both,3069.76,2762.78,United Healthcare,Default,Fee Schedule,2504.92,,,,1811.16,2504.92
VOYAGER 4.5-7.5 MAS,C1713,HCPCS,278,RC,,both,3258.41,2932.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2280.89,,,,1922.46,2658.86
VOYAGER 4.5-7.5 MAS,C1713,HCPCS,278,RC,,both,3258.41,2932.57,Cigna,Default,Percent of Total Billed Charges,1922.46,,,,1922.46,2658.86
VOYAGER 4.5-7.5 MAS,C1713,HCPCS,278,RC,,both,3258.41,2932.57,United Healthcare,Default,Fee Schedule,2658.86,,,,1922.46,2658.86
ADAPTIX CAGE 28X10,L8699,HCPCS,278,RC,,both,12004.65,10804.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8403.26,,,,7082.74,9795.79
ADAPTIX CAGE 28X10,L8699,HCPCS,278,RC,,both,12004.65,10804.19,Cigna,Default,Percent of Total Billed Charges,7082.74,,,,7082.74,9795.79
ADAPTIX CAGE 28X10,L8699,HCPCS,278,RC,,both,12004.65,10804.19,United Healthcare,Default,Fee Schedule,9795.79,,,,7082.74,9795.79
STERIS RAPTOR GRASPING DEVICE,272,RC,,,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
STERIS RAPTOR GRASPING DEVICE,272,RC,,,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
STERIS RAPTOR GRASPING DEVICE,272,RC,,,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
CATH BALLOON MUSTANG 7X40X135CM,C1725,HCPCS,278,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH BALLOON MUSTANG 7X40X135CM,C1725,HCPCS,278,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH BALLOON MUSTANG 7X40X135CM,C1725,HCPCS,278,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
NAVIGATOR 12/14X36CM SHEATH ACCESS,272,RC,,,,both,412.28,371.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,288.6,,,,243.25,336.42
NAVIGATOR 12/14X36CM SHEATH ACCESS,272,RC,,,,both,412.28,371.05,Cigna,Default,Percent of Total Billed Charges,243.25,,,,243.25,336.42
NAVIGATOR 12/14X36CM SHEATH ACCESS,272,RC,,,,both,412.28,371.05,United Healthcare,Default,Fee Schedule,336.42,,,,243.25,336.42
FORCEP RAT TOOTH GRASPING,272,RC,,,,both,309.03,278.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.32,,,,182.33,252.17
FORCEP RAT TOOTH GRASPING,272,RC,,,,both,309.03,278.13,Cigna,Default,Percent of Total Billed Charges,182.33,,,,182.33,252.17
FORCEP RAT TOOTH GRASPING,272,RC,,,,both,309.03,278.13,United Healthcare,Default,Fee Schedule,252.17,,,,182.33,252.17
7X24 CONTOUR URETERAL STENT,278,RC,,,,both,379.28,341.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.5,,,,223.78,309.49
7X24 CONTOUR URETERAL STENT,278,RC,,,,both,379.28,341.35,Cigna,Default,Percent of Total Billed Charges,223.78,,,,223.78,309.49
7X24 CONTOUR URETERAL STENT,278,RC,,,,both,379.28,341.35,United Healthcare,Default,Fee Schedule,309.49,,,,223.78,309.49
7X30 CONTOUR URETERAL STENT,278,RC,,,,both,379.28,341.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.5,,,,223.78,309.49
7X30 CONTOUR URETERAL STENT,278,RC,,,,both,379.28,341.35,Cigna,Default,Percent of Total Billed Charges,223.78,,,,223.78,309.49
7X30 CONTOUR URETERAL STENT,278,RC,,,,both,379.28,341.35,United Healthcare,Default,Fee Schedule,309.49,,,,223.78,309.49
STENT PERCUFLEX 8FRX26CM,278,RC,,,,both,266.16,239.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.31,,,,157.03,217.19
STENT PERCUFLEX 8FRX26CM,278,RC,,,,both,266.16,239.54,Cigna,Default,Percent of Total Billed Charges,157.03,,,,157.03,217.19
STENT PERCUFLEX 8FRX26CM,278,RC,,,,both,266.16,239.54,United Healthcare,Default,Fee Schedule,217.19,,,,157.03,217.19
STENT PERCUFLEX 8FRX24CM,278,RC,,,,both,266.16,239.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.31,,,,157.03,217.19
STENT PERCUFLEX 8FRX24CM,278,RC,,,,both,266.16,239.54,Cigna,Default,Percent of Total Billed Charges,157.03,,,,157.03,217.19
STENT PERCUFLEX 8FRX24CM,278,RC,,,,both,266.16,239.54,United Healthcare,Default,Fee Schedule,217.19,,,,157.03,217.19
STENT PERCUFLEX 8FRX28CM,120,RC,,,,both,266.16,239.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.31,,,,157.03,191.37
STENT PERCUFLEX 8FRX28CM,120,RC,,,,both,266.16,239.54,Cigna,Default,Percent of Total Billed Charges,157.03,,,,157.03,191.37
STENT PERCUFLEX 8FRX28CM,120,RC,,,,both,266.16,239.54,United Healthcare,Default,Percent of Total Billed Charges,191.37,,,,157.03,191.37
6X30 URETERAL STENT,278,RC,,,,both,47.93,43.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.55,,,,28.28,39.11
6X30 URETERAL STENT,278,RC,,,,both,47.93,43.14,Cigna,Default,Percent of Total Billed Charges,28.28,,,,28.28,39.11
6X30 URETERAL STENT,278,RC,,,,both,47.93,43.14,United Healthcare,Default,Fee Schedule,39.11,,,,28.28,39.11
PSN FEM PS CMT CCR STD SZ6 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ6 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CCR STD SZ6 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
PSN ASF PS 13MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 13MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 13MM VE L 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
PSN TIB STM 5 DEG SIZE C L,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
PSN TIB STM 5 DEG SIZE C L,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
PSN TIB STM 5 DEG SIZE C L,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
ARCOS 16X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
ARCOS 16X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
ARCOS 16X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
MINIONE BUTTON 20FR SIZE 4.0 CM,272,RC,,,,both,452.75,407.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.92,,,,267.12,369.44
MINIONE BUTTON 20FR SIZE 4.0 CM,272,RC,,,,both,452.75,407.48,Cigna,Default,Percent of Total Billed Charges,267.12,,,,267.12,369.44
MINIONE BUTTON 20FR SIZE 4.0 CM,272,RC,,,,both,452.75,407.48,United Healthcare,Default,Fee Schedule,369.44,,,,267.12,369.44
PSN FEM PS CMT CCR NRW SZ7 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4079.25,,,,3438.22,4755.24
PSN FEM PS CMT CCR NRW SZ7 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,Cigna,Default,Percent of Total Billed Charges,3438.22,,,,3438.22,4755.24
PSN FEM PS CMT CCR NRW SZ7 L,C1776,HCPCS,278,RC,,both,5827.5,5244.75,United Healthcare,Default,Fee Schedule,4755.24,,,,3438.22,4755.24
SKY 1 LEVEL PLTE 14MM TI,278,RC,,,,both,2315.18,2083.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1620.63,,,,1365.96,1889.19
SKY 1 LEVEL PLTE 14MM TI,278,RC,,,,both,2315.18,2083.66,Cigna,Default,Percent of Total Billed Charges,1365.96,,,,1365.96,1889.19
SKY 1 LEVEL PLTE 14MM TI,278,RC,,,,both,2315.18,2083.66,United Healthcare,Default,Fee Schedule,1889.19,,,,1365.96,1889.19
DISTRACTOR PIN 14MM,C1713,HCPCS,278,RC,,both,199.8,179.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.86,,,,117.88,163.04
DISTRACTOR PIN 14MM,C1713,HCPCS,278,RC,,both,199.8,179.82,Cigna,Default,Percent of Total Billed Charges,117.88,,,,117.88,163.04
DISTRACTOR PIN 14MM,C1713,HCPCS,278,RC,,both,199.8,179.82,United Healthcare,Default,Fee Schedule,163.04,,,,117.88,163.04
7.0 MM T1 CAN MTRX PLYAX SCRW 55MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2244.87,,,,1892.11,2616.88
7.0 MM T1 CAN MTRX PLYAX SCRW 55MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Cigna,Default,Percent of Total Billed Charges,1892.11,,,,1892.11,2616.88
7.0 MM T1 CAN MTRX PLYAX SCRW 55MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,United Healthcare,Default,Fee Schedule,2616.88,,,,1892.11,2616.88
PSN ASF PS 14MM VE R 10-12 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 14MM VE R 10-12 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 14MM VE R 10-12 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
28MM DIA COCR MOD HD +3MM NK,C1776,HCPCS,278,RC,,both,1415.25,1273.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,990.68,,,,835,1154.84
28MM DIA COCR MOD HD +3MM NK,C1776,HCPCS,278,RC,,both,1415.25,1273.73,Cigna,Default,Percent of Total Billed Charges,835,,,,835,1154.84
28MM DIA COCR MOD HD +3MM NK,C1776,HCPCS,278,RC,,both,1415.25,1273.73,United Healthcare,Default,Fee Schedule,1154.84,,,,835,1154.84
WAVEWRITTER ALPHA 16  GEN KIT,C1820,HCPCS,278,RC,,both,68265,61438.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47785.5,,,,40276.35,55704.24
WAVEWRITTER ALPHA 16  GEN KIT,C1820,HCPCS,278,RC,,both,68265,61438.5,Cigna,Default,Percent of Total Billed Charges,40276.35,,,,40276.35,55704.24
WAVEWRITTER ALPHA 16  GEN KIT,C1820,HCPCS,278,RC,,both,68265,61438.5,United Healthcare,Default,Fee Schedule,55704.24,,,,40276.35,55704.24
SKY VARIABLE S-D SCREW 12MM T1,272,RC,,,,both,411.59,370.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,288.11,,,,242.84,335.86
SKY VARIABLE S-D SCREW 12MM T1,272,RC,,,,both,411.59,370.43,Cigna,Default,Percent of Total Billed Charges,242.84,,,,242.84,335.86
SKY VARIABLE S-D SCREW 12MM T1,272,RC,,,,both,411.59,370.43,United Healthcare,Default,Fee Schedule,335.86,,,,242.84,335.86
LUTONIX 018  4X40 4F,C1725,HCPCS,278,RC,,both,6327,5694.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4428.9,,,,3732.93,5162.83
LUTONIX 018  4X40 4F,C1725,HCPCS,278,RC,,both,6327,5694.3,Cigna,Default,Percent of Total Billed Charges,3732.93,,,,3732.93,5162.83
LUTONIX 018  4X40 4F,C1725,HCPCS,278,RC,,both,6327,5694.3,United Healthcare,Default,Fee Schedule,5162.83,,,,3732.93,5162.83
ANTI-ROTATION PIN 3.0MM-SM,C1713,HCPCS,278,RC,,both,452.75,407.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.92,,,,267.12,369.44
ANTI-ROTATION PIN 3.0MM-SM,C1713,HCPCS,278,RC,,both,452.75,407.48,Cigna,Default,Percent of Total Billed Charges,267.12,,,,267.12,369.44
ANTI-ROTATION PIN 3.0MM-SM,C1713,HCPCS,278,RC,,both,452.75,407.48,United Healthcare,Default,Fee Schedule,369.44,,,,267.12,369.44
STRATAFIX 3-0 SH,272,RC,,,,both,106.03,95.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.22,,,,62.56,86.52
STRATAFIX 3-0 SH,272,RC,,,,both,106.03,95.43,Cigna,Default,Percent of Total Billed Charges,62.56,,,,62.56,86.52
STRATAFIX 3-0 SH,272,RC,,,,both,106.03,95.43,United Healthcare,Default,Fee Schedule,86.52,,,,62.56,86.52
SUTURE STRATAFIX 4-0 PS-2,272,RC,,,,both,67.11,60.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.98,,,,39.59,54.76
SUTURE STRATAFIX 4-0 PS-2,272,RC,,,,both,67.11,60.4,Cigna,Default,Percent of Total Billed Charges,39.59,,,,39.59,54.76
SUTURE STRATAFIX 4-0 PS-2,272,RC,,,,both,67.11,60.4,United Healthcare,Default,Fee Schedule,54.76,,,,39.59,54.76
OBRIEN SUPRAPUNIC ACCESS SHEATH,272,RC,,,,both,474.36,426.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,332.05,,,,279.87,387.08
OBRIEN SUPRAPUNIC ACCESS SHEATH,272,RC,,,,both,474.36,426.92,Cigna,Default,Percent of Total Billed Charges,279.87,,,,279.87,387.08
OBRIEN SUPRAPUNIC ACCESS SHEATH,272,RC,,,,both,474.36,426.92,United Healthcare,Default,Fee Schedule,387.08,,,,279.87,387.08
6.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2244.87,,,,1892.11,2616.88
6.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,Cigna,Default,Percent of Total Billed Charges,1892.11,,,,1892.11,2616.88
6.0 MM T1 CAN MTRX PLYAX SCRW 50MM,C1713,HCPCS,278,RC,,both,3206.96,2886.26,United Healthcare,Default,Fee Schedule,2616.88,,,,1892.11,2616.88
ASCOPE 4 BRONCHO SLIM,272,RC,,,,both,922.64,830.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,645.85,,,,544.36,752.87
ASCOPE 4 BRONCHO SLIM,272,RC,,,,both,922.64,830.38,Cigna,Default,Percent of Total Billed Charges,544.36,,,,544.36,752.87
ASCOPE 4 BRONCHO SLIM,272,RC,,,,both,922.64,830.38,United Healthcare,Default,Fee Schedule,752.87,,,,544.36,752.87
ASCOPE GASTRO,272,RC,,,,both,1714.95,1543.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1200.46,,,,1011.82,1399.4
ASCOPE GASTRO,272,RC,,,,both,1714.95,1543.46,Cigna,Default,Percent of Total Billed Charges,1011.82,,,,1011.82,1399.4
ASCOPE GASTRO,272,RC,,,,both,1714.95,1543.46,United Healthcare,Default,Fee Schedule,1399.4,,,,1011.82,1399.4
22.2MM DIA COCR MOD HE-3MM NK,C1776,HCPCS,278,RC,,both,1415.25,1273.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,990.68,,,,835,1154.84
22.2MM DIA COCR MOD HE-3MM NK,C1776,HCPCS,278,RC,,both,1415.25,1273.73,Cigna,Default,Percent of Total Billed Charges,835,,,,835,1154.84
22.2MM DIA COCR MOD HE-3MM NK,C1776,HCPCS,278,RC,,both,1415.25,1273.73,United Healthcare,Default,Fee Schedule,1154.84,,,,835,1154.84
OVERTUBE ESOPHOGEAL 9.8-11.7 25cm50FR,272,RC,,,,both,609.38,548.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,426.57,,,,359.53,497.25
OVERTUBE ESOPHOGEAL 9.8-11.7 25cm50FR,272,RC,,,,both,609.38,548.44,Cigna,Default,Percent of Total Billed Charges,359.53,,,,359.53,497.25
OVERTUBE ESOPHOGEAL 9.8-11.7 25cm50FR,272,RC,,,,both,609.38,548.44,United Healthcare,Default,Fee Schedule,497.25,,,,359.53,497.25
SUB MR8 15 CM MATCH HEAD 3MM,272,RC,,,,both,446.54,401.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,312.58,,,,263.46,364.38
SUB MR8 15 CM MATCH HEAD 3MM,272,RC,,,,both,446.54,401.89,Cigna,Default,Percent of Total Billed Charges,263.46,,,,263.46,364.38
SUB MR8 15 CM MATCH HEAD 3MM,272,RC,,,,both,446.54,401.89,United Healthcare,Default,Fee Schedule,364.38,,,,263.46,364.38
PLASMA OVAL BUTTON 24FR URO 12-30DEG,272,RC,,,,both,2053.27,1847.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1437.29,,,,1211.43,1675.47
PLASMA OVAL BUTTON 24FR URO 12-30DEG,272,RC,,,,both,2053.27,1847.94,Cigna,Default,Percent of Total Billed Charges,1211.43,,,,1211.43,1675.47
PLASMA OVAL BUTTON 24FR URO 12-30DEG,272,RC,,,,both,2053.27,1847.94,United Healthcare,Default,Fee Schedule,1675.47,,,,1211.43,1675.47
ARCOS 1 PC 15X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,6907.75,6216.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4835.42,,,,4075.57,5636.72
ARCOS 1 PC 15X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,6907.75,6216.98,Cigna,Default,Percent of Total Billed Charges,4075.57,,,,4075.57,5636.72
ARCOS 1 PC 15X175MM BRCH BODY HI,C1776,HCPCS,278,RC,,both,6907.75,6216.98,United Healthcare,Default,Fee Schedule,5636.72,,,,4075.57,5636.72
PSN ASF PS 11MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 11MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 11MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
MEDIUM PLASMA LOOP,272,RC,,,,both,1700.66,1530.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1190.46,,,,1003.39,1387.74
MEDIUM PLASMA LOOP,272,RC,,,,both,1700.66,1530.59,Cigna,Default,Percent of Total Billed Charges,1003.39,,,,1003.39,1387.74
MEDIUM PLASMA LOOP,272,RC,,,,both,1700.66,1530.59,United Healthcare,Default,Fee Schedule,1387.74,,,,1003.39,1387.74
*LAG SCREW 10.5X110  Z NAIL,278,RC,,,,both,1926.24,1733.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1348.37,,,,1136.48,1571.81
*LAG SCREW 10.5X110  Z NAIL,278,RC,,,,both,1926.24,1733.62,Cigna,Default,Percent of Total Billed Charges,1136.48,,,,1136.48,1571.81
*LAG SCREW 10.5X110  Z NAIL,278,RC,,,,both,1926.24,1733.62,United Healthcare,Default,Fee Schedule,1571.81,,,,1136.48,1571.81
UROVAC BLADDER EVACUATOR,272,RC,,,,both,100.76,90.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.53,,,,59.45,82.22
UROVAC BLADDER EVACUATOR,272,RC,,,,both,100.76,90.68,Cigna,Default,Percent of Total Billed Charges,59.45,,,,59.45,82.22
UROVAC BLADDER EVACUATOR,272,RC,,,,both,100.76,90.68,United Healthcare,Default,Fee Schedule,82.22,,,,59.45,82.22
ACIS-STERILE LORDOTIC/STANDARD-10MM HT,C1889,HCPCS,278,RC,,both,3086.91,2778.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2160.84,,,,1821.28,2518.92
ACIS-STERILE LORDOTIC/STANDARD-10MM HT,C1889,HCPCS,278,RC,,both,3086.91,2778.22,Cigna,Default,Percent of Total Billed Charges,1821.28,,,,1821.28,2518.92
ACIS-STERILE LORDOTIC/STANDARD-10MM HT,C1889,HCPCS,278,RC,,both,3086.91,2778.22,United Healthcare,Default,Fee Schedule,2518.92,,,,1821.28,2518.92
PSN ASF PS 11MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2040.79,,,,1720.09,2378.97
PSN ASF PS 11MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,Cigna,Default,Percent of Total Billed Charges,1720.09,,,,1720.09,2378.97
PSN ASF PS 11MM VE L 10-12 GH,C1776,HCPCS,278,RC,,both,2915.41,2623.87,United Healthcare,Default,Fee Schedule,2378.97,,,,1720.09,2378.97
VIPER2 1.45 BLUNT GUIDE WIRE,C1769,HCPCS,278,RC,,both,171.5,154.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.05,,,,101.18,139.94
VIPER2 1.45 BLUNT GUIDE WIRE,C1769,HCPCS,278,RC,,both,171.5,154.35,Cigna,Default,Percent of Total Billed Charges,101.18,,,,101.18,139.94
VIPER2 1.45 BLUNT GUIDE WIRE,C1769,HCPCS,278,RC,,both,171.5,154.35,United Healthcare,Default,Fee Schedule,139.94,,,,101.18,139.94
SUB ELECTRODE BLADE 6.5 E-Z INSULATED,272,RC,,,,both,49.87,44.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.91,,,,29.42,40.69
SUB ELECTRODE BLADE 6.5 E-Z INSULATED,272,RC,,,,both,49.87,44.88,Cigna,Default,Percent of Total Billed Charges,29.42,,,,29.42,40.69
SUB ELECTRODE BLADE 6.5 E-Z INSULATED,272,RC,,,,both,49.87,44.88,United Healthcare,Default,Fee Schedule,40.69,,,,29.42,40.69
ZERO-P VA IMP 7MM LORDOTIC,C1776,HCPCS,278,RC,,both,6993,6293.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4895.1,,,,4125.87,5706.29
ZERO-P VA IMP 7MM LORDOTIC,C1776,HCPCS,278,RC,,both,6993,6293.7,Cigna,Default,Percent of Total Billed Charges,4125.87,,,,4125.87,5706.29
ZERO-P VA IMP 7MM LORDOTIC,C1776,HCPCS,278,RC,,both,6993,6293.7,United Healthcare,Default,Fee Schedule,5706.29,,,,4125.87,5706.29
3.7 TI CERV SPINE SCREW 16MM,C1713,HCPCS,278,RC,,both,685.98,617.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,480.19,,,,404.73,559.76
3.7 TI CERV SPINE SCREW 16MM,C1713,HCPCS,278,RC,,both,685.98,617.38,Cigna,Default,Percent of Total Billed Charges,404.73,,,,404.73,559.76
3.7 TI CERV SPINE SCREW 16MM,C1713,HCPCS,278,RC,,both,685.98,617.38,United Healthcare,Default,Fee Schedule,559.76,,,,404.73,559.76
WAVEWRITTER ALPHA 16  GEN KIT(SC1216),C1820,HCPCS,278,RC,,both,68265,61438.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47785.5,,,,40276.35,55704.24
WAVEWRITTER ALPHA 16  GEN KIT(SC1216),C1820,HCPCS,278,RC,,both,68265,61438.5,Cigna,Default,Percent of Total Billed Charges,40276.35,,,,40276.35,55704.24
WAVEWRITTER ALPHA 16  GEN KIT(SC1216),C1820,HCPCS,278,RC,,both,68265,61438.5,United Healthcare,Default,Fee Schedule,55704.24,,,,40276.35,55704.24
"PRECISION S8 ADAPTER, 15CM",272,RC,,,,both,2560.56,2304.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1792.39,,,,1510.73,2089.42
"PRECISION S8 ADAPTER, 15CM",272,RC,,,,both,2560.56,2304.5,Cigna,Default,Percent of Total Billed Charges,1510.73,,,,1510.73,2089.42
"PRECISION S8 ADAPTER, 15CM",272,RC,,,,both,2560.56,2304.5,United Healthcare,Default,Fee Schedule,2089.42,,,,1510.73,2089.42
2X8 O.R. CABLE & EXTENSION,272,RC,,,,both,20.6,18.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.42,,,,12.15,16.81
2X8 O.R. CABLE & EXTENSION,272,RC,,,,both,20.6,18.54,Cigna,Default,Percent of Total Billed Charges,12.15,,,,12.15,16.81
2X8 O.R. CABLE & EXTENSION,272,RC,,,,both,20.6,18.54,United Healthcare,Default,Fee Schedule,16.81,,,,12.15,16.81
PSN ASF PS 14MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 14MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 14MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
PTA SCORING CATH BALLON 3MM 5F SHEATH,C1725,HCPCS,278,RC,,both,3663,3296.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2564.1,,,,2161.17,2989.01
PTA SCORING CATH BALLON 3MM 5F SHEATH,C1725,HCPCS,278,RC,,both,3663,3296.7,Cigna,Default,Percent of Total Billed Charges,2161.17,,,,2161.17,2989.01
PTA SCORING CATH BALLON 3MM 5F SHEATH,C1725,HCPCS,278,RC,,both,3663,3296.7,United Healthcare,Default,Fee Schedule,2989.01,,,,2161.17,2989.01
VIABAHN ENDOPROSTHESIS 8MMX5MM 7FR,C1874,HCPCS,278,RC,,both,11048.94,9944.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7734.26,,,,6518.87,9015.94
VIABAHN ENDOPROSTHESIS 8MMX5MM 7FR,C1874,HCPCS,278,RC,,both,11048.94,9944.05,Cigna,Default,Percent of Total Billed Charges,6518.87,,,,6518.87,9015.94
VIABAHN ENDOPROSTHESIS 8MMX5MM 7FR,C1874,HCPCS,278,RC,,both,11048.94,9944.05,United Healthcare,Default,Fee Schedule,9015.94,,,,6518.87,9015.94
VIABAHN ENDOPROSTHESIS 8MMX15CM 7FR,C1874,HCPCS,278,RC,,both,13469.85,12122.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9428.9,,,,7947.21,10991.4
VIABAHN ENDOPROSTHESIS 8MMX15CM 7FR,C1874,HCPCS,278,RC,,both,13469.85,12122.87,Cigna,Default,Percent of Total Billed Charges,7947.21,,,,7947.21,10991.4
VIABAHN ENDOPROSTHESIS 8MMX15CM 7FR,C1874,HCPCS,278,RC,,both,13469.85,12122.87,United Healthcare,Default,Fee Schedule,10991.4,,,,7947.21,10991.4
VIPER 2 LORDOTIC ROD 50MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.44,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 50MM,C1776,HCPCS,278,RC,,both,799.2,719.28,Cigna,Default,Percent of Total Billed Charges,471.53,,,,471.53,652.15
VIPER 2 LORDOTIC ROD 50MM,C1776,HCPCS,278,RC,,both,799.2,719.28,United Healthcare,Default,Fee Schedule,652.15,,,,471.53,652.15
SNARE HOT/COLD SMALL .3MMXX230CMX10MM,272,RC,,,,both,80.73,72.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.51,,,,47.63,65.88
SNARE HOT/COLD SMALL .3MMXX230CMX10MM,272,RC,,,,both,80.73,72.66,Cigna,Default,Percent of Total Billed Charges,47.63,,,,47.63,65.88
SNARE HOT/COLD SMALL .3MMXX230CMX10MM,272,RC,,,,both,80.73,72.66,United Healthcare,Default,Fee Schedule,65.88,,,,47.63,65.88
SNARE HOT/COLD LARGE .3MMX230CMX15MM,272,RC,,,,both,80.73,72.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.51,,,,47.63,65.88
SNARE HOT/COLD LARGE .3MMX230CMX15MM,272,RC,,,,both,80.73,72.66,Cigna,Default,Percent of Total Billed Charges,47.63,,,,47.63,65.88
SNARE HOT/COLD LARGE .3MMX230CMX15MM,272,RC,,,,both,80.73,72.66,United Healthcare,Default,Fee Schedule,65.88,,,,47.63,65.88
"ARTHOCELL PLUS ALLOGRAFT, 5.0CC",C1768,HCPCS,278,RC,,both,11655,10489.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8158.5,,,,6876.45,9510.48
"ARTHOCELL PLUS ALLOGRAFT, 5.0CC",C1768,HCPCS,278,RC,,both,11655,10489.5,Cigna,Default,Percent of Total Billed Charges,6876.45,,,,6876.45,9510.48
"ARTHOCELL PLUS ALLOGRAFT, 5.0CC",C1768,HCPCS,278,RC,,both,11655,10489.5,United Healthcare,Default,Fee Schedule,9510.48,,,,6876.45,9510.48
CACELLOUS SCREW 3.0 X 16MM,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
CACELLOUS SCREW 3.0 X 16MM,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
CACELLOUS SCREW 3.0 X 16MM,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 30MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 30MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 30MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 34MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 34MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 34MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 38MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 38MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 38MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 42MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 42MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 42MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 46MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 46MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 46MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 48MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 48MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCRW TM SS 3.5 X 48MMCORT,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LO PRO SCREW SS CANCLUS 4.0X20MM,C1713,HCPCS,278,RC,,both,157.85,142.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.5,,,,93.13,128.81
LO PRO SCREW SS CANCLUS 4.0X20MM,C1713,HCPCS,278,RC,,both,157.85,142.07,Cigna,Default,Percent of Total Billed Charges,93.13,,,,93.13,128.81
LO PRO SCREW SS CANCLUS 4.0X20MM,C1713,HCPCS,278,RC,,both,157.85,142.07,United Healthcare,Default,Fee Schedule,128.81,,,,93.13,128.81
LOCKING MED. HOOK PLT SS 3H,C1713,HCPCS,278,RC,,both,3021.98,2719.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2115.39,,,,1782.97,2465.94
LOCKING MED. HOOK PLT SS 3H,C1713,HCPCS,278,RC,,both,3021.98,2719.78,Cigna,Default,Percent of Total Billed Charges,1782.97,,,,1782.97,2465.94
LOCKING MED. HOOK PLT SS 3H,C1713,HCPCS,278,RC,,both,3021.98,2719.78,United Healthcare,Default,Fee Schedule,2465.94,,,,1782.97,2465.94
LOCKING THIRD TUBULAR PLT SS 6H,C1713,HCPCS,278,RC,,both,879.12,791.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,615.38,,,,518.68,717.36
LOCKING THIRD TUBULAR PLT SS 6H,C1713,HCPCS,278,RC,,both,879.12,791.21,Cigna,Default,Percent of Total Billed Charges,518.68,,,,518.68,717.36
LOCKING THIRD TUBULAR PLT SS 6H,C1713,HCPCS,278,RC,,both,879.12,791.21,United Healthcare,Default,Fee Schedule,717.36,,,,518.68,717.36
*6.5MM CANNULATED SCREW 16MM THD 80MM,C1713,HCPCS,278,RC,,both,825.31,742.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,577.72,,,,486.93,673.45
*6.5MM CANNULATED SCREW 16MM THD 80MM,C1713,HCPCS,278,RC,,both,825.31,742.78,Cigna,Default,Percent of Total Billed Charges,486.93,,,,486.93,673.45
*6.5MM CANNULATED SCREW 16MM THD 80MM,C1713,HCPCS,278,RC,,both,825.31,742.78,United Healthcare,Default,Fee Schedule,673.45,,,,486.93,673.45
MEDIUM-LONG PLASMA LOOP 24FR,272,RC,,,,both,1700.66,1530.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1190.46,,,,1003.39,1387.74
MEDIUM-LONG PLASMA LOOP 24FR,272,RC,,,,both,1700.66,1530.59,Cigna,Default,Percent of Total Billed Charges,1003.39,,,,1003.39,1387.74
MEDIUM-LONG PLASMA LOOP 24FR,272,RC,,,,both,1700.66,1530.59,United Healthcare,Default,Fee Schedule,1387.74,,,,1003.39,1387.74
LARGE PLASMA LOOP 24FR,272,RC,,,,both,1774.47,1597.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1242.13,,,,1046.94,1447.97
LARGE PLASMA LOOP 24FR,272,RC,,,,both,1774.47,1597.02,Cigna,Default,Percent of Total Billed Charges,1046.94,,,,1046.94,1447.97
LARGE PLASMA LOOP 24FR,272,RC,,,,both,1774.47,1597.02,United Healthcare,Default,Fee Schedule,1447.97,,,,1046.94,1447.97
SKY 2 LEVEL PLATE 24MM TI,L8699,HCPCS,278,RC,,both,2572.43,2315.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1800.7,,,,1517.73,2099.1
SKY 2 LEVEL PLATE 24MM TI,L8699,HCPCS,278,RC,,both,2572.43,2315.19,Cigna,Default,Percent of Total Billed Charges,1517.73,,,,1517.73,2099.1
SKY 2 LEVEL PLATE 24MM TI,L8699,HCPCS,278,RC,,both,2572.43,2315.19,United Healthcare,Default,Fee Schedule,2099.1,,,,1517.73,2099.1
PILLCAM PATENCY CAPSULE,C1781,HCPCS,278,RC,,both,127.1,114.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.97,,,,74.99,103.71
PILLCAM PATENCY CAPSULE,C1781,HCPCS,278,RC,,both,127.1,114.39,Cigna,Default,Percent of Total Billed Charges,74.99,,,,74.99,103.71
PILLCAM PATENCY CAPSULE,C1781,HCPCS,278,RC,,both,127.1,114.39,United Healthcare,Default,Fee Schedule,103.71,,,,74.99,103.71
PILLCAM SB3,C1781,HCPCS,278,RC,,both,1917.41,1725.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1342.19,,,,1131.27,1564.61
PILLCAM SB3,C1781,HCPCS,278,RC,,both,1917.41,1725.67,Cigna,Default,Percent of Total Billed Charges,1131.27,,,,1131.27,1564.61
PILLCAM SB3,C1781,HCPCS,278,RC,,both,1917.41,1725.67,United Healthcare,Default,Fee Schedule,1564.61,,,,1131.27,1564.61
CAPSURE PERMANENT FIXATION W/15-FASTNER,C1781,HCPCS,278,RC,,both,1731.6,1558.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1212.12,,,,1021.64,1412.99
CAPSURE PERMANENT FIXATION W/15-FASTNER,C1781,HCPCS,278,RC,,both,1731.6,1558.44,Cigna,Default,Percent of Total Billed Charges,1021.64,,,,1021.64,1412.99
CAPSURE PERMANENT FIXATION W/15-FASTNER,C1781,HCPCS,278,RC,,both,1731.6,1558.44,United Healthcare,Default,Fee Schedule,1412.99,,,,1021.64,1412.99
"MESH, XL LEFT, 12CMX17CM ANATOMICAL",C1781,HCPCS,278,RC,,both,859.47,773.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,601.63,,,,507.09,701.33
"MESH, XL LEFT, 12CMX17CM ANATOMICAL",C1781,HCPCS,278,RC,,both,859.47,773.52,Cigna,Default,Percent of Total Billed Charges,507.09,,,,507.09,701.33
"MESH, XL LEFT, 12CMX17CM ANATOMICAL",C1781,HCPCS,278,RC,,both,859.47,773.52,United Healthcare,Default,Fee Schedule,701.33,,,,507.09,701.33
"MESH, XL RIGHT, 12CMX17CM ANATOMICAL",C1781,HCPCS,278,RC,,both,859.47,773.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,601.63,,,,507.09,701.33
"MESH, XL RIGHT, 12CMX17CM ANATOMICAL",C1781,HCPCS,278,RC,,both,859.47,773.52,Cigna,Default,Percent of Total Billed Charges,507.09,,,,507.09,701.33
"MESH, XL RIGHT, 12CMX17CM ANATOMICAL",C1781,HCPCS,278,RC,,both,859.47,773.52,United Healthcare,Default,Fee Schedule,701.33,,,,507.09,701.33
"MESH, LG LEFT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,547.78,,,,461.7,638.56
"MESH, LG LEFT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,Cigna,Default,Percent of Total Billed Charges,461.7,,,,461.7,638.56
"MESH, LG LEFT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,United Healthcare,Default,Fee Schedule,638.56,,,,461.7,638.56
"MESH, LG RIGHT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,547.78,,,,461.7,638.56
"MESH, LG RIGHT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,Cigna,Default,Percent of Total Billed Charges,461.7,,,,461.7,638.56
"MESH, LG RIGHT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,United Healthcare,Default,Fee Schedule,638.56,,,,461.7,638.56
GENEX 10CC KTW/BEAD MOLD TRAY,C1713,HCPCS,278,RC,,both,12499.99,11249.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8749.99,,,,7374.99,10199.99
GENEX 10CC KTW/BEAD MOLD TRAY,C1713,HCPCS,278,RC,,both,12499.99,11249.99,Cigna,Default,Percent of Total Billed Charges,7374.99,,,,7374.99,10199.99
GENEX 10CC KTW/BEAD MOLD TRAY,C1713,HCPCS,278,RC,,both,12499.99,11249.99,United Healthcare,Default,Fee Schedule,10199.99,,,,7374.99,10199.99
BACTISURE WOUND LAVAGE WW,C1713,HCPCS,278,RC,,both,2497.5,2247.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1748.25,,,,1473.52,2037.96
BACTISURE WOUND LAVAGE WW,C1713,HCPCS,278,RC,,both,2497.5,2247.75,Cigna,Default,Percent of Total Billed Charges,1473.52,,,,1473.52,2037.96
BACTISURE WOUND LAVAGE WW,C1713,HCPCS,278,RC,,both,2497.5,2247.75,United Healthcare,Default,Fee Schedule,2037.96,,,,1473.52,2037.96
CONTINUUM VIVACIT-E NEUTRAL LINER 36X62,C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
CONTINUUM VIVACIT-E NEUTRAL LINER 36X62,C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
CONTINUUM VIVACIT-E NEUTRAL LINER 36X62,C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
HERNIA PATCH MED 2.5IN VENTALEX ST,C1781,HCPCS,278,RC,,both,1593.07,1433.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1115.15,,,,939.91,1299.95
HERNIA PATCH MED 2.5IN VENTALEX ST,C1781,HCPCS,278,RC,,both,1593.07,1433.76,Cigna,Default,Percent of Total Billed Charges,939.91,,,,939.91,1299.95
HERNIA PATCH MED 2.5IN VENTALEX ST,C1781,HCPCS,278,RC,,both,1593.07,1433.76,United Healthcare,Default,Fee Schedule,1299.95,,,,939.91,1299.95
HERNIA PATCH LG 3.2 IN VENTRALEX ST,C1781,HCPCS,278,RC,,both,2060.6,1854.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1442.42,,,,1215.75,1681.45
HERNIA PATCH LG 3.2 IN VENTRALEX ST,C1781,HCPCS,278,RC,,both,2060.6,1854.54,Cigna,Default,Percent of Total Billed Charges,1215.75,,,,1215.75,1681.45
HERNIA PATCH LG 3.2 IN VENTRALEX ST,C1781,HCPCS,278,RC,,both,2060.6,1854.54,United Healthcare,Default,Fee Schedule,1681.45,,,,1215.75,1681.45
SEGURA 2.4 BASKET STAINLESS STEEL,272,RC,,,,both,603.9,543.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,422.73,,,,356.3,492.78
SEGURA 2.4 BASKET STAINLESS STEEL,272,RC,,,,both,603.9,543.51,Cigna,Default,Percent of Total Billed Charges,356.3,,,,356.3,492.78
SEGURA 2.4 BASKET STAINLESS STEEL,272,RC,,,,both,603.9,543.51,United Healthcare,Default,Fee Schedule,492.78,,,,356.3,492.78
V-LOC 180 2-0 GRN GS22 STUTURE,272,RC,,,,both,121.52,109.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.06,,,,71.7,99.16
V-LOC 180 2-0 GRN GS22 STUTURE,272,RC,,,,both,121.52,109.37,Cigna,Default,Percent of Total Billed Charges,71.7,,,,71.7,99.16
V-LOC 180 2-0 GRN GS22 STUTURE,272,RC,,,,both,121.52,109.37,United Healthcare,Default,Fee Schedule,99.16,,,,71.7,99.16
SUTURE 0 VICRYL UR-6 J603H,272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
SUTURE 0 VICRYL UR-6 J603H,272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
SUTURE 0 VICRYL UR-6 J603H,272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
PSN ASF PS 16MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 16MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 16MM VE R 6-9 CD,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
GUIDEWIRE .035X450CM ANGLED DREAMWIRE,A4649,HCPCS,272,RC,,both,598.28,538.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,418.8,,,,352.99,488.2
GUIDEWIRE .035X450CM ANGLED DREAMWIRE,A4649,HCPCS,272,RC,,both,598.28,538.45,Cigna,Default,Percent of Total Billed Charges,352.99,,,,352.99,488.2
GUIDEWIRE .035X450CM ANGLED DREAMWIRE,A4649,HCPCS,272,RC,,both,598.28,538.45,United Healthcare,Default,Fee Schedule,488.2,,,,352.99,488.2
*DILATOR MALONEY 46FR BOUGIE,272,RC,,,,both,764.57,688.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,535.2,,,,451.1,623.89
*DILATOR MALONEY 46FR BOUGIE,272,RC,,,,both,764.57,688.11,Cigna,Default,Percent of Total Billed Charges,451.1,,,,451.1,623.89
*DILATOR MALONEY 46FR BOUGIE,272,RC,,,,both,764.57,688.11,United Healthcare,Default,Fee Schedule,623.89,,,,451.1,623.89
*DILATOR MALONEY 42FR BOUGIE,272,RC,,,,both,715.62,644.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,500.93,,,,422.22,583.95
*DILATOR MALONEY 42FR BOUGIE,272,RC,,,,both,715.62,644.06,Cigna,Default,Percent of Total Billed Charges,422.22,,,,422.22,583.95
*DILATOR MALONEY 42FR BOUGIE,272,RC,,,,both,715.62,644.06,United Healthcare,Default,Fee Schedule,583.95,,,,422.22,583.95
FAST 2.0MM DRILL BIT MINIQUICK,272,RC,,,,both,179.82,161.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.87,,,,106.09,146.73
FAST 2.0MM DRILL BIT MINIQUICK,272,RC,,,,both,179.82,161.84,Cigna,Default,Percent of Total Billed Charges,106.09,,,,106.09,146.73
FAST 2.0MM DRILL BIT MINIQUICK,272,RC,,,,both,179.82,161.84,United Healthcare,Default,Fee Schedule,146.73,,,,106.09,146.73
2.5MM LOCK PLATE STRAIGHT,C1713,HCPCS,278,RC,,both,1538.46,1384.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1076.92,,,,907.69,1255.38
2.5MM LOCK PLATE STRAIGHT,C1713,HCPCS,278,RC,,both,1538.46,1384.61,Cigna,Default,Percent of Total Billed Charges,907.69,,,,907.69,1255.38
2.5MM LOCK PLATE STRAIGHT,C1713,HCPCS,278,RC,,both,1538.46,1384.61,United Healthcare,Default,Fee Schedule,1255.38,,,,907.69,1255.38
2.0/2.5MM/DRIVER BIT,C1713,HCPCS,278,RC,,both,144,129.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.8,,,,84.96,117.5
2.0/2.5MM/DRIVER BIT,C1713,HCPCS,278,RC,,both,144,129.6,Cigna,Default,Percent of Total Billed Charges,84.96,,,,84.96,117.5
2.0/2.5MM/DRIVER BIT,C1713,HCPCS,278,RC,,both,144,129.6,United Healthcare,Default,Fee Schedule,117.5,,,,84.96,117.5
PEG FULL THREAD 2.5X15MM,C1713,HCPCS,278,RC,,both,319.68,287.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.78,,,,188.61,260.86
PEG FULL THREAD 2.5X15MM,C1713,HCPCS,278,RC,,both,319.68,287.71,Cigna,Default,Percent of Total Billed Charges,188.61,,,,188.61,260.86
PEG FULL THREAD 2.5X15MM,C1713,HCPCS,278,RC,,both,319.68,287.71,United Healthcare,Default,Fee Schedule,260.86,,,,188.61,260.86
PEG FULL THREAD 2.5X16MM,C1713,HCPCS,278,RC,,both,319.68,287.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.78,,,,188.61,260.86
PEG FULL THREAD 2.5X16MM,C1713,HCPCS,278,RC,,both,319.68,287.71,Cigna,Default,Percent of Total Billed Charges,188.61,,,,188.61,260.86
PEG FULL THREAD 2.5X16MM,C1713,HCPCS,278,RC,,both,319.68,287.71,United Healthcare,Default,Fee Schedule,260.86,,,,188.61,260.86
1.7 MM SQAURE DRIVER,C1713,HCPCS,278,RC,,both,275.79,248.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,193.05,,,,162.72,225.04
1.7 MM SQAURE DRIVER,C1713,HCPCS,278,RC,,both,275.79,248.21,Cigna,Default,Percent of Total Billed Charges,162.72,,,,162.72,225.04
1.7 MM SQAURE DRIVER,C1713,HCPCS,278,RC,,both,275.79,248.21,United Healthcare,Default,Fee Schedule,225.04,,,,162.72,225.04
DVR LOCK NARROW R,C1713,HCPCS,278,RC,,both,2977.02,2679.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2083.91,,,,1756.44,2429.25
DVR LOCK NARROW R,C1713,HCPCS,278,RC,,both,2977.02,2679.32,Cigna,Default,Percent of Total Billed Charges,1756.44,,,,1756.44,2429.25
DVR LOCK NARROW R,C1713,HCPCS,278,RC,,both,2977.02,2679.32,United Healthcare,Default,Fee Schedule,2429.25,,,,1756.44,2429.25
"SUTURE SILK 2-0 BB 30"" ETH K883H",272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
"SUTURE SILK 2-0 BB 30"" ETH K883H",272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
"SUTURE SILK 2-0 BB 30"" ETH K883H",272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,12087.9,10879.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8461.53,,,,7131.86,9863.73
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,12087.9,10879.11,Cigna,Default,Percent of Total Billed Charges,7131.86,,,,7131.86,9863.73
VIABAHN ENDOPROSTHESIS,C1874,HCPCS,278,RC,,both,12087.9,10879.11,United Healthcare,Default,Fee Schedule,9863.73,,,,7131.86,9863.73
ULTRAVERSE 5X40X130 5FR SHEATH,C1725,HCPCS,272,RC,,both,1202.13,1081.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,841.49,,,,709.26,980.94
ULTRAVERSE 5X40X130 5FR SHEATH,C1725,HCPCS,272,RC,,both,1202.13,1081.92,Cigna,Default,Percent of Total Billed Charges,709.26,,,,709.26,980.94
ULTRAVERSE 5X40X130 5FR SHEATH,C1725,HCPCS,272,RC,,both,1202.13,1081.92,United Healthcare,Default,Fee Schedule,980.94,,,,709.26,980.94
PSN FEM PS CMT TIV STD SZ 7L,C1776,HCPCS,278,RC,,both,7142.85,6428.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5000,,,,4214.28,5828.57
PSN FEM PS CMT TIV STD SZ 7L,C1776,HCPCS,278,RC,,both,7142.85,6428.57,Cigna,Default,Percent of Total Billed Charges,4214.28,,,,4214.28,5828.57
PSN FEM PS CMT TIV STD SZ 7L,C1776,HCPCS,278,RC,,both,7142.85,6428.57,United Healthcare,Default,Fee Schedule,5828.57,,,,4214.28,5828.57
CANNULATED COMPRESSION SCREW W/ S.S.,C1713,HCPCS,278,RC,,both,1262.14,1135.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,883.5,,,,744.66,1029.91
CANNULATED COMPRESSION SCREW W/ S.S.,C1713,HCPCS,278,RC,,both,1262.14,1135.93,Cigna,Default,Percent of Total Billed Charges,744.66,,,,744.66,1029.91
CANNULATED COMPRESSION SCREW W/ S.S.,C1713,HCPCS,278,RC,,both,1262.14,1135.93,United Healthcare,Default,Fee Schedule,1029.91,,,,744.66,1029.91
ENDURITY PACEMAKER GENERATOR,C1785,HCPCS,275,RC,,both,14319,12887.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10023.3,,,,8448.21,11684.3
ENDURITY PACEMAKER GENERATOR,C1785,HCPCS,275,RC,,both,14319,12887.1,Cigna,Default,Percent of Total Billed Charges,8448.21,,,,8448.21,11684.3
ENDURITY PACEMAKER GENERATOR,C1785,HCPCS,275,RC,,both,14319,12887.1,United Healthcare,Default,Fee Schedule,11684.3,,,,8448.21,11684.3
OMNICURVE 11G 20 MM FX KIT,C1713,HCPCS,278,RC,,both,7888.77,7099.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5522.14,,,,4654.37,6437.24
OMNICURVE 11G 20 MM FX KIT,C1713,HCPCS,278,RC,,both,7888.77,7099.89,Cigna,Default,Percent of Total Billed Charges,4654.37,,,,4654.37,6437.24
OMNICURVE 11G 20 MM FX KIT,C1713,HCPCS,278,RC,,both,7888.77,7099.89,United Healthcare,Default,Fee Schedule,6437.24,,,,4654.37,6437.24
"SUTURE ETHIBOND EXCEL X834H SH, SIZE 0,",272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
"SUTURE ETHIBOND EXCEL X834H SH, SIZE 0,",272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
"SUTURE ETHIBOND EXCEL X834H SH, SIZE 0,",272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
10MM STERILE MARGIN MARKER CHARM,A4648,HCPCS,278,RC,,both,79.95,71.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.96,,,,47.17,65.24
10MM STERILE MARGIN MARKER CHARM,A4648,HCPCS,278,RC,,both,79.95,71.96,Cigna,Default,Percent of Total Billed Charges,47.17,,,,47.17,65.24
10MM STERILE MARGIN MARKER CHARM,A4648,HCPCS,278,RC,,both,79.95,71.96,United Healthcare,Default,Fee Schedule,65.24,,,,47.17,65.24
MARGIN MARKER STERILE INK KIT,A4648,HCPCS,278,RC,,both,553.15,497.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,387.2,,,,326.36,451.37
MARGIN MARKER STERILE INK KIT,A4648,HCPCS,278,RC,,both,553.15,497.84,Cigna,Default,Percent of Total Billed Charges,326.36,,,,326.36,451.37
MARGIN MARKER STERILE INK KIT,A4648,HCPCS,278,RC,,both,553.15,497.84,United Healthcare,Default,Fee Schedule,451.37,,,,326.36,451.37
FIBERGRAFT BG PUTTY M 6CC,C1713,HCPCS,278,RC,,both,4137.09,3723.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2895.96,,,,2440.88,3375.87
FIBERGRAFT BG PUTTY M 6CC,C1713,HCPCS,278,RC,,both,4137.09,3723.38,Cigna,Default,Percent of Total Billed Charges,2440.88,,,,2440.88,3375.87
FIBERGRAFT BG PUTTY M 6CC,C1713,HCPCS,278,RC,,both,4137.09,3723.38,United Healthcare,Default,Fee Schedule,3375.87,,,,2440.88,3375.87
"NEEDLE SPINAL 22GX7"", SPINOCAN",272,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
"NEEDLE SPINAL 22GX7"", SPINOCAN",272,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
"NEEDLE SPINAL 22GX7"", SPINOCAN",272,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
PSN ASF PS 12MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 12MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 12MM VE R 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
CODA ACP 2 LEVEL PLATE 26MM,C1713,HCPCS,278,RC,,both,2747.25,2472.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1923.08,,,,1620.88,2241.76
CODA ACP 2 LEVEL PLATE 26MM,C1713,HCPCS,278,RC,,both,2747.25,2472.53,Cigna,Default,Percent of Total Billed Charges,1620.88,,,,1620.88,2241.76
CODA ACP 2 LEVEL PLATE 26MM,C1713,HCPCS,278,RC,,both,2747.25,2472.53,United Healthcare,Default,Fee Schedule,2241.76,,,,1620.88,2241.76
CODA VASD SCREW 3.5 X 16MM,C1713,HCPCS,278,RC,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
CODA VASD SCREW 3.5 X 16MM,C1713,HCPCS,278,RC,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
CODA VASD SCREW 3.5 X 16MM,C1713,HCPCS,278,RC,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
CODA ACP 1 LEVEL PLTE 10MM,C1713,HCPCS,278,RC,,both,2472.53,2225.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1730.77,,,,1458.79,2017.58
CODA ACP 1 LEVEL PLTE 10MM,C1713,HCPCS,278,RC,,both,2472.53,2225.28,Cigna,Default,Percent of Total Billed Charges,1458.79,,,,1458.79,2017.58
CODA ACP 1 LEVEL PLTE 10MM,C1713,HCPCS,278,RC,,both,2472.53,2225.28,United Healthcare,Default,Fee Schedule,2017.58,,,,1458.79,2017.58
PSN ASF PS 12MM VE L 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 12MM VE L 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 12MM VE L 10-11 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
4-0 V-LOCK 90 MONOFILAMENT SUTURE,272,RC,,,,both,89.01,80.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.31,,,,52.52,72.63
4-0 V-LOCK 90 MONOFILAMENT SUTURE,272,RC,,,,both,89.01,80.11,Cigna,Default,Percent of Total Billed Charges,52.52,,,,52.52,72.63
4-0 V-LOCK 90 MONOFILAMENT SUTURE,272,RC,,,,both,89.01,80.11,United Healthcare,Default,Fee Schedule,72.63,,,,52.52,72.63
ASORBABLE HEMOSTAT 2'X3' SURGICEL,258,RC,,,,both,119.99,107.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.99,,,,70.79,97.91
ASORBABLE HEMOSTAT 2'X3' SURGICEL,258,RC,,,,both,119.99,107.99,Cigna,Default,Percent of Total Billed Charges,70.79,,,,70.79,97.91
ASORBABLE HEMOSTAT 2'X3' SURGICEL,258,RC,,,,both,119.99,107.99,United Healthcare,Default,Fee Schedule,97.91,,,,70.79,97.91
BIOMET BONE CEMENT R 1X40 US,C1713,HCPCS,278,RC,,both,199.8,179.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.86,,,,117.88,163.04
BIOMET BONE CEMENT R 1X40 US,C1713,HCPCS,278,RC,,both,199.8,179.82,Cigna,Default,Percent of Total Billed Charges,117.88,,,,117.88,163.04
BIOMET BONE CEMENT R 1X40 US,C1713,HCPCS,278,RC,,both,199.8,179.82,United Healthcare,Default,Fee Schedule,163.04,,,,117.88,163.04
VARIABLE SELF DRILLING  SCREW 3.5X14,C1713,HCPCS,278,RC,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
VARIABLE SELF DRILLING  SCREW 3.5X14,C1713,HCPCS,278,RC,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
VARIABLE SELF DRILLING  SCREW 3.5X14,C1713,HCPCS,278,RC,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
*DNUVARIABLE SELF DRILLING SCREW 3.5X16,C1713,HCPCS,278,RC,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
*DNUVARIABLE SELF DRILLING SCREW 3.5X16,C1713,HCPCS,278,RC,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
*DNUVARIABLE SELF DRILLING SCREW 3.5X16,C1713,HCPCS,278,RC,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
MODULAR NECK K 12/14 TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.34,,,,748.75,1035.55
MODULAR NECK K 12/14 TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,Cigna,Default,Percent of Total Billed Charges,748.75,,,,748.75,1035.55
MODULAR NECK K 12/14 TAPER,C1776,HCPCS,278,RC,,both,1269.06,1142.15,United Healthcare,Default,Fee Schedule,1035.55,,,,748.75,1035.55
"CONTINUUM VIVACIT-E NEUTRAL LINER, II 36",C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
"CONTINUUM VIVACIT-E NEUTRAL LINER, II 36",C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
"CONTINUUM VIVACIT-E NEUTRAL LINER, II 36",C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
WAVEWRITER ALPHA 16  GEN KIT(SC-1416),C1820,HCPCS,278,RC,,both,61605,55444.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43123.5,,,,36346.95,50269.68
WAVEWRITER ALPHA 16  GEN KIT(SC-1416),C1820,HCPCS,278,RC,,both,61605,55444.5,Cigna,Default,Percent of Total Billed Charges,36346.95,,,,36346.95,50269.68
WAVEWRITER ALPHA 16  GEN KIT(SC-1416),C1820,HCPCS,278,RC,,both,61605,55444.5,United Healthcare,Default,Fee Schedule,50269.68,,,,36346.95,50269.68
VERSASTEP PLUS 12MM,272,RC,,,,both,494.14,444.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,345.9,,,,291.54,403.22
VERSASTEP PLUS 12MM,272,RC,,,,both,494.14,444.73,Cigna,Default,Percent of Total Billed Charges,291.54,,,,291.54,403.22
VERSASTEP PLUS 12MM,272,RC,,,,both,494.14,444.73,United Healthcare,Default,Fee Schedule,403.22,,,,291.54,403.22
SIGNA POWERSHELL,272,RC,,,,both,1111.65,1000.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,778.16,,,,655.87,907.11
SIGNA POWERSHELL,272,RC,,,,both,1111.65,1000.49,Cigna,Default,Percent of Total Billed Charges,655.87,,,,655.87,907.11
SIGNA POWERSHELL,272,RC,,,,both,1111.65,1000.49,United Healthcare,Default,Fee Schedule,907.11,,,,655.87,907.11
ENDO RETRACT II,272,RC,,,,both,1053.81,948.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,737.67,,,,621.75,859.91
ENDO RETRACT II,272,RC,,,,both,1053.81,948.43,Cigna,Default,Percent of Total Billed Charges,621.75,,,,621.75,859.91
ENDO RETRACT II,272,RC,,,,both,1053.81,948.43,United Healthcare,Default,Fee Schedule,859.91,,,,621.75,859.91
ENDO TAN RELOAD 45MM,272,RC,,,,both,1311.42,1180.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,917.99,,,,773.74,1070.12
ENDO TAN RELOAD 45MM,272,RC,,,,both,1311.42,1180.28,Cigna,Default,Percent of Total Billed Charges,773.74,,,,773.74,1070.12
ENDO TAN RELOAD 45MM,272,RC,,,,both,1311.42,1180.28,United Healthcare,Default,Fee Schedule,1070.12,,,,773.74,1070.12
ENDO CATCH II,272,RC,,,,both,827.67,744.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,579.37,,,,488.33,675.38
ENDO CATCH II,272,RC,,,,both,827.67,744.9,Cigna,Default,Percent of Total Billed Charges,488.33,,,,488.33,675.38
ENDO CATCH II,272,RC,,,,both,827.67,744.9,United Healthcare,Default,Fee Schedule,675.38,,,,488.33,675.38
CODA ACP 1 LEVEL PLTE  12MM,C1713,HCPCS,278,RC,,both,2472.53,2225.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1730.77,,,,1458.79,2017.58
CODA ACP 1 LEVEL PLTE  12MM,C1713,HCPCS,278,RC,,both,2472.53,2225.28,Cigna,Default,Percent of Total Billed Charges,1458.79,,,,1458.79,2017.58
CODA ACP 1 LEVEL PLTE  12MM,C1713,HCPCS,278,RC,,both,2472.53,2225.28,United Healthcare,Default,Fee Schedule,2017.58,,,,1458.79,2017.58
*DNO NEUROSTIM PATIENT TRIAL KIT 72,272,RC,,,,both,301.9,271.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.33,,,,178.12,246.35
*DNO NEUROSTIM PATIENT TRIAL KIT 72,272,RC,,,,both,301.9,271.71,Cigna,Default,Percent of Total Billed Charges,178.12,,,,178.12,246.35
*DNO NEUROSTIM PATIENT TRIAL KIT 72,272,RC,,,,both,301.9,271.71,United Healthcare,Default,Fee Schedule,246.35,,,,178.12,246.35
SCOUT 7.5 CM DELIVERY NEEDLE AND REFLECT,A4648,HCPCS,278,RC,,both,1714.95,1543.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1200.46,,,,1011.82,1399.4
SCOUT 7.5 CM DELIVERY NEEDLE AND REFLECT,A4648,HCPCS,278,RC,,both,1714.95,1543.46,Cigna,Default,Percent of Total Billed Charges,1011.82,,,,1011.82,1399.4
SCOUT 7.5 CM DELIVERY NEEDLE AND REFLECT,A4648,HCPCS,278,RC,,both,1714.95,1543.46,United Healthcare,Default,Fee Schedule,1399.4,,,,1011.82,1399.4
5.5MM TI CURVED ROD 125MM,278,RC,,,,both,566.1,509.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,396.27,,,,334,461.94
5.5MM TI CURVED ROD 125MM,278,RC,,,,both,566.1,509.49,Cigna,Default,Percent of Total Billed Charges,334,,,,334,461.94
5.5MM TI CURVED ROD 125MM,278,RC,,,,both,566.1,509.49,United Healthcare,Default,Fee Schedule,461.94,,,,334,461.94
4-0 V-LOCK 90 MONO COCML 24MML P-143/8,272,RC,,,,both,87.82,79.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.47,,,,51.81,71.66
4-0 V-LOCK 90 MONO COCML 24MML P-143/8,272,RC,,,,both,87.82,79.04,Cigna,Default,Percent of Total Billed Charges,51.81,,,,51.81,71.66
4-0 V-LOCK 90 MONO COCML 24MML P-143/8,272,RC,,,,both,87.82,79.04,United Healthcare,Default,Fee Schedule,71.66,,,,51.81,71.66
BIPOLAR SHEL 45MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,675.99,,,,569.76,788.01
BIPOLAR SHEL 45MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,Cigna,Default,Percent of Total Billed Charges,569.76,,,,569.76,788.01
BIPOLAR SHEL 45MM OD,C1776,HCPCS,278,RC,,both,965.7,869.13,United Healthcare,Default,Fee Schedule,788.01,,,,569.76,788.01
PSN ASF PS 13MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 13MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 13MM VE L 6-9 GH,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
TENODESIS GRAFT SIZING KIT W/FIBERLOOP T,C1776,HCPCS,278,RC,,both,1080.59,972.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,756.41,,,,637.55,881.76
TENODESIS GRAFT SIZING KIT W/FIBERLOOP T,C1776,HCPCS,278,RC,,both,1080.59,972.53,Cigna,Default,Percent of Total Billed Charges,637.55,,,,637.55,881.76
TENODESIS GRAFT SIZING KIT W/FIBERLOOP T,C1776,HCPCS,278,RC,,both,1080.59,972.53,United Healthcare,Default,Fee Schedule,881.76,,,,637.55,881.76
SUTURE VICRYL 3-0 TIES ETH J910T,272,RC,,,,both,25.17,22.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.62,,,,14.85,20.54
SUTURE VICRYL 3-0 TIES ETH J910T,272,RC,,,,both,25.17,22.65,Cigna,Default,Percent of Total Billed Charges,14.85,,,,14.85,20.54
SUTURE VICRYL 3-0 TIES ETH J910T,272,RC,,,,both,25.17,22.65,United Healthcare,Default,Fee Schedule,20.54,,,,14.85,20.54
SYNFIX EVO PROTECTION SLEEVE+AWL,C1713,HCPCS,278,RC,,both,416.25,374.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,291.38,,,,245.59,339.66
SYNFIX EVO PROTECTION SLEEVE+AWL,C1713,HCPCS,278,RC,,both,416.25,374.63,Cigna,Default,Percent of Total Billed Charges,245.59,,,,245.59,339.66
SYNFIX EVO PROTECTION SLEEVE+AWL,C1713,HCPCS,278,RC,,both,416.25,374.63,United Healthcare,Default,Fee Schedule,339.66,,,,245.59,339.66
SYNFIX EVO THREAD LOCK SLEEVE-ST,C1713,HCPCS,278,RC,,both,992.34,893.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,694.64,,,,585.48,809.75
SYNFIX EVO THREAD LOCK SLEEVE-ST,C1713,HCPCS,278,RC,,both,992.34,893.11,Cigna,Default,Percent of Total Billed Charges,585.48,,,,585.48,809.75
SYNFIX EVO THREAD LOCK SLEEVE-ST,C1713,HCPCS,278,RC,,both,992.34,893.11,United Healthcare,Default,Fee Schedule,809.75,,,,585.48,809.75
SYNFIX EVO FINE TIP SCREW/25MM-ST,C1713,HCPCS,278,RC,,both,1581.75,1423.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1107.22,,,,933.23,1290.71
SYNFIX EVO FINE TIP SCREW/25MM-ST,C1713,HCPCS,278,RC,,both,1581.75,1423.58,Cigna,Default,Percent of Total Billed Charges,933.23,,,,933.23,1290.71
SYNFIX EVO FINE TIP SCREW/25MM-ST,C1713,HCPCS,278,RC,,both,1581.75,1423.58,United Healthcare,Default,Fee Schedule,1290.71,,,,933.23,1290.71
SYNFIX EVO SPACER SM DEEP 10.5MM/10 DEG,C1713,HCPCS,278,RC,,both,14985,13486.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10489.5,,,,8841.15,12227.76
SYNFIX EVO SPACER SM DEEP 10.5MM/10 DEG,C1713,HCPCS,278,RC,,both,14985,13486.5,Cigna,Default,Percent of Total Billed Charges,8841.15,,,,8841.15,12227.76
SYNFIX EVO SPACER SM DEEP 10.5MM/10 DEG,C1713,HCPCS,278,RC,,both,14985,13486.5,United Healthcare,Default,Fee Schedule,12227.76,,,,8841.15,12227.76
PSN ASF PS 16MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1981.35,,,,1670,2309.69
PSN ASF PS 16MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,Cigna,Default,Percent of Total Billed Charges,1670,,,,1670,2309.69
PSN ASF PS 16MM VE L 6-9 EF,C1776,HCPCS,278,RC,,both,2830.5,2547.45,United Healthcare,Default,Fee Schedule,2309.69,,,,1670,2309.69
"CONTINUUM VIVACIT-E NEUTRAL LINER, HH 32",C1776,HCPCS,278,RC,,both,2997,2697.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2097.9,,,,1768.23,2445.55
"CONTINUUM VIVACIT-E NEUTRAL LINER, HH 32",C1776,HCPCS,278,RC,,both,2997,2697.3,Cigna,Default,Percent of Total Billed Charges,1768.23,,,,1768.23,2445.55
"CONTINUUM VIVACIT-E NEUTRAL LINER, HH 32",C1776,HCPCS,278,RC,,both,2997,2697.3,United Healthcare,Default,Fee Schedule,2445.55,,,,1768.23,2445.55
CER OPTION TYPE 1 TPR SLEEVE -3,C1889,HCPCS,278,RC,,both,342.99,308.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,240.09,,,,202.36,279.88
CER OPTION TYPE 1 TPR SLEEVE -3,C1889,HCPCS,278,RC,,both,342.99,308.69,Cigna,Default,Percent of Total Billed Charges,202.36,,,,202.36,279.88
CER OPTION TYPE 1 TPR SLEEVE -3,C1889,HCPCS,278,RC,,both,342.99,308.69,United Healthcare,Default,Fee Schedule,279.88,,,,202.36,279.88
MINIONE BUTTON 16FR SIZE 2.3CM,272,RC,,,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
MINIONE BUTTON 16FR SIZE 2.3CM,272,RC,,,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
MINIONE BUTTON 16FR SIZE 2.3CM,272,RC,,,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
MINIONE BUTTON 16FR SIZE 2.5 CM,272,RC,,,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
MINIONE BUTTON 16FR SIZE 2.5 CM,272,RC,,,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
MINIONE BUTTON 16FR SIZE 2.5 CM,272,RC,,,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
PROLENE SOFT MESH 50X50,C1781,HCPCS,278,RC,,both,2026.86,1824.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1418.8,,,,1195.85,1653.92
PROLENE SOFT MESH 50X50,C1781,HCPCS,278,RC,,both,2026.86,1824.17,Cigna,Default,Percent of Total Billed Charges,1195.85,,,,1195.85,1653.92
PROLENE SOFT MESH 50X50,C1781,HCPCS,278,RC,,both,2026.86,1824.17,United Healthcare,Default,Fee Schedule,1653.92,,,,1195.85,1653.92
STENT WALLFLEX ESOPHAGEAL 18MMX15.3CMX78,C1874,HCPCS,278,RC,,both,8320.31,7488.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5824.22,,,,4908.98,6789.37
STENT WALLFLEX ESOPHAGEAL 18MMX15.3CMX78,C1874,HCPCS,278,RC,,both,8320.31,7488.28,Cigna,Default,Percent of Total Billed Charges,4908.98,,,,4908.98,6789.37
STENT WALLFLEX ESOPHAGEAL 18MMX15.3CMX78,C1874,HCPCS,278,RC,,both,8320.31,7488.28,United Healthcare,Default,Fee Schedule,6789.37,,,,4908.98,6789.37
STENT WALLFLEX ESOPHAGEAL 23MMX10.5CMX78,C1874,HCPCS,278,RC,,both,8320.31,7488.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5824.22,,,,4908.98,6789.37
STENT WALLFLEX ESOPHAGEAL 23MMX10.5CMX78,C1874,HCPCS,278,RC,,both,8320.31,7488.28,Cigna,Default,Percent of Total Billed Charges,4908.98,,,,4908.98,6789.37
STENT WALLFLEX ESOPHAGEAL 23MMX10.5CMX78,C1874,HCPCS,278,RC,,both,8320.31,7488.28,United Healthcare,Default,Fee Schedule,6789.37,,,,4908.98,6789.37
PLEURX CATHETER ACCESS KIT SYSTEM,272,RC,,,,both,111.25,100.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.88,,,,65.64,90.78
PLEURX CATHETER ACCESS KIT SYSTEM,272,RC,,,,both,111.25,100.13,Cigna,Default,Percent of Total Billed Charges,65.64,,,,65.64,90.78
PLEURX CATHETER ACCESS KIT SYSTEM,272,RC,,,,both,111.25,100.13,United Healthcare,Default,Fee Schedule,90.78,,,,65.64,90.78
APLIGRAF 44CM,Q4186,HCPCS,636,RC,,both,4478.85,4030.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3135.2,,,,2642.52,3654.74
APLIGRAF 44CM,Q4186,HCPCS,636,RC,,both,4478.85,4030.97,Cigna,Default,Percent of Total Billed Charges,2642.52,,,,2642.52,3654.74
APLIGRAF 44CM,Q4186,HCPCS,636,RC,,both,4478.85,4030.97,United Healthcare,Default,Fee Schedule,3654.74,,,,2642.52,3654.74
CODA VASD SCREW 3.5 X 18MM,C1713,HCPCS,278,RC,,both,439.56,395.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.69,,,,259.34,358.68
CODA VASD SCREW 3.5 X 18MM,C1713,HCPCS,278,RC,,both,439.56,395.6,Cigna,Default,Percent of Total Billed Charges,259.34,,,,259.34,358.68
CODA VASD SCREW 3.5 X 18MM,C1713,HCPCS,278,RC,,both,439.56,395.6,United Healthcare,Default,Fee Schedule,358.68,,,,259.34,358.68
X-PAC 12X32MM LORDOTIC,C1776,HCPCS,278,RC,,both,17898.75,16108.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12529.12,,,,10560.26,14605.38
X-PAC 12X32MM LORDOTIC,C1776,HCPCS,278,RC,,both,17898.75,16108.88,Cigna,Default,Percent of Total Billed Charges,10560.26,,,,10560.26,14605.38
X-PAC 12X32MM LORDOTIC,C1776,HCPCS,278,RC,,both,17898.75,16108.88,United Healthcare,Default,Fee Schedule,14605.38,,,,10560.26,14605.38
CATH MUSTANG 12X40X75,C1725,HCPCS,278,RC,,both,532.8,479.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,372.96,,,,314.35,434.76
CATH MUSTANG 12X40X75,C1725,HCPCS,278,RC,,both,532.8,479.52,Cigna,Default,Percent of Total Billed Charges,314.35,,,,314.35,434.76
CATH MUSTANG 12X40X75,C1725,HCPCS,278,RC,,both,532.8,479.52,United Healthcare,Default,Fee Schedule,434.76,,,,314.35,434.76
VIABAHN SX ENDO HEPARIN 10MMX15CM,C1874,HCPCS,278,RC,,both,13489.83,12140.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9442.88,,,,7959,11007.7
VIABAHN SX ENDO HEPARIN 10MMX15CM,C1874,HCPCS,278,RC,,both,13489.83,12140.85,Cigna,Default,Percent of Total Billed Charges,7959,,,,7959,11007.7
VIABAHN SX ENDO HEPARIN 10MMX15CM,C1874,HCPCS,278,RC,,both,13489.83,12140.85,United Healthcare,Default,Fee Schedule,11007.7,,,,7959,11007.7
VIABAHN SX ENDO HEPARIN 9MMX10CM,C1874,HCPCS,278,RC,,both,11841.48,10657.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8289.04,,,,6986.47,9662.65
VIABAHN SX ENDO HEPARIN 9MMX10CM,C1874,HCPCS,278,RC,,both,11841.48,10657.33,Cigna,Default,Percent of Total Billed Charges,6986.47,,,,6986.47,9662.65
VIABAHN SX ENDO HEPARIN 9MMX10CM,C1874,HCPCS,278,RC,,both,11841.48,10657.33,United Healthcare,Default,Fee Schedule,9662.65,,,,6986.47,9662.65
PLEURX CATHETER ACCESS KIT SYSTEM & STAR,272,RC,,,,both,2673.99,2406.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1871.79,,,,1577.65,2181.98
PLEURX CATHETER ACCESS KIT SYSTEM & STAR,272,RC,,,,both,2673.99,2406.59,Cigna,Default,Percent of Total Billed Charges,1577.65,,,,1577.65,2181.98
PLEURX CATHETER ACCESS KIT SYSTEM & STAR,272,RC,,,,both,2673.99,2406.59,United Healthcare,Default,Fee Schedule,2181.98,,,,1577.65,2181.98
SYNFIX EVO SPACER SM  10.5MM/6 DEG,C1713,HCPCS,278,RC,,both,14985,13486.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10489.5,,,,8841.15,12227.76
SYNFIX EVO SPACER SM  10.5MM/6 DEG,C1713,HCPCS,278,RC,,both,14985,13486.5,Cigna,Default,Percent of Total Billed Charges,8841.15,,,,8841.15,12227.76
SYNFIX EVO SPACER SM  10.5MM/6 DEG,C1713,HCPCS,278,RC,,both,14985,13486.5,United Healthcare,Default,Fee Schedule,12227.76,,,,8841.15,12227.76
SYNFIX EVO FINE TIP SCREW/30MM-ST,C1713,HCPCS,278,RC,,both,1581.75,1423.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1107.22,,,,933.23,1290.71
SYNFIX EVO FINE TIP SCREW/30MM-ST,C1713,HCPCS,278,RC,,both,1581.75,1423.58,Cigna,Default,Percent of Total Billed Charges,933.23,,,,933.23,1290.71
SYNFIX EVO FINE TIP SCREW/30MM-ST,C1713,HCPCS,278,RC,,both,1581.75,1423.58,United Healthcare,Default,Fee Schedule,1290.71,,,,933.23,1290.71
WAVEWRITER ALPHA  GEN KIT(SC-1232),C1820,HCPCS,278,RC,,both,59940,53946,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41958,,,,35364.6,48911.04
WAVEWRITER ALPHA  GEN KIT(SC-1232),C1820,HCPCS,278,RC,,both,59940,53946,Cigna,Default,Percent of Total Billed Charges,35364.6,,,,35364.6,48911.04
WAVEWRITER ALPHA  GEN KIT(SC-1232),C1820,HCPCS,278,RC,,both,59940,53946,United Healthcare,Default,Fee Schedule,48911.04,,,,35364.6,48911.04
COVEREDGE  50X4X8 LEAD KIT,C1820,HCPCS,278,RC,,both,14985,13486.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10489.5,,,,8841.15,12227.76
COVEREDGE  50X4X8 LEAD KIT,C1820,HCPCS,278,RC,,both,14985,13486.5,Cigna,Default,Percent of Total Billed Charges,8841.15,,,,8841.15,12227.76
COVEREDGE  50X4X8 LEAD KIT,C1820,HCPCS,278,RC,,both,14985,13486.5,United Healthcare,Default,Fee Schedule,12227.76,,,,8841.15,12227.76
SUTURE EHIBOND V-37 GRN 4X30IN,272,RC,,,,both,51.4,46.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.98,,,,30.33,41.94
SUTURE EHIBOND V-37 GRN 4X30IN,272,RC,,,,both,51.4,46.26,Cigna,Default,Percent of Total Billed Charges,30.33,,,,30.33,41.94
SUTURE EHIBOND V-37 GRN 4X30IN,272,RC,,,,both,51.4,46.26,United Healthcare,Default,Fee Schedule,41.94,,,,30.33,41.94
SUTURE MERSILENE BP-1 12INX3/16IN,272,RC,,,,both,106.52,95.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.56,,,,62.85,86.92
SUTURE MERSILENE BP-1 12INX3/16IN,272,RC,,,,both,106.52,95.87,Cigna,Default,Percent of Total Billed Charges,62.85,,,,62.85,86.92
SUTURE MERSILENE BP-1 12INX3/16IN,272,RC,,,,both,106.52,95.87,United Healthcare,Default,Fee Schedule,86.92,,,,62.85,86.92
CODA ACP 2 LEVEL PLATE 24MM,C1713,HCPCS,278,RC,,both,2747.25,2472.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1923.08,,,,1620.88,2241.76
CODA ACP 2 LEVEL PLATE 24MM,C1713,HCPCS,278,RC,,both,2747.25,2472.53,Cigna,Default,Percent of Total Billed Charges,1620.88,,,,1620.88,2241.76
CODA ACP 2 LEVEL PLATE 24MM,C1713,HCPCS,278,RC,,both,2747.25,2472.53,United Healthcare,Default,Fee Schedule,2241.76,,,,1620.88,2241.76
SCREW 2.7MM  26MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.39,,,,130.97,181.14
SCREW 2.7MM  26MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Cigna,Default,Percent of Total Billed Charges,130.97,,,,130.97,181.14
SCREW 2.7MM  26MM,C1713,HCPCS,278,RC,,both,221.98,199.78,United Healthcare,Default,Fee Schedule,181.14,,,,130.97,181.14
LOCK SCREW SQUARE 2.7MM  24MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,258.97,,,,218.28,301.89
LOCK SCREW SQUARE 2.7MM  24MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Cigna,Default,Percent of Total Billed Charges,218.28,,,,218.28,301.89
LOCK SCREW SQUARE 2.7MM  24MM,C1713,HCPCS,278,RC,,both,369.96,332.96,United Healthcare,Default,Fee Schedule,301.89,,,,218.28,301.89
LOCK SCREW SQUARE 2.7MM  22MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,258.97,,,,218.28,301.89
LOCK SCREW SQUARE 2.7MM  22MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Cigna,Default,Percent of Total Billed Charges,218.28,,,,218.28,301.89
LOCK SCREW SQUARE 2.7MM  22MM,C1713,HCPCS,278,RC,,both,369.96,332.96,United Healthcare,Default,Fee Schedule,301.89,,,,218.28,301.89
LP NON LOCK 2.7MMX 20MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.39,,,,130.97,181.14
LP NON LOCK 2.7MMX 20MM,C1713,HCPCS,278,RC,,both,221.98,199.78,Cigna,Default,Percent of Total Billed Charges,130.97,,,,130.97,181.14
LP NON LOCK 2.7MMX 20MM,C1713,HCPCS,278,RC,,both,221.98,199.78,United Healthcare,Default,Fee Schedule,181.14,,,,130.97,181.14
DVR CROSSLOCK  MINI PLATE LEFT,C1713,HCPCS,278,RC,,both,2754.54,2479.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1928.18,,,,1625.18,2247.7
DVR CROSSLOCK  MINI PLATE LEFT,C1713,HCPCS,278,RC,,both,2754.54,2479.09,Cigna,Default,Percent of Total Billed Charges,1625.18,,,,1625.18,2247.7
DVR CROSSLOCK  MINI PLATE LEFT,C1713,HCPCS,278,RC,,both,2754.54,2479.09,United Healthcare,Default,Fee Schedule,2247.7,,,,1625.18,2247.7
TRILOGY ACET SHELL 54MM,C1776,HCPCS,278,RC,,both,2863.8,2577.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2004.66,,,,1689.64,2336.86
TRILOGY ACET SHELL 54MM,C1776,HCPCS,278,RC,,both,2863.8,2577.42,Cigna,Default,Percent of Total Billed Charges,1689.64,,,,1689.64,2336.86
TRILOGY ACET SHELL 54MM,C1776,HCPCS,278,RC,,both,2863.8,2577.42,United Healthcare,Default,Fee Schedule,2336.86,,,,1689.64,2336.86
BONE SCREW 6.5X40 SELF-TAP,C1776,HCPCS,278,RC,,both,233.1,209.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.17,,,,137.53,190.21
BONE SCREW 6.5X40 SELF-TAP,C1776,HCPCS,278,RC,,both,233.1,209.79,Cigna,Default,Percent of Total Billed Charges,137.53,,,,137.53,190.21
BONE SCREW 6.5X40 SELF-TAP,C1776,HCPCS,278,RC,,both,233.1,209.79,United Healthcare,Default,Fee Schedule,190.21,,,,137.53,190.21
TRILOGY MODULAR CUP 10 DEG 50/52/54X32,C1776,HCPCS,278,RC,,both,2664,2397.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1864.8,,,,1571.76,2173.82
TRILOGY MODULAR CUP 10 DEG 50/52/54X32,C1776,HCPCS,278,RC,,both,2664,2397.6,Cigna,Default,Percent of Total Billed Charges,1571.76,,,,1571.76,2173.82
TRILOGY MODULAR CUP 10 DEG 50/52/54X32,C1776,HCPCS,278,RC,,both,2664,2397.6,United Healthcare,Default,Fee Schedule,2173.82,,,,1571.76,2173.82
RM PRIMARY STEM 12MM STANDARD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4836.82,,,,4076.75,5638.36
RM PRIMARY STEM 12MM STANDARD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,Cigna,Default,Percent of Total Billed Charges,4076.75,,,,4076.75,5638.36
RM PRIMARY STEM 12MM STANDARD,C1776,HCPCS,278,RC,,both,6909.75,6218.78,United Healthcare,Default,Fee Schedule,5638.36,,,,4076.75,5638.36
"BIOLOX DELTA FEM HEAD, 32MM, +7MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1740.68,,,,1467.14,2029.13
"BIOLOX DELTA FEM HEAD, 32MM, +7MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,Cigna,Default,Percent of Total Billed Charges,1467.14,,,,1467.14,2029.13
"BIOLOX DELTA FEM HEAD, 32MM, +7MM",C1776,HCPCS,278,RC,,both,2486.68,2238.01,United Healthcare,Default,Fee Schedule,2029.13,,,,1467.14,2029.13
SCREW 2.4 LOCKING 2.7MM  20MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,258.97,,,,218.28,301.89
SCREW 2.4 LOCKING 2.7MM  20MM,C1713,HCPCS,278,RC,,both,369.96,332.96,Cigna,Default,Percent of Total Billed Charges,218.28,,,,218.28,301.89
SCREW 2.4 LOCKING 2.7MM  20MM,C1713,HCPCS,278,RC,,both,369.96,332.96,United Healthcare,Default,Fee Schedule,301.89,,,,218.28,301.89
MULTIDIRECTIONAL SCREW 2.7 18MM,C1713,HCPCS,278,RC,,both,534.76,481.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,374.33,,,,315.51,436.36
MULTIDIRECTIONAL SCREW 2.7 18MM,C1713,HCPCS,278,RC,,both,534.76,481.28,Cigna,Default,Percent of Total Billed Charges,315.51,,,,315.51,436.36
MULTIDIRECTIONAL SCREW 2.7 18MM,C1713,HCPCS,278,RC,,both,534.76,481.28,United Healthcare,Default,Fee Schedule,436.36,,,,315.51,436.36
MULTIDIRECTIONAL SCREW 2.7MM 22MM,C1713,HCPCS,278,RC,,both,534.76,481.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,374.33,,,,315.51,436.36
MULTIDIRECTIONAL SCREW 2.7MM 22MM,C1713,HCPCS,278,RC,,both,534.76,481.28,Cigna,Default,Percent of Total Billed Charges,315.51,,,,315.51,436.36
MULTIDIRECTIONAL SCREW 2.7MM 22MM,C1713,HCPCS,278,RC,,both,534.76,481.28,United Healthcare,Default,Fee Schedule,436.36,,,,315.51,436.36
PSN ASF PS 10MM PLY L 6-9 EF,C1776,HCPCS,278,RC,,both,2081.25,1873.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1456.88,,,,1227.94,1698.3
PSN ASF PS 10MM PLY L 6-9 EF,C1776,HCPCS,278,RC,,both,2081.25,1873.13,Cigna,Default,Percent of Total Billed Charges,1227.94,,,,1227.94,1698.3
PSN ASF PS 10MM PLY L 6-9 EF,C1776,HCPCS,278,RC,,both,2081.25,1873.13,United Healthcare,Default,Fee Schedule,1698.3,,,,1227.94,1698.3
PHASIX ST MESH 7CMX10CM,C1781,HCPCS,278,RC,,both,8307.68,7476.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5815.38,,,,4901.53,6779.07
PHASIX ST MESH 7CMX10CM,C1781,HCPCS,278,RC,,both,8307.68,7476.91,Cigna,Default,Percent of Total Billed Charges,4901.53,,,,4901.53,6779.07
PHASIX ST MESH 7CMX10CM,C1781,HCPCS,278,RC,,both,8307.68,7476.91,United Healthcare,Default,Fee Schedule,6779.07,,,,4901.53,6779.07
STRAIGHT URETHRAL DILATOR SET 8FR-24FR,272,RC,,,,both,1201.8,1081.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,841.26,,,,709.06,980.67
STRAIGHT URETHRAL DILATOR SET 8FR-24FR,272,RC,,,,both,1201.8,1081.62,Cigna,Default,Percent of Total Billed Charges,709.06,,,,709.06,980.67
STRAIGHT URETHRAL DILATOR SET 8FR-24FR,272,RC,,,,both,1201.8,1081.62,United Healthcare,Default,Fee Schedule,980.67,,,,709.06,980.67
S-CURVE URETHTHAL DILATOR 26FR,272,RC,,,,both,164.84,148.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.39,,,,97.26,134.51
S-CURVE URETHTHAL DILATOR 26FR,272,RC,,,,both,164.84,148.36,Cigna,Default,Percent of Total Billed Charges,97.26,,,,97.26,134.51
S-CURVE URETHTHAL DILATOR 26FR,272,RC,,,,both,164.84,148.36,United Healthcare,Default,Fee Schedule,134.51,,,,97.26,134.51
S-CURVE URETHRAL DILATOR 24FR,272,RC,,,,both,164.84,148.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.39,,,,97.26,134.51
S-CURVE URETHRAL DILATOR 24FR,272,RC,,,,both,164.84,148.36,Cigna,Default,Percent of Total Billed Charges,97.26,,,,97.26,134.51
S-CURVE URETHRAL DILATOR 24FR,272,RC,,,,both,164.84,148.36,United Healthcare,Default,Fee Schedule,134.51,,,,97.26,134.51
LUTONIX 018  6X80,C1725,HCPCS,278,RC,,both,6516.81,5865.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4561.77,,,,3844.92,5317.72
LUTONIX 018  6X80,C1725,HCPCS,278,RC,,both,6516.81,5865.13,Cigna,Default,Percent of Total Billed Charges,3844.92,,,,3844.92,5317.72
LUTONIX 018  6X80,C1725,HCPCS,278,RC,,both,6516.81,5865.13,United Healthcare,Default,Fee Schedule,5317.72,,,,3844.92,5317.72
"CATH ANGIO 14G 5.25""",272,RC,,,,both,54.15,48.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.9,,,,31.95,44.19
"CATH ANGIO 14G 5.25""",272,RC,,,,both,54.15,48.74,Cigna,Default,Percent of Total Billed Charges,31.95,,,,31.95,44.19
"CATH ANGIO 14G 5.25""",272,RC,,,,both,54.15,48.74,United Healthcare,Default,Fee Schedule,44.19,,,,31.95,44.19
CATH ANGIO SOFT-VU 4FR 80CM,272,RC,,,,both,108.24,97.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.77,,,,63.86,88.32
CATH ANGIO SOFT-VU 4FR 80CM,272,RC,,,,both,108.24,97.42,Cigna,Default,Percent of Total Billed Charges,63.86,,,,63.86,88.32
CATH ANGIO SOFT-VU 4FR 80CM,272,RC,,,,both,108.24,97.42,United Healthcare,Default,Fee Schedule,88.32,,,,63.86,88.32
"*MESH, LG RIGHT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,547.78,,,,461.7,638.56
"*MESH, LG RIGHT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,Cigna,Default,Percent of Total Billed Charges,461.7,,,,461.7,638.56
"*MESH, LG RIGHT, 10CMX16CM ANATOMICAL",C1781,HCPCS,278,RC,,both,782.55,704.3,United Healthcare,Default,Fee Schedule,638.56,,,,461.7,638.56
DNU SYRINGE 10 ML SOD CHLORIDE INJECTION,270,RC,,,,both,6.25,5.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.38,,,,3.69,5.1
DNU SYRINGE 10 ML SOD CHLORIDE INJECTION,270,RC,,,,both,6.25,5.63,Cigna,Default,Percent of Total Billed Charges,3.69,,,,3.69,5.1
DNU SYRINGE 10 ML SOD CHLORIDE INJECTION,270,RC,,,,both,6.25,5.63,United Healthcare,Default,Fee Schedule,5.1,,,,3.69,5.1
2ND ADDL LEVEL SPINE  INJ,360,RC,,,,both,961.04,864.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,672.73,,,,567.01,784.21
2ND ADDL LEVEL SPINE  INJ,360,RC,,,,both,961.04,864.94,Cigna,Default,Percent of Total Billed Charges,567.01,,,,567.01,784.21
2ND ADDL LEVEL SPINE  INJ,360,RC,,,,both,961.04,864.94,United Healthcare,Default,Fee Schedule,784.21,,,,567.01,784.21
3RD ADDL LEVEL SPINE INJ,360,RC,,,,both,961.04,864.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,672.73,,,,567.01,784.21
3RD ADDL LEVEL SPINE INJ,360,RC,,,,both,961.04,864.94,Cigna,Default,Percent of Total Billed Charges,567.01,,,,567.01,784.21
3RD ADDL LEVEL SPINE INJ,360,RC,,,,both,961.04,864.94,United Healthcare,Default,Fee Schedule,784.21,,,,567.01,784.21
BILAT RF ABLATION LUMBAR OR SACRAL,64635,HCPCS,360,RC,50,both,9471.1,8523.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6629.77,,,,5587.95,7728.42
BILAT RF ABLATION LUMBAR OR SACRAL,64635,HCPCS,360,RC,50,both,9471.1,8523.99,Cigna,Default,Percent of Total Billed Charges,5587.95,,,,5587.95,7728.42
BILAT RF ABLATION LUMBAR OR SACRAL,64635,HCPCS,360,RC,50,both,9471.1,8523.99,United Healthcare,Default,Fee Schedule,7728.42,,,,5587.95,7728.42
ADD'L LEVEL RF ABLATION LUMBAR SACRAL,64636,HCPCS,360,RC,,both,3157.02,2841.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2209.91,,,,1862.64,2576.13
ADD'L LEVEL RF ABLATION LUMBAR SACRAL,64636,HCPCS,360,RC,,both,3157.02,2841.32,Cigna,Default,Percent of Total Billed Charges,1862.64,,,,1862.64,2576.13
ADD'L LEVEL RF ABLATION LUMBAR SACRAL,64636,HCPCS,360,RC,,both,3157.02,2841.32,United Healthcare,Default,Fee Schedule,2576.13,,,,1862.64,2576.13
BILAT ADD'L LEVEL RF ABLATION LUMBAR OR,64636,HCPCS,360,RC,,both,4597.61,4137.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3218.33,,,,2712.59,3751.65
BILAT ADD'L LEVEL RF ABLATION LUMBAR OR,64636,HCPCS,360,RC,,both,4597.61,4137.85,Cigna,Default,Percent of Total Billed Charges,2712.59,,,,2712.59,3751.65
BILAT ADD'L LEVEL RF ABLATION LUMBAR OR,64636,HCPCS,360,RC,,both,4597.61,4137.85,United Healthcare,Default,Fee Schedule,3751.65,,,,2712.59,3751.65
BILAT ADD'L LEVEL RF ABLATION CERVICAL O,64634,HCPCS,360,RC,,both,4597.61,4137.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3218.33,,,,2712.59,3751.65
BILAT ADD'L LEVEL RF ABLATION CERVICAL O,64634,HCPCS,360,RC,,both,4597.61,4137.85,Cigna,Default,Percent of Total Billed Charges,2712.59,,,,2712.59,3751.65
BILAT ADD'L LEVEL RF ABLATION CERVICAL O,64634,HCPCS,360,RC,,both,4597.61,4137.85,United Healthcare,Default,Fee Schedule,3751.65,,,,2712.59,3751.65
ADD'L LEVEL RF ABLATION CERV OR THORACIC,64634,HCPCS,360,RC,,both,3157.01,2841.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2209.91,,,,1862.64,2576.12
ADD'L LEVEL RF ABLATION CERV OR THORACIC,64634,HCPCS,360,RC,,both,3157.01,2841.31,Cigna,Default,Percent of Total Billed Charges,1862.64,,,,1862.64,2576.12
ADD'L LEVEL RF ABLATION CERV OR THORACIC,64634,HCPCS,360,RC,,both,3157.01,2841.31,United Healthcare,Default,Fee Schedule,2576.12,,,,1862.64,2576.12
BILAT CERV OR THORACIC RF ABLAT,64633,HCPCS,360,RC,50,both,9205.73,8285.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6444.01,,,,5431.38,7511.88
BILAT CERV OR THORACIC RF ABLAT,64633,HCPCS,360,RC,50,both,9205.73,8285.16,Cigna,Default,Percent of Total Billed Charges,5431.38,,,,5431.38,7511.88
BILAT CERV OR THORACIC RF ABLAT,64633,HCPCS,360,RC,50,both,9205.73,8285.16,United Healthcare,Default,Fee Schedule,7511.88,,,,5431.38,7511.88
INSJ STABLJ DEV W/O DCMPRN,22869,HCPCS,360,RC,,both,70389.31,63350.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49272.52,,,,41529.69,57437.68
INSJ STABLJ DEV W/O DCMPRN,22869,HCPCS,360,RC,,both,70389.31,63350.38,Cigna,Default,Percent of Total Billed Charges,41529.69,,,,41529.69,57437.68
INSJ STABLJ DEV W/O DCMPRN,22869,HCPCS,360,RC,,both,70389.31,63350.38,United Healthcare,Default,Fee Schedule,57437.68,,,,41529.69,57437.68
IMPLANT NEUROELECTRODES,360,RC,,,,both,21811.47,19630.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15268.03,,,,12868.77,17798.16
IMPLANT NEUROELECTRODES,360,RC,,,,both,21811.47,19630.32,Cigna,Default,Percent of Total Billed Charges,12868.77,,,,12868.77,17798.16
IMPLANT NEUROELECTRODES,360,RC,,,,both,21811.47,19630.32,United Healthcare,Default,Fee Schedule,17798.16,,,,12868.77,17798.16
INC/REPL SPINE NSTIM PG/RCVR,360,RC,,,,both,101736.41,91562.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71215.49,,,,60024.48,83016.91
INC/REPL SPINE NSTIM PG/RCVR,360,RC,,,,both,101736.41,91562.77,Cigna,Default,Percent of Total Billed Charges,60024.48,,,,60024.48,83016.91
INC/REPL SPINE NSTIM PG/RCVR,360,RC,,,,both,101736.41,91562.77,United Healthcare,Default,Fee Schedule,83016.91,,,,60024.48,83016.91
LAMINECT IMPL NS ELECTRODES; EPIDURAL PE,360,RC,,,,both,71559.93,64403.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50091.95,,,,42220.36,58392.9
LAMINECT IMPL NS ELECTRODES; EPIDURAL PE,360,RC,,,,both,71559.93,64403.94,Cigna,Default,Percent of Total Billed Charges,42220.36,,,,42220.36,58392.9
LAMINECT IMPL NS ELECTRODES; EPIDURAL PE,360,RC,,,,both,71559.93,64403.94,United Healthcare,Default,Fee Schedule,58392.9,,,,42220.36,58392.9
GENICULAR RF ABLAT,64624,HCPCS,360,RC,,both,6130.15,5517.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4291.1,,,,3616.79,5002.2
GENICULAR RF ABLAT,64624,HCPCS,360,RC,,both,6130.15,5517.14,Cigna,Default,Percent of Total Billed Charges,3616.79,,,,3616.79,5002.2
GENICULAR RF ABLAT,64624,HCPCS,360,RC,,both,6130.15,5517.14,United Healthcare,Default,Fee Schedule,5002.2,,,,3616.79,5002.2
LUMBAR OR SACRAL RF ABLAT,64635,HCPCS,360,RC,,both,6314.05,5682.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4419.84,,,,3725.29,5152.26
LUMBAR OR SACRAL RF ABLAT,64635,HCPCS,360,RC,,both,6314.05,5682.65,Cigna,Default,Percent of Total Billed Charges,3725.29,,,,3725.29,5152.26
LUMBAR OR SACRAL RF ABLAT,64635,HCPCS,360,RC,,both,6314.05,5682.65,United Healthcare,Default,Fee Schedule,5152.26,,,,3725.29,5152.26
CERV OR THORACIC RF ABLAT,64633,HCPCS,360,RC,,both,6315.13,5683.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4420.59,,,,3725.93,5153.15
CERV OR THORACIC RF ABLAT,64633,HCPCS,360,RC,,both,6315.13,5683.62,Cigna,Default,Percent of Total Billed Charges,3725.93,,,,3725.93,5153.15
CERV OR THORACIC RF ABLAT,64633,HCPCS,360,RC,,both,6315.13,5683.62,United Healthcare,Default,Fee Schedule,5153.15,,,,3725.93,5153.15
BLOCK- STELLATE GANGLION,64510,HCPCS,360,RC,,both,2960.03,2664.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2072.02,,,,1746.42,2415.38
BLOCK- STELLATE GANGLION,64510,HCPCS,360,RC,,both,2960.03,2664.03,Cigna,Default,Percent of Total Billed Charges,1746.42,,,,1746.42,2415.38
BLOCK- STELLATE GANGLION,64510,HCPCS,360,RC,,both,2960.03,2664.03,United Healthcare,Default,Fee Schedule,2415.38,,,,1746.42,2415.38
LAMINECTOMY SINGLE LUMBAR,360,RC,,,,both,22543.92,20289.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15780.74,,,,13300.91,18395.84
LAMINECTOMY SINGLE LUMBAR,360,RC,,,,both,22543.92,20289.53,Cigna,Default,Percent of Total Billed Charges,13300.91,,,,13300.91,18395.84
LAMINECTOMY SINGLE LUMBAR,360,RC,,,,both,22543.92,20289.53,United Healthcare,Default,Fee Schedule,18395.84,,,,13300.91,18395.84
NECK SPINE FUSE & REMOV BEL C2,360,RC,,,,both,43029.93,38726.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30120.95,,,,25387.66,35112.42
NECK SPINE FUSE & REMOV BEL C2,360,RC,,,,both,43029.93,38726.94,Cigna,Default,Percent of Total Billed Charges,25387.66,,,,25387.66,35112.42
NECK SPINE FUSE & REMOV BEL C2,360,RC,,,,both,43029.93,38726.94,United Healthcare,Default,Fee Schedule,35112.42,,,,25387.66,35112.42
LUMBAR SPINE FUSION,360,RC,,,,both,43029.93,38726.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30120.95,,,,25387.66,35112.42
LUMBAR SPINE FUSION,360,RC,,,,both,43029.93,38726.94,Cigna,Default,Percent of Total Billed Charges,25387.66,,,,25387.66,35112.42
LUMBAR SPINE FUSION,360,RC,,,,both,43029.93,38726.94,United Healthcare,Default,Fee Schedule,35112.42,,,,25387.66,35112.42
KYPHOPLASTY; PERQ VERTEBRAL AUGMENTATION,360,RC,,,,both,21912.12,19720.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15338.48,,,,12928.15,17880.29
KYPHOPLASTY; PERQ VERTEBRAL AUGMENTATION,360,RC,,,,both,21912.12,19720.91,Cigna,Default,Percent of Total Billed Charges,12928.15,,,,12928.15,17880.29
KYPHOPLASTY; PERQ VERTEBRAL AUGMENTATION,360,RC,,,,both,21912.12,19720.91,United Healthcare,Default,Fee Schedule,17880.29,,,,12928.15,17880.29
LUMBAR SPINE FUSION,360,RC,,,,both,44446.24,40001.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31112.37,,,,26223.28,36268.13
LUMBAR SPINE FUSION,360,RC,,,,both,44446.24,40001.62,Cigna,Default,Percent of Total Billed Charges,26223.28,,,,26223.28,36268.13
LUMBAR SPINE FUSION,360,RC,,,,both,44446.24,40001.62,United Healthcare,Default,Fee Schedule,36268.13,,,,26223.28,36268.13
SPINE FUSION EXTRA SEGMENT,360,RC,,,,both,8525.26,7672.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5967.68,,,,5029.9,6956.61
SPINE FUSION EXTRA SEGMENT,360,RC,,,,both,8525.26,7672.73,Cigna,Default,Percent of Total Billed Charges,5029.9,,,,5029.9,6956.61
SPINE FUSION EXTRA SEGMENT,360,RC,,,,both,8525.26,7672.73,United Healthcare,Default,Fee Schedule,6956.61,,,,5029.9,6956.61
REMOVE SPINAL LAMINA ADD-ON,360,RC,,,,both,8738.62,7864.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6117.03,,,,5155.79,7130.71
REMOVE SPINAL LAMINA ADD-ON,360,RC,,,,both,8738.62,7864.76,Cigna,Default,Percent of Total Billed Charges,5155.79,,,,5155.79,7130.71
REMOVE SPINAL LAMINA ADD-ON,360,RC,,,,both,8738.62,7864.76,United Healthcare,Default,Fee Schedule,7130.71,,,,5155.79,7130.71
INSJ BIOMECHANICAL DEVICE,360,RC,,,,both,6129.23,5516.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4290.46,,,,3616.25,5001.45
INSJ BIOMECHANICAL DEVICE,360,RC,,,,both,6129.23,5516.31,Cigna,Default,Percent of Total Billed Charges,3616.25,,,,3616.25,5001.45
INSJ BIOMECHANICAL DEVICE,360,RC,,,,both,6129.23,5516.31,United Healthcare,Default,Fee Schedule,5001.45,,,,3616.25,5001.45
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,11089.42,9980.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7762.59,,,,6542.76,9048.97
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,11089.42,9980.48,Cigna,Default,Percent of Total Billed Charges,6542.76,,,,6542.76,9048.97
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,11089.42,9980.48,United Healthcare,Default,Fee Schedule,9048.97,,,,6542.76,9048.97
ADDL LEVEL NECK SPINE FUSION,360,RC,,,,both,5829.28,5246.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4080.5,,,,3439.28,4756.69
ADDL LEVEL NECK SPINE FUSION,360,RC,,,,both,5829.28,5246.35,Cigna,Default,Percent of Total Billed Charges,3439.28,,,,3439.28,4756.69
ADDL LEVEL NECK SPINE FUSION,360,RC,,,,both,5829.28,5246.35,United Healthcare,Default,Fee Schedule,4756.69,,,,3439.28,4756.69
SP BONE ALGRFT MORSEL ADD ON,20930,HCPCS,360,RC,,both,6348.87,5713.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4444.21,,,,3745.83,5180.68
SP BONE ALGRFT MORSEL ADD ON,20930,HCPCS,360,RC,,both,6348.87,5713.98,Cigna,Default,Percent of Total Billed Charges,3745.83,,,,3745.83,5180.68
SP BONE ALGRFT MORSEL ADD ON,20930,HCPCS,360,RC,,both,6348.87,5713.98,United Healthcare,Default,Fee Schedule,5180.68,,,,3745.83,5180.68
SP BONE ALGRFT STRUCT ADD ON,20931,HCPCS,360,RC,,both,8951.66,8056.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6266.16,,,,5281.48,7304.55
SP BONE ALGRFT STRUCT ADD ON,20931,HCPCS,360,RC,,both,8951.66,8056.49,Cigna,Default,Percent of Total Billed Charges,5281.48,,,,5281.48,7304.55
SP BONE ALGRFT STRUCT ADD ON,20931,HCPCS,360,RC,,both,8951.66,8056.49,United Healthcare,Default,Fee Schedule,7304.55,,,,5281.48,7304.55
SP BONE AGRFT LOCAL ADD ON,20936,HCPCS,360,RC,,both,3287.55,2958.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2301.28,,,,1939.65,2682.64
SP BONE AGRFT LOCAL ADD ON,20936,HCPCS,360,RC,,both,3287.55,2958.8,Cigna,Default,Percent of Total Billed Charges,1939.65,,,,1939.65,2682.64
SP BONE AGRFT LOCAL ADD ON,20936,HCPCS,360,RC,,both,3287.55,2958.8,United Healthcare,Default,Fee Schedule,2682.64,,,,1939.65,2682.64
I&D ABSCESS P-SPINE l/s/ls,360,RC,,,,both,6698.9,6029.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4689.23,,,,3952.35,5466.3
I&D ABSCESS P-SPINE l/s/ls,360,RC,,,,both,6698.9,6029.01,Cigna,Default,Percent of Total Billed Charges,3952.35,,,,3952.35,5466.3
I&D ABSCESS P-SPINE l/s/ls,360,RC,,,,both,6698.9,6029.01,United Healthcare,Default,Fee Schedule,5466.3,,,,3952.35,5466.3
PERQ VERTEBRAL AUGMENTATION,360,RC,,,,both,22577.53,20319.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.27,,,,13320.74,18423.26
PERQ VERTEBRAL AUGMENTATION,360,RC,,,,both,22577.53,20319.78,Cigna,Default,Percent of Total Billed Charges,13320.74,,,,13320.74,18423.26
PERQ VERTEBRAL AUGMENTATION,360,RC,,,,both,22577.53,20319.78,United Healthcare,Default,Fee Schedule,18423.26,,,,13320.74,18423.26
PERQ VERTEBRAUL AUGMENTATION,360,RC,,,,both,22577.53,20319.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.27,,,,13320.74,18423.26
PERQ VERTEBRAUL AUGMENTATION,360,RC,,,,both,22577.53,20319.78,Cigna,Default,Percent of Total Billed Charges,13320.74,,,,13320.74,18423.26
PERQ VERTEBRAUL AUGMENTATION,360,RC,,,,both,22577.53,20319.78,United Healthcare,Default,Fee Schedule,18423.26,,,,13320.74,18423.26
ADDL NECK SPINE FUSION,360,RC,,,,both,5825.04,5242.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4077.53,,,,3436.77,4753.23
ADDL NECK SPINE FUSION,360,RC,,,,both,5825.04,5242.54,Cigna,Default,Percent of Total Billed Charges,3436.77,,,,3436.77,4753.23
ADDL NECK SPINE FUSION,360,RC,,,,both,5825.04,5242.54,United Healthcare,Default,Fee Schedule,4753.23,,,,3436.77,4753.23
NECK SPINE FUSION,360,RC,,,,both,43151.79,38836.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30206.25,,,,25459.56,35211.86
NECK SPINE FUSION,360,RC,,,,both,43151.79,38836.61,Cigna,Default,Percent of Total Billed Charges,25459.56,,,,25459.56,35211.86
NECK SPINE FUSION,360,RC,,,,both,43151.79,38836.61,United Healthcare,Default,Fee Schedule,35211.86,,,,25459.56,35211.86
ADDL SPINAL FUSION,360,RC,,,,both,5071.29,4564.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3549.9,,,,2992.06,4138.17
ADDL SPINAL FUSION,360,RC,,,,both,5071.29,4564.16,Cigna,Default,Percent of Total Billed Charges,2992.06,,,,2992.06,4138.17
ADDL SPINAL FUSION,360,RC,,,,both,5071.29,4564.16,United Healthcare,Default,Fee Schedule,4138.17,,,,2992.06,4138.17
NECK SPINE FUSION,360,RC,,,,both,13387.72,12048.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9371.4,,,,7898.75,10924.38
NECK SPINE FUSION,360,RC,,,,both,13387.72,12048.95,Cigna,Default,Percent of Total Billed Charges,7898.75,,,,7898.75,10924.38
NECK SPINE FUSION,360,RC,,,,both,13387.72,12048.95,United Healthcare,Default,Fee Schedule,10924.38,,,,7898.75,10924.38
THORAX SPINE FUSION,360,RC,,,,both,6463.29,5816.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4524.3,,,,3813.34,5274.04
THORAX SPINE FUSION,360,RC,,,,both,6463.29,5816.96,Cigna,Default,Percent of Total Billed Charges,3813.34,,,,3813.34,5274.04
THORAX SPINE FUSION,360,RC,,,,both,6463.29,5816.96,United Healthcare,Default,Fee Schedule,5274.04,,,,3813.34,5274.04
SPINE FUSION EXTRA SEGMENT,360,RC,,,,both,3593.27,3233.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2515.29,,,,2120.03,2932.11
SPINE FUSION EXTRA SEGMENT,360,RC,,,,both,3593.27,3233.94,Cigna,Default,Percent of Total Billed Charges,2120.03,,,,2120.03,2932.11
SPINE FUSION EXTRA SEGMENT,360,RC,,,,both,3593.27,3233.94,United Healthcare,Default,Fee Schedule,2932.11,,,,2120.03,2932.11
LUMBAR SPINE FUSION COMBINED,360,RC,,,,both,44446.33,40001.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31112.43,,,,26223.33,36268.21
LUMBAR SPINE FUSION COMBINED,360,RC,,,,both,44446.33,40001.7,Cigna,Default,Percent of Total Billed Charges,26223.33,,,,26223.33,36268.21
LUMBAR SPINE FUSION COMBINED,360,RC,,,,both,44446.33,40001.7,United Healthcare,Default,Fee Schedule,36268.21,,,,26223.33,36268.21
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,2656.46,2390.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1859.52,,,,1567.31,2167.67
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,2656.46,2390.81,Cigna,Default,Percent of Total Billed Charges,1567.31,,,,1567.31,2167.67
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,2656.46,2390.81,United Healthcare,Default,Fee Schedule,2167.67,,,,1567.31,2167.67
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,5963.89,5367.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4174.72,,,,3518.7,4866.53
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,5963.89,5367.5,Cigna,Default,Percent of Total Billed Charges,3518.7,,,,3518.7,4866.53
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,5963.89,5367.5,United Healthcare,Default,Fee Schedule,4866.53,,,,3518.7,4866.53
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,8841.02,7956.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6188.71,,,,5216.2,7214.27
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,8841.02,7956.92,Cigna,Default,Percent of Total Billed Charges,5216.2,,,,5216.2,7214.27
INSERT SPINE FIXATION DEVICE,360,RC,,,,both,8841.02,7956.92,United Healthcare,Default,Fee Schedule,7214.27,,,,5216.2,7214.27
INSJ BIOMECHANICAL DEVICE,360,RC,,,,both,6024.82,5422.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4217.37,,,,3554.64,4916.25
INSJ BIOMECHANICAL DEVICE,360,RC,,,,both,6024.82,5422.34,Cigna,Default,Percent of Total Billed Charges,3554.64,,,,3554.64,4916.25
INSJ BIOMECHANICAL DEVICE,360,RC,,,,both,6024.82,5422.34,United Healthcare,Default,Fee Schedule,4916.25,,,,3554.64,4916.25
CERV ARTIFIC DISKECTOMY,360,RC,,,,both,56584.19,50925.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39608.93,,,,33384.67,46172.7
CERV ARTIFIC DISKECTOMY,360,RC,,,,both,56584.19,50925.77,Cigna,Default,Percent of Total Billed Charges,33384.67,,,,33384.67,46172.7
CERV ARTIFIC DISKECTOMY,360,RC,,,,both,56584.19,50925.77,United Healthcare,Default,Fee Schedule,46172.7,,,,33384.67,46172.7
LOW BACK DISK SURGERY,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
LOW BACK DISK SURGERY,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
LOW BACK DISK SURGERY,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
SPINAL DISK SURGERY ADD ON,360,RC,,,,both,11528.74,10375.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8070.12,,,,6801.96,9407.45
SPINAL DISK SURGERY ADD ON,360,RC,,,,both,11528.74,10375.87,Cigna,Default,Percent of Total Billed Charges,6801.96,,,,6801.96,9407.45
SPINAL DISK SURGERY ADD ON,360,RC,,,,both,11528.74,10375.87,United Healthcare,Default,Fee Schedule,9407.45,,,,6801.96,9407.45
REMOVE SPINE LAMINA 1 CRVL,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 CRVL,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 CRVL,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 THRC,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 THRC,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 THRC,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 LMBR,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 LMBR,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
REMOVE SPINE LAMINA 1 LMBR,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
REMOVE VERT BODY DCMPRN CRVL,360,RC,,,,both,6873.34,6186.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4811.34,,,,4055.27,5608.65
REMOVE VERT BODY DCMPRN CRVL,360,RC,,,,both,6873.34,6186.01,Cigna,Default,Percent of Total Billed Charges,4055.27,,,,4055.27,5608.65
REMOVE VERT BODY DCMPRN CRVL,360,RC,,,,both,6873.34,6186.01,United Healthcare,Default,Fee Schedule,5608.65,,,,4055.27,5608.65
REMOVE VERTEBRAL BODY ADD-ON,360,RC,,,,both,6873.34,6186.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4811.34,,,,4055.27,5608.65
REMOVE VERTEBRAL BODY ADD-ON,360,RC,,,,both,6873.34,6186.01,Cigna,Default,Percent of Total Billed Charges,4055.27,,,,4055.27,5608.65
REMOVE VERTEBRAL BODY ADD-ON,360,RC,,,,both,6873.34,6186.01,United Healthcare,Default,Fee Schedule,5608.65,,,,4055.27,5608.65
EXCISE INTRSPINL LESION THRC,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
EXCISE INTRSPINL LESION THRC,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
EXCISE INTRSPINL LESION THRC,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
EXCISE INTRSPINL LESION LMBR,360,RC,,,,both,22577.54,20319.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15804.28,,,,13320.75,18423.27
EXCISE INTRSPINL LESION LMBR,360,RC,,,,both,22577.54,20319.79,Cigna,Default,Percent of Total Billed Charges,13320.75,,,,13320.75,18423.27
EXCISE INTRSPINL LESION LMBR,360,RC,,,,both,22577.54,20319.79,United Healthcare,Default,Fee Schedule,18423.27,,,,13320.75,18423.27
BX/EXC XDRL SPINE LESN THRC,360,RC,,,,both,40637.17,36573.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28446.02,,,,23975.93,33159.93
BX/EXC XDRL SPINE LESN THRC,360,RC,,,,both,40637.17,36573.45,Cigna,Default,Percent of Total Billed Charges,23975.93,,,,23975.93,33159.93
BX/EXC XDRL SPINE LESN THRC,360,RC,,,,both,40637.17,36573.45,United Healthcare,Default,Fee Schedule,33159.93,,,,23975.93,33159.93
REPAIR LAMINECTOMY DEFECT,360,RC,,,,both,4726.96,4254.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3308.87,,,,2788.91,3857.2
REPAIR LAMINECTOMY DEFECT,360,RC,,,,both,4726.96,4254.26,Cigna,Default,Percent of Total Billed Charges,2788.91,,,,2788.91,3857.2
REPAIR LAMINECTOMY DEFECT,360,RC,,,,both,4726.96,4254.26,United Healthcare,Default,Fee Schedule,3857.2,,,,2788.91,3857.2
REMOVE SPINE ELTRD PLATE,360,RC,,,,both,7722.74,6950.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5405.92,,,,4556.42,6301.76
REMOVE SPINE ELTRD PLATE,360,RC,,,,both,7722.74,6950.47,Cigna,Default,Percent of Total Billed Charges,4556.42,,,,4556.42,6301.76
REMOVE SPINE ELTRD PLATE,360,RC,,,,both,7722.74,6950.47,United Healthcare,Default,Fee Schedule,6301.76,,,,4556.42,6301.76
INSRT/REDO SPINE N GENERATOR,360,RC,,,,both,103012.97,92711.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72109.08,,,,60777.65,84058.58
INSRT/REDO SPINE N GENERATOR,360,RC,,,,both,103012.97,92711.67,Cigna,Default,Percent of Total Billed Charges,60777.65,,,,60777.65,84058.58
INSRT/REDO SPINE N GENERATOR,360,RC,,,,both,103012.97,92711.67,United Healthcare,Default,Fee Schedule,84058.58,,,,60777.65,84058.58
REVISE/REMOVE NEURORECEIVER,360,RC,,,,both,11808.31,10627.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8265.82,,,,6966.9,9635.58
REVISE/REMOVE NEURORECEIVER,360,RC,,,,both,11808.31,10627.48,Cigna,Default,Percent of Total Billed Charges,6966.9,,,,6966.9,9635.58
REVISE/REMOVE NEURORECEIVER,360,RC,,,,both,11808.31,10627.48,United Healthcare,Default,Fee Schedule,9635.58,,,,6966.9,9635.58
I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LU,360,RC,,,,both,8982.39,8084.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6287.67,,,,5299.61,7329.63
I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LU,360,RC,,,,both,8982.39,8084.15,Cigna,Default,Percent of Total Billed Charges,5299.61,,,,5299.61,7329.63
I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LU,360,RC,,,,both,8982.39,8084.15,United Healthcare,Default,Fee Schedule,7329.63,,,,5299.61,7329.63
DECOMPRESS SPINAL CORD LMBR,360,RC,,,,both,22596.6,20336.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15817.62,,,,13331.99,18438.83
DECOMPRESS SPINAL CORD LMBR,360,RC,,,,both,22596.6,20336.94,Cigna,Default,Percent of Total Billed Charges,13331.99,,,,13331.99,18438.83
DECOMPRESS SPINAL CORD LMBR,360,RC,,,,both,22596.6,20336.94,United Healthcare,Default,Fee Schedule,18438.83,,,,13331.99,18438.83
NEURO CARPAL TUNNEL,360,RC,,,,both,6312.65,5681.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4418.86,,,,3724.46,5151.12
NEURO CARPAL TUNNEL,360,RC,,,,both,6312.65,5681.39,Cigna,Default,Percent of Total Billed Charges,3724.46,,,,3724.46,5151.12
NEURO CARPAL TUNNEL,360,RC,,,,both,6312.65,5681.39,United Healthcare,Default,Fee Schedule,5151.12,,,,3724.46,5151.12
LAM FACETEC/FORAMOT DURING TLIF 1 VRT SG,360,RC,,,,both,5371.75,4834.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3760.22,,,,3169.33,4383.35
LAM FACETEC/FORAMOT DURING TLIF 1 VRT SG,360,RC,,,,both,5371.75,4834.58,Cigna,Default,Percent of Total Billed Charges,3169.33,,,,3169.33,4383.35
LAM FACETEC/FORAMOT DURING TLIF 1 VRT SG,360,RC,,,,both,5371.75,4834.58,United Healthcare,Default,Fee Schedule,4383.35,,,,3169.33,4383.35
LAM FACETEC/FORAMOT DURING TLIF EA ADDL,360,RC,,,,both,5371.75,4834.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3760.22,,,,3169.33,4383.35
LAM FACETEC/FORAMOT DURING TLIF EA ADDL,360,RC,,,,both,5371.75,4834.58,Cigna,Default,Percent of Total Billed Charges,3169.33,,,,3169.33,4383.35
LAM FACETEC/FORAMOT DURING TLIF EA ADDL,360,RC,,,,both,5371.75,4834.58,United Healthcare,Default,Fee Schedule,4383.35,,,,3169.33,4383.35
DRAIN/INJ SM JNT/BURSA,20600,HCPCS,983,RC,,both,193,173.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.1,,,,113.87,135.1
DRAIN/INJ SM JNT/BURSA,20600,HCPCS,983,RC,,both,193,173.7,Cigna,Default,Percent of Total Billed Charges,113.87,,,,113.87,135.1
DRAIN/INJ SM JNT/BURSA,20600,HCPCS,983,RC,,both,193,173.7,United Healthcare,Default,Fee Schedule,,,,,113.87,135.1
ADMIN INJ SC/IM,96372,HCPCS,519,RC,,both,172.8,155.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.96,,,,101.95,141
ADMIN INJ SC/IM,96372,HCPCS,519,RC,,both,172.8,155.52,Cigna,Default,Percent of Total Billed Charges,101.95,,,,101.95,141
ADMIN INJ SC/IM,96372,HCPCS,519,RC,,both,172.8,155.52,United Healthcare,Default,Fee Schedule,141,,,,101.95,141
INJ TRIG PT 1/2 MSCL,20552,HCPCS,983,RC,,both,750.75,675.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,525.52,,,,442.94,525.52
INJ TRIG PT 1/2 MSCL,20552,HCPCS,983,RC,,both,750.75,675.68,Cigna,Default,Percent of Total Billed Charges,442.94,,,,442.94,525.52
INJ TRIG PT 1/2 MSCL,20552,HCPCS,983,RC,,both,750.75,675.68,United Healthcare,Default,Fee Schedule,,,,,442.94,525.52
INJ TRIG PT > 3 MSCL,20553,HCPCS,983,RC,,both,750.75,675.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,525.52,,,,442.94,525.52
INJ TRIG PT > 3 MSCL,20553,HCPCS,983,RC,,both,750.75,675.68,Cigna,Default,Percent of Total Billed Charges,442.94,,,,442.94,525.52
INJ TRIG PT > 3 MSCL,20553,HCPCS,983,RC,,both,750.75,675.68,United Healthcare,Default,Fee Schedule,,,,,442.94,525.52
DRAIN/INJ INT JNT/BURSA,20605,HCPCS,983,RC,,both,219,197.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.3,,,,129.21,153.3
DRAIN/INJ INT JNT/BURSA,20605,HCPCS,983,RC,,both,219,197.1,Cigna,Default,Percent of Total Billed Charges,129.21,,,,129.21,153.3
DRAIN/INJ INT JNT/BURSA,20605,HCPCS,983,RC,,both,219,197.1,United Healthcare,Default,Fee Schedule,,,,,129.21,153.3
DRAIN/INJ MAJ JNT/BURSA,20610,HCPCS,983,RC,,both,279,251.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.3,,,,164.61,195.3
DRAIN/INJ MAJ JNT/BURSA,20610,HCPCS,983,RC,,both,279,251.1,Cigna,Default,Percent of Total Billed Charges,164.61,,,,164.61,195.3
DRAIN/INJ MAJ JNT/BURSA,20610,HCPCS,983,RC,,both,279,251.1,United Healthcare,Default,Fee Schedule,,,,,164.61,195.3
PRP NJX,0232T,HCPCS,983,RC,,both,5669.3,5102.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3968.51,,,,3344.89,3968.51
PRP NJX,0232T,HCPCS,983,RC,,both,5669.3,5102.37,Cigna,Default,Percent of Total Billed Charges,3344.89,,,,3344.89,3968.51
PRP NJX,0232T,HCPCS,983,RC,,both,5669.3,5102.37,United Healthcare,Default,Fee Schedule,,,,,3344.89,3968.51
METHOTREXATE 5mg,J9260,HCPCS,983,RC,,both,49.56,44.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.69,,,,29.24,34.69
METHOTREXATE 5mg,J9260,HCPCS,983,RC,,both,49.56,44.6,Cigna,Default,Percent of Total Billed Charges,29.24,,,,29.24,34.69
METHOTREXATE 5mg,J9260,HCPCS,983,RC,,both,49.56,44.6,United Healthcare,Default,Fee Schedule,,,,,29.24,34.69
MONOVISC INJ PER DOSE,J7327,HCPCS,983,RC,,both,2819.01,2537.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1973.31,,,,1663.22,1973.31
MONOVISC INJ PER DOSE,J7327,HCPCS,983,RC,,both,2819.01,2537.11,Cigna,Default,Percent of Total Billed Charges,1663.22,,,,1663.22,1973.31
MONOVISC INJ PER DOSE,J7327,HCPCS,983,RC,,both,2819.01,2537.11,United Healthcare,Default,Fee Schedule,,,,,1663.22,1973.31
DENOSUMAG INJ PROLIA 1 mg,J0897,HCPCS,983,RC,,both,58,52.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.6,,,,34.22,40.6
DENOSUMAG INJ PROLIA 1 mg,J0897,HCPCS,983,RC,,both,58,52.2,Cigna,Default,Percent of Total Billed Charges,34.22,,,,34.22,40.6
DENOSUMAG INJ PROLIA 1 mg,J0897,HCPCS,983,RC,,both,58,52.2,United Healthcare,Default,Fee Schedule,,,,,34.22,40.6
NEW PATIENT COMP 60 MIN,99205,HCPCS,983,RC,,both,410,369,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287,,,,241.9,287
NEW PATIENT COMP 60 MIN,99205,HCPCS,983,RC,,both,410,369,Cigna,Default,Percent of Total Billed Charges,241.9,,,,241.9,287
NEW PATIENT COMP 60 MIN,99205,HCPCS,983,RC,,both,410,369,United Healthcare,Default,Fee Schedule,,,,,241.9,287
OP CONSULT LEVEL 2,99242,HCPCS,960,RC,,outpatient,214,192.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.8,,,,126.26,149.8
OP CONSULT LEVEL 2,99242,HCPCS,960,RC,,outpatient,214,192.6,Cigna,Default,Percent of Total Billed Charges,126.26,,,,126.26,149.8
OP CONSULT LEVEL 2,99242,HCPCS,960,RC,,outpatient,214,192.6,United Healthcare,Default,Fee Schedule,,,,,126.26,149.8
OP CONSULT LEVEL 3,99243,HCPCS,960,RC,,outpatient,288,259.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.6,,,,169.92,201.6
OP CONSULT LEVEL 3,99243,HCPCS,960,RC,,outpatient,288,259.2,Cigna,Default,Percent of Total Billed Charges,169.92,,,,169.92,201.6
OP CONSULT LEVEL 3,99243,HCPCS,960,RC,,outpatient,288,259.2,United Healthcare,Default,Fee Schedule,,,,,169.92,201.6
OFFICE CONSULTATION,99244,HCPCS,960,RC,,outpatient,402,361.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,281.4,,,,237.18,281.4
OFFICE CONSULTATION,99244,HCPCS,960,RC,,outpatient,402,361.8,Cigna,Default,Percent of Total Billed Charges,237.18,,,,237.18,281.4
OFFICE CONSULTATION,99244,HCPCS,960,RC,,outpatient,402,361.8,United Healthcare,Default,Fee Schedule,,,,,237.18,281.4
OP CONSULT LEVEL 5,99245,HCPCS,960,RC,,outpatient,503,452.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.1,,,,296.77,352.1
OP CONSULT LEVEL 5,99245,HCPCS,960,RC,,outpatient,503,452.7,Cigna,Default,Percent of Total Billed Charges,296.77,,,,296.77,352.1
OP CONSULT LEVEL 5,99245,HCPCS,960,RC,,outpatient,503,452.7,United Healthcare,Default,Fee Schedule,,,,,296.77,352.1
PRO LONG SERV 1ST HOUR,99354,HCPCS,960,RC,,outpatient,206,185.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.2,,,,121.54,144.2
PRO LONG SERV 1ST HOUR,99354,HCPCS,960,RC,,outpatient,206,185.4,Cigna,Default,Percent of Total Billed Charges,121.54,,,,121.54,144.2
PRO LONG SERV 1ST HOUR,99354,HCPCS,960,RC,,outpatient,206,185.4,United Healthcare,Default,Fee Schedule,,,,,121.54,144.2
PRO LONG SERV EACH ADD 30,99355,HCPCS,960,RC,,outpatient,177,159.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.9,,,,104.43,123.9
PRO LONG SERV EACH ADD 30,99355,HCPCS,960,RC,,outpatient,177,159.3,Cigna,Default,Percent of Total Billed Charges,104.43,,,,104.43,123.9
PRO LONG SERV EACH ADD 30,99355,HCPCS,960,RC,,outpatient,177,159.3,United Healthcare,Default,Fee Schedule,,,,,104.43,123.9
EXT SERV 1ST HOUR,99358,HCPCS,960,RC,,outpatient,209,188.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.3,,,,123.31,146.3
EXT SERV 1ST HOUR,99358,HCPCS,960,RC,,outpatient,209,188.1,Cigna,Default,Percent of Total Billed Charges,123.31,,,,123.31,146.3
EXT SERV 1ST HOUR,99358,HCPCS,960,RC,,outpatient,209,188.1,United Healthcare,Default,Fee Schedule,,,,,123.31,146.3
EXT SERV EA ADDL 30 MIN,99359,HCPCS,960,RC,,outpatient,147,132.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.9,,,,86.73,102.9
EXT SERV EA ADDL 30 MIN,99359,HCPCS,960,RC,,outpatient,147,132.3,Cigna,Default,Percent of Total Billed Charges,86.73,,,,86.73,102.9
EXT SERV EA ADDL 30 MIN,99359,HCPCS,960,RC,,outpatient,147,132.3,United Healthcare,Default,Fee Schedule,,,,,86.73,102.9
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-,360,RC,,,,both,6312.67,5681.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4418.87,,,,3724.48,5151.14
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-,360,RC,,,,both,6312.67,5681.4,Cigna,Default,Percent of Total Billed Charges,3724.48,,,,3724.48,5151.14
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-,360,RC,,,,both,6312.67,5681.4,United Healthcare,Default,Fee Schedule,5151.14,,,,3724.48,5151.14
DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUO,360,RC,,,,both,2224.36,2001.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1557.05,,,,1312.37,1815.08
DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUO,360,RC,,,,both,2224.36,2001.92,Cigna,Default,Percent of Total Billed Charges,1312.37,,,,1312.37,1815.08
DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUO,360,RC,,,,both,2224.36,2001.92,United Healthcare,Default,Fee Schedule,1815.08,,,,1312.37,1815.08
ESTABLISH BRAIN CAVITY SHUNT,360,RC,,,,both,18230.54,16407.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12761.38,,,,10756.02,14876.12
ESTABLISH BRAIN CAVITY SHUNT,360,RC,,,,both,18230.54,16407.49,Cigna,Default,Percent of Total Billed Charges,10756.02,,,,10756.02,14876.12
ESTABLISH BRAIN CAVITY SHUNT,360,RC,,,,both,18230.54,16407.49,United Healthcare,Default,Fee Schedule,14876.12,,,,10756.02,14876.12
THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,62272,HCPCS,360,RC,,both,2224.36,2001.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1557.05,,,,1312.37,1815.08
THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,62272,HCPCS,360,RC,,both,2224.36,2001.92,Cigna,Default,Percent of Total Billed Charges,1312.37,,,,1312.37,1815.08
THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,62272,HCPCS,360,RC,,both,2224.36,2001.92,United Healthcare,Default,Fee Schedule,1815.08,,,,1312.37,1815.08
TAP BLOCK SPINE,64486,HCPCS,360,RC,,both,763.49,687.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,534.44,,,,450.46,623.01
TAP BLOCK SPINE,64486,HCPCS,360,RC,,both,763.49,687.14,Cigna,Default,Percent of Total Billed Charges,450.46,,,,450.46,623.01
TAP BLOCK SPINE,64486,HCPCS,360,RC,,both,763.49,687.14,United Healthcare,Default,Fee Schedule,623.01,,,,450.46,623.01
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-N,360,RC,,,,both,6134.76,5521.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4294.33,,,,3619.51,5005.96
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-N,360,RC,,,,both,6134.76,5521.28,Cigna,Default,Percent of Total Billed Charges,3619.51,,,,3619.51,5005.96
NEUROPLASTY; ULNAR NERVE TRANSPOSITION-N,360,RC,,,,both,6134.76,5521.28,United Healthcare,Default,Fee Schedule,5005.96,,,,3619.51,5005.96
TOT DISC ARTHRP 2ND LVL CRV,360,RC,,,,both,18160.23,16344.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12712.16,,,,10714.54,14818.75
TOT DISC ARTHRP 2ND LVL CRV,360,RC,,,,both,18160.23,16344.21,Cigna,Default,Percent of Total Billed Charges,10714.54,,,,10714.54,14818.75
TOT DISC ARTHRP 2ND LVL CRV,360,RC,,,,both,18160.23,16344.21,United Healthcare,Default,Fee Schedule,14818.75,,,,10714.54,14818.75
CYSTO W/ LITHOTRIPSY BILAT,52353,HCPCS,360,RC,,both,24220.5,21798.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16954.35,,,,14290.1,19763.93
CYSTO W/ LITHOTRIPSY BILAT,52353,HCPCS,360,RC,,both,24220.5,21798.45,Cigna,Default,Percent of Total Billed Charges,14290.1,,,,14290.1,19763.93
CYSTO W/ LITHOTRIPSY BILAT,52353,HCPCS,360,RC,,both,24220.5,21798.45,United Healthcare,Default,Fee Schedule,19763.93,,,,14290.1,19763.93
TRANSRECTAL ULTRASOUND,76872,HCPCS,360,RC,,both,381.37,343.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,266.96,,,,225.01,311.2
TRANSRECTAL ULTRASOUND,76872,HCPCS,360,RC,,both,381.37,343.23,Cigna,Default,Percent of Total Billed Charges,225.01,,,,225.01,311.2
TRANSRECTAL ULTRASOUND,76872,HCPCS,360,RC,,both,381.37,343.23,United Healthcare,Default,Fee Schedule,311.2,,,,225.01,311.2
PROSTATE BIOPSY,360,RC,,,,both,6272.08,5644.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4390.46,,,,3700.53,5118.02
PROSTATE BIOPSY,360,RC,,,,both,6272.08,5644.87,Cigna,Default,Percent of Total Billed Charges,3700.53,,,,3700.53,5118.02
PROSTATE BIOPSY,360,RC,,,,both,6272.08,5644.87,United Healthcare,Default,Fee Schedule,5118.02,,,,3700.53,5118.02
URO ULTRASOUND RENTAL - 1 PT,360,RC,,,,both,2119.68,1907.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1483.78,,,,1250.61,1729.66
URO ULTRASOUND RENTAL - 1 PT,360,RC,,,,both,2119.68,1907.71,Cigna,Default,Percent of Total Billed Charges,1250.61,,,,1250.61,1729.66
URO ULTRASOUND RENTAL - 1 PT,360,RC,,,,both,2119.68,1907.71,United Healthcare,Default,Fee Schedule,1729.66,,,,1250.61,1729.66
TRANSRECTAL PROBE RENTAL - 1 PT,272,RC,,,,both,1059.84,953.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,741.89,,,,625.31,864.83
TRANSRECTAL PROBE RENTAL - 1 PT,272,RC,,,,both,1059.84,953.86,Cigna,Default,Percent of Total Billed Charges,625.31,,,,625.31,864.83
TRANSRECTAL PROBE RENTAL - 1 PT,272,RC,,,,both,1059.84,953.86,United Healthcare,Default,Fee Schedule,864.83,,,,625.31,864.83
URO ULTRASOUND RENTAL- 2 PT,360,RC,,,,both,1028.97,926.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,720.28,,,,607.09,839.64
URO ULTRASOUND RENTAL- 2 PT,360,RC,,,,both,1028.97,926.07,Cigna,Default,Percent of Total Billed Charges,607.09,,,,607.09,839.64
URO ULTRASOUND RENTAL- 2 PT,360,RC,,,,both,1028.97,926.07,United Healthcare,Default,Fee Schedule,839.64,,,,607.09,839.64
URO ULTRASOUND RENTAL- 3 PT,360,RC,,,,both,685.98,617.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,480.19,,,,404.73,559.76
URO ULTRASOUND RENTAL- 3 PT,360,RC,,,,both,685.98,617.38,Cigna,Default,Percent of Total Billed Charges,404.73,,,,404.73,559.76
URO ULTRASOUND RENTAL- 3 PT,360,RC,,,,both,685.98,617.38,United Healthcare,Default,Fee Schedule,559.76,,,,404.73,559.76
URO ULTRASOUND RENTAL- 4 PTS,360,RC,,,,both,514.49,463.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,360.14,,,,303.55,419.82
URO ULTRASOUND RENTAL- 4 PTS,360,RC,,,,both,514.49,463.04,Cigna,Default,Percent of Total Billed Charges,303.55,,,,303.55,419.82
URO ULTRASOUND RENTAL- 4 PTS,360,RC,,,,both,514.49,463.04,United Healthcare,Default,Fee Schedule,419.82,,,,303.55,419.82
TRANSRECTAL PROBE RENTAL- 2 PT,360,RC,,,,both,514.49,463.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,360.14,,,,303.55,419.82
TRANSRECTAL PROBE RENTAL- 2 PT,360,RC,,,,both,514.49,463.04,Cigna,Default,Percent of Total Billed Charges,303.55,,,,303.55,419.82
TRANSRECTAL PROBE RENTAL- 2 PT,360,RC,,,,both,514.49,463.04,United Healthcare,Default,Fee Schedule,419.82,,,,303.55,419.82
TRANSRECTAL PROBE RENTAL- 3 PTS,360,RC,,,,both,342.99,308.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,240.09,,,,202.36,279.88
TRANSRECTAL PROBE RENTAL- 3 PTS,360,RC,,,,both,342.99,308.69,Cigna,Default,Percent of Total Billed Charges,202.36,,,,202.36,279.88
TRANSRECTAL PROBE RENTAL- 3 PTS,360,RC,,,,both,342.99,308.69,United Healthcare,Default,Fee Schedule,279.88,,,,202.36,279.88
TRANSRECTAL PROBE RENTAL- 4 PTS,360,RC,,,,both,257.24,231.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.07,,,,151.77,209.91
TRANSRECTAL PROBE RENTAL- 4 PTS,360,RC,,,,both,257.24,231.52,Cigna,Default,Percent of Total Billed Charges,151.77,,,,151.77,209.91
TRANSRECTAL PROBE RENTAL- 4 PTS,360,RC,,,,both,257.24,231.52,United Healthcare,Default,Fee Schedule,209.91,,,,151.77,209.91
HOLMIUM MSTRPULSE HF,272,RC,,,,both,1059.84,953.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,741.89,,,,625.31,864.83
HOLMIUM MSTRPULSE HF,272,RC,,,,both,1059.84,953.86,Cigna,Default,Percent of Total Billed Charges,625.31,,,,625.31,864.83
HOLMIUM MSTRPULSE HF,272,RC,,,,both,1059.84,953.86,United Healthcare,Default,Fee Schedule,864.83,,,,625.31,864.83
HOLMIUM MP 200 FIBER,272,RC,,,,both,1094.14,984.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,765.9,,,,645.54,892.82
HOLMIUM MP 200 FIBER,272,RC,,,,both,1094.14,984.73,Cigna,Default,Percent of Total Billed Charges,645.54,,,,645.54,892.82
HOLMIUM MP 200 FIBER,272,RC,,,,both,1094.14,984.73,United Healthcare,Default,Fee Schedule,892.82,,,,645.54,892.82
HOLMIUM LOW WATT,360,RC,,,,both,1714.95,1543.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1200.46,,,,1011.82,1399.4
HOLMIUM LOW WATT,360,RC,,,,both,1714.95,1543.46,Cigna,Default,Percent of Total Billed Charges,1011.82,,,,1011.82,1399.4
HOLMIUM LOW WATT,360,RC,,,,both,1714.95,1543.46,United Healthcare,Default,Fee Schedule,1399.4,,,,1011.82,1399.4
HOLMIUM 200 FORTEC FIBER,360,RC,,,,both,778.59,700.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,545.01,,,,459.37,635.33
HOLMIUM 200 FORTEC FIBER,360,RC,,,,both,778.59,700.73,Cigna,Default,Percent of Total Billed Charges,459.37,,,,459.37,635.33
HOLMIUM 200 FORTEC FIBER,360,RC,,,,both,778.59,700.73,United Healthcare,Default,Fee Schedule,635.33,,,,459.37,635.33
HOLMIUM HIGH WATT LASER,360,RC,,,,both,1886.44,1697.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1320.51,,,,1113,1539.34
HOLMIUM HIGH WATT LASER,360,RC,,,,both,1886.44,1697.8,Cigna,Default,Percent of Total Billed Charges,1113,,,,1113,1539.34
HOLMIUM HIGH WATT LASER,360,RC,,,,both,1886.44,1697.8,United Healthcare,Default,Fee Schedule,1539.34,,,,1113,1539.34
FIBER DUST THULIUM FIBER LASER,272,RC,,,,both,999,899.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,699.3,,,,589.41,815.18
FIBER DUST THULIUM FIBER LASER,272,RC,,,,both,999,899.1,Cigna,Default,Percent of Total Billed Charges,589.41,,,,589.41,815.18
FIBER DUST THULIUM FIBER LASER,272,RC,,,,both,999,899.1,United Healthcare,Default,Fee Schedule,815.18,,,,589.41,815.18
THULIUM TFL 272 FORTEC FIBER,272,RC,,,,both,1063.27,956.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,744.29,,,,627.33,867.63
THULIUM TFL 272 FORTEC FIBER,272,RC,,,,both,1063.27,956.94,Cigna,Default,Percent of Total Billed Charges,627.33,,,,627.33,867.63
THULIUM TFL 272 FORTEC FIBER,272,RC,,,,both,1063.27,956.94,United Healthcare,Default,Fee Schedule,867.63,,,,627.33,867.63
FIBER DUST THULIUM FIBER LASER  2,360,RC,,,,both,2658.17,2392.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1860.72,,,,1568.32,2169.07
FIBER DUST THULIUM FIBER LASER  2,360,RC,,,,both,2658.17,2392.35,Cigna,Default,Percent of Total Billed Charges,1568.32,,,,1568.32,2169.07
FIBER DUST THULIUM FIBER LASER  2,360,RC,,,,both,2658.17,2392.35,United Healthcare,Default,Fee Schedule,2169.07,,,,1568.32,2169.07
CYSTOSCOPY W/ STENT PLACEMENT UNILAT,360,RC,,,,both,10770.02,9693.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7539.01,,,,6354.31,8788.34
CYSTOSCOPY W/ STENT PLACEMENT UNILAT,360,RC,,,,both,10770.02,9693.02,Cigna,Default,Percent of Total Billed Charges,6354.31,,,,6354.31,8788.34
CYSTOSCOPY W/ STENT PLACEMENT UNILAT,360,RC,,,,both,10770.02,9693.02,United Healthcare,Default,Fee Schedule,8788.34,,,,6354.31,8788.34
CYSTOSCOPY W/ STENT PLACEMENT BILAT,52353,HCPCS,360,RC,,both,16155.03,14539.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11308.52,,,,9531.47,13182.5
CYSTOSCOPY W/ STENT PLACEMENT BILAT,52353,HCPCS,360,RC,,both,16155.03,14539.53,Cigna,Default,Percent of Total Billed Charges,9531.47,,,,9531.47,13182.5
CYSTOSCOPY W/ STENT PLACEMENT BILAT,52353,HCPCS,360,RC,,both,16155.03,14539.53,United Healthcare,Default,Fee Schedule,13182.5,,,,9531.47,13182.5
CYSTO/URETERO W/LITHOTRIPSY,360,RC,,,,both,16128.01,14515.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11289.61,,,,9515.53,13160.46
CYSTO/URETERO W/LITHOTRIPSY,360,RC,,,,both,16128.01,14515.21,Cigna,Default,Percent of Total Billed Charges,9515.53,,,,9515.53,13160.46
CYSTO/URETERO W/LITHOTRIPSY,360,RC,,,,both,16128.01,14515.21,United Healthcare,Default,Fee Schedule,13160.46,,,,9515.53,13160.46
TRANSURETHRAL RESECTION OF PROSTATE (TUR,360,RC,,,,both,16128.01,14515.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11289.61,,,,9515.53,13160.46
TRANSURETHRAL RESECTION OF PROSTATE (TUR,360,RC,,,,both,16128.01,14515.21,Cigna,Default,Percent of Total Billed Charges,9515.53,,,,9515.53,13160.46
TRANSURETHRAL RESECTION OF PROSTATE (TUR,360,RC,,,,both,16128.01,14515.21,United Healthcare,Default,Fee Schedule,13160.46,,,,9515.53,13160.46
CYSTO W/URETEROSCOPY W/RMVL STONES,360,RC,,,,both,10993.34,9894.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7695.34,,,,6486.07,8970.57
CYSTO W/URETEROSCOPY W/RMVL STONES,360,RC,,,,both,10993.34,9894.01,Cigna,Default,Percent of Total Billed Charges,6486.07,,,,6486.07,8970.57
CYSTO W/URETEROSCOPY W/RMVL STONES,360,RC,,,,both,10993.34,9894.01,United Healthcare,Default,Fee Schedule,8970.57,,,,6486.07,8970.57
CYSTO/URETERO W/LITHOTRIPSY &INDWELL STE,360,RC,,,,both,16128.01,14515.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11289.61,,,,9515.53,13160.46
CYSTO/URETERO W/LITHOTRIPSY &INDWELL STE,360,RC,,,,both,16128.01,14515.21,Cigna,Default,Percent of Total Billed Charges,9515.53,,,,9515.53,13160.46
CYSTO/URETERO W/LITHOTRIPSY &INDWELL STE,360,RC,,,,both,16128.01,14515.21,United Healthcare,Default,Fee Schedule,13160.46,,,,9515.53,13160.46
CYSTOURETHROSCOPY W/DEST &/RMVL BLADDER,360,RC,,,,both,10993.34,9894.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7695.34,,,,6486.07,8970.57
CYSTOURETHROSCOPY W/DEST &/RMVL BLADDER,360,RC,,,,both,10993.34,9894.01,Cigna,Default,Percent of Total Billed Charges,6486.07,,,,6486.07,8970.57
CYSTOURETHROSCOPY W/DEST &/RMVL BLADDER,360,RC,,,,both,10993.34,9894.01,United Healthcare,Default,Fee Schedule,8970.57,,,,6486.07,8970.57
URONAV MRI FUSION SYSTEM- RNTL,360,RC,,,,both,5299.2,4769.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3709.44,,,,3126.53,4324.15
URONAV MRI FUSION SYSTEM- RNTL,360,RC,,,,both,5299.2,4769.28,Cigna,Default,Percent of Total Billed Charges,3126.53,,,,3126.53,4324.15
URONAV MRI FUSION SYSTEM- RNTL,360,RC,,,,both,5299.2,4769.28,United Healthcare,Default,Fee Schedule,4324.15,,,,3126.53,4324.15
US URONAV,360,RC,,,,both,1886.44,1697.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1320.51,,,,1113,1539.34
US URONAV,360,RC,,,,both,1886.44,1697.8,Cigna,Default,Percent of Total Billed Charges,1113,,,,1113,1539.34
US URONAV,360,RC,,,,both,1886.44,1697.8,United Healthcare,Default,Fee Schedule,1539.34,,,,1113,1539.34
US BX SNGL NDL GUIDE UA 1322-S,360,RC,,,,both,174.92,157.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.44,,,,103.2,142.73
US BX SNGL NDL GUIDE UA 1322-S,360,RC,,,,both,174.92,157.43,Cigna,Default,Percent of Total Billed Charges,103.2,,,,103.2,142.73
US BX SNGL NDL GUIDE UA 1322-S,360,RC,,,,both,174.92,157.43,United Healthcare,Default,Fee Schedule,142.73,,,,103.2,142.73
US LATEX FREE PROBE CVR 8818,360,RC,,,,both,41.13,37.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.79,,,,24.27,33.56
US LATEX FREE PROBE CVR 8818,360,RC,,,,both,41.13,37.02,Cigna,Default,Percent of Total Billed Charges,24.27,,,,24.27,33.56
US LATEX FREE PROBE CVR 8818,360,RC,,,,both,41.13,37.02,United Healthcare,Default,Fee Schedule,33.56,,,,24.27,33.56
URONAV BK 8808e/8818 PROBE HLDR,360,RC,,,,both,264.1,237.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.87,,,,155.82,215.51
URONAV BK 8808e/8818 PROBE HLDR,360,RC,,,,both,264.1,237.69,Cigna,Default,Percent of Total Billed Charges,155.82,,,,155.82,215.51
URONAV BK 8808e/8818 PROBE HLDR,360,RC,,,,both,264.1,237.69,United Healthcare,Default,Fee Schedule,215.51,,,,155.82,215.51
CYSTO W/ TX or BX,360,RC,,,,both,10673.04,9605.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7471.13,,,,6297.09,8709.2
CYSTO W/ TX or BX,360,RC,,,,both,10673.04,9605.74,Cigna,Default,Percent of Total Billed Charges,6297.09,,,,6297.09,8709.2
CYSTO W/ TX or BX,360,RC,,,,both,10673.04,9605.74,United Healthcare,Default,Fee Schedule,8709.2,,,,6297.09,8709.2
URONAV MRI FUSION SYSTEM- RNTL T1,360,RC,,,,both,3996,3596.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2797.2,,,,2357.64,3260.74
URONAV MRI FUSION SYSTEM- RNTL T1,360,RC,,,,both,3996,3596.4,Cigna,Default,Percent of Total Billed Charges,2357.64,,,,2357.64,3260.74
URONAV MRI FUSION SYSTEM- RNTL T1,360,RC,,,,both,3996,3596.4,United Healthcare,Default,Fee Schedule,3260.74,,,,2357.64,3260.74
US URONAV T1,360,RC,,,,both,915.75,824.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,641.02,,,,540.29,747.25
US URONAV T1,360,RC,,,,both,915.75,824.18,Cigna,Default,Percent of Total Billed Charges,540.29,,,,540.29,747.25
US URONAV T1,360,RC,,,,both,915.75,824.18,United Healthcare,Default,Fee Schedule,747.25,,,,540.29,747.25
RADICAL NEPHRECTOMY,360,RC,,,,both,33481,30132.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23436.7,,,,19753.79,27320.5
RADICAL NEPHRECTOMY,360,RC,,,,both,33481,30132.9,Cigna,Default,Percent of Total Billed Charges,19753.79,,,,19753.79,27320.5
RADICAL NEPHRECTOMY,360,RC,,,,both,33481,30132.9,United Healthcare,Default,Fee Schedule,27320.5,,,,19753.79,27320.5
TRANSURETHRAL INCISION PROSTATE,360,RC,,,,both,11060.86,9954.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7742.6,,,,6525.91,9025.66
TRANSURETHRAL INCISION PROSTATE,360,RC,,,,both,11060.86,9954.77,Cigna,Default,Percent of Total Billed Charges,6525.91,,,,6525.91,9025.66
TRANSURETHRAL INCISION PROSTATE,360,RC,,,,both,11060.86,9954.77,United Healthcare,Default,Fee Schedule,9025.66,,,,6525.91,9025.66
URO ULTRASOUND RENTAL- 3 LASER ENUCLEATI,360,RC,,,,both,2267.73,2040.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1587.41,,,,1337.96,1850.47
URO ULTRASOUND RENTAL- 3 LASER ENUCLEATI,360,RC,,,,both,2267.73,2040.96,Cigna,Default,Percent of Total Billed Charges,1337.96,,,,1337.96,1850.47
URO ULTRASOUND RENTAL- 3 LASER ENUCLEATI,360,RC,,,,both,2267.73,2040.96,United Healthcare,Default,Fee Schedule,1850.47,,,,1337.96,1850.47
MORCELLATOR RESECTOSCOPE,360,RC,,,,both,812.52,731.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,568.76,,,,479.39,663.02
MORCELLATOR RESECTOSCOPE,360,RC,,,,both,812.52,731.27,Cigna,Default,Percent of Total Billed Charges,479.39,,,,479.39,663.02
MORCELLATOR RESECTOSCOPE,360,RC,,,,both,812.52,731.27,United Healthcare,Default,Fee Schedule,663.02,,,,479.39,663.02
PIRANHA BLADES RWOLF,360,RC,,,,both,1948.05,1753.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1363.64,,,,1149.35,1589.61
PIRANHA BLADES RWOLF,360,RC,,,,both,1948.05,1753.25,Cigna,Default,Percent of Total Billed Charges,1149.35,,,,1149.35,1589.61
PIRANHA BLADES RWOLF,360,RC,,,,both,1948.05,1753.25,United Healthcare,Default,Fee Schedule,1589.61,,,,1149.35,1589.61
PIRAHNA TUBING SET,360,RC,,,,both,139.89,125.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.92,,,,82.54,114.15
PIRAHNA TUBING SET,360,RC,,,,both,139.89,125.9,Cigna,Default,Percent of Total Billed Charges,82.54,,,,82.54,114.15
PIRAHNA TUBING SET,360,RC,,,,both,139.89,125.9,United Healthcare,Default,Fee Schedule,114.15,,,,82.54,114.15
PIRANHA OVERFLOW PROTECT,360,RC,,,,both,119.88,107.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.92,,,,70.73,97.82
PIRANHA OVERFLOW PROTECT,360,RC,,,,both,119.88,107.89,Cigna,Default,Percent of Total Billed Charges,70.73,,,,70.73,97.82
PIRANHA OVERFLOW PROTECT,360,RC,,,,both,119.88,107.89,United Healthcare,Default,Fee Schedule,97.82,,,,70.73,97.82
PIRANHA TISSUE CONTAINER,360,RC,,,,both,163.17,146.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.22,,,,96.27,133.15
PIRANHA TISSUE CONTAINER,360,RC,,,,both,163.17,146.85,Cigna,Default,Percent of Total Billed Charges,96.27,,,,96.27,133.15
PIRANHA TISSUE CONTAINER,360,RC,,,,both,163.17,146.85,United Healthcare,Default,Fee Schedule,133.15,,,,96.27,133.15
HOLMIUM MP 550 FORTEC FIBER,360,RC,,,,both,1235.43,1111.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,864.8,,,,728.9,1008.11
HOLMIUM MP 550 FORTEC FIBER,360,RC,,,,both,1235.43,1111.89,Cigna,Default,Percent of Total Billed Charges,728.9,,,,728.9,1008.11
HOLMIUM MP 550 FORTEC FIBER,360,RC,,,,both,1235.43,1111.89,United Healthcare,Default,Fee Schedule,1008.11,,,,728.9,1008.11
INC & REM FB SQ; SMPL,10120,HCPCS,983,RC,,both,411.06,369.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.74,,,,242.53,287.74
INC & REM FB SQ; SMPL,10120,HCPCS,983,RC,,both,411.06,369.95,Cigna,Default,Percent of Total Billed Charges,242.53,,,,242.53,287.74
INC & REM FB SQ; SMPL,10120,HCPCS,983,RC,,both,411.06,369.95,United Healthcare,Default,Fee Schedule,,,,,242.53,287.74
REM SKIN TAGS; = 15 LESIONS,11200,HCPCS,983,RC,,both,233.58,210.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.51,,,,137.81,163.51
REM SKIN TAGS; = 15 LESIONS,11200,HCPCS,983,RC,,both,233.58,210.22,Cigna,Default,Percent of Total Billed Charges,137.81,,,,137.81,163.51
REM SKIN TAGS; = 15 LESIONS,11200,HCPCS,983,RC,,both,233.58,210.22,United Healthcare,Default,Fee Schedule,,,,,137.81,163.51
DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,HCPCS,983,RC,,both,284.58,256.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,199.21,,,,167.9,199.21
DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,HCPCS,983,RC,,both,284.58,256.12,Cigna,Default,Percent of Total Billed Charges,167.9,,,,167.9,199.21
DRAIN/INJ MAJOR JOINT/BURSA W/O US,20610,HCPCS,983,RC,,both,284.58,256.12,United Healthcare,Default,Fee Schedule,,,,,167.9,199.21
STRAPPING; ELBOW OR WRIST,29260,HCPCS,983,RC,,both,136.68,123.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.68,,,,80.64,95.68
STRAPPING; ELBOW OR WRIST,29260,HCPCS,983,RC,,both,136.68,123.01,Cigna,Default,Percent of Total Billed Charges,80.64,,,,80.64,95.68
STRAPPING; ELBOW OR WRIST,29260,HCPCS,983,RC,,both,136.68,123.01,United Healthcare,Default,Fee Schedule,,,,,80.64,95.68
REMOVE IMPACTED EAR WAX UNI,69209,HCPCS,510,RC,,both,153,137.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.1,,,,90.27,124.85
REMOVE IMPACTED EAR WAX UNI,69209,HCPCS,510,RC,,both,153,137.7,Cigna,Default,Percent of Total Billed Charges,90.27,,,,90.27,124.85
REMOVE IMPACTED EAR WAX UNI,69209,HCPCS,510,RC,,both,153,137.7,United Healthcare,Default,Fee Schedule,124.85,,,,90.27,124.85
REMOVE IMPACTED EAR WAX UNI,69210,HCPCS,983,RC,,both,130.56,117.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.39,,,,77.03,91.39
REMOVE IMPACTED EAR WAX UNI,69210,HCPCS,983,RC,,both,130.56,117.5,Cigna,Default,Percent of Total Billed Charges,77.03,,,,77.03,91.39
REMOVE IMPACTED EAR WAX UNI,69210,HCPCS,983,RC,,both,130.56,117.5,United Healthcare,Default,Fee Schedule,,,,,77.03,91.39
N-AUTOM URINALYS WO MICRO,81002,HCPCS,983,RC,,both,13.26,11.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.28,,,,7.82,9.28
N-AUTOM URINALYS WO MICRO,81002,HCPCS,983,RC,,both,13.26,11.93,Cigna,Default,Percent of Total Billed Charges,7.82,,,,7.82,9.28
N-AUTOM URINALYS WO MICRO,81002,HCPCS,983,RC,,both,13.26,11.93,United Healthcare,Default,Fee Schedule,,,,,7.82,9.28
SKIN TEST; TB ID,86580,HCPCS,983,RC,,both,29.58,26.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.71,,,,17.45,20.71
SKIN TEST; TB ID,86580,HCPCS,983,RC,,both,29.58,26.62,Cigna,Default,Percent of Total Billed Charges,17.45,,,,17.45,20.71
SKIN TEST; TB ID,86580,HCPCS,983,RC,,both,29.58,26.62,United Healthcare,Default,Fee Schedule,,,,,17.45,20.71
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,43.86,39.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.7,,,,25.88,30.7
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,43.86,39.47,Cigna,Default,Percent of Total Billed Charges,25.88,,,,25.88,30.7
IMMUNIZATION ADMIN 1 VACCINE,90471,HCPCS,771,RC,,both,43.86,39.47,United Healthcare,Default,Fee Schedule,,,,,25.88,30.7
IMMUNIZATION ADM; EA ADDTL VACCINE,90472,HCPCS,771,RC,,both,26.52,23.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.56,,,,15.65,18.56
IMMUNIZATION ADM; EA ADDTL VACCINE,90472,HCPCS,771,RC,,both,26.52,23.87,Cigna,Default,Percent of Total Billed Charges,15.65,,,,15.65,18.56
IMMUNIZATION ADM; EA ADDTL VACCINE,90472,HCPCS,771,RC,,both,26.52,23.87,United Healthcare,Default,Fee Schedule,,,,,15.65,18.56
HEPA VACC PED/ADOL 2 DOSE IM,90633,HCPCS,983,RC,,both,74.46,67.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.12,,,,43.93,52.12
HEPA VACC PED/ADOL 2 DOSE IM,90633,HCPCS,983,RC,,both,74.46,67.01,Cigna,Default,Percent of Total Billed Charges,43.93,,,,43.93,52.12
HEPA VACC PED/ADOL 2 DOSE IM,90633,HCPCS,983,RC,,both,74.46,67.01,United Healthcare,Default,Fee Schedule,,,,,43.93,52.12
HIB PRP-OMP VACC 3 DOSE IM,90647,HCPCS,983,RC,,both,57.12,51.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.98,,,,33.7,39.98
HIB PRP-OMP VACC 3 DOSE IM,90647,HCPCS,983,RC,,both,57.12,51.41,Cigna,Default,Percent of Total Billed Charges,33.7,,,,33.7,39.98
HIB PRP-OMP VACC 3 DOSE IM,90647,HCPCS,983,RC,,both,57.12,51.41,United Healthcare,Default,Fee Schedule,,,,,33.7,39.98
HIB PRP-OMP VACC 3 DOSE IM,92960,HCPCS,480,RC,26,both,370.75,333.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,259.52,,,,218.74,302.53
HIB PRP-OMP VACC 3 DOSE IM,92960,HCPCS,480,RC,26,both,370.75,333.68,Cigna,Default,Percent of Total Billed Charges,218.74,,,,218.74,302.53
HIB PRP-OMP VACC 3 DOSE IM,92960,HCPCS,480,RC,26,both,370.75,333.68,United Healthcare,Default,Fee Schedule,302.53,,,,218.74,302.53
HIB PRP-T VACCINE 4 DOSE IM,90648,HCPCS,983,RC,,both,57.12,51.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.98,,,,33.7,39.98
HIB PRP-T VACCINE 4 DOSE IM,90648,HCPCS,983,RC,,both,57.12,51.41,Cigna,Default,Percent of Total Billed Charges,33.7,,,,33.7,39.98
HIB PRP-T VACCINE 4 DOSE IM,90648,HCPCS,983,RC,,both,57.12,51.41,United Healthcare,Default,Fee Schedule,,,,,33.7,39.98
HIB PRP-T VACCINE 4 DOSE IM,90648,HCPCS,480,RC,26,both,370.75,333.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,259.52,,,,218.74,302.53
HIB PRP-T VACCINE 4 DOSE IM,90648,HCPCS,480,RC,26,both,370.75,333.68,Cigna,Default,Percent of Total Billed Charges,218.74,,,,218.74,302.53
HIB PRP-T VACCINE 4 DOSE IM,90648,HCPCS,480,RC,26,both,370.75,333.68,United Healthcare,Default,Fee Schedule,302.53,,,,218.74,302.53
IIV ADJUVANT VACCINE IM,90653,HCPCS,983,RC,,both,31.62,28.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.13,,,,18.66,22.13
IIV ADJUVANT VACCINE IM,90653,HCPCS,983,RC,,both,31.62,28.46,Cigna,Default,Percent of Total Billed Charges,18.66,,,,18.66,22.13
IIV ADJUVANT VACCINE IM,90653,HCPCS,983,RC,,both,31.62,28.46,United Healthcare,Default,Fee Schedule,,,,,18.66,22.13
IIV3 VACCINE SPLT 0.5 ML IM,90658,HCPCS,983,RC,,both,31.62,28.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.13,,,,18.66,22.13
IIV3 VACCINE SPLT 0.5 ML IM,90658,HCPCS,983,RC,,both,31.62,28.46,Cigna,Default,Percent of Total Billed Charges,18.66,,,,18.66,22.13
IIV3 VACCINE SPLT 0.5 ML IM,90658,HCPCS,983,RC,,both,31.62,28.46,United Healthcare,Default,Fee Schedule,,,,,18.66,22.13
PCV13 VACCINE IM,90670,HCPCS,983,RC,,both,232.56,209.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.79,,,,137.21,162.79
PCV13 VACCINE IM,90670,HCPCS,983,RC,,both,232.56,209.3,Cigna,Default,Percent of Total Billed Charges,137.21,,,,137.21,162.79
PCV13 VACCINE IM,90670,HCPCS,983,RC,,both,232.56,209.3,United Healthcare,Default,Fee Schedule,,,,,137.21,162.79
RV1 VACC 2 DOSE LIVE ORAL,90681,HCPCS,983,RC,,both,187.68,168.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.38,,,,110.73,131.38
RV1 VACC 2 DOSE LIVE ORAL,90681,HCPCS,983,RC,,both,187.68,168.91,Cigna,Default,Percent of Total Billed Charges,110.73,,,,110.73,131.38
RV1 VACC 2 DOSE LIVE ORAL,90681,HCPCS,983,RC,,both,187.68,168.91,United Healthcare,Default,Fee Schedule,,,,,110.73,131.38
DTAP VACCINE < 7 YRS IM,90700,HCPCS,983,RC,,both,60.18,54.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.13,,,,35.51,42.13
DTAP VACCINE < 7 YRS IM,90700,HCPCS,983,RC,,both,60.18,54.16,Cigna,Default,Percent of Total Billed Charges,35.51,,,,35.51,42.13
DTAP VACCINE < 7 YRS IM,90700,HCPCS,983,RC,,both,60.18,54.16,United Healthcare,Default,Fee Schedule,,,,,35.51,42.13
SQ MMR VACCINE,90707,HCPCS,983,RC,,both,98.94,89.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.26,,,,58.37,69.26
SQ MMR VACCINE,90707,HCPCS,983,RC,,both,98.94,89.05,Cigna,Default,Percent of Total Billed Charges,58.37,,,,58.37,69.26
SQ MMR VACCINE,90707,HCPCS,983,RC,,both,98.94,89.05,United Healthcare,Default,Fee Schedule,,,,,58.37,69.26
POLIOVIRUS IPV SC/IM,90713,HCPCS,983,RC,,both,62.22,56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.55,,,,36.71,43.55
POLIOVIRUS IPV SC/IM,90713,HCPCS,983,RC,,both,62.22,56,Cigna,Default,Percent of Total Billed Charges,36.71,,,,36.71,43.55
POLIOVIRUS IPV SC/IM,90713,HCPCS,983,RC,,both,62.22,56,United Healthcare,Default,Fee Schedule,,,,,36.71,43.55
TDAP VACCINE >7 IM,90715,HCPCS,983,RC,,both,83.64,75.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.55,,,,49.35,58.55
TDAP VACCINE >7 IM,90715,HCPCS,983,RC,,both,83.64,75.28,Cigna,Default,Percent of Total Billed Charges,49.35,,,,49.35,58.55
TDAP VACCINE >7 IM,90715,HCPCS,983,RC,,both,83.64,75.28,United Healthcare,Default,Fee Schedule,,,,,49.35,58.55
VAR VACCINE LIVE SUBQ,90716,HCPCS,983,RC,,both,160.14,144.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.1,,,,94.48,112.1
VAR VACCINE LIVE SUBQ,90716,HCPCS,983,RC,,both,160.14,144.13,Cigna,Default,Percent of Total Billed Charges,94.48,,,,94.48,112.1
VAR VACCINE LIVE SUBQ,90716,HCPCS,983,RC,,both,160.14,144.13,United Healthcare,Default,Fee Schedule,,,,,94.48,112.1
DTAP-HEP B-IPV VACCINE IM,90723,HCPCS,983,RC,,both,139.74,125.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.82,,,,82.45,97.82
DTAP-HEP B-IPV VACCINE IM,90723,HCPCS,983,RC,,both,139.74,125.77,Cigna,Default,Percent of Total Billed Charges,82.45,,,,82.45,97.82
DTAP-HEP B-IPV VACCINE IM,90723,HCPCS,983,RC,,both,139.74,125.77,United Healthcare,Default,Fee Schedule,,,,,82.45,97.82
PPSV23 VACC 2 YRS+ SUBQ/IM,90732,HCPCS,983,RC,,both,111.18,100.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.83,,,,65.6,77.83
PPSV23 VACC 2 YRS+ SUBQ/IM,90732,HCPCS,983,RC,,both,111.18,100.06,Cigna,Default,Percent of Total Billed Charges,65.6,,,,65.6,77.83
PPSV23 VACC 2 YRS+ SUBQ/IM,90732,HCPCS,983,RC,,both,111.18,100.06,United Healthcare,Default,Fee Schedule,,,,,65.6,77.83
MPSV4 VACCINE SUBQ,90733,HCPCS,983,RC,,both,186.66,167.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,130.66,,,,110.13,130.66
MPSV4 VACCINE SUBQ,90733,HCPCS,983,RC,,both,186.66,167.99,Cigna,Default,Percent of Total Billed Charges,110.13,,,,110.13,130.66
MPSV4 VACCINE SUBQ,90733,HCPCS,983,RC,,both,186.66,167.99,United Healthcare,Default,Fee Schedule,,,,,110.13,130.66
MCV4 MENACWY VACCINE IM,90734,HCPCS,983,RC,,both,191.76,172.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.23,,,,113.14,134.23
MCV4 MENACWY VACCINE IM,90734,HCPCS,983,RC,,both,191.76,172.58,Cigna,Default,Percent of Total Billed Charges,113.14,,,,113.14,134.23
MCV4 MENACWY VACCINE IM,90734,HCPCS,983,RC,,both,191.76,172.58,United Healthcare,Default,Fee Schedule,,,,,113.14,134.23
DEVELOPMENTAL SCREEN W/SCORE,96110,HCPCS,918,RC,,both,28.56,25.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.99,,,,16.85,23.3
DEVELOPMENTAL SCREEN W/SCORE,96110,HCPCS,918,RC,,both,28.56,25.7,Cigna,Default,Percent of Total Billed Charges,16.85,,,,16.85,23.3
DEVELOPMENTAL SCREEN W/SCORE,96110,HCPCS,918,RC,,both,28.56,25.7,United Healthcare,Default,Fee Schedule,23.3,,,,16.85,23.3
SPECIAL REPORTS,99080,HCPCS,983,RC,,both,36.72,33.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.7,,,,21.66,25.7
SPECIAL REPORTS,99080,HCPCS,983,RC,,both,36.72,33.05,Cigna,Default,Percent of Total Billed Charges,21.66,,,,21.66,25.7
SPECIAL REPORTS,99080,HCPCS,983,RC,,both,36.72,33.05,United Healthcare,Default,Fee Schedule,,,,,21.66,25.7
SUBSEQUENT HOSPITAL CARE 35 MIN,99233,HCPCS,983,RC,,inpatient,240.72,216.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.5,,,,142.02,168.5
SUBSEQUENT HOSPITAL CARE 35 MIN,99233,HCPCS,983,RC,,inpatient,240.72,216.65,Cigna,Default,Percent of Total Billed Charges,142.02,,,,142.02,168.5
SUBSEQUENT HOSPITAL CARE 35 MIN,99233,HCPCS,983,RC,,inpatient,240.72,216.65,United Healthcare,Default,Fee Schedule,,,,,142.02,168.5
HOSP DC DAY MANAGEMENT; 30 MIN/< (MD),99238,HCPCS,983,RC,,inpatient,173.4,156.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.38,,,,102.31,121.38
HOSP DC DAY MANAGEMENT; 30 MIN/< (MD),99238,HCPCS,983,RC,,inpatient,173.4,156.06,Cigna,Default,Percent of Total Billed Charges,102.31,,,,102.31,121.38
HOSP DC DAY MANAGEMENT; 30 MIN/< (MD),99238,HCPCS,983,RC,,inpatient,173.4,156.06,United Healthcare,Default,Fee Schedule,,,,,102.31,121.38
NURSING FACILITY CARE INIT 35 MIN,99305,HCPCS,983,RC,,outpatient,234.6,211.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.22,,,,138.41,164.22
NURSING FACILITY CARE INIT 35 MIN,99305,HCPCS,983,RC,,outpatient,234.6,211.14,Cigna,Default,Percent of Total Billed Charges,138.41,,,,138.41,164.22
NURSING FACILITY CARE INIT 35 MIN,99305,HCPCS,983,RC,,outpatient,234.6,211.14,United Healthcare,Default,Fee Schedule,,,,,138.41,164.22
NURSING FAC CARE SUBSEQ 10 MIN,99307,HCPCS,983,RC,,outpatient,83.64,75.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.55,,,,49.35,58.55
NURSING FAC CARE SUBSEQ 10 MIN,99307,HCPCS,983,RC,,outpatient,83.64,75.28,Cigna,Default,Percent of Total Billed Charges,49.35,,,,49.35,58.55
NURSING FAC CARE SUBSEQ 10 MIN,99307,HCPCS,983,RC,,outpatient,83.64,75.28,United Healthcare,Default,Fee Schedule,,,,,49.35,58.55
NURSING FAC CARE SUBSEQ 15 MIN,99308,HCPCS,983,RC,,outpatient,124.44,112,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.11,,,,73.42,87.11
NURSING FAC CARE SUBSEQ 15 MIN,99308,HCPCS,983,RC,,outpatient,124.44,112,Cigna,Default,Percent of Total Billed Charges,73.42,,,,73.42,87.11
NURSING FAC CARE SUBSEQ 15 MIN,99308,HCPCS,983,RC,,outpatient,124.44,112,United Healthcare,Default,Fee Schedule,,,,,73.42,87.11
NURSING FAC CARE SUBSEQ 25 MIN,99309,HCPCS,983,RC,,outpatient,162.18,145.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.53,,,,95.69,113.53
NURSING FAC CARE SUBSEQ 25 MIN,99309,HCPCS,983,RC,,outpatient,162.18,145.96,Cigna,Default,Percent of Total Billed Charges,95.69,,,,95.69,113.53
NURSING FAC CARE SUBSEQ 25 MIN,99309,HCPCS,983,RC,,outpatient,162.18,145.96,United Healthcare,Default,Fee Schedule,,,,,95.69,113.53
SNF DISCHARGE DAY; 30 MINUTES,99315,HCPCS,983,RC,,outpatient,138.72,124.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.1,,,,81.84,97.1
SNF DISCHARGE DAY; 30 MINUTES,99315,HCPCS,983,RC,,outpatient,138.72,124.85,Cigna,Default,Percent of Total Billed Charges,81.84,,,,81.84,97.1
SNF DISCHARGE DAY; 30 MINUTES,99315,HCPCS,983,RC,,outpatient,138.72,124.85,United Healthcare,Default,Fee Schedule,,,,,81.84,97.1
INIT PM E/M NEW PAT INF <1 YR,99381,HCPCS,515,RC,,outpatient,196.86,177.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.8,,,,116.15,160.64
INIT PM E/M NEW PAT INF <1 YR,99381,HCPCS,515,RC,,outpatient,196.86,177.17,Cigna,Default,Percent of Total Billed Charges,116.15,,,,116.15,160.64
INIT PM E/M NEW PAT INF <1 YR,99381,HCPCS,515,RC,,outpatient,196.86,177.17,United Healthcare,Default,Fee Schedule,160.64,,,,116.15,160.64
INIT PM E/M NEW PAT 1-4 YRS,99382,HCPCS,515,RC,,outpatient,209.1,188.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.37,,,,123.37,170.63
INIT PM E/M NEW PAT 1-4 YRS,99382,HCPCS,515,RC,,outpatient,209.1,188.19,Cigna,Default,Percent of Total Billed Charges,123.37,,,,123.37,170.63
INIT PM E/M NEW PAT 1-4 YRS,99382,HCPCS,515,RC,,outpatient,209.1,188.19,United Healthcare,Default,Fee Schedule,170.63,,,,123.37,170.63
PREV VISIT NEW AGE 5-11,99383,HCPCS,515,RC,,outpatient,211.14,190.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.8,,,,124.57,172.29
PREV VISIT NEW AGE 5-11,99383,HCPCS,515,RC,,outpatient,211.14,190.03,Cigna,Default,Percent of Total Billed Charges,124.57,,,,124.57,172.29
PREV VISIT NEW AGE 5-11,99383,HCPCS,515,RC,,outpatient,211.14,190.03,United Healthcare,Default,Fee Schedule,172.29,,,,124.57,172.29
PREV VISIT NEW AGE 12-17,99384,HCPCS,515,RC,,outpatient,233.58,210.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.51,,,,137.81,190.6
PREV VISIT NEW AGE 12-17,99384,HCPCS,515,RC,,outpatient,233.58,210.22,Cigna,Default,Percent of Total Billed Charges,137.81,,,,137.81,190.6
PREV VISIT NEW AGE 12-17,99384,HCPCS,515,RC,,outpatient,233.58,210.22,United Healthcare,Default,Fee Schedule,190.6,,,,137.81,190.6
PREV VISIT NEW AGE 18-39,99385,HCPCS,770,RC,,outpatient,290.32,261.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,203.22,,,,171.29,203.22
PREV VISIT NEW AGE 18-39,99385,HCPCS,770,RC,,outpatient,290.32,261.29,Cigna,Default,Percent of Total Billed Charges,171.29,,,,171.29,203.22
PREV VISIT NEW AGE 18-39,99385,HCPCS,770,RC,,outpatient,290.32,261.29,United Healthcare,Default,Fee Schedule,,,,,171.29,203.22
PREV VISIT NEW AGE 40-64,99386,HCPCS,510,RC,,outpatient,297.84,268.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.49,,,,175.73,243.04
PREV VISIT NEW AGE 40-64,99386,HCPCS,510,RC,,outpatient,297.84,268.06,Cigna,Default,Percent of Total Billed Charges,175.73,,,,175.73,243.04
PREV VISIT NEW AGE 40-64,99386,HCPCS,510,RC,,outpatient,297.84,268.06,United Healthcare,Default,Fee Schedule,243.04,,,,175.73,243.04
INIT PM E/M NEW PAT 65+ YRS,99387,HCPCS,510,RC,,outpatient,303.96,273.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,212.77,,,,179.34,248.03
INIT PM E/M NEW PAT 65+ YRS,99387,HCPCS,510,RC,,outpatient,303.96,273.56,Cigna,Default,Percent of Total Billed Charges,179.34,,,,179.34,248.03
INIT PM E/M NEW PAT 65+ YRS,99387,HCPCS,510,RC,,outpatient,303.96,273.56,United Healthcare,Default,Fee Schedule,248.03,,,,179.34,248.03
PER PM REEVAL EST PAT INF <1 YR,99391,HCPCS,515,RC,,outpatient,171.36,154.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,119.95,,,,101.1,139.83
PER PM REEVAL EST PAT INF <1 YR,99391,HCPCS,515,RC,,outpatient,171.36,154.22,Cigna,Default,Percent of Total Billed Charges,101.1,,,,101.1,139.83
PER PM REEVAL EST PAT INF <1 YR,99391,HCPCS,515,RC,,outpatient,171.36,154.22,United Healthcare,Default,Fee Schedule,139.83,,,,101.1,139.83
PREV VISIT EST AGE 1-4,99392,HCPCS,515,RC,,outpatient,181.56,163.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.09,,,,107.12,148.15
PREV VISIT EST AGE 1-4,99392,HCPCS,515,RC,,outpatient,181.56,163.4,Cigna,Default,Percent of Total Billed Charges,107.12,,,,107.12,148.15
PREV VISIT EST AGE 1-4,99392,HCPCS,515,RC,,outpatient,181.56,163.4,United Healthcare,Default,Fee Schedule,148.15,,,,107.12,148.15
PREV VISIT EST AGE 5-11,99393,HCPCS,515,RC,,outpatient,183.6,165.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.52,,,,108.32,149.82
PREV VISIT EST AGE 5-11,99393,HCPCS,515,RC,,outpatient,183.6,165.24,Cigna,Default,Percent of Total Billed Charges,108.32,,,,108.32,149.82
PREV VISIT EST AGE 5-11,99393,HCPCS,515,RC,,outpatient,183.6,165.24,United Healthcare,Default,Fee Schedule,149.82,,,,108.32,149.82
PREV VISIT EST AGE 12-17,99394,HCPCS,515,RC,,outpatient,200.94,180.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.66,,,,118.55,163.97
PREV VISIT EST AGE 12-17,99394,HCPCS,515,RC,,outpatient,200.94,180.85,Cigna,Default,Percent of Total Billed Charges,118.55,,,,118.55,163.97
PREV VISIT EST AGE 12-17,99394,HCPCS,515,RC,,outpatient,200.94,180.85,United Healthcare,Default,Fee Schedule,163.97,,,,118.55,163.97
PREV VISIT EST AGE 18-39,99395,HCPCS,770,RC,,outpatient,249.32,224.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.52,,,,147.1,174.52
PREV VISIT EST AGE 18-39,99395,HCPCS,770,RC,,outpatient,249.32,224.39,Cigna,Default,Percent of Total Billed Charges,147.1,,,,147.1,174.52
PREV VISIT EST AGE 18-39,99395,HCPCS,770,RC,,outpatient,249.32,224.39,United Healthcare,Default,Fee Schedule,,,,,147.1,174.52
REV VISIT EST AGE 40-64,99396,HCPCS,770,RC,,outpatient,245.82,221.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.07,,,,145.03,172.07
REV VISIT EST AGE 40-64,99396,HCPCS,770,RC,,outpatient,245.82,221.24,Cigna,Default,Percent of Total Billed Charges,145.03,,,,145.03,172.07
REV VISIT EST AGE 40-64,99396,HCPCS,770,RC,,outpatient,245.82,221.24,United Healthcare,Default,Fee Schedule,,,,,145.03,172.07
PER PM REEVAL EST PAT 65+ YR,99397,HCPCS,770,RC,,outpatient,260.1,234.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,182.07,,,,153.46,182.07
PER PM REEVAL EST PAT 65+ YR,99397,HCPCS,770,RC,,outpatient,260.1,234.09,Cigna,Default,Percent of Total Billed Charges,153.46,,,,153.46,182.07
PER PM REEVAL EST PAT 65+ YR,99397,HCPCS,770,RC,,outpatient,260.1,234.09,United Healthcare,Default,Fee Schedule,,,,,153.46,182.07
INFLUENZA IA W DO,983,RC,,,,both,51,45.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.7,,,,30.09,35.7
INFLUENZA IA W DO,983,RC,,,,both,51,45.9,Cigna,Default,Percent of Total Billed Charges,30.09,,,,30.09,35.7
INFLUENZA IA W DO,983,RC,,,,both,51,45.9,United Healthcare,Default,Fee Schedule,,,,,30.09,35.7
STREP A ASSAY W/OPTIC,87880,HCPCS,983,RC,qw,both,51,45.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.7,,,,30.09,35.7
STREP A ASSAY W/OPTIC,87880,HCPCS,983,RC,qw,both,51,45.9,Cigna,Default,Percent of Total Billed Charges,30.09,,,,30.09,35.7
STREP A ASSAY W/OPTIC,87880,HCPCS,983,RC,qw,both,51,45.9,United Healthcare,Default,Fee Schedule,,,,,30.09,35.7
ADMIN FLU VIRUS VACCINE,G0008,HCPCS,771,RC,,both,36.49,32.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.54,,,,21.53,25.54
ADMIN FLU VIRUS VACCINE,G0008,HCPCS,771,RC,,both,36.49,32.84,Cigna,Default,Percent of Total Billed Charges,21.53,,,,21.53,25.54
ADMIN FLU VIRUS VACCINE,G0008,HCPCS,771,RC,,both,36.49,32.84,United Healthcare,Default,Fee Schedule,,,,,21.53,25.54
ADMIN PNEUMONIA VACCINE,G0009,HCPCS,771,RC,,both,38.98,35.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.29,,,,23,27.29
ADMIN PNEUMONIA VACCINE,G0009,HCPCS,771,RC,,both,38.98,35.08,Cigna,Default,Percent of Total Billed Charges,23,,,,23,27.29
ADMIN PNEUMONIA VACCINE,G0009,HCPCS,771,RC,,both,38.98,35.08,United Healthcare,Default,Fee Schedule,,,,,23,27.29
CA SCRNING PELV & BRST EXAM,G0101,HCPCS,983,RC,,both,93.51,84.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.46,,,,55.17,65.46
CA SCRNING PELV & BRST EXAM,G0101,HCPCS,983,RC,,both,93.51,84.16,Cigna,Default,Percent of Total Billed Charges,55.17,,,,55.17,65.46
CA SCRNING PELV & BRST EXAM,G0101,HCPCS,983,RC,,both,93.51,84.16,United Healthcare,Default,Fee Schedule,,,,,55.17,65.46
"INIT PREVENTIVE EXAM, NEW BENEFICIARY",G0402,HCPCS,983,RC,,outpatient,275.61,248.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,192.93,,,,162.61,192.93
"INIT PREVENTIVE EXAM, NEW BENEFICIARY",G0402,HCPCS,983,RC,,outpatient,275.61,248.05,Cigna,Default,Percent of Total Billed Charges,162.61,,,,162.61,192.93
"INIT PREVENTIVE EXAM, NEW BENEFICIARY",G0402,HCPCS,983,RC,,outpatient,275.61,248.05,United Healthcare,Default,Fee Schedule,,,,,162.61,192.93
PPPS INITIAL VISIT,G0438,HCPCS,983,RC,,outpatient,312.22,281,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,218.55,,,,184.21,218.55
PPPS INITIAL VISIT,G0438,HCPCS,983,RC,,outpatient,312.22,281,Cigna,Default,Percent of Total Billed Charges,184.21,,,,184.21,218.55
PPPS INITIAL VISIT,G0438,HCPCS,983,RC,,outpatient,312.22,281,United Healthcare,Default,Fee Schedule,,,,,184.21,218.55
PPPS SUBSEQ VISIT,G0439,HCPCS,983,RC,,outpatient,224.75,202.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.32,,,,132.6,157.32
PPPS SUBSEQ VISIT,G0439,HCPCS,983,RC,,outpatient,224.75,202.28,Cigna,Default,Percent of Total Billed Charges,132.6,,,,132.6,157.32
PPPS SUBSEQ VISIT,G0439,HCPCS,983,RC,,outpatient,224.75,202.28,United Healthcare,Default,Fee Schedule,,,,,132.6,157.32
METHYLPREDNISOLONE INJ TO 40 MG,J2919,HCPCS,983,RC,,both,17.37,15.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.16,,,,10.25,12.16
METHYLPREDNISOLONE INJ TO 40 MG,J2919,HCPCS,983,RC,,both,17.37,15.63,Cigna,Default,Percent of Total Billed Charges,10.25,,,,10.25,12.16
METHYLPREDNISOLONE INJ TO 40 MG,J2919,HCPCS,983,RC,,both,17.37,15.63,United Healthcare,Default,Fee Schedule,,,,,10.25,12.16
OBTAINING SCREEN PAP SMEAR,Q0091,HCPCS,983,RC,,both,79.39,71.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.57,,,,46.84,55.57
OBTAINING SCREEN PAP SMEAR,Q0091,HCPCS,983,RC,,both,79.39,71.45,Cigna,Default,Percent of Total Billed Charges,46.84,,,,46.84,55.57
OBTAINING SCREEN PAP SMEAR,Q0091,HCPCS,983,RC,,both,79.39,71.45,United Healthcare,Default,Fee Schedule,,,,,46.84,55.57
FLUVIRIN VACC 3 YRS & > IM,Q2037,HCPCS,983,RC,,both,31.3,28.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.91,,,,18.47,21.91
FLUVIRIN VACC 3 YRS & > IM,Q2037,HCPCS,983,RC,,both,31.3,28.17,Cigna,Default,Percent of Total Billed Charges,18.47,,,,18.47,21.91
FLUVIRIN VACC 3 YRS & > IM,Q2037,HCPCS,983,RC,,both,31.3,28.17,United Healthcare,Default,Fee Schedule,,,,,18.47,21.91
AIRWAY INHALATION TREATMENT,94640,HCPCS,419,RC,,both,73.44,66.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.41,,,,43.33,59.93
AIRWAY INHALATION TREATMENT,94640,HCPCS,419,RC,,both,73.44,66.1,Cigna,Default,Percent of Total Billed Charges,43.33,,,,43.33,59.93
AIRWAY INHALATION TREATMENT,94640,HCPCS,419,RC,,both,73.44,66.1,United Healthcare,Default,Fee Schedule,59.93,,,,43.33,59.93
HEMACUE,85018,HCPCS,983,RC,qw,both,44.88,40.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.42,,,,26.48,31.42
HEMACUE,85018,HCPCS,983,RC,qw,both,44.88,40.39,Cigna,Default,Percent of Total Billed Charges,26.48,,,,26.48,31.42
HEMACUE,85018,HCPCS,983,RC,qw,both,44.88,40.39,United Healthcare,Default,Fee Schedule,,,,,26.48,31.42
HEMATOCRIT,85014,HCPCS,305,RC,,both,16.07,14.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.25,,,,9.48,13.11
HEMATOCRIT,85014,HCPCS,305,RC,,both,16.07,14.46,Cigna,Default,Percent of Total Billed Charges,9.48,,,,9.48,13.11
HEMATOCRIT,85014,HCPCS,305,RC,,both,16.07,14.46,United Healthcare,Default,Fee Schedule,13.11,,,,9.48,13.11
DESTRUCTION B9 LESIONS 1-14,17110,HCPCS,983,RC,,both,298,268.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.6,,,,175.82,208.6
DESTRUCTION B9 LESIONS 1-14,17110,HCPCS,983,RC,,both,298,268.2,Cigna,Default,Percent of Total Billed Charges,175.82,,,,175.82,208.6
DESTRUCTION B9 LESIONS 1-14,17110,HCPCS,983,RC,,both,298,268.2,United Healthcare,Default,Fee Schedule,,,,,175.82,208.6
TIF EGD PARTIAL/COMPL ESOPHAGOGASTRIC FU,43210,HCPCS,360,RC,,both,32659.84,29393.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22861.89,,,,19269.31,26650.43
TIF EGD PARTIAL/COMPL ESOPHAGOGASTRIC FU,43210,HCPCS,360,RC,,both,32659.84,29393.86,Cigna,Default,Percent of Total Billed Charges,19269.31,,,,19269.31,26650.43
TIF EGD PARTIAL/COMPL ESOPHAGOGASTRIC FU,43210,HCPCS,360,RC,,both,32659.84,29393.86,United Healthcare,Default,Fee Schedule,26650.43,,,,19269.31,26650.43
TRANSFER TRAINING PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
TRANSFER TRAINING PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
TRANSFER TRAINING PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
HOT PACK TREATMENTS PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
HOT PACK TREATMENTS PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
HOT PACK TREATMENTS PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
ICE PACK TREATMENTS PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
ICE PACK TREATMENTS PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
ICE PACK TREATMENTS PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
LOWER EXTREMITY EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
LOWER EXTREMITY EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
LOWER EXTREMITY EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
MAT EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
MAT EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
MAT EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
RANGE OF MOTION EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
RANGE OF MOTION EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
RANGE OF MOTION EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
SPLINTING PROCEDURES PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
SPLINTING PROCEDURES PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
SPLINTING PROCEDURES PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
TOILETING EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
TOILETING EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
TOILETING EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
UPPPER EXTREMITY EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.69
UPPPER EXTREMITY EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.69
UPPPER EXTREMITY EXERCISES PER 10 MIN,440,RC,,,,both,5.75,5.18,United Healthcare,Default,Fee Schedule,4.69,,,,3.39,4.69
ATTEND WIPES-NH,270,RC,,,,both,2.31,2.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.62,,,,1.36,1.88
ATTEND WIPES-NH,270,RC,,,,both,2.31,2.08,Cigna,Default,Percent of Total Billed Charges,1.36,,,,1.36,1.88
ATTEND WIPES-NH,270,RC,,,,both,2.31,2.08,United Healthcare,Default,Fee Schedule,1.88,,,,1.36,1.88
ATTEND WIPES-ECF,270,RC,,,,both,2.31,2.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.62,,,,1.36,1.88
ATTEND WIPES-ECF,270,RC,,,,both,2.31,2.08,Cigna,Default,Percent of Total Billed Charges,1.36,,,,1.36,1.88
ATTEND WIPES-ECF,270,RC,,,,both,2.31,2.08,United Healthcare,Default,Fee Schedule,1.88,,,,1.36,1.88
K PUMP,270,RC,,,,both,35.88,32.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.12,,,,21.17,29.28
K PUMP,270,RC,,,,both,35.88,32.29,Cigna,Default,Percent of Total Billed Charges,21.17,,,,21.17,29.28
K PUMP,270,RC,,,,both,35.88,32.29,United Healthcare,Default,Fee Schedule,29.28,,,,21.17,29.28
HOME SLEEP TEST,95806,HCPCS,920,RC,,both,1097.39,987.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,768.17,,,,647.46,895.47
HOME SLEEP TEST,95806,HCPCS,920,RC,,both,1097.39,987.65,Cigna,Default,Percent of Total Billed Charges,647.46,,,,647.46,895.47
HOME SLEEP TEST,95806,HCPCS,920,RC,,both,1097.39,987.65,United Healthcare,Default,Fee Schedule,895.47,,,,647.46,895.47
POLYSOMNOGRAPHY WO PAP,95810,HCPCS,920,RC,,both,6992.06,6292.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4894.44,,,,4125.32,5705.52
POLYSOMNOGRAPHY WO PAP,95810,HCPCS,920,RC,,both,6992.06,6292.85,Cigna,Default,Percent of Total Billed Charges,4125.32,,,,4125.32,5705.52
POLYSOMNOGRAPHY WO PAP,95810,HCPCS,920,RC,,both,6992.06,6292.85,United Healthcare,Default,Fee Schedule,5705.52,,,,4125.32,5705.52
POLYSOMNOGRAPHY W PAP,95811,HCPCS,920,RC,,both,6992.06,6292.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4894.44,,,,4125.32,5705.52
POLYSOMNOGRAPHY W PAP,95811,HCPCS,920,RC,,both,6992.06,6292.85,Cigna,Default,Percent of Total Billed Charges,4125.32,,,,4125.32,5705.52
POLYSOMNOGRAPHY W PAP,95811,HCPCS,920,RC,,both,6992.06,6292.85,United Healthcare,Default,Fee Schedule,5705.52,,,,4125.32,5705.52
SPIROMETRY P & P,94060,HCPCS,460,RC,,both,895.71,806.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,627,,,,528.47,730.9
SPIROMETRY P & P,94060,HCPCS,460,RC,,both,895.71,806.14,Cigna,Default,Percent of Total Billed Charges,528.47,,,,528.47,730.9
SPIROMETRY P & P,94060,HCPCS,460,RC,,both,895.71,806.14,United Healthcare,Default,Fee Schedule,730.9,,,,528.47,730.9
BR PROV W/METHACHOLINE,94070,HCPCS,460,RC,,both,534,480.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,373.8,,,,315.06,435.74
BR PROV W/METHACHOLINE,94070,HCPCS,460,RC,,both,534,480.6,Cigna,Default,Percent of Total Billed Charges,315.06,,,,315.06,435.74
BR PROV W/METHACHOLINE,94070,HCPCS,460,RC,,both,534,480.6,United Healthcare,Default,Fee Schedule,435.74,,,,315.06,435.74
VENT INIT DAY MANAGEMENT,94002,HCPCS,410,RC,,both,2072.39,1865.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1450.67,,,,1222.71,1691.07
VENT INIT DAY MANAGEMENT,94002,HCPCS,410,RC,,both,2072.39,1865.15,Cigna,Default,Percent of Total Billed Charges,1222.71,,,,1222.71,1691.07
VENT INIT DAY MANAGEMENT,94002,HCPCS,410,RC,,both,2072.39,1865.15,United Healthcare,Default,Fee Schedule,1691.07,,,,1222.71,1691.07
EKG STRESS TEST,93017,HCPCS,482,RC,,both,895.71,806.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,627,,,,528.47,730.9
EKG STRESS TEST,93017,HCPCS,482,RC,,both,895.71,806.14,Cigna,Default,Percent of Total Billed Charges,528.47,,,,528.47,730.9
EKG STRESS TEST,93017,HCPCS,482,RC,,both,895.71,806.14,United Healthcare,Default,Fee Schedule,730.9,,,,528.47,730.9
EKG RHYTHM STRIP,93041,HCPCS,730,RC,,both,206.48,185.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.54,,,,121.82,168.49
EKG RHYTHM STRIP,93041,HCPCS,730,RC,,both,206.48,185.83,Cigna,Default,Percent of Total Billed Charges,121.82,,,,121.82,168.49
EKG RHYTHM STRIP,93041,HCPCS,730,RC,,both,206.48,185.83,United Healthcare,Default,Fee Schedule,168.49,,,,121.82,168.49
EKG 12 LEAD,93005,HCPCS,730,RC,,both,209.94,188.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.96,,,,123.86,171.31
EKG 12 LEAD,93005,HCPCS,730,RC,,both,209.94,188.95,Cigna,Default,Percent of Total Billed Charges,123.86,,,,123.86,171.31
EKG 12 LEAD,93005,HCPCS,730,RC,,both,209.94,188.95,United Healthcare,Default,Fee Schedule,171.31,,,,123.86,171.31
DOBUTAMINE STRESS TEST EKG ONLY,93017,HCPCS,482,RC,,both,895.71,806.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,627,,,,528.47,730.9
DOBUTAMINE STRESS TEST EKG ONLY,93017,HCPCS,482,RC,,both,895.71,806.14,Cigna,Default,Percent of Total Billed Charges,528.47,,,,528.47,730.9
DOBUTAMINE STRESS TEST EKG ONLY,93017,HCPCS,482,RC,,both,895.71,806.14,United Healthcare,Default,Fee Schedule,730.9,,,,528.47,730.9
CONT NEB (INT.HR),94644,HCPCS,410,RC,,both,693.94,624.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,485.76,,,,409.42,566.26
CONT NEB (INT.HR),94644,HCPCS,410,RC,,both,693.94,624.55,Cigna,Default,Percent of Total Billed Charges,409.42,,,,409.42,566.26
CONT NEB (INT.HR),94644,HCPCS,410,RC,,both,693.94,624.55,United Healthcare,Default,Fee Schedule,566.26,,,,409.42,566.26
CONT NEB (SUB HR),94645,HCPCS,410,RC,,both,693.94,624.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,485.76,,,,409.42,566.26
CONT NEB (SUB HR),94645,HCPCS,410,RC,,both,693.94,624.55,Cigna,Default,Percent of Total Billed Charges,409.42,,,,409.42,566.26
CONT NEB (SUB HR),94645,HCPCS,410,RC,,both,693.94,624.55,United Healthcare,Default,Fee Schedule,566.26,,,,409.42,566.26
DEMO/EVAL TX OP,94664,HCPCS,410,RC,,both,687.67,618.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,481.37,,,,405.73,561.14
DEMO/EVAL TX OP,94664,HCPCS,410,RC,,both,687.67,618.9,Cigna,Default,Percent of Total Billed Charges,405.73,,,,405.73,561.14
DEMO/EVAL TX OP,94664,HCPCS,410,RC,,both,687.67,618.9,United Healthcare,Default,Fee Schedule,561.14,,,,405.73,561.14
OXYGEN PER HOUR,271,RC,,,,both,14.83,13.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.38,,,,8.75,12.1
OXYGEN PER HOUR,271,RC,,,,both,14.83,13.35,Cigna,Default,Percent of Total Billed Charges,8.75,,,,8.75,12.1
OXYGEN PER HOUR,271,RC,,,,both,14.83,13.35,United Healthcare,Default,Fee Schedule,12.1,,,,8.75,12.1
HOLTER MONITOR HOOKUP ONLY,93225,HCPCS,731,RC,,both,367.46,330.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.22,,,,216.8,299.85
HOLTER MONITOR HOOKUP ONLY,93225,HCPCS,731,RC,,both,367.46,330.71,Cigna,Default,Percent of Total Billed Charges,216.8,,,,216.8,299.85
HOLTER MONITOR HOOKUP ONLY,93225,HCPCS,731,RC,,both,367.46,330.71,United Healthcare,Default,Fee Schedule,299.85,,,,216.8,299.85
HOLTER HOOKUP 24 - 48 HOURS,93225,HCPCS,731,RC,,both,383.6,345.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.52,,,,226.32,313.02
HOLTER HOOKUP 24 - 48 HOURS,93225,HCPCS,731,RC,,both,383.6,345.24,Cigna,Default,Percent of Total Billed Charges,226.32,,,,226.32,313.02
HOLTER HOOKUP 24 - 48 HOURS,93225,HCPCS,731,RC,,both,383.6,345.24,United Healthcare,Default,Fee Schedule,313.02,,,,226.32,313.02
HOLTER HOOKUP 3 - 7 DAYS,93242,HCPCS,731,RC,,both,115.96,104.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.17,,,,68.42,94.62
HOLTER HOOKUP 3 - 7 DAYS,93242,HCPCS,731,RC,,both,115.96,104.36,Cigna,Default,Percent of Total Billed Charges,68.42,,,,68.42,94.62
HOLTER HOOKUP 3 - 7 DAYS,93242,HCPCS,731,RC,,both,115.96,104.36,United Healthcare,Default,Fee Schedule,94.62,,,,68.42,94.62
HOLTER HOOKUP 8-15 DAYS,93246,HCPCS,731,RC,,both,190.73,171.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.51,,,,112.53,155.64
HOLTER HOOKUP 8-15 DAYS,93246,HCPCS,731,RC,,both,190.73,171.66,Cigna,Default,Percent of Total Billed Charges,112.53,,,,112.53,155.64
HOLTER HOOKUP 8-15 DAYS,93246,HCPCS,731,RC,,both,190.73,171.66,United Healthcare,Default,Fee Schedule,155.64,,,,112.53,155.64
NEB/MDI INITIAL,94640,HCPCS,410,RC,,both,693.94,624.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,485.76,,,,409.42,566.26
NEB/MDI INITIAL,94640,HCPCS,410,RC,,both,693.94,624.55,Cigna,Default,Percent of Total Billed Charges,409.42,,,,409.42,566.26
NEB/MDI INITIAL,94640,HCPCS,410,RC,,both,693.94,624.55,United Healthcare,Default,Fee Schedule,566.26,,,,409.42,566.26
SPUTUM INDUCT 0.9% SALINE,89220,HCPCS,300,RC,,both,518.63,466.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,363.04,,,,305.99,423.2
SPUTUM INDUCT 0.9% SALINE,89220,HCPCS,300,RC,,both,518.63,466.77,Cigna,Default,Percent of Total Billed Charges,305.99,,,,305.99,423.2
SPUTUM INDUCT 0.9% SALINE,89220,HCPCS,300,RC,,both,518.63,466.77,United Healthcare,Default,Fee Schedule,423.2,,,,305.99,423.2
VITAL CAPACITY ONLY,94150,HCPCS,460,RC,,both,540.77,486.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,378.54,,,,319.05,441.27
VITAL CAPACITY ONLY,94150,HCPCS,460,RC,,both,540.77,486.69,Cigna,Default,Percent of Total Billed Charges,319.05,,,,319.05,441.27
VITAL CAPACITY ONLY,94150,HCPCS,460,RC,,both,540.77,486.69,United Healthcare,Default,Fee Schedule,441.27,,,,319.05,441.27
PULSE OX,94760,HCPCS,460,RC,,both,51.72,46.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.2,,,,30.51,42.2
PULSE OX,94760,HCPCS,460,RC,,both,51.72,46.55,Cigna,Default,Percent of Total Billed Charges,30.51,,,,30.51,42.2
PULSE OX,94760,HCPCS,460,RC,,both,51.72,46.55,United Healthcare,Default,Fee Schedule,42.2,,,,30.51,42.2
DEMONSTRATION & EVALUATION OF TX,94664,HCPCS,410,RC,,both,687.67,618.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,481.37,,,,405.73,561.14
DEMONSTRATION & EVALUATION OF TX,94664,HCPCS,410,RC,,both,687.67,618.9,Cigna,Default,Percent of Total Billed Charges,405.73,,,,405.73,561.14
DEMONSTRATION & EVALUATION OF TX,94664,HCPCS,410,RC,,both,687.67,618.9,United Healthcare,Default,Fee Schedule,561.14,,,,405.73,561.14
CPT INITIAL,94667,HCPCS,410,RC,,both,391.09,351.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,273.76,,,,230.74,319.13
CPT INITIAL,94667,HCPCS,410,RC,,both,391.09,351.98,Cigna,Default,Percent of Total Billed Charges,230.74,,,,230.74,319.13
CPT INITIAL,94667,HCPCS,410,RC,,both,391.09,351.98,United Healthcare,Default,Fee Schedule,319.13,,,,230.74,319.13
SPIROMTRY PRE ONLY,94010,HCPCS,460,RC,,both,503,452.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.1,,,,296.77,410.45
SPIROMTRY PRE ONLY,94010,HCPCS,460,RC,,both,503,452.7,Cigna,Default,Percent of Total Billed Charges,296.77,,,,296.77,410.45
SPIROMTRY PRE ONLY,94010,HCPCS,460,RC,,both,503,452.7,United Healthcare,Default,Fee Schedule,410.45,,,,296.77,410.45
NEB/MDI SUB,94640,HCPCS,410,RC,,both,693.94,624.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,485.76,,,,409.42,566.26
NEB/MDI SUB,94640,HCPCS,410,RC,,both,693.94,624.55,Cigna,Default,Percent of Total Billed Charges,409.42,,,,409.42,566.26
NEB/MDI SUB,94640,HCPCS,410,RC,,both,693.94,624.55,United Healthcare,Default,Fee Schedule,566.26,,,,409.42,566.26
CPT SUBSEQUENT,94668,HCPCS,410,RC,,both,391.09,351.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,273.76,,,,230.74,319.13
CPT SUBSEQUENT,94668,HCPCS,410,RC,,both,391.09,351.98,Cigna,Default,Percent of Total Billed Charges,230.74,,,,230.74,319.13
CPT SUBSEQUENT,94668,HCPCS,410,RC,,both,391.09,351.98,United Healthcare,Default,Fee Schedule,319.13,,,,230.74,319.13
LUNG DIFFUSION,94729,HCPCS,460,RC,,both,263.8,237.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.66,,,,155.64,215.26
LUNG DIFFUSION,94729,HCPCS,460,RC,,both,263.8,237.42,Cigna,Default,Percent of Total Billed Charges,155.64,,,,155.64,215.26
LUNG DIFFUSION,94729,HCPCS,460,RC,,both,263.8,237.42,United Healthcare,Default,Fee Schedule,215.26,,,,155.64,215.26
BIPAP CPAP MANAGEMENT,94660,HCPCS,410,RC,,both,687.67,618.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,481.37,,,,405.73,561.14
BIPAP CPAP MANAGEMENT,94660,HCPCS,410,RC,,both,687.67,618.9,Cigna,Default,Percent of Total Billed Charges,405.73,,,,405.73,561.14
BIPAP CPAP MANAGEMENT,94660,HCPCS,410,RC,,both,687.67,618.9,United Healthcare,Default,Fee Schedule,561.14,,,,405.73,561.14
ARTERIAL PUNCTURE,36600,HCPCS,300,RC,,both,384.43,345.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,269.1,,,,226.81,313.69
ARTERIAL PUNCTURE,36600,HCPCS,300,RC,,both,384.43,345.99,Cigna,Default,Percent of Total Billed Charges,226.81,,,,226.81,313.69
ARTERIAL PUNCTURE,36600,HCPCS,300,RC,,both,384.43,345.99,United Healthcare,Default,Fee Schedule,313.69,,,,226.81,313.69
FUNCTIONAL RESIDUAL CAPACITY,94727,HCPCS,460,RC,,both,503,452.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.1,,,,296.77,410.45
FUNCTIONAL RESIDUAL CAPACITY,94727,HCPCS,460,RC,,both,503,452.7,Cigna,Default,Percent of Total Billed Charges,296.77,,,,296.77,410.45
FUNCTIONAL RESIDUAL CAPACITY,94727,HCPCS,460,RC,,both,503,452.7,United Healthcare,Default,Fee Schedule,410.45,,,,296.77,410.45
"Vital Capacity, Total",94150,HCPCS,460,RC,,both,488.82,439.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,342.17,,,,288.4,398.88
"Vital Capacity, Total",94150,HCPCS,460,RC,,both,488.82,439.94,Cigna,Default,Percent of Total Billed Charges,288.4,,,,288.4,398.88
"Vital Capacity, Total",94150,HCPCS,460,RC,,both,488.82,439.94,United Healthcare,Default,Fee Schedule,398.88,,,,288.4,398.88
FV LOOP ONLY,94375,HCPCS,460,RC,,both,918.12,826.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,642.68,,,,541.69,749.19
FV LOOP ONLY,94375,HCPCS,460,RC,,both,918.12,826.31,Cigna,Default,Percent of Total Billed Charges,541.69,,,,541.69,749.19
FV LOOP ONLY,94375,HCPCS,460,RC,,both,918.12,826.31,United Healthcare,Default,Fee Schedule,749.19,,,,541.69,749.19
MDI INITIAL,94640,HCPCS,410,RC,,both,248.25,223.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.78,,,,146.47,202.57
MDI INITIAL,94640,HCPCS,410,RC,,both,248.25,223.43,Cigna,Default,Percent of Total Billed Charges,146.47,,,,146.47,202.57
MDI INITIAL,94640,HCPCS,410,RC,,both,248.25,223.43,United Healthcare,Default,Fee Schedule,202.57,,,,146.47,202.57
MDI SUBS,9464076,HCPCS,412,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
MDI SUBS,9464076,HCPCS,412,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
MDI SUBS,9464076,HCPCS,412,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
PULSE OX MULTIPLE DETERMINATIONS,94761,HCPCS,460,RC,,both,139.77,125.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.84,,,,82.46,114.05
PULSE OX MULTIPLE DETERMINATIONS,94761,HCPCS,460,RC,,both,139.77,125.79,Cigna,Default,Percent of Total Billed Charges,82.46,,,,82.46,114.05
PULSE OX MULTIPLE DETERMINATIONS,94761,HCPCS,460,RC,,both,139.77,125.79,United Healthcare,Default,Fee Schedule,114.05,,,,82.46,114.05
NIPPV INIT,94002,HCPCS,410,RC,,both,2072.39,1865.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1450.67,,,,1222.71,1691.07
NIPPV INIT,94002,HCPCS,410,RC,,both,2072.39,1865.15,Cigna,Default,Percent of Total Billed Charges,1222.71,,,,1222.71,1691.07
NIPPV INIT,94002,HCPCS,410,RC,,both,2072.39,1865.15,United Healthcare,Default,Fee Schedule,1691.07,,,,1222.71,1691.07
NIPPV SUBS,94003,HCPCS,410,RC,,both,1699.86,1529.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1189.9,,,,1002.92,1387.09
NIPPV SUBS,94003,HCPCS,410,RC,,both,1699.86,1529.87,Cigna,Default,Percent of Total Billed Charges,1002.92,,,,1002.92,1387.09
NIPPV SUBS,94003,HCPCS,410,RC,,both,1699.86,1529.87,United Healthcare,Default,Fee Schedule,1387.09,,,,1002.92,1387.09
NASOTRACHEAL SX,31720,HCPCS,410,RC,,both,687.67,618.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,481.37,,,,405.73,561.14
NASOTRACHEAL SX,31720,HCPCS,410,RC,,both,687.67,618.9,Cigna,Default,Percent of Total Billed Charges,405.73,,,,405.73,561.14
NASOTRACHEAL SX,31720,HCPCS,410,RC,,both,687.67,618.9,United Healthcare,Default,Fee Schedule,561.14,,,,405.73,561.14
INTUBATION/ASSIST EMERG,31500,HCPCS,450,RC,,both,718.03,646.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,502.62,,,,423.64,585.91
INTUBATION/ASSIST EMERG,31500,HCPCS,450,RC,,both,718.03,646.23,Cigna,Default,Percent of Total Billed Charges,423.64,,,,423.64,585.91
INTUBATION/ASSIST EMERG,31500,HCPCS,450,RC,,both,718.03,646.23,United Healthcare,Default,Fee Schedule,585.91,,,,423.64,585.91
INTERMITTANT POSSITIVE PRESSURE,94640,HCPCS,412,RC,,both,97.25,87.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.08,,,,57.38,79.36
INTERMITTANT POSSITIVE PRESSURE,94640,HCPCS,412,RC,,both,97.25,87.53,Cigna,Default,Percent of Total Billed Charges,57.38,,,,57.38,79.36
INTERMITTANT POSSITIVE PRESSURE,94640,HCPCS,412,RC,,both,97.25,87.53,United Healthcare,Default,Fee Schedule,79.36,,,,57.38,79.36
IPPB SUBS RX,9464076,HCPCS,412,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
IPPB SUBS RX,9464076,HCPCS,412,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
IPPB SUBS RX,9464076,HCPCS,412,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
IGV PLETHYSMOGRAPHY,94726,HCPCS,460,RC,,both,918.12,826.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,642.68,,,,541.69,749.19
IGV PLETHYSMOGRAPHY,94726,HCPCS,460,RC,,both,918.12,826.31,Cigna,Default,Percent of Total Billed Charges,541.69,,,,541.69,749.19
IGV PLETHYSMOGRAPHY,94726,HCPCS,460,RC,,both,918.12,826.31,United Healthcare,Default,Fee Schedule,749.19,,,,541.69,749.19
OXYGEN PER DAY,270,RC,,,,both,228.09,205.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,159.66,,,,134.57,186.12
OXYGEN PER DAY,270,RC,,,,both,228.09,205.28,Cigna,Default,Percent of Total Billed Charges,134.57,,,,134.57,186.12
OXYGEN PER DAY,270,RC,,,,both,228.09,205.28,United Healthcare,Default,Fee Schedule,186.12,,,,134.57,186.12
VENT SUBS DAY MANAGEMENT,94003,HCPCS,410,RC,,both,1699.86,1529.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1189.9,,,,1002.92,1387.09
VENT SUBS DAY MANAGEMENT,94003,HCPCS,410,RC,,both,1699.86,1529.87,Cigna,Default,Percent of Total Billed Charges,1002.92,,,,1002.92,1387.09
VENT SUBS DAY MANAGEMENT,94003,HCPCS,410,RC,,both,1699.86,1529.87,United Healthcare,Default,Fee Schedule,1387.09,,,,1002.92,1387.09
MAX VOL VENT-ONLY,94200,HCPCS,460,RC,,both,387.56,348.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,271.29,,,,228.66,316.25
MAX VOL VENT-ONLY,94200,HCPCS,460,RC,,both,387.56,348.8,Cigna,Default,Percent of Total Billed Charges,228.66,,,,228.66,316.25
MAX VOL VENT-ONLY,94200,HCPCS,460,RC,,both,387.56,348.8,United Healthcare,Default,Fee Schedule,316.25,,,,228.66,316.25
GAS ANALYSIS,94680,HCPCS,460,RC,,both,503,452.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.1,,,,296.77,410.45
GAS ANALYSIS,94680,HCPCS,460,RC,,both,503,452.7,Cigna,Default,Percent of Total Billed Charges,296.77,,,,296.77,410.45
GAS ANALYSIS,94680,HCPCS,460,RC,,both,503,452.7,United Healthcare,Default,Fee Schedule,410.45,,,,296.77,410.45
PULSE OX OVERNIGHT STUDY,94762,HCPCS,460,RC,,both,503,452.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.1,,,,296.77,410.45
PULSE OX OVERNIGHT STUDY,94762,HCPCS,460,RC,,both,503,452.7,Cigna,Default,Percent of Total Billed Charges,296.77,,,,296.77,410.45
PULSE OX OVERNIGHT STUDY,94762,HCPCS,460,RC,,both,503,452.7,United Healthcare,Default,Fee Schedule,410.45,,,,296.77,410.45
EKG 12 LEAD SUBSEQUENT,93005,HCPCS,730,RC,76,both,209.94,188.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.96,,,,123.86,171.31
EKG 12 LEAD SUBSEQUENT,93005,HCPCS,730,RC,76,both,209.94,188.95,Cigna,Default,Percent of Total Billed Charges,123.86,,,,123.86,171.31
EKG 12 LEAD SUBSEQUENT,93005,HCPCS,730,RC,76,both,209.94,188.95,United Healthcare,Default,Fee Schedule,171.31,,,,123.86,171.31
"PULSE OX 6 MINUTE WALK TEST includes HR,",94618,HCPCS,460,RC,,both,382.94,344.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.06,,,,225.93,312.48
"PULSE OX 6 MINUTE WALK TEST includes HR,",94618,HCPCS,460,RC,,both,382.94,344.65,Cigna,Default,Percent of Total Billed Charges,225.93,,,,225.93,312.48
"PULSE OX 6 MINUTE WALK TEST includes HR,",94618,HCPCS,460,RC,,both,382.94,344.65,United Healthcare,Default,Fee Schedule,312.48,,,,225.93,312.48
SMOKING CESSATION,99406,HCPCS,942,RC,,both,112.24,101.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.57,,,,66.22,91.59
SMOKING CESSATION,99406,HCPCS,942,RC,,both,112.24,101.02,Cigna,Default,Percent of Total Billed Charges,66.22,,,,66.22,91.59
SMOKING CESSATION,99406,HCPCS,942,RC,,both,112.24,101.02,United Healthcare,Default,Fee Schedule,91.59,,,,66.22,91.59
EKG KING OF HEARTS EVENT MONITOR,93270,HCPCS,731,RC,,both,217.5,195.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.25,,,,128.32,177.48
EKG KING OF HEARTS EVENT MONITOR,93270,HCPCS,731,RC,,both,217.5,195.75,Cigna,Default,Percent of Total Billed Charges,128.32,,,,128.32,177.48
EKG KING OF HEARTS EVENT MONITOR,93270,HCPCS,731,RC,,both,217.5,195.75,United Healthcare,Default,Fee Schedule,177.48,,,,128.32,177.48
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,360,RC,,both,127,114.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.9,,,,74.93,103.63
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,360,RC,,both,127,114.3,Cigna,Default,Percent of Total Billed Charges,74.93,,,,74.93,103.63
ARTHROCENTESIS MAJOR JT/BURSA,20610,HCPCS,360,RC,,both,127,114.3,United Healthcare,Default,Fee Schedule,103.63,,,,74.93,103.63
INITIAL HOSPITAL CARE HIGH,99223,HCPCS,987,RC,GF,inpatient,245.25,220.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.68,,,,144.7,171.68
INITIAL HOSPITAL CARE HIGH,99223,HCPCS,987,RC,GF,inpatient,245.25,220.73,Cigna,Default,Percent of Total Billed Charges,144.7,,,,144.7,171.68
INITIAL HOSPITAL CARE HIGH,99223,HCPCS,987,RC,GF,inpatient,245.25,220.73,United Healthcare,Default,Fee Schedule,,,,,144.7,171.68
HOSPITAL DISCHARGE MANAGEMENT <30 MIN,99238,HCPCS,987,RC,GF,both,131.25,118.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.88,,,,77.44,91.88
HOSPITAL DISCHARGE MANAGEMENT <30 MIN,99238,HCPCS,987,RC,GF,both,131.25,118.13,Cigna,Default,Percent of Total Billed Charges,77.44,,,,77.44,91.88
HOSPITAL DISCHARGE MANAGEMENT <30 MIN,99238,HCPCS,987,RC,GF,both,131.25,118.13,United Healthcare,Default,Fee Schedule,,,,,77.44,91.88
SUBSEQUENT HOSP E&M W/2 COMPONENTS,99232,HCPCS,987,RC,GF,inpatient,87.5,78.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.25,,,,51.62,61.25
SUBSEQUENT HOSP E&M W/2 COMPONENTS,99232,HCPCS,987,RC,GF,inpatient,87.5,78.75,Cigna,Default,Percent of Total Billed Charges,51.62,,,,51.62,61.25
SUBSEQUENT HOSP E&M W/2 COMPONENTS,99232,HCPCS,987,RC,GF,inpatient,87.5,78.75,United Healthcare,Default,Fee Schedule,,,,,51.62,61.25
NUR FAC DISCHARGE DAY MANAGMT<30MIN,99315,HCPCS,960,RC,GF,outpatient,74.5,67.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.15,,,,43.96,52.15
NUR FAC DISCHARGE DAY MANAGMT<30MIN,99315,HCPCS,960,RC,GF,outpatient,74.5,67.05,Cigna,Default,Percent of Total Billed Charges,43.96,,,,43.96,52.15
NUR FAC DISCHARGE DAY MANAGMT<30MIN,99315,HCPCS,960,RC,GF,outpatient,74.5,67.05,United Healthcare,Default,Fee Schedule,,,,,43.96,52.15
TB INTRADERMAL TEST,86580,HCPCS,302,RC,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
TB INTRADERMAL TEST,86580,HCPCS,302,RC,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
TB INTRADERMAL TEST,86580,HCPCS,302,RC,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
HOME VISIT LOW COMPLEXITY ESTAB PT.,99348,HCPCS,960,RC,GF,outpatient,97.75,87.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.42,,,,57.67,68.42
HOME VISIT LOW COMPLEXITY ESTAB PT.,99348,HCPCS,960,RC,GF,outpatient,97.75,87.98,Cigna,Default,Percent of Total Billed Charges,57.67,,,,57.67,68.42
HOME VISIT LOW COMPLEXITY ESTAB PT.,99348,HCPCS,960,RC,GF,outpatient,97.75,87.98,United Healthcare,Default,Fee Schedule,,,,,57.67,68.42
STRAPPING; UNNA BOOT,29580,HCPCS,761,RC,,both,87.5,78.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.25,,,,51.62,71.4
STRAPPING; UNNA BOOT,29580,HCPCS,761,RC,,both,87.5,78.75,Cigna,Default,Percent of Total Billed Charges,51.62,,,,51.62,71.4
STRAPPING; UNNA BOOT,29580,HCPCS,761,RC,,both,87.5,78.75,United Healthcare,Default,Fee Schedule,71.4,,,,51.62,71.4
DESTRCT  WARTS/MOLLUSCUM TO 14 LES,17110,HCPCS,360,RC,,both,109.5,98.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.65,,,,64.6,89.35
DESTRCT  WARTS/MOLLUSCUM TO 14 LES,17110,HCPCS,360,RC,,both,109.5,98.55,Cigna,Default,Percent of Total Billed Charges,64.6,,,,64.6,89.35
DESTRCT  WARTS/MOLLUSCUM TO 14 LES,17110,HCPCS,360,RC,,both,109.5,98.55,United Healthcare,Default,Fee Schedule,89.35,,,,64.6,89.35
REMOVAL OF SKIN TAGS; UP TO 15,11200,HCPCS,360,RC,,both,240.75,216.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.52,,,,142.04,196.45
REMOVAL OF SKIN TAGS; UP TO 15,11200,HCPCS,360,RC,,both,240.75,216.68,Cigna,Default,Percent of Total Billed Charges,142.04,,,,142.04,196.45
REMOVAL OF SKIN TAGS; UP TO 15,11200,HCPCS,360,RC,,both,240.75,216.68,United Healthcare,Default,Fee Schedule,196.45,,,,142.04,196.45
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,360,RC,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,360,RC,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
REMOV IMPACTED CERUMEN (SEP PRO),69210,HCPCS,360,RC,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
TRIGGER POINT INJECTION ONE/TWO MUSCLES,20552,HCPCS,360,RC,,both,87.5,78.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.25,,,,51.62,71.4
TRIGGER POINT INJECTION ONE/TWO MUSCLES,20552,HCPCS,360,RC,,both,87.5,78.75,Cigna,Default,Percent of Total Billed Charges,51.62,,,,51.62,71.4
TRIGGER POINT INJECTION ONE/TWO MUSCLES,20552,HCPCS,360,RC,,both,87.5,78.75,United Healthcare,Default,Fee Schedule,71.4,,,,51.62,71.4
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,360,RC,,both,192.5,173.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.75,,,,113.58,157.08
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,360,RC,,both,192.5,173.25,Cigna,Default,Percent of Total Billed Charges,113.58,,,,113.58,157.08
I&D ABCESS; SIMPL/SNGL,10060,HCPCS,360,RC,,both,192.5,173.25,United Healthcare,Default,Fee Schedule,157.08,,,,113.58,157.08
I&D HEMATOMA/SEROMA/FLUID COLLEC,10140,HCPCS,360,RC,,both,219,197.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.3,,,,129.21,178.7
I&D HEMATOMA/SEROMA/FLUID COLLEC,10140,HCPCS,360,RC,,both,219,197.1,Cigna,Default,Percent of Total Billed Charges,129.21,,,,129.21,178.7
I&D HEMATOMA/SEROMA/FLUID COLLEC,10140,HCPCS,360,RC,,both,219,197.1,United Healthcare,Default,Fee Schedule,178.7,,,,129.21,178.7
I&D ABSCESS; PERINEUM,56405,HCPCS,360,RC,,both,262.75,236.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.92,,,,155.02,214.4
I&D ABSCESS; PERINEUM,56405,HCPCS,360,RC,,both,262.75,236.48,Cigna,Default,Percent of Total Billed Charges,155.02,,,,155.02,214.4
I&D ABSCESS; PERINEUM,56405,HCPCS,360,RC,,both,262.75,236.48,United Healthcare,Default,Fee Schedule,214.4,,,,155.02,214.4
SELECT DEBRIDEMENT 20 CM OR LESS,97597,HCPCS,510,RC,,both,197,177.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.9,,,,116.23,160.75
SELECT DEBRIDEMENT 20 CM OR LESS,97597,HCPCS,510,RC,,both,197,177.3,Cigna,Default,Percent of Total Billed Charges,116.23,,,,116.23,160.75
SELECT DEBRIDEMENT 20 CM OR LESS,97597,HCPCS,510,RC,,both,197,177.3,United Healthcare,Default,Fee Schedule,160.75,,,,116.23,160.75
OT EVAL LOW COMPLEX 20 MIN,97165,HCPCS,434,RC,GO,both,372.71,335.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.9,,,,219.9,304.13
OT EVAL LOW COMPLEX 20 MIN,97165,HCPCS,434,RC,GO,both,372.71,335.44,Cigna,Default,Percent of Total Billed Charges,219.9,,,,219.9,304.13
OT EVAL LOW COMPLEX 20 MIN,97165,HCPCS,434,RC,GO,both,372.71,335.44,United Healthcare,Default,Fee Schedule,304.13,,,,219.9,304.13
OT EVAL MOD COMPLEX 30 MIN,97166,HCPCS,434,RC,GO,both,432.58,389.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,302.81,,,,255.22,352.99
OT EVAL MOD COMPLEX 30 MIN,97166,HCPCS,434,RC,GO,both,432.58,389.32,Cigna,Default,Percent of Total Billed Charges,255.22,,,,255.22,352.99
OT EVAL MOD COMPLEX 30 MIN,97166,HCPCS,434,RC,GO,both,432.58,389.32,United Healthcare,Default,Fee Schedule,352.99,,,,255.22,352.99
OT EVAL HIGH COMPLEX 45 MINS,97167,HCPCS,434,RC,GO,both,494.65,445.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,346.26,,,,291.84,403.63
OT EVAL HIGH COMPLEX 45 MINS,97167,HCPCS,434,RC,GO,both,494.65,445.19,Cigna,Default,Percent of Total Billed Charges,291.84,,,,291.84,403.63
OT EVAL HIGH COMPLEX 45 MINS,97167,HCPCS,434,RC,GO,both,494.65,445.19,United Healthcare,Default,Fee Schedule,403.63,,,,291.84,403.63
PT EVAL LOW COMPLEX 20 MIN,97161,HCPCS,424,RC,GP,both,423.45,381.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,296.42,,,,249.84,345.54
PT EVAL LOW COMPLEX 20 MIN,97161,HCPCS,424,RC,GP,both,423.45,381.11,Cigna,Default,Percent of Total Billed Charges,249.84,,,,249.84,345.54
PT EVAL LOW COMPLEX 20 MIN,97161,HCPCS,424,RC,GP,both,423.45,381.11,United Healthcare,Default,Fee Schedule,345.54,,,,249.84,345.54
PT EVAL MOD COMPLEX 30 MIN,97162,HCPCS,424,RC,GP,both,451.75,406.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.22,,,,266.53,368.63
PT EVAL MOD COMPLEX 30 MIN,97162,HCPCS,424,RC,GP,both,451.75,406.58,Cigna,Default,Percent of Total Billed Charges,266.53,,,,266.53,368.63
PT EVAL MOD COMPLEX 30 MIN,97162,HCPCS,424,RC,GP,both,451.75,406.58,United Healthcare,Default,Fee Schedule,368.63,,,,266.53,368.63
PT EVAL HIGH COMPLEX 45 MIN,97163,HCPCS,424,RC,GP,both,528,475.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,369.6,,,,311.52,430.85
PT EVAL HIGH COMPLEX 45 MIN,97163,HCPCS,424,RC,GP,both,528,475.2,Cigna,Default,Percent of Total Billed Charges,311.52,,,,311.52,430.85
PT EVAL HIGH COMPLEX 45 MIN,97163,HCPCS,424,RC,GP,both,528,475.2,United Healthcare,Default,Fee Schedule,430.85,,,,311.52,430.85
OT OCCUPATIONAL THERAPY EVALUATION,97003,HCPCS,434,RC,GO,both,198.75,178.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.12,,,,117.26,162.18
OT OCCUPATIONAL THERAPY EVALUATION,97003,HCPCS,434,RC,GO,both,198.75,178.88,Cigna,Default,Percent of Total Billed Charges,117.26,,,,117.26,162.18
OT OCCUPATIONAL THERAPY EVALUATION,97003,HCPCS,434,RC,GO,both,198.75,178.88,United Healthcare,Default,Fee Schedule,162.18,,,,117.26,162.18
OT RE-EVAL EST PLAN CARE,97168,HCPCS,434,RC,GO,both,231.81,208.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.27,,,,136.77,189.16
OT RE-EVAL EST PLAN CARE,97168,HCPCS,434,RC,GO,both,231.81,208.63,Cigna,Default,Percent of Total Billed Charges,136.77,,,,136.77,189.16
OT RE-EVAL EST PLAN CARE,97168,HCPCS,434,RC,GO,both,231.81,208.63,United Healthcare,Default,Fee Schedule,189.16,,,,136.77,189.16
"OT THERAPEUTIC EXERCISE,15 MINUTES",97110,HCPCS,430,RC,GO,both,166.56,149.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.59,,,,98.27,135.91
"OT THERAPEUTIC EXERCISE,15 MINUTES",97110,HCPCS,430,RC,GO,both,166.56,149.9,Cigna,Default,Percent of Total Billed Charges,98.27,,,,98.27,135.91
"OT THERAPEUTIC EXERCISE,15 MINUTES",97110,HCPCS,430,RC,GO,both,166.56,149.9,United Healthcare,Default,Fee Schedule,135.91,,,,98.27,135.91
"OT THERAPEUTIC ACTIVITIES, 15 MINUTES",97530,HCPCS,430,RC,GO,both,146.45,131.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.52,,,,86.41,119.5
"OT THERAPEUTIC ACTIVITIES, 15 MINUTES",97530,HCPCS,430,RC,GO,both,146.45,131.81,Cigna,Default,Percent of Total Billed Charges,86.41,,,,86.41,119.5
"OT THERAPEUTIC ACTIVITIES, 15 MINUTES",97530,HCPCS,430,RC,GO,both,146.45,131.81,United Healthcare,Default,Fee Schedule,119.5,,,,86.41,119.5
OT NEUROMUSC RE-EDUCATION 15 MIN.,97112,HCPCS,430,RC,GO,both,166.56,149.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.59,,,,98.27,135.91
OT NEUROMUSC RE-EDUCATION 15 MIN.,97112,HCPCS,430,RC,GO,both,166.56,149.9,Cigna,Default,Percent of Total Billed Charges,98.27,,,,98.27,135.91
OT NEUROMUSC RE-EDUCATION 15 MIN.,97112,HCPCS,430,RC,GO,both,166.56,149.9,United Healthcare,Default,Fee Schedule,135.91,,,,98.27,135.91
"OT PROSTHETIC TRAINING, 15 MIN.",97761,HCPCS,430,RC,GO,both,80.86,72.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.6,,,,47.71,65.98
"OT PROSTHETIC TRAINING, 15 MIN.",97761,HCPCS,430,RC,GO,both,80.86,72.77,Cigna,Default,Percent of Total Billed Charges,47.71,,,,47.71,65.98
"OT PROSTHETIC TRAINING, 15 MIN.",97761,HCPCS,430,RC,GO,both,80.86,72.77,United Healthcare,Default,Fee Schedule,65.98,,,,47.71,65.98
OT SELF CARE/HOME MGMT TRN 15 MIN.,97535,HCPCS,430,RC,GO,both,146.26,131.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.38,,,,86.29,119.35
OT SELF CARE/HOME MGMT TRN 15 MIN.,97535,HCPCS,430,RC,GO,both,146.26,131.63,Cigna,Default,Percent of Total Billed Charges,86.29,,,,86.29,119.35
OT SELF CARE/HOME MGMT TRN 15 MIN.,97535,HCPCS,430,RC,GO,both,146.26,131.63,United Healthcare,Default,Fee Schedule,119.35,,,,86.29,119.35
NEGATIVE PRESS WOUND TX 50 CM OR GREATER,97605,HCPCS,420,RC,GP,both,237.25,213.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.08,,,,139.98,193.6
NEGATIVE PRESS WOUND TX 50 CM OR GREATER,97605,HCPCS,420,RC,GP,both,237.25,213.53,Cigna,Default,Percent of Total Billed Charges,139.98,,,,139.98,193.6
NEGATIVE PRESS WOUND TX 50 CM OR GREATER,97605,HCPCS,420,RC,GP,both,237.25,213.53,United Healthcare,Default,Fee Schedule,193.6,,,,139.98,193.6
NEGATIVE PRESSURE TX GREATER THAN 50 CM,97606,HCPCS,420,RC,GP,both,237.25,213.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.08,,,,139.98,193.6
NEGATIVE PRESSURE TX GREATER THAN 50 CM,97606,HCPCS,420,RC,GP,both,237.25,213.53,Cigna,Default,Percent of Total Billed Charges,139.98,,,,139.98,193.6
NEGATIVE PRESSURE TX GREATER THAN 50 CM,97606,HCPCS,420,RC,GP,both,237.25,213.53,United Healthcare,Default,Fee Schedule,193.6,,,,139.98,193.6
PT VASOPNEUMATIC DEVICES,97016,HCPCS,420,RC,GP,both,50,45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35,,,,29.5,40.8
PT VASOPNEUMATIC DEVICES,97016,HCPCS,420,RC,GP,both,50,45,Cigna,Default,Percent of Total Billed Charges,29.5,,,,29.5,40.8
PT VASOPNEUMATIC DEVICES,97016,HCPCS,420,RC,GP,both,50,45,United Healthcare,Default,Fee Schedule,40.8,,,,29.5,40.8
"PT TENS, ELEC STIM MANUAL, 15 MINUTES",97032,HCPCS,420,RC,GP,both,252.75,227.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.92,,,,149.12,206.24
"PT TENS, ELEC STIM MANUAL, 15 MINUTES",97032,HCPCS,420,RC,GP,both,252.75,227.48,Cigna,Default,Percent of Total Billed Charges,149.12,,,,149.12,206.24
"PT TENS, ELEC STIM MANUAL, 15 MINUTES",97032,HCPCS,420,RC,GP,both,252.75,227.48,United Healthcare,Default,Fee Schedule,206.24,,,,149.12,206.24
SELECT DEBRIDEMENT GREATER THAN 20 CM,97598,HCPCS,420,RC,,both,629.37,566.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,440.56,,,,371.33,513.57
SELECT DEBRIDEMENT GREATER THAN 20 CM,97598,HCPCS,420,RC,,both,629.37,566.43,Cigna,Default,Percent of Total Billed Charges,371.33,,,,371.33,513.57
SELECT DEBRIDEMENT GREATER THAN 20 CM,97598,HCPCS,420,RC,,both,629.37,566.43,United Healthcare,Default,Fee Schedule,513.57,,,,371.33,513.57
SELECT DEBRIDEMENT 20 CM OR LESS,97597,HCPCS,420,RC,,both,700.9,630.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,490.63,,,,413.53,571.93
SELECT DEBRIDEMENT 20 CM OR LESS,97597,HCPCS,420,RC,,both,700.9,630.81,Cigna,Default,Percent of Total Billed Charges,413.53,,,,413.53,571.93
SELECT DEBRIDEMENT 20 CM OR LESS,97597,HCPCS,420,RC,,both,700.9,630.81,United Healthcare,Default,Fee Schedule,571.93,,,,413.53,571.93
PT STRAPPING-LOW BACK,29799,HCPCS,420,RC,,both,110.5,99.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.35,,,,65.2,90.17
PT STRAPPING-LOW BACK,29799,HCPCS,420,RC,,both,110.5,99.45,Cigna,Default,Percent of Total Billed Charges,65.2,,,,65.2,90.17
PT STRAPPING-LOW BACK,29799,HCPCS,420,RC,,both,110.5,99.45,United Healthcare,Default,Fee Schedule,90.17,,,,65.2,90.17
PT STRAPPING-SHOULDER,29240,HCPCS,420,RC,,both,209.38,188.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.57,,,,123.53,170.85
PT STRAPPING-SHOULDER,29240,HCPCS,420,RC,,both,209.38,188.44,Cigna,Default,Percent of Total Billed Charges,123.53,,,,123.53,170.85
PT STRAPPING-SHOULDER,29240,HCPCS,420,RC,,both,209.38,188.44,United Healthcare,Default,Fee Schedule,170.85,,,,123.53,170.85
PT TAPING- KNEE,29530,HCPCS,420,RC,,both,204.27,183.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.99,,,,120.52,166.68
PT TAPING- KNEE,29530,HCPCS,420,RC,,both,204.27,183.84,Cigna,Default,Percent of Total Billed Charges,120.52,,,,120.52,166.68
PT TAPING- KNEE,29530,HCPCS,420,RC,,both,204.27,183.84,United Healthcare,Default,Fee Schedule,166.68,,,,120.52,166.68
"PT THERAPEUTIC EXERCISE, 15 MINS.",97110,HCPCS,420,RC,GP,both,221,198.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.7,,,,130.39,180.34
"PT THERAPEUTIC EXERCISE, 15 MINS.",97110,HCPCS,420,RC,GP,both,221,198.9,Cigna,Default,Percent of Total Billed Charges,130.39,,,,130.39,180.34
"PT THERAPEUTIC EXERCISE, 15 MINS.",97110,HCPCS,420,RC,GP,both,221,198.9,United Healthcare,Default,Fee Schedule,180.34,,,,130.39,180.34
"PT AQUATIC THERAPY, 15 MINS",97113,HCPCS,420,RC,GP,both,217.5,195.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.25,,,,128.32,177.48
"PT AQUATIC THERAPY, 15 MINS",97113,HCPCS,420,RC,GP,both,217.5,195.75,Cigna,Default,Percent of Total Billed Charges,128.32,,,,128.32,177.48
"PT AQUATIC THERAPY, 15 MINS",97113,HCPCS,420,RC,GP,both,217.5,195.75,United Healthcare,Default,Fee Schedule,177.48,,,,128.32,177.48
"PT NEUROMUSC, 15 MINS.",97112,HCPCS,420,RC,GP,both,225,202.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.5,,,,132.75,183.6
"PT NEUROMUSC, 15 MINS.",97112,HCPCS,420,RC,GP,both,225,202.5,Cigna,Default,Percent of Total Billed Charges,132.75,,,,132.75,183.6
"PT NEUROMUSC, 15 MINS.",97112,HCPCS,420,RC,GP,both,225,202.5,United Healthcare,Default,Fee Schedule,183.6,,,,132.75,183.6
"PT GAIT TRAINING, 15 MINUTES",97116,HCPCS,420,RC,GP,both,181.28,163.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.9,,,,106.96,147.92
"PT GAIT TRAINING, 15 MINUTES",97116,HCPCS,420,RC,GP,both,181.28,163.15,Cigna,Default,Percent of Total Billed Charges,106.96,,,,106.96,147.92
"PT GAIT TRAINING, 15 MINUTES",97116,HCPCS,420,RC,GP,both,181.28,163.15,United Healthcare,Default,Fee Schedule,147.92,,,,106.96,147.92
PT WHIRLPOOL,97022,HCPCS,420,RC,GP,both,230,207,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,161,,,,135.7,187.68
PT WHIRLPOOL,97022,HCPCS,420,RC,GP,both,230,207,Cigna,Default,Percent of Total Billed Charges,135.7,,,,135.7,187.68
PT WHIRLPOOL,97022,HCPCS,420,RC,GP,both,230,207,United Healthcare,Default,Fee Schedule,187.68,,,,135.7,187.68
"PT PROSTHETIC TRAINING, 15 MIN",97761,HCPCS,420,RC,GO,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
"PT PROSTHETIC TRAINING, 15 MIN",97761,HCPCS,420,RC,GO,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
"PT PROSTHETIC TRAINING, 15 MIN",97761,HCPCS,420,RC,GO,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
PT RE EVALUATION,97164,HCPCS,424,RC,GP,both,226.29,203.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.4,,,,133.51,184.65
PT RE EVALUATION,97164,HCPCS,424,RC,GP,both,226.29,203.66,Cigna,Default,Percent of Total Billed Charges,133.51,,,,133.51,184.65
PT RE EVALUATION,97164,HCPCS,424,RC,GP,both,226.29,203.66,United Healthcare,Default,Fee Schedule,184.65,,,,133.51,184.65
PT MECHANICAL TRACTION,97012,HCPCS,420,RC,GP,both,227,204.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.9,,,,133.93,185.23
PT MECHANICAL TRACTION,97012,HCPCS,420,RC,GP,both,227,204.3,Cigna,Default,Percent of Total Billed Charges,133.93,,,,133.93,185.23
PT MECHANICAL TRACTION,97012,HCPCS,420,RC,GP,both,227,204.3,United Healthcare,Default,Fee Schedule,185.23,,,,133.93,185.23
"PT CHECKOUT ORTH/PROST USE, 15MIN",97763,HCPCS,420,RC,GP,both,165.5,148.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.85,,,,97.64,135.05
"PT CHECKOUT ORTH/PROST USE, 15MIN",97763,HCPCS,420,RC,GP,both,165.5,148.95,Cigna,Default,Percent of Total Billed Charges,97.64,,,,97.64,135.05
"PT CHECKOUT ORTH/PROST USE, 15MIN",97763,HCPCS,420,RC,GP,both,165.5,148.95,United Healthcare,Default,Fee Schedule,135.05,,,,97.64,135.05
OT CHECKOUT ORTH/PROST USE 15MIN,97762,HCPCS,430,RC,GO,both,81.25,73.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.88,,,,47.94,66.3
OT CHECKOUT ORTH/PROST USE 15MIN,97762,HCPCS,430,RC,GO,both,81.25,73.13,Cigna,Default,Percent of Total Billed Charges,47.94,,,,47.94,66.3
OT CHECKOUT ORTH/PROST USE 15MIN,97762,HCPCS,430,RC,GO,both,81.25,73.13,United Healthcare,Default,Fee Schedule,66.3,,,,47.94,66.3
PT SELF CARE/HOME MGMT TRN 15 MIN,97535,HCPCS,420,RC,GP,both,146.26,131.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.38,,,,86.29,119.35
PT SELF CARE/HOME MGMT TRN 15 MIN,97535,HCPCS,420,RC,GP,both,146.26,131.63,Cigna,Default,Percent of Total Billed Charges,86.29,,,,86.29,119.35
PT SELF CARE/HOME MGMT TRN 15 MIN,97535,HCPCS,420,RC,GP,both,146.26,131.63,United Healthcare,Default,Fee Schedule,119.35,,,,86.29,119.35
"PT ULTRASOUND, 15 MINUTES",97035,HCPCS,420,RC,GP,both,225.57,203.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.9,,,,133.09,184.07
"PT ULTRASOUND, 15 MINUTES",97035,HCPCS,420,RC,GP,both,225.57,203.01,Cigna,Default,Percent of Total Billed Charges,133.09,,,,133.09,184.07
"PT ULTRASOUND, 15 MINUTES",97035,HCPCS,420,RC,GP,both,225.57,203.01,United Healthcare,Default,Fee Schedule,184.07,,,,133.09,184.07
"PT THERAPEUTIC ACTIVITY,  15 MINUTES",97530,HCPCS,420,RC,GP,both,236,212.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.2,,,,139.24,192.58
"PT THERAPEUTIC ACTIVITY,  15 MINUTES",97530,HCPCS,420,RC,GP,both,236,212.4,Cigna,Default,Percent of Total Billed Charges,139.24,,,,139.24,192.58
"PT THERAPEUTIC ACTIVITY,  15 MINUTES",97530,HCPCS,420,RC,GP,both,236,212.4,United Healthcare,Default,Fee Schedule,192.58,,,,139.24,192.58
"PT IONTOPHORESIS, 15 MINUTES",97033,HCPCS,420,RC,GP,both,241.45,217.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.02,,,,142.46,197.02
"PT IONTOPHORESIS, 15 MINUTES",97033,HCPCS,420,RC,GP,both,241.45,217.31,Cigna,Default,Percent of Total Billed Charges,142.46,,,,142.46,197.02
"PT IONTOPHORESIS, 15 MINUTES",97033,HCPCS,420,RC,GP,both,241.45,217.31,United Healthcare,Default,Fee Schedule,197.02,,,,142.46,197.02
ELECTRICAL STIMULATION (UNATTENDED),G0283,HCPCS,429,RC,GP,both,200,180,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140,,,,118,163.2
ELECTRICAL STIMULATION (UNATTENDED),G0283,HCPCS,429,RC,GP,both,200,180,Cigna,Default,Percent of Total Billed Charges,118,,,,118,163.2
ELECTRICAL STIMULATION (UNATTENDED),G0283,HCPCS,429,RC,GP,both,200,180,United Healthcare,Default,Fee Schedule,163.2,,,,118,163.2
NEUROPSYCHOLOGICAL TESTING ADMIN W/COMP,96120,HCPCS,918,RC,,both,27.5,24.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.25,,,,16.22,22.44
NEUROPSYCHOLOGICAL TESTING ADMIN W/COMP,96120,HCPCS,918,RC,,both,27.5,24.75,Cigna,Default,Percent of Total Billed Charges,16.22,,,,16.22,22.44
NEUROPSYCHOLOGICAL TESTING ADMIN W/COMP,96120,HCPCS,918,RC,,both,27.5,24.75,United Healthcare,Default,Fee Schedule,22.44,,,,16.22,22.44
STANDARDIZED COGNITIVE ASSESSMENT,96125,HCPCS,918,RC,,both,410.27,369.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,287.19,,,,242.06,334.78
STANDARDIZED COGNITIVE ASSESSMENT,96125,HCPCS,918,RC,,both,410.27,369.24,Cigna,Default,Percent of Total Billed Charges,242.06,,,,242.06,334.78
STANDARDIZED COGNITIVE ASSESSMENT,96125,HCPCS,918,RC,,both,410.27,369.24,United Healthcare,Default,Fee Schedule,334.78,,,,242.06,334.78
"PHYSICAL PERFORMANCE TESTING, 15 MINUTES",97750,HCPCS,420,RC,GP,both,74.05,66.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.84,,,,43.69,60.42
"PHYSICAL PERFORMANCE TESTING, 15 MINUTES",97750,HCPCS,420,RC,GP,both,74.05,66.65,Cigna,Default,Percent of Total Billed Charges,43.69,,,,43.69,60.42
"PHYSICAL PERFORMANCE TESTING, 15 MINUTES",97750,HCPCS,420,RC,GP,both,74.05,66.65,United Healthcare,Default,Fee Schedule,60.42,,,,43.69,60.42
"CANALITH REPOSITIONING, UNTIMED",95992,HCPCS,420,RC,GP,both,321.57,289.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.1,,,,189.73,262.4
"CANALITH REPOSITIONING, UNTIMED",95992,HCPCS,420,RC,GP,both,321.57,289.41,Cigna,Default,Percent of Total Billed Charges,189.73,,,,189.73,262.4
"CANALITH REPOSITIONING, UNTIMED",95992,HCPCS,420,RC,GP,both,321.57,289.41,United Healthcare,Default,Fee Schedule,262.4,,,,189.73,262.4
PT MYOFACIAL RELEASE,97140,HCPCS,420,RC,,both,202,181.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.4,,,,119.18,164.83
PT MYOFACIAL RELEASE,97140,HCPCS,420,RC,,both,202,181.8,Cigna,Default,Percent of Total Billed Charges,119.18,,,,119.18,164.83
PT MYOFACIAL RELEASE,97140,HCPCS,420,RC,,both,202,181.8,United Healthcare,Default,Fee Schedule,164.83,,,,119.18,164.83
"PT MANUAL THERAPY,15 MINUTES",97140,HCPCS,420,RC,GP,both,202,181.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.4,,,,119.18,164.83
"PT MANUAL THERAPY,15 MINUTES",97140,HCPCS,420,RC,GP,both,202,181.8,Cigna,Default,Percent of Total Billed Charges,119.18,,,,119.18,164.83
"PT MANUAL THERAPY,15 MINUTES",97140,HCPCS,420,RC,GP,both,202,181.8,United Healthcare,Default,Fee Schedule,164.83,,,,119.18,164.83
THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTE,97129,HCPCS,440,RC,,both,179.94,161.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.96,,,,106.16,146.83
THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTE,97129,HCPCS,440,RC,,both,179.94,161.95,Cigna,Default,Percent of Total Billed Charges,106.16,,,,106.16,146.83
THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTE,97129,HCPCS,440,RC,,both,179.94,161.95,United Healthcare,Default,Fee Schedule,146.83,,,,106.16,146.83
THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MI,97130,HCPCS,440,RC,,both,173.28,155.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.3,,,,102.24,141.4
THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MI,97130,HCPCS,440,RC,,both,173.28,155.95,Cigna,Default,Percent of Total Billed Charges,102.24,,,,102.24,141.4
THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MI,97130,HCPCS,440,RC,,both,173.28,155.95,United Healthcare,Default,Fee Schedule,141.4,,,,102.24,141.4
CARDIAC REHAB PHASE 2 W ECG MONITOR,93798,HCPCS,943,RC,,both,115.5,103.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.85,,,,68.14,94.25
CARDIAC REHAB PHASE 2 W ECG MONITOR,93798,HCPCS,943,RC,,both,115.5,103.95,Cigna,Default,Percent of Total Billed Charges,68.14,,,,68.14,94.25
CARDIAC REHAB PHASE 2 W ECG MONITOR,93798,HCPCS,943,RC,,both,115.5,103.95,United Healthcare,Default,Fee Schedule,94.25,,,,68.14,94.25
"MM MANUAL THERAPY,15 MINUTES",97140,HCPCS,420,RC,,both,93.86,84.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.7,,,,55.38,76.59
"MM MANUAL THERAPY,15 MINUTES",97140,HCPCS,420,RC,,both,93.86,84.47,Cigna,Default,Percent of Total Billed Charges,55.38,,,,55.38,76.59
"MM MANUAL THERAPY,15 MINUTES",97140,HCPCS,420,RC,,both,93.86,84.47,United Healthcare,Default,Fee Schedule,76.59,,,,55.38,76.59
MM MASSAGETHERAPY,97124,HCPCS,420,RC,,both,82.42,74.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.69,,,,48.63,67.25
MM MASSAGETHERAPY,97124,HCPCS,420,RC,,both,82.42,74.18,Cigna,Default,Percent of Total Billed Charges,48.63,,,,48.63,67.25
MM MASSAGETHERAPY,97124,HCPCS,420,RC,,both,82.42,74.18,United Healthcare,Default,Fee Schedule,67.25,,,,48.63,67.25
PULMONARY REHAB 1 HR SESSION FOR COPD DX,94625,HCPCS,948,RC,,both,200.57,180.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.4,,,,118.34,163.67
PULMONARY REHAB 1 HR SESSION FOR COPD DX,94625,HCPCS,948,RC,,both,200.57,180.51,Cigna,Default,Percent of Total Billed Charges,118.34,,,,118.34,163.67
PULMONARY REHAB 1 HR SESSION FOR COPD DX,94625,HCPCS,948,RC,,both,200.57,180.51,United Healthcare,Default,Fee Schedule,163.67,,,,118.34,163.67
PULMONARY REHAB 15 MIN SESSION FOR NON C,G0238,HCPCS,948,RC,,both,120.92,108.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.64,,,,71.34,98.67
PULMONARY REHAB 15 MIN SESSION FOR NON C,G0238,HCPCS,948,RC,,both,120.92,108.83,Cigna,Default,Percent of Total Billed Charges,71.34,,,,71.34,98.67
PULMONARY REHAB 15 MIN SESSION FOR NON C,G0238,HCPCS,948,RC,,both,120.92,108.83,United Healthcare,Default,Fee Schedule,98.67,,,,71.34,98.67
PULMONARY REHAB GROUP SESSION FOR NON CO,G0239,HCPCS,948,RC,,both,119.43,107.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.6,,,,70.46,97.45
PULMONARY REHAB GROUP SESSION FOR NON CO,G0239,HCPCS,948,RC,,both,119.43,107.49,Cigna,Default,Percent of Total Billed Charges,70.46,,,,70.46,97.45
PULMONARY REHAB GROUP SESSION FOR NON CO,G0239,HCPCS,948,RC,,both,119.43,107.49,United Healthcare,Default,Fee Schedule,97.45,,,,70.46,97.45
pulmonary rehabilitation; without contin,94625,HCPCS,948,RC,,both,189.31,170.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.52,,,,111.69,154.48
pulmonary rehabilitation; without contin,94625,HCPCS,948,RC,,both,189.31,170.38,Cigna,Default,Percent of Total Billed Charges,111.69,,,,111.69,154.48
pulmonary rehabilitation; without contin,94625,HCPCS,948,RC,,both,189.31,170.38,United Healthcare,Default,Fee Schedule,154.48,,,,111.69,154.48
PULMONARY REHABILITATION 1 HOUR SESSION,94626,HCPCS,948,RC,,both,194.99,175.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.49,,,,115.04,159.11
PULMONARY REHABILITATION 1 HOUR SESSION,94626,HCPCS,948,RC,,both,194.99,175.49,Cigna,Default,Percent of Total Billed Charges,115.04,,,,115.04,159.11
PULMONARY REHABILITATION 1 HOUR SESSION,94626,HCPCS,948,RC,,both,194.99,175.49,United Healthcare,Default,Fee Schedule,159.11,,,,115.04,159.11
CARDIAC REHAB PHASE 2 W ECG MONITOR,93798,HCPCS,943,RC,,both,377.61,339.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.33,,,,222.79,308.13
CARDIAC REHAB PHASE 2 W ECG MONITOR,93798,HCPCS,943,RC,,both,377.61,339.85,Cigna,Default,Percent of Total Billed Charges,222.79,,,,222.79,308.13
CARDIAC REHAB PHASE 2 W ECG MONITOR,93798,HCPCS,943,RC,,both,377.61,339.85,United Healthcare,Default,Fee Schedule,308.13,,,,222.79,308.13
MMRA ABDOMEN W/O CONTRAST,74185,HCPCS,610,RC,,both,2761.66,2485.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1933.16,,,,910,2253.51
MMRA ABDOMEN W/O CONTRAST,74185,HCPCS,610,RC,,both,2761.66,2485.49,Cigna,Default,Case Rate,910,,,,910,2253.51
MMRA ABDOMEN W/O CONTRAST,74185,HCPCS,610,RC,,both,2761.66,2485.49,United Healthcare,Default,Fee Schedule,2253.51,,,,910,2253.51
MMRI U EXTR; ANY JOINT W CONTRAST,73222,HCPCS,610,RC,,both,3887.91,3499.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2721.54,,,,910,3172.53
MMRI U EXTR; ANY JOINT W CONTRAST,73222,HCPCS,610,RC,,both,3887.91,3499.12,Cigna,Default,Case Rate,910,,,,910,3172.53
MMRI U EXTR; ANY JOINT W CONTRAST,73222,HCPCS,610,RC,,both,3887.91,3499.12,United Healthcare,Default,Fee Schedule,3172.53,,,,910,3172.53
MMRA BRAIN WITHOUT CONTRAST,70544,HCPCS,615,RC,,both,3195.77,2876.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2237.04,,,,910,2607.75
MMRA BRAIN WITHOUT CONTRAST,70544,HCPCS,615,RC,,both,3195.77,2876.19,Cigna,Default,Case Rate,910,,,,910,2607.75
MMRA BRAIN WITHOUT CONTRAST,70544,HCPCS,615,RC,,both,3195.77,2876.19,United Healthcare,Default,Fee Schedule,2607.75,,,,910,2607.75
MMRA BRAIN WITH CONTRAST,70546,HCPCS,615,RC,,both,3679.6,3311.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2575.72,,,,910,3002.55
MMRA BRAIN WITH CONTRAST,70546,HCPCS,615,RC,,both,3679.6,3311.64,Cigna,Default,Case Rate,910,,,,910,3002.55
MMRA BRAIN WITH CONTRAST,70546,HCPCS,615,RC,,both,3679.6,3311.64,United Healthcare,Default,Fee Schedule,3002.55,,,,910,3002.55
MMRA NECK WO CONTRAST,70547,HCPCS,615,RC,,both,3195.77,2876.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2237.04,,,,910,2607.75
MMRA NECK WO CONTRAST,70547,HCPCS,615,RC,,both,3195.77,2876.19,Cigna,Default,Case Rate,910,,,,910,2607.75
MMRA NECK WO CONTRAST,70547,HCPCS,615,RC,,both,3195.77,2876.19,United Healthcare,Default,Fee Schedule,2607.75,,,,910,2607.75
MMRI THORACIC SPINE W/CONTRAST,72147,HCPCS,612,RC,,both,3794.21,3414.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2655.95,,,,910,3096.08
MMRI THORACIC SPINE W/CONTRAST,72147,HCPCS,612,RC,,both,3794.21,3414.79,Cigna,Default,Case Rate,910,,,,910,3096.08
MMRI THORACIC SPINE W/CONTRAST,72147,HCPCS,612,RC,,both,3794.21,3414.79,United Healthcare,Default,Fee Schedule,3096.08,,,,910,3096.08
MMRI LUMBAR SPINE WITH CONTRAST,72149,HCPCS,612,RC,,both,3906.56,3515.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2734.59,,,,910,3187.75
MMRI LUMBAR SPINE WITH CONTRAST,72149,HCPCS,612,RC,,both,3906.56,3515.9,Cigna,Default,Case Rate,910,,,,910,3187.75
MMRI LUMBAR SPINE WITH CONTRAST,72149,HCPCS,612,RC,,both,3906.56,3515.9,United Healthcare,Default,Fee Schedule,3187.75,,,,910,3187.75
MMRI CERVICAL SPINE WITH CONTRAST,72142,HCPCS,612,RC,,both,3906.56,3515.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2734.59,,,,910,3187.75
MMRI CERVICAL SPINE WITH CONTRAST,72142,HCPCS,612,RC,,both,3906.56,3515.9,Cigna,Default,Case Rate,910,,,,910,3187.75
MMRI CERVICAL SPINE WITH CONTRAST,72142,HCPCS,612,RC,,both,3906.56,3515.9,United Healthcare,Default,Fee Schedule,3187.75,,,,910,3187.75
MMRI BRAIN W/O CONTRAST,70551,HCPCS,611,RC,,both,3117.83,2806.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2182.48,,,,910,2544.15
MMRI BRAIN W/O CONTRAST,70551,HCPCS,611,RC,,both,3117.83,2806.05,Cigna,Default,Case Rate,910,,,,910,2544.15
MMRI BRAIN W/O CONTRAST,70551,HCPCS,611,RC,,both,3117.83,2806.05,United Healthcare,Default,Fee Schedule,2544.15,,,,910,2544.15
MMRI BRAIN WITH AND WITHOUT CONTRAST,70553,HCPCS,611,RC,,both,4016.67,3615,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2811.67,,,,910,3277.6
MMRI BRAIN WITH AND WITHOUT CONTRAST,70553,HCPCS,611,RC,,both,4016.67,3615,Cigna,Default,Case Rate,910,,,,910,3277.6
MMRI BRAIN WITH AND WITHOUT CONTRAST,70553,HCPCS,611,RC,,both,4016.67,3615,United Healthcare,Default,Fee Schedule,3277.6,,,,910,3277.6
MMRI LOCALIZIN BIOPSY,76393,HCPCS,610,RC,,both,942,847.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,659.4,,,,659.4,910
MMRI LOCALIZIN BIOPSY,76393,HCPCS,610,RC,,both,942,847.8,Cigna,Default,Case Rate,910,,,,659.4,910
MMRI LOCALIZIN BIOPSY,76393,HCPCS,610,RC,,both,942,847.8,United Healthcare,Default,Fee Schedule,768.67,,,,659.4,910
MMRI ORBIT / FACE / NECK W/O CONTRAST,70540,HCPCS,614,RC,,both,3453.74,3108.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2417.62,,,,910,2818.25
MMRI ORBIT / FACE / NECK W/O CONTRAST,70540,HCPCS,614,RC,,both,3453.74,3108.37,Cigna,Default,Case Rate,910,,,,910,2818.25
MMRI ORBIT / FACE / NECK W/O CONTRAST,70540,HCPCS,614,RC,,both,3453.74,3108.37,United Healthcare,Default,Fee Schedule,2818.25,,,,910,2818.25
MMRI CERVICAL SPINE W/O CONTRAST,72141,HCPCS,612,RC,,both,3428.41,3085.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2399.89,,,,910,2797.58
MMRI CERVICAL SPINE W/O CONTRAST,72141,HCPCS,612,RC,,both,3428.41,3085.57,Cigna,Default,Case Rate,910,,,,910,2797.58
MMRI CERVICAL SPINE W/O CONTRAST,72141,HCPCS,612,RC,,both,3428.41,3085.57,United Healthcare,Default,Fee Schedule,2797.58,,,,910,2797.58
MMRI THORACIC SPINE W/O CONTRAST,72146,HCPCS,612,RC,,both,3428.41,3085.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2399.89,,,,910,2797.58
MMRI THORACIC SPINE W/O CONTRAST,72146,HCPCS,612,RC,,both,3428.41,3085.57,Cigna,Default,Case Rate,910,,,,910,2797.58
MMRI THORACIC SPINE W/O CONTRAST,72146,HCPCS,612,RC,,both,3428.41,3085.57,United Healthcare,Default,Fee Schedule,2797.58,,,,910,2797.58
MMRI LUMBAR SPINE W/O CONTRAST,72148,HCPCS,612,RC,,both,3428.41,3085.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2399.89,,,,910,2797.58
MMRI LUMBAR SPINE W/O CONTRAST,72148,HCPCS,612,RC,,both,3428.41,3085.57,Cigna,Default,Case Rate,910,,,,910,2797.58
MMRI LUMBAR SPINE W/O CONTRAST,72148,HCPCS,612,RC,,both,3428.41,3085.57,United Healthcare,Default,Fee Schedule,2797.58,,,,910,2797.58
MMRI CHEST W/O CONTRAST,71550,HCPCS,614,RC,,both,2668.05,2401.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1867.64,,,,910,2177.13
MMRI CHEST W/O CONTRAST,71550,HCPCS,614,RC,,both,2668.05,2401.25,Cigna,Default,Case Rate,910,,,,910,2177.13
MMRI CHEST W/O CONTRAST,71550,HCPCS,614,RC,,both,2668.05,2401.25,United Healthcare,Default,Fee Schedule,2177.13,,,,910,2177.13
MMRI ABDOMEN W/O CONTRAST,74181,HCPCS,614,RC,,both,3683.5,3315.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2578.45,,,,910,3005.74
MMRI ABDOMEN W/O CONTRAST,74181,HCPCS,614,RC,,both,3683.5,3315.15,Cigna,Default,Case Rate,910,,,,910,3005.74
MMRI ABDOMEN W/O CONTRAST,74181,HCPCS,614,RC,,both,3683.5,3315.15,United Healthcare,Default,Fee Schedule,3005.74,,,,910,3005.74
MMRI  HEAD & / OR NECK,70544,HCPCS,611,RC,,both,2273.25,2045.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1591.28,,,,910,1854.97
MMRI  HEAD & / OR NECK,70544,HCPCS,611,RC,,both,2273.25,2045.93,Cigna,Default,Case Rate,910,,,,910,1854.97
MMRI  HEAD & / OR NECK,70544,HCPCS,611,RC,,both,2273.25,2045.93,United Healthcare,Default,Fee Schedule,1854.97,,,,910,1854.97
MMRI PELVIS W/O CONTRAST,72195,HCPCS,614,RC,,both,3683.5,3315.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2578.45,,,,910,3005.74
MMRI PELVIS W/O CONTRAST,72195,HCPCS,614,RC,,both,3683.5,3315.15,Cigna,Default,Case Rate,910,,,,910,3005.74
MMRI PELVIS W/O CONTRAST,72195,HCPCS,614,RC,,both,3683.5,3315.15,United Healthcare,Default,Fee Schedule,3005.74,,,,910,3005.74
MMRI SPECIFY,76499,HCPCS,610,RC,,both,2032.5,1829.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1422.75,,,,910,1658.52
MMRI SPECIFY,76499,HCPCS,610,RC,,both,2032.5,1829.25,Cigna,Default,Case Rate,910,,,,910,1658.52
MMRI SPECIFY,76499,HCPCS,610,RC,,both,2032.5,1829.25,United Healthcare,Default,Fee Schedule,1658.52,,,,910,1658.52
MMRI ELBOW JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3583.87,3225.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2508.71,,,,910,2924.44
MMRI ELBOW JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3583.87,3225.48,Cigna,Default,Case Rate,910,,,,910,2924.44
MMRI ELBOW JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3583.87,3225.48,United Healthcare,Default,Fee Schedule,2924.44,,,,910,2924.44
MMRI ELBOW LEFT - W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3583.87,3225.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2508.71,,,,910,2924.44
MMRI ELBOW LEFT - W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3583.87,3225.48,Cigna,Default,Case Rate,910,,,,910,2924.44
MMRI ELBOW LEFT - W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3583.87,3225.48,United Healthcare,Default,Fee Schedule,2924.44,,,,910,2924.44
MMRI SHOULDER JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI SHOULDER JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI SHOULDER JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI SHOULDER JT LEFT W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI SHOULDER JT LEFT W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI SHOULDER JT LEFT W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI GREAT VESSELS,71550,HCPCS,610,RC,,both,4099.81,3689.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2869.87,,,,910,3345.44
MMRI GREAT VESSELS,71550,HCPCS,610,RC,,both,4099.81,3689.83,Cigna,Default,Case Rate,910,,,,910,3345.44
MMRI GREAT VESSELS,71550,HCPCS,610,RC,,both,4099.81,3689.83,United Healthcare,Default,Fee Schedule,3345.44,,,,910,3345.44
MMRI UPPER EXTREMITY LEFT - W/O CONTRAST,73218,HCPCS,614,RC,LT,both,3367.68,3030.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2357.38,,,,910,2748.03
MMRI UPPER EXTREMITY LEFT - W/O CONTRAST,73218,HCPCS,614,RC,LT,both,3367.68,3030.91,Cigna,Default,Case Rate,910,,,,910,2748.03
MMRI UPPER EXTREMITY LEFT - W/O CONTRAST,73218,HCPCS,614,RC,LT,both,3367.68,3030.91,United Healthcare,Default,Fee Schedule,2748.03,,,,910,2748.03
MMRI UPPER EXTREMITY RT W/O CONTRAST,73218,HCPCS,610,RC,RT,both,3468.71,3121.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2428.1,,,,910,2830.47
MMRI UPPER EXTREMITY RT W/O CONTRAST,73218,HCPCS,610,RC,RT,both,3468.71,3121.84,Cigna,Default,Case Rate,910,,,,910,2830.47
MMRI UPPER EXTREMITY RT W/O CONTRAST,73218,HCPCS,610,RC,RT,both,3468.71,3121.84,United Healthcare,Default,Fee Schedule,2830.47,,,,910,2830.47
MMRI UPPER EXTREMITY  RIGHT W/CONTRAST,73219,HCPCS,610,RC,RT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI UPPER EXTREMITY  RIGHT W/CONTRAST,73219,HCPCS,610,RC,RT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI UPPER EXTREMITY  RIGHT W/CONTRAST,73219,HCPCS,610,RC,RT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI CARDIAC,75552,HCPCS,610,RC,,both,2073,1865.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1451.1,,,,910,1691.57
MMRI CARDIAC,75552,HCPCS,610,RC,,both,2073,1865.7,Cigna,Default,Case Rate,910,,,,910,1691.57
MMRI CARDIAC,75552,HCPCS,610,RC,,both,2073,1865.7,United Healthcare,Default,Fee Schedule,1691.57,,,,910,1691.57
MMRI UPPER EXTREMITY LEFT - W/CONTRAST,73219,HCPCS,614,RC,LT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI UPPER EXTREMITY LEFT - W/CONTRAST,73219,HCPCS,614,RC,LT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI UPPER EXTREMITY LEFT - W/CONTRAST,73219,HCPCS,614,RC,LT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI KNEE RIGHT - W/O CONTRAST,73721,HCPCS,614,RC,RT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI KNEE RIGHT - W/O CONTRAST,73721,HCPCS,614,RC,RT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI KNEE RIGHT - W/O CONTRAST,73721,HCPCS,614,RC,RT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI KNEE LEFT - W/O CONTRAST,73721,HCPCS,614,RC,LT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI KNEE LEFT - W/O CONTRAST,73721,HCPCS,614,RC,LT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI KNEE LEFT - W/O CONTRAST,73721,HCPCS,614,RC,LT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI HIP JT LEFT - WITHOUT CONTRAST,73721,HCPCS,610,RC,LT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI HIP JT LEFT - WITHOUT CONTRAST,73721,HCPCS,610,RC,LT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI HIP JT LEFT - WITHOUT CONTRAST,73721,HCPCS,610,RC,LT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI HIP JT RIGHT W/O CONTRAST,73721,HCPCS,610,RC,RT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI HIP JT RIGHT W/O CONTRAST,73721,HCPCS,610,RC,RT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI HIP JT RIGHT W/O CONTRAST,73721,HCPCS,610,RC,RT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI SHOULDER LT W/CONTRAST,73222,HCPCS,610,RC,LT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI SHOULDER LT W/CONTRAST,73222,HCPCS,610,RC,LT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI SHOULDER LT W/CONTRAST,73222,HCPCS,610,RC,LT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI SHOULDER JT RIGHT W/CONTRAST,73222,HCPCS,610,RC,RT,both,3930.24,3537.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2751.17,,,,910,3207.08
MMRI SHOULDER JT RIGHT W/CONTRAST,73222,HCPCS,610,RC,RT,both,3930.24,3537.22,Cigna,Default,Case Rate,910,,,,910,3207.08
MMRI SHOULDER JT RIGHT W/CONTRAST,73222,HCPCS,610,RC,RT,both,3930.24,3537.22,United Healthcare,Default,Fee Schedule,3207.08,,,,910,3207.08
MMRI LOWER EXT RIGHT W/O CONTRAST,73718,HCPCS,614,RC,RT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI LOWER EXT RIGHT W/O CONTRAST,73718,HCPCS,614,RC,RT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI LOWER EXT RIGHT W/O CONTRAST,73718,HCPCS,614,RC,RT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI LOWER EXT RIGHT WITH CONTRAST,73719,HCPCS,614,RC,RT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI LOWER EXT RIGHT WITH CONTRAST,73719,HCPCS,614,RC,RT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI LOWER EXT RIGHT WITH CONTRAST,73719,HCPCS,614,RC,RT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI LOWER EXT RIGHT WO/W CONTRAST,73720,HCPCS,614,RC,RT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI LOWER EXT RIGHT WO/W CONTRAST,73720,HCPCS,614,RC,RT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI LOWER EXT RIGHT WO/W CONTRAST,73720,HCPCS,614,RC,RT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI LOWER EXT LEFT - WITHOUT CONTRAST,73718,HCPCS,614,RC,LT,both,3455.19,3109.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2418.63,,,,910,2819.44
MMRI LOWER EXT LEFT - WITHOUT CONTRAST,73718,HCPCS,614,RC,LT,both,3455.19,3109.67,Cigna,Default,Case Rate,910,,,,910,2819.44
MMRI LOWER EXT LEFT - WITHOUT CONTRAST,73718,HCPCS,614,RC,LT,both,3455.19,3109.67,United Healthcare,Default,Fee Schedule,2819.44,,,,910,2819.44
MMRI LOWER EXT LEFT - WITH CONTRAST,73719,HCPCS,614,RC,LT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI LOWER EXT LEFT - WITH CONTRAST,73719,HCPCS,614,RC,LT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI LOWER EXT LEFT - WITH CONTRAST,73719,HCPCS,614,RC,LT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI LOWER EXT LEFT WO / W CONTRAST,73720,HCPCS,614,RC,LT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI LOWER EXT LEFT WO / W CONTRAST,73720,HCPCS,614,RC,LT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI LOWER EXT LEFT WO / W CONTRAST,73720,HCPCS,614,RC,LT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI TESLASCAN,610,RC,,,,both,529,476.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,370.3,,,,370.3,529
MMRI TESLASCAN,610,RC,,,,both,529,476.1,Cigna,Default,Case Rate,529,,,,370.3,529
MMRI TESLASCAN,610,RC,,,,both,529,476.1,United Healthcare,Default,Fee Schedule,431.66,,,,370.3,529
MMRI BRAIN /+CONT,70553,HCPCS,611,RC,,both,2681.05,2412.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1876.74,,,,910,2187.74
MMRI BRAIN /+CONT,70553,HCPCS,611,RC,,both,2681.05,2412.95,Cigna,Default,Case Rate,910,,,,910,2187.74
MMRI BRAIN /+CONT,70553,HCPCS,611,RC,,both,2681.05,2412.95,United Healthcare,Default,Fee Schedule,2187.74,,,,910,2187.74
MMRI CONTRAST MEDIA,A9579,HCPCS,636,RC,,both,292.51,263.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,204.76,,,,172.58,238.69
MMRI CONTRAST MEDIA,A9579,HCPCS,636,RC,,both,292.51,263.26,Cigna,Default,Percent of Total Billed Charges,172.58,,,,172.58,238.69
MMRI CONTRAST MEDIA,A9579,HCPCS,636,RC,,both,292.51,263.26,United Healthcare,Default,Fee Schedule,238.69,,,,172.58,238.69
MMRI CONTRAST GADOLINIUM,A9579,HCPCS,636,RC,,both,12.38,11.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.67,,,,7.3,10.1
MMRI CONTRAST GADOLINIUM,A9579,HCPCS,636,RC,,both,12.38,11.14,Cigna,Default,Percent of Total Billed Charges,7.3,,,,7.3,10.1
MMRI CONTRAST GADOLINIUM,A9579,HCPCS,636,RC,,both,12.38,11.14,United Healthcare,Default,Fee Schedule,10.1,,,,7.3,10.1
MMRI BRAIN W/CONTRAST GADOLINIUM,70552,HCPCS,611,RC,,both,3679.6,3311.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2575.72,,,,910,3002.55
MMRI BRAIN W/CONTRAST GADOLINIUM,70552,HCPCS,611,RC,,both,3679.6,3311.64,Cigna,Default,Case Rate,910,,,,910,3002.55
MMRI BRAIN W/CONTRAST GADOLINIUM,70552,HCPCS,611,RC,,both,3679.6,3311.64,United Healthcare,Default,Fee Schedule,3002.55,,,,910,3002.55
MMRI ORBIT/FACE/NECK WITH CONTRAST,70542,HCPCS,614,RC,,both,3818.92,3437.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2673.24,,,,910,3116.24
MMRI ORBIT/FACE/NECK WITH CONTRAST,70542,HCPCS,614,RC,,both,3818.92,3437.03,Cigna,Default,Case Rate,910,,,,910,3116.24
MMRI ORBIT/FACE/NECK WITH CONTRAST,70542,HCPCS,614,RC,,both,3818.92,3437.03,United Healthcare,Default,Fee Schedule,3116.24,,,,910,3116.24
MMRI ORBIT/FACE/NECK W/O,70540,HCPCS,614,RC,,both,3453.74,3108.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2417.62,,,,910,2818.25
MMRI ORBIT/FACE/NECK W/O,70540,HCPCS,614,RC,,both,3453.74,3108.37,Cigna,Default,Case Rate,910,,,,910,2818.25
MMRI ORBIT/FACE/NECK W/O,70540,HCPCS,614,RC,,both,3453.74,3108.37,United Healthcare,Default,Fee Schedule,2818.25,,,,910,2818.25
MMRI ORBIT / FACE / NECK WO / W CONTRAST,70543,HCPCS,614,RC,,both,4155.99,3740.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2909.19,,,,910,3391.29
MMRI ORBIT / FACE / NECK WO / W CONTRAST,70543,HCPCS,614,RC,,both,4155.99,3740.39,Cigna,Default,Case Rate,910,,,,910,3391.29
MMRI ORBIT / FACE / NECK WO / W CONTRAST,70543,HCPCS,614,RC,,both,4155.99,3740.39,United Healthcare,Default,Fee Schedule,3391.29,,,,910,3391.29
MMRI CERVICAL SPINE WO / W CONTRAST,72156,HCPCS,612,RC,,both,4243.62,3819.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2970.53,,,,910,3462.79
MMRI CERVICAL SPINE WO / W CONTRAST,72156,HCPCS,612,RC,,both,4243.62,3819.26,Cigna,Default,Case Rate,910,,,,910,3462.79
MMRI CERVICAL SPINE WO / W CONTRAST,72156,HCPCS,612,RC,,both,4243.62,3819.26,United Healthcare,Default,Fee Schedule,3462.79,,,,910,3462.79
MMRI THORACIC SPINE WO/W CONTRAST,72157,HCPCS,612,RC,,both,4131.27,3718.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2891.89,,,,910,3371.12
MMRI THORACIC SPINE WO/W CONTRAST,72157,HCPCS,612,RC,,both,4131.27,3718.14,Cigna,Default,Case Rate,910,,,,910,3371.12
MMRI THORACIC SPINE WO/W CONTRAST,72157,HCPCS,612,RC,,both,4131.27,3718.14,United Healthcare,Default,Fee Schedule,3371.12,,,,910,3371.12
MMRI LUMBAR WO/W CONTRAST,72158,HCPCS,612,RC,,both,4243.62,3819.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2970.53,,,,910,3462.79
MMRI LUMBAR WO/W CONTRAST,72158,HCPCS,612,RC,,both,4243.62,3819.26,Cigna,Default,Case Rate,910,,,,910,3462.79
MMRI LUMBAR WO/W CONTRAST,72158,HCPCS,612,RC,,both,4243.62,3819.26,United Healthcare,Default,Fee Schedule,3462.79,,,,910,3462.79
MMRI CHEST WITH CONTRAST,71551,HCPCS,614,RC,,both,3423.87,3081.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2396.71,,,,910,2793.88
MMRI CHEST WITH CONTRAST,71551,HCPCS,614,RC,,both,3423.87,3081.48,Cigna,Default,Case Rate,910,,,,910,2793.88
MMRI CHEST WITH CONTRAST,71551,HCPCS,614,RC,,both,3423.87,3081.48,United Healthcare,Default,Fee Schedule,2793.88,,,,910,2793.88
MMRI CHEST WO / W CONTRAST,71552,HCPCS,614,RC,,both,3589.34,3230.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2512.54,,,,910,2928.9
MMRI CHEST WO / W CONTRAST,71552,HCPCS,614,RC,,both,3589.34,3230.41,Cigna,Default,Case Rate,910,,,,910,2928.9
MMRI CHEST WO / W CONTRAST,71552,HCPCS,614,RC,,both,3589.34,3230.41,United Healthcare,Default,Fee Schedule,2928.9,,,,910,2928.9
MMRI ABDOMEN WO/W CONTRAST,74183,HCPCS,610,RC,,both,4042.5,3638.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2829.75,,,,910,3298.68
MMRI ABDOMEN WO/W CONTRAST,74183,HCPCS,610,RC,,both,4042.5,3638.25,Cigna,Default,Case Rate,910,,,,910,3298.68
MMRI ABDOMEN WO/W CONTRAST,74183,HCPCS,610,RC,,both,4042.5,3638.25,United Healthcare,Default,Fee Schedule,3298.68,,,,910,3298.68
MMRI ABDOMEN WITH CONTRAST,74182,HCPCS,614,RC,,both,4206.83,3786.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2944.78,,,,910,3432.77
MMRI ABDOMEN WITH CONTRAST,74182,HCPCS,614,RC,,both,4206.83,3786.15,Cigna,Default,Case Rate,910,,,,910,3432.77
MMRI ABDOMEN WITH CONTRAST,74182,HCPCS,614,RC,,both,4206.83,3786.15,United Healthcare,Default,Fee Schedule,3432.77,,,,910,3432.77
MMRI PELVIS WITH CONTRAST,72196,HCPCS,614,RC,,both,4144.14,3729.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2900.9,,,,910,3381.62
MMRI PELVIS WITH CONTRAST,72196,HCPCS,614,RC,,both,4144.14,3729.73,Cigna,Default,Case Rate,910,,,,910,3381.62
MMRI PELVIS WITH CONTRAST,72196,HCPCS,614,RC,,both,4144.14,3729.73,United Healthcare,Default,Fee Schedule,3381.62,,,,910,3381.62
MMRI PELVIS WO / W CONTRAST,72197,HCPCS,614,RC,,both,4489.63,4040.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3142.74,,,,910,3663.54
MMRI PELVIS WO / W CONTRAST,72197,HCPCS,614,RC,,both,4489.63,4040.67,Cigna,Default,Case Rate,910,,,,910,3663.54
MMRI PELVIS WO / W CONTRAST,72197,HCPCS,614,RC,,both,4489.63,4040.67,United Healthcare,Default,Fee Schedule,3663.54,,,,910,3663.54
MMRI SPECIFY F/U,76499,HCPCS,610,RC,,both,1016.75,915.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,711.72,,,,711.72,910
MMRI SPECIFY F/U,76499,HCPCS,610,RC,,both,1016.75,915.08,Cigna,Default,Case Rate,910,,,,711.72,910
MMRI SPECIFY F/U,76499,HCPCS,610,RC,,both,1016.75,915.08,United Healthcare,Default,Fee Schedule,829.67,,,,711.72,910
MMRI SHOULDER JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,4275.72,3848.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2993,,,,910,3488.99
MMRI SHOULDER JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,4275.72,3848.15,Cigna,Default,Case Rate,910,,,,910,3488.99
MMRI SHOULDER JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,4275.72,3848.15,United Healthcare,Default,Fee Schedule,3488.99,,,,910,3488.99
MMRI SHOULDER JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,4275.72,3848.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2993,,,,910,3488.99
MMRI SHOULDER JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,4275.72,3848.15,Cigna,Default,Case Rate,910,,,,910,3488.99
MMRI SHOULDER JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,4275.72,3848.15,United Healthcare,Default,Fee Schedule,3488.99,,,,910,3488.99
MMRI ELBOW JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI ELBOW JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI ELBOW JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI ELBOW JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,3929.36,3536.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2750.55,,,,910,3206.36
MMRI ELBOW JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,3929.36,3536.42,Cigna,Default,Case Rate,910,,,,910,3206.36
MMRI ELBOW JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,3929.36,3536.42,United Healthcare,Default,Fee Schedule,3206.36,,,,910,3206.36
MMRI GREAT VESSELS WO / W CONTRAST,71550,HCPCS,610,RC,,both,4790.78,4311.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3353.55,,,,910,3909.28
MMRI GREAT VESSELS WO / W CONTRAST,71550,HCPCS,610,RC,,both,4790.78,4311.7,Cigna,Default,Case Rate,910,,,,910,3909.28
MMRI GREAT VESSELS WO / W CONTRAST,71550,HCPCS,610,RC,,both,4790.78,4311.7,United Healthcare,Default,Fee Schedule,3909.28,,,,910,3909.28
MMRI CARDIAC W/CONT,75553,HCPCS,610,RC,,both,2573,2315.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1801.1,,,,910,2099.57
MMRI CARDIAC W/CONT,75553,HCPCS,610,RC,,both,2573,2315.7,Cigna,Default,Case Rate,910,,,,910,2099.57
MMRI CARDIAC W/CONT,75553,HCPCS,610,RC,,both,2573,2315.7,United Healthcare,Default,Fee Schedule,2099.57,,,,910,2099.57
MMRI UPPER EXTREMITY RIGHT WO/W CONTRAST,73220,HCPCS,614,RC,RT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI UPPER EXTREMITY RIGHT WO/W CONTRAST,73220,HCPCS,614,RC,RT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI UPPER EXTREMITY RIGHT WO/W CONTRAST,73220,HCPCS,614,RC,RT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI UPPER EXTREMITY LEFT WO/W CONTRAST,73220,HCPCS,610,RC,LT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI UPPER EXTREMITY LEFT WO/W CONTRAST,73220,HCPCS,610,RC,LT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI UPPER EXTREMITY LEFT WO/W CONTRAST,73220,HCPCS,610,RC,LT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI KNEE LEFT WO / W CONTRAST,73723,HCPCS,614,RC,LT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI KNEE LEFT WO / W CONTRAST,73723,HCPCS,614,RC,LT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI KNEE LEFT WO / W CONTRAST,73723,HCPCS,614,RC,LT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI KNEE RIGHT WO / W CONTRAST,73723,HCPCS,614,RC,RT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI KNEE RIGHT WO / W CONTRAST,73723,HCPCS,614,RC,RT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI KNEE RIGHT WO / W CONTRAST,73723,HCPCS,614,RC,RT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI KNEE RIGHT W/CONTRAST,73722,HCPCS,614,RC,RT,both,3833.53,3450.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2683.47,,,,910,3128.16
MMRI KNEE RIGHT W/CONTRAST,73722,HCPCS,614,RC,RT,both,3833.53,3450.18,Cigna,Default,Case Rate,910,,,,910,3128.16
MMRI KNEE RIGHT W/CONTRAST,73722,HCPCS,614,RC,RT,both,3833.53,3450.18,United Healthcare,Default,Fee Schedule,3128.16,,,,910,3128.16
MMRI KNEE LEFT W/CONTRAST,73722,HCPCS,614,RC,LT,both,3833.53,3450.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2683.47,,,,910,3128.16
MMRI KNEE LEFT W/CONTRAST,73722,HCPCS,614,RC,LT,both,3833.53,3450.18,Cigna,Default,Case Rate,910,,,,910,3128.16
MMRI KNEE LEFT W/CONTRAST,73722,HCPCS,614,RC,LT,both,3833.53,3450.18,United Healthcare,Default,Fee Schedule,3128.16,,,,910,3128.16
MMRI HIP JT RIGHT WO/W CONTRAST,73723,HCPCS,610,RC,RT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI HIP JT RIGHT WO/W CONTRAST,73723,HCPCS,610,RC,RT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI HIP JT RIGHT WO/W CONTRAST,73723,HCPCS,610,RC,RT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI HIP JT LEFT WO/W CONTRAST,73723,HCPCS,610,RC,LT,both,4274.85,3847.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2992.4,,,,910,3488.28
MMRI HIP JT LEFT WO/W CONTRAST,73723,HCPCS,610,RC,LT,both,4274.85,3847.37,Cigna,Default,Case Rate,910,,,,910,3488.28
MMRI HIP JT LEFT WO/W CONTRAST,73723,HCPCS,610,RC,LT,both,4274.85,3847.37,United Healthcare,Default,Fee Schedule,3488.28,,,,910,3488.28
MMRI HIP JT RIGHT W/CONTRAST,73722,HCPCS,610,RC,RT,both,3833.53,3450.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2683.47,,,,910,3128.16
MMRI HIP JT RIGHT W/CONTRAST,73722,HCPCS,610,RC,RT,both,3833.53,3450.18,Cigna,Default,Case Rate,910,,,,910,3128.16
MMRI HIP JT RIGHT W/CONTRAST,73722,HCPCS,610,RC,RT,both,3833.53,3450.18,United Healthcare,Default,Fee Schedule,3128.16,,,,910,3128.16
MMRI HIP JT LEFT W/CONTRAST,73722,HCPCS,610,RC,LT,both,1716.22,1544.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1201.35,,,,910,1400.44
MMRI HIP JT LEFT W/CONTRAST,73722,HCPCS,610,RC,LT,both,1716.22,1544.6,Cigna,Default,Case Rate,910,,,,910,1400.44
MMRI HIP JT LEFT W/CONTRAST,73722,HCPCS,610,RC,LT,both,1716.22,1544.6,United Healthcare,Default,Fee Schedule,1400.44,,,,910,1400.44
BASIC METABOLIC PANEL POINT OF CARE,80048,HCPCS,301,RC,,both,126.81,114.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.77,,,,74.82,103.48
BASIC METABOLIC PANEL POINT OF CARE,80048,HCPCS,301,RC,,both,126.81,114.13,Cigna,Default,Percent of Total Billed Charges,74.82,,,,74.82,103.48
BASIC METABOLIC PANEL POINT OF CARE,80048,HCPCS,301,RC,,both,126.81,114.13,United Healthcare,Default,Fee Schedule,103.48,,,,74.82,103.48
COMP METABOLIC PANEL POINT OF CARE,80053,HCPCS,301,RC,,both,183.42,165.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.39,,,,108.22,149.67
COMP METABOLIC PANEL POINT OF CARE,80053,HCPCS,301,RC,,both,183.42,165.08,Cigna,Default,Percent of Total Billed Charges,108.22,,,,108.22,149.67
COMP METABOLIC PANEL POINT OF CARE,80053,HCPCS,301,RC,,both,183.42,165.08,United Healthcare,Default,Fee Schedule,149.67,,,,108.22,149.67
AMYLASE POINT OF CARE,82150,HCPCS,301,RC,,both,211.3,190.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.91,,,,124.67,172.42
AMYLASE POINT OF CARE,82150,HCPCS,301,RC,,both,211.3,190.17,Cigna,Default,Percent of Total Billed Charges,124.67,,,,124.67,172.42
AMYLASE POINT OF CARE,82150,HCPCS,301,RC,,both,211.3,190.17,United Healthcare,Default,Fee Schedule,172.42,,,,124.67,172.42
CK POINT OF CARE,82550,HCPCS,301,RC,,both,82.88,74.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.02,,,,48.9,67.63
CK POINT OF CARE,82550,HCPCS,301,RC,,both,82.88,74.59,Cigna,Default,Percent of Total Billed Charges,48.9,,,,48.9,67.63
CK POINT OF CARE,82550,HCPCS,301,RC,,both,82.88,74.59,United Healthcare,Default,Fee Schedule,67.63,,,,48.9,67.63
BACK UP CBC,85025,HCPCS,300,RC,,both,62.91,56.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.04,,,,37.12,51.33
BACK UP CBC,85025,HCPCS,300,RC,,both,62.91,56.62,Cigna,Default,Percent of Total Billed Charges,37.12,,,,37.12,51.33
BACK UP CBC,85025,HCPCS,300,RC,,both,62.91,56.62,United Healthcare,Default,Fee Schedule,51.33,,,,37.12,51.33
CK-MB POINT OF CARE,82553,HCPCS,301,RC,,both,114.04,102.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.83,,,,67.28,93.06
CK-MB POINT OF CARE,82553,HCPCS,301,RC,,both,114.04,102.64,Cigna,Default,Percent of Total Billed Charges,67.28,,,,67.28,93.06
CK-MB POINT OF CARE,82553,HCPCS,301,RC,,both,114.04,102.64,United Healthcare,Default,Fee Schedule,93.06,,,,67.28,93.06
TROPONIN POINT OF CARE,84484,HCPCS,301,RC,,both,172.31,155.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.62,,,,101.66,140.6
TROPONIN POINT OF CARE,84484,HCPCS,301,RC,,both,172.31,155.08,Cigna,Default,Percent of Total Billed Charges,101.66,,,,101.66,140.6
TROPONIN POINT OF CARE,84484,HCPCS,301,RC,,both,172.31,155.08,United Healthcare,Default,Fee Schedule,140.6,,,,101.66,140.6
MYOGLOBIN POINT OF CARE,83874,HCPCS,301,RC,,both,155.96,140.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.17,,,,92.02,127.26
MYOGLOBIN POINT OF CARE,83874,HCPCS,301,RC,,both,155.96,140.36,Cigna,Default,Percent of Total Billed Charges,92.02,,,,92.02,127.26
MYOGLOBIN POINT OF CARE,83874,HCPCS,301,RC,,both,155.96,140.36,United Healthcare,Default,Fee Schedule,127.26,,,,92.02,127.26
ORG ID REF LAB,87077,HCPCS,300,RC,,both,70.78,63.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.55,,,,41.76,57.76
ORG ID REF LAB,87077,HCPCS,300,RC,,both,70.78,63.7,Cigna,Default,Percent of Total Billed Charges,41.76,,,,41.76,57.76
ORG ID REF LAB,87077,HCPCS,300,RC,,both,70.78,63.7,United Healthcare,Default,Fee Schedule,57.76,,,,41.76,57.76
URIC ACID POINT OF CARE,84550,HCPCS,301,RC,,both,57.37,51.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.16,,,,33.85,46.81
URIC ACID POINT OF CARE,84550,HCPCS,301,RC,,both,57.37,51.63,Cigna,Default,Percent of Total Billed Charges,33.85,,,,33.85,46.81
URIC ACID POINT OF CARE,84550,HCPCS,301,RC,,both,57.37,51.63,United Healthcare,Default,Fee Schedule,46.81,,,,33.85,46.81
ELECTROLYTE PANEL,80051,HCPCS,301,RC,,both,79.78,71.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.85,,,,47.07,65.1
ELECTROLYTE PANEL,80051,HCPCS,301,RC,,both,79.78,71.8,Cigna,Default,Percent of Total Billed Charges,47.07,,,,47.07,65.1
ELECTROLYTE PANEL,80051,HCPCS,301,RC,,both,79.78,71.8,United Healthcare,Default,Fee Schedule,65.1,,,,47.07,65.1
HEPATIC PANEL,80076,HCPCS,301,RC,,both,128.24,115.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.77,,,,75.66,104.64
HEPATIC PANEL,80076,HCPCS,301,RC,,both,128.24,115.42,Cigna,Default,Percent of Total Billed Charges,75.66,,,,75.66,104.64
HEPATIC PANEL,80076,HCPCS,301,RC,,both,128.24,115.42,United Healthcare,Default,Fee Schedule,104.64,,,,75.66,104.64
EMPLOYEE CBC,85025,HCPCS,300,RC,,both,179.94,161.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.96,,,,106.16,146.83
EMPLOYEE CBC,85025,HCPCS,300,RC,,both,179.94,161.95,Cigna,Default,Percent of Total Billed Charges,106.16,,,,106.16,146.83
EMPLOYEE CBC,85025,HCPCS,300,RC,,both,179.94,161.95,United Healthcare,Default,Fee Schedule,146.83,,,,106.16,146.83
EMPLOYEE URINALYSIS,81003,HCPCS,300,RC,,both,5.61,5.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.93,,,,3.31,4.58
EMPLOYEE URINALYSIS,81003,HCPCS,300,RC,,both,5.61,5.05,Cigna,Default,Percent of Total Billed Charges,3.31,,,,3.31,4.58
EMPLOYEE URINALYSIS,81003,HCPCS,300,RC,,both,5.61,5.05,United Healthcare,Default,Fee Schedule,4.58,,,,3.31,4.58
EMPLOYEE NICOTINE SCREEN,80305,HCPCS,301,RC,,both,4.05,3.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.84,,,,2.39,3.3
EMPLOYEE NICOTINE SCREEN,80305,HCPCS,301,RC,,both,4.05,3.65,Cigna,Default,Percent of Total Billed Charges,2.39,,,,2.39,3.3
EMPLOYEE NICOTINE SCREEN,80305,HCPCS,301,RC,,both,4.05,3.65,United Healthcare,Default,Fee Schedule,3.3,,,,2.39,3.3
EMPLOYEE NICOTINE CONFIRM,80323,HCPCS,300,RC,,both,21.78,19.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.25,,,,12.85,17.77
EMPLOYEE NICOTINE CONFIRM,80323,HCPCS,300,RC,,both,21.78,19.6,Cigna,Default,Percent of Total Billed Charges,12.85,,,,12.85,17.77
EMPLOYEE NICOTINE CONFIRM,80323,HCPCS,300,RC,,both,21.78,19.6,United Healthcare,Default,Fee Schedule,17.77,,,,12.85,17.77
EMPLOYEE RUBELLA,86762,HCPCS,300,RC,,both,10.2,9.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.14,,,,6.02,8.32
EMPLOYEE RUBELLA,86762,HCPCS,300,RC,,both,10.2,9.18,Cigna,Default,Percent of Total Billed Charges,6.02,,,,6.02,8.32
EMPLOYEE RUBELLA,86762,HCPCS,300,RC,,both,10.2,9.18,United Healthcare,Default,Fee Schedule,8.32,,,,6.02,8.32
EMPLOYEE RUBEOLA,86765,HCPCS,300,RC,,both,20.93,18.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.65,,,,12.35,17.08
EMPLOYEE RUBEOLA,86765,HCPCS,300,RC,,both,20.93,18.84,Cigna,Default,Percent of Total Billed Charges,12.35,,,,12.35,17.08
EMPLOYEE RUBEOLA,86765,HCPCS,300,RC,,both,20.93,18.84,United Healthcare,Default,Fee Schedule,17.08,,,,12.35,17.08
EMPLOYEE MUMPS,86735,HCPCS,300,RC,,both,14.3,12.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.01,,,,8.44,11.67
EMPLOYEE MUMPS,86735,HCPCS,300,RC,,both,14.3,12.87,Cigna,Default,Percent of Total Billed Charges,8.44,,,,8.44,11.67
EMPLOYEE MUMPS,86735,HCPCS,300,RC,,both,14.3,12.87,United Healthcare,Default,Fee Schedule,11.67,,,,8.44,11.67
EMPLOYEE VARICELLA,86787,HCPCS,300,RC,,both,13.12,11.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.18,,,,7.74,10.71
EMPLOYEE VARICELLA,86787,HCPCS,300,RC,,both,13.12,11.81,Cigna,Default,Percent of Total Billed Charges,7.74,,,,7.74,10.71
EMPLOYEE VARICELLA,86787,HCPCS,300,RC,,both,13.12,11.81,United Healthcare,Default,Fee Schedule,10.71,,,,7.74,10.71
EMPLOYEE HEP B AB,86706,HCPCS,300,RC,,both,247.56,222.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.29,,,,146.06,202.01
EMPLOYEE HEP B AB,86706,HCPCS,300,RC,,both,247.56,222.8,Cigna,Default,Percent of Total Billed Charges,146.06,,,,146.06,202.01
EMPLOYEE HEP B AB,86706,HCPCS,300,RC,,both,247.56,222.8,United Healthcare,Default,Fee Schedule,202.01,,,,146.06,202.01
EMPLOYEE QUANTIFERON TB,86480,HCPCS,300,RC,,both,61.79,55.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.25,,,,36.46,50.42
EMPLOYEE QUANTIFERON TB,86480,HCPCS,300,RC,,both,61.79,55.61,Cigna,Default,Percent of Total Billed Charges,36.46,,,,36.46,50.42
EMPLOYEE QUANTIFERON TB,86480,HCPCS,300,RC,,both,61.79,55.61,United Healthcare,Default,Fee Schedule,50.42,,,,36.46,50.42
EMPLOYEE ALCOHOL,80320,HCPCS,301,RC,,both,21.34,19.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.94,,,,12.59,17.41
EMPLOYEE ALCOHOL,80320,HCPCS,301,RC,,both,21.34,19.21,Cigna,Default,Percent of Total Billed Charges,12.59,,,,12.59,17.41
EMPLOYEE ALCOHOL,80320,HCPCS,301,RC,,both,21.34,19.21,United Healthcare,Default,Fee Schedule,17.41,,,,12.59,17.41
EMPLOYEE HIV 1/2,87389,HCPCS,300,RC,,both,18.96,17.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.27,,,,11.19,15.47
EMPLOYEE HIV 1/2,87389,HCPCS,300,RC,,both,18.96,17.06,Cigna,Default,Percent of Total Billed Charges,11.19,,,,11.19,15.47
EMPLOYEE HIV 1/2,87389,HCPCS,300,RC,,both,18.96,17.06,United Healthcare,Default,Fee Schedule,15.47,,,,11.19,15.47
EMPLOYEE HEP B AG,87340,HCPCS,300,RC,,both,12.5,11.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.75,,,,7.38,10.2
EMPLOYEE HEP B AG,87340,HCPCS,300,RC,,both,12.5,11.25,Cigna,Default,Percent of Total Billed Charges,7.38,,,,7.38,10.2
EMPLOYEE HEP B AG,87340,HCPCS,300,RC,,both,12.5,11.25,United Healthcare,Default,Fee Schedule,10.2,,,,7.38,10.2
EMPLOYEE HEP C AB,86803,HCPCS,300,RC,,both,13.57,12.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.5,,,,8.01,11.07
EMPLOYEE HEP C AB,86803,HCPCS,300,RC,,both,13.57,12.21,Cigna,Default,Percent of Total Billed Charges,8.01,,,,8.01,11.07
EMPLOYEE HEP C AB,86803,HCPCS,300,RC,,both,13.57,12.21,United Healthcare,Default,Fee Schedule,11.07,,,,8.01,11.07
ALBUMIN SERUM,82040,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
ALBUMIN SERUM,82040,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
ALBUMIN SERUM,82040,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
ALBUMIN REFERRED,82040,HCPCS,301,RC,,both,12,10.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.4,,,,7.08,9.79
ALBUMIN REFERRED,82040,HCPCS,301,RC,,both,12,10.8,Cigna,Default,Percent of Total Billed Charges,7.08,,,,7.08,9.79
ALBUMIN REFERRED,82040,HCPCS,301,RC,,both,12,10.8,United Healthcare,Default,Fee Schedule,9.79,,,,7.08,9.79
"ALBUMIN URINE, OR OTHER SOURCES",82042,HCPCS,301,RC,,both,20.2,18.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.14,,,,11.92,16.48
"ALBUMIN URINE, OR OTHER SOURCES",82042,HCPCS,301,RC,,both,20.2,18.18,Cigna,Default,Percent of Total Billed Charges,11.92,,,,11.92,16.48
"ALBUMIN URINE, OR OTHER SOURCES",82042,HCPCS,301,RC,,both,20.2,18.18,United Healthcare,Default,Fee Schedule,16.48,,,,11.92,16.48
COBALT BLOOD,83018,HCPCS,301,RC,,both,50.35,45.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.24,,,,29.71,41.09
COBALT BLOOD,83018,HCPCS,301,RC,,both,50.35,45.32,Cigna,Default,Percent of Total Billed Charges,29.71,,,,29.71,41.09
COBALT BLOOD,83018,HCPCS,301,RC,,both,50.35,45.32,United Healthcare,Default,Fee Schedule,41.09,,,,29.71,41.09
CHROMIUM SERUM,82495,HCPCS,301,RC,,both,35.96,32.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.17,,,,21.22,29.34
CHROMIUM SERUM,82495,HCPCS,301,RC,,both,35.96,32.36,Cigna,Default,Percent of Total Billed Charges,21.22,,,,21.22,29.34
CHROMIUM SERUM,82495,HCPCS,301,RC,,both,35.96,32.36,United Healthcare,Default,Fee Schedule,29.34,,,,21.22,29.34
IODINE URINE,83018,HCPCS,301,RC,,both,556.16,500.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,389.31,,,,328.13,453.83
IODINE URINE,83018,HCPCS,301,RC,,both,556.16,500.54,Cigna,Default,Percent of Total Billed Charges,328.13,,,,328.13,453.83
IODINE URINE,83018,HCPCS,301,RC,,both,556.16,500.54,United Healthcare,Default,Fee Schedule,453.83,,,,328.13,453.83
ARSENIC FRACTIONATED,82175,HCPCS,301,RC,,both,265.89,239.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.12,,,,156.88,216.97
ARSENIC FRACTIONATED,82175,HCPCS,301,RC,,both,265.89,239.3,Cigna,Default,Percent of Total Billed Charges,156.88,,,,156.88,216.97
ARSENIC FRACTIONATED,82175,HCPCS,301,RC,,both,265.89,239.3,United Healthcare,Default,Fee Schedule,216.97,,,,156.88,216.97
ARSENIC - QUANTITATIVE,82175,HCPCS,301,RC,,both,100.27,90.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.19,,,,59.16,81.82
ARSENIC - QUANTITATIVE,82175,HCPCS,301,RC,,both,100.27,90.24,Cigna,Default,Percent of Total Billed Charges,59.16,,,,59.16,81.82
ARSENIC - QUANTITATIVE,82175,HCPCS,301,RC,,both,100.27,90.24,United Healthcare,Default,Fee Schedule,81.82,,,,59.16,81.82
ATOMIC ABSORPTION SPECT. EA ANALYTE,82190,HCPCS,301,RC,,both,459.5,413.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,321.65,,,,271.1,374.95
ATOMIC ABSORPTION SPECT. EA ANALYTE,82190,HCPCS,301,RC,,both,459.5,413.55,Cigna,Default,Percent of Total Billed Charges,271.1,,,,271.1,374.95
ATOMIC ABSORPTION SPECT. EA ANALYTE,82190,HCPCS,301,RC,,both,459.5,413.55,United Healthcare,Default,Fee Schedule,374.95,,,,271.1,374.95
CADMIUM - BLOOD,82300,HCPCS,301,RC,,both,112.35,101.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.64,,,,66.29,91.68
CADMIUM - BLOOD,82300,HCPCS,301,RC,,both,112.35,101.12,Cigna,Default,Percent of Total Billed Charges,66.29,,,,66.29,91.68
CADMIUM - BLOOD,82300,HCPCS,301,RC,,both,112.35,101.12,United Healthcare,Default,Fee Schedule,91.68,,,,66.29,91.68
ALUMINUM - SERUM,82108,HCPCS,301,RC,,both,84.25,75.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.98,,,,49.71,68.75
ALUMINUM - SERUM,82108,HCPCS,301,RC,,both,84.25,75.83,Cigna,Default,Percent of Total Billed Charges,49.71,,,,49.71,68.75
ALUMINUM - SERUM,82108,HCPCS,301,RC,,both,84.25,75.83,United Healthcare,Default,Fee Schedule,68.75,,,,49.71,68.75
MUMPS AB IGM,86735,HCPCS,300,RC,,both,90.18,81.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.13,,,,53.21,73.59
MUMPS AB IGM,86735,HCPCS,300,RC,,both,90.18,81.16,Cigna,Default,Percent of Total Billed Charges,53.21,,,,53.21,73.59
MUMPS AB IGM,86735,HCPCS,300,RC,,both,90.18,81.16,United Healthcare,Default,Fee Schedule,73.59,,,,53.21,73.59
B-19 PARVOVIRUS IGG,86747,HCPCS,302,RC,,both,61.61,55.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.13,,,,36.35,50.27
B-19 PARVOVIRUS IGG,86747,HCPCS,302,RC,,both,61.61,55.45,Cigna,Default,Percent of Total Billed Charges,36.35,,,,36.35,50.27
B-19 PARVOVIRUS IGG,86747,HCPCS,302,RC,,both,61.61,55.45,United Healthcare,Default,Fee Schedule,50.27,,,,36.35,50.27
B-19 PARVOVIRUS IGM,86747,HCPCS,302,RC,,both,61.61,55.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.13,,,,36.35,50.27
B-19 PARVOVIRUS IGM,86747,HCPCS,302,RC,,both,61.61,55.45,Cigna,Default,Percent of Total Billed Charges,36.35,,,,36.35,50.27
B-19 PARVOVIRUS IGM,86747,HCPCS,302,RC,,both,61.61,55.45,United Healthcare,Default,Fee Schedule,50.27,,,,36.35,50.27
LIPOPROTEIN (LITTLE A),83695,HCPCS,301,RC,,both,66.01,59.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.21,,,,38.95,53.86
LIPOPROTEIN (LITTLE A),83695,HCPCS,301,RC,,both,66.01,59.41,Cigna,Default,Percent of Total Billed Charges,38.95,,,,38.95,53.86
LIPOPROTEIN (LITTLE A),83695,HCPCS,301,RC,,both,66.01,59.41,United Healthcare,Default,Fee Schedule,53.86,,,,38.95,53.86
AMYLASE SERUM,82150,HCPCS,301,RC,,both,211.3,190.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.91,,,,124.67,172.42
AMYLASE SERUM,82150,HCPCS,301,RC,,both,211.3,190.17,Cigna,Default,Percent of Total Billed Charges,124.67,,,,124.67,172.42
AMYLASE SERUM,82150,HCPCS,301,RC,,both,211.3,190.17,United Healthcare,Default,Fee Schedule,172.42,,,,124.67,172.42
AMYLASE BODY FLUID,82150,HCPCS,301,RC,,both,93.79,84.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.65,,,,55.34,76.53
AMYLASE BODY FLUID,82150,HCPCS,301,RC,,both,93.79,84.41,Cigna,Default,Percent of Total Billed Charges,55.34,,,,55.34,76.53
AMYLASE BODY FLUID,82150,HCPCS,301,RC,,both,93.79,84.41,United Healthcare,Default,Fee Schedule,76.53,,,,55.34,76.53
LIPASE-BODY FLUID,83690,HCPCS,301,RC,,both,103.6,93.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.52,,,,61.12,84.54
LIPASE-BODY FLUID,83690,HCPCS,301,RC,,both,103.6,93.24,Cigna,Default,Percent of Total Billed Charges,61.12,,,,61.12,84.54
LIPASE-BODY FLUID,83690,HCPCS,301,RC,,both,103.6,93.24,United Healthcare,Default,Fee Schedule,84.54,,,,61.12,84.54
UREA NITROGEN SERUM,84520,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
UREA NITROGEN SERUM,84520,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
UREA NITROGEN SERUM,84520,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
BLASTOMYCES AB-BY ID,86612,HCPCS,300,RC,,both,58.9,53.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.23,,,,34.75,48.06
BLASTOMYCES AB-BY ID,86612,HCPCS,300,RC,,both,58.9,53.01,Cigna,Default,Percent of Total Billed Charges,34.75,,,,34.75,48.06
BLASTOMYCES AB-BY ID,86612,HCPCS,300,RC,,both,58.9,53.01,United Healthcare,Default,Fee Schedule,48.06,,,,34.75,48.06
RENAL FAILURE INDICIES 5,84540,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
RENAL FAILURE INDICIES 5,84540,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
RENAL FAILURE INDICIES 5,84540,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
UREA NITROGEN URINE,84540,HCPCS,301,RC,,both,64.34,57.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.04,,,,37.96,52.5
UREA NITROGEN URINE,84540,HCPCS,301,RC,,both,64.34,57.91,Cigna,Default,Percent of Total Billed Charges,37.96,,,,37.96,52.5
UREA NITROGEN URINE,84540,HCPCS,301,RC,,both,64.34,57.91,United Healthcare,Default,Fee Schedule,52.5,,,,37.96,52.5
UREA NITROGEN 24 HR URINE,84540,HCPCS,301,RC,,both,64.34,57.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.04,,,,37.96,52.5
UREA NITROGEN 24 HR URINE,84540,HCPCS,301,RC,,both,64.34,57.91,Cigna,Default,Percent of Total Billed Charges,37.96,,,,37.96,52.5
UREA NITROGEN 24 HR URINE,84540,HCPCS,301,RC,,both,64.34,57.91,United Healthcare,Default,Fee Schedule,52.5,,,,37.96,52.5
AMYLASE URINE,82150,HCPCS,301,RC,,both,211.3,190.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.91,,,,124.67,172.42
AMYLASE URINE,82150,HCPCS,301,RC,,both,211.3,190.17,Cigna,Default,Percent of Total Billed Charges,124.67,,,,124.67,172.42
AMYLASE URINE,82150,HCPCS,301,RC,,both,211.3,190.17,United Healthcare,Default,Fee Schedule,172.42,,,,124.67,172.42
ANGIOTENSIN I - CONVERTING ENZYME (ACE),82164,HCPCS,301,RC,,both,81.17,73.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.82,,,,47.89,66.23
ANGIOTENSIN I - CONVERTING ENZYME (ACE),82164,HCPCS,301,RC,,both,81.17,73.05,Cigna,Default,Percent of Total Billed Charges,47.89,,,,47.89,66.23
ANGIOTENSIN I - CONVERTING ENZYME (ACE),82164,HCPCS,301,RC,,both,81.17,73.05,United Healthcare,Default,Fee Schedule,66.23,,,,47.89,66.23
TCO2 BICARBONATE,82374,HCPCS,301,RC,,both,34.9,31.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.43,,,,20.59,28.48
TCO2 BICARBONATE,82374,HCPCS,301,RC,,both,34.9,31.41,Cigna,Default,Percent of Total Billed Charges,20.59,,,,20.59,28.48
TCO2 BICARBONATE,82374,HCPCS,301,RC,,both,34.9,31.41,United Healthcare,Default,Fee Schedule,28.48,,,,20.59,28.48
BILIRUBIN TOTAL,82247,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
BILIRUBIN TOTAL,82247,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
BILIRUBIN TOTAL,82247,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
BILIRUBIN DIRECT,82248,HCPCS,301,RC,,both,48.95,44.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.26,,,,28.88,39.94
BILIRUBIN DIRECT,82248,HCPCS,301,RC,,both,48.95,44.06,Cigna,Default,Percent of Total Billed Charges,28.88,,,,28.88,39.94
BILIRUBIN DIRECT,82248,HCPCS,301,RC,,both,48.95,44.06,United Healthcare,Default,Fee Schedule,39.94,,,,28.88,39.94
CALCIUM-SERUM,82310,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
CALCIUM-SERUM,82310,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
CALCIUM-SERUM,82310,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
CHOLESTEROL TOTAL,82465,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
CHOLESTEROL TOTAL,82465,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
CHOLESTEROL TOTAL,82465,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
CK SERUM,82550,HCPCS,301,RC,,both,82.88,74.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.02,,,,48.9,67.63
CK SERUM,82550,HCPCS,301,RC,,both,82.88,74.59,Cigna,Default,Percent of Total Billed Charges,48.9,,,,48.9,67.63
CK SERUM,82550,HCPCS,301,RC,,both,82.88,74.59,United Healthcare,Default,Fee Schedule,67.63,,,,48.9,67.63
REFERRED CK,82550,HCPCS,301,RC,,both,82.88,74.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.02,,,,48.9,67.63
REFERRED CK,82550,HCPCS,301,RC,,both,82.88,74.59,Cigna,Default,Percent of Total Billed Charges,48.9,,,,48.9,67.63
REFERRED CK,82550,HCPCS,301,RC,,both,82.88,74.59,United Healthcare,Default,Fee Schedule,67.63,,,,48.9,67.63
CREATININE-SERUM,82565,HCPCS,301,RC,,both,54.96,49.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.47,,,,32.43,44.85
CREATININE-SERUM,82565,HCPCS,301,RC,,both,54.96,49.46,Cigna,Default,Percent of Total Billed Charges,32.43,,,,32.43,44.85
CREATININE-SERUM,82565,HCPCS,301,RC,,both,54.96,49.46,United Healthcare,Default,Fee Schedule,44.85,,,,32.43,44.85
CREATININE-BODY FLUI,82570,HCPCS,301,RC,,both,58.45,52.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.92,,,,34.49,47.7
CREATININE-BODY FLUI,82570,HCPCS,301,RC,,both,58.45,52.61,Cigna,Default,Percent of Total Billed Charges,34.49,,,,34.49,47.7
CREATININE-BODY FLUI,82570,HCPCS,301,RC,,both,58.45,52.61,United Healthcare,Default,Fee Schedule,47.7,,,,34.49,47.7
CREATININE-URINE,82570,HCPCS,301,RC,,both,58.45,52.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.92,,,,34.49,47.7
CREATININE-URINE,82570,HCPCS,301,RC,,both,58.45,52.61,Cigna,Default,Percent of Total Billed Charges,34.49,,,,34.49,47.7
CREATININE-URINE,82570,HCPCS,301,RC,,both,58.45,52.61,United Healthcare,Default,Fee Schedule,47.7,,,,34.49,47.7
CREATININE 24 HR URINE,82570,HCPCS,301,RC,,both,58.45,52.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.92,,,,34.49,47.7
CREATININE 24 HR URINE,82570,HCPCS,301,RC,,both,58.45,52.61,Cigna,Default,Percent of Total Billed Charges,34.49,,,,34.49,47.7
CREATININE 24 HR URINE,82570,HCPCS,301,RC,,both,58.45,52.61,United Healthcare,Default,Fee Schedule,47.7,,,,34.49,47.7
RENAL FAILURE INDICIES 4,82570,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
RENAL FAILURE INDICIES 4,82570,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
RENAL FAILURE INDICIES 4,82570,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
CREATININE CLEARANCE,82575,HCPCS,301,RC,,both,105.34,94.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.74,,,,62.15,85.96
CREATININE CLEARANCE,82575,HCPCS,301,RC,,both,105.34,94.81,Cigna,Default,Percent of Total Billed Charges,62.15,,,,62.15,85.96
CREATININE CLEARANCE,82575,HCPCS,301,RC,,both,105.34,94.81,United Healthcare,Default,Fee Schedule,85.96,,,,62.15,85.96
GLUCOSE,82947,HCPCS,301,RC,,both,45.8,41.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.06,,,,27.02,37.37
GLUCOSE,82947,HCPCS,301,RC,,both,45.8,41.22,Cigna,Default,Percent of Total Billed Charges,27.02,,,,27.02,37.37
GLUCOSE,82947,HCPCS,301,RC,,both,45.8,41.22,United Healthcare,Default,Fee Schedule,37.37,,,,27.02,37.37
GLUCOSE PRANDIAL,82950,HCPCS,301,RC,,both,38.25,34.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.78,,,,22.57,31.21
GLUCOSE PRANDIAL,82950,HCPCS,301,RC,,both,38.25,34.43,Cigna,Default,Percent of Total Billed Charges,22.57,,,,22.57,31.21
GLUCOSE PRANDIAL,82950,HCPCS,301,RC,,both,38.25,34.43,United Healthcare,Default,Fee Schedule,31.21,,,,22.57,31.21
RENAL FAILURE INDICIES 3,82945,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
RENAL FAILURE INDICIES 3,82945,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
RENAL FAILURE INDICIES 3,82945,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
GLUCOSE URINE,82945,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
GLUCOSE URINE,82945,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
GLUCOSE URINE,82945,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
GLUCOSE 24 HR URINE,82945,HCPCS,301,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
GLUCOSE 24 HR URINE,82945,HCPCS,301,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
GLUCOSE 24 HR URINE,82945,HCPCS,301,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
GLUCOSE BODY FLUID,82945,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
GLUCOSE BODY FLUID,82945,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
GLUCOSE BODY FLUID,82945,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
GLUCOSE TLRNCE (1ST 3 SPEC.),82951,HCPCS,301,RC,,both,128.65,115.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.06,,,,75.9,104.98
GLUCOSE TLRNCE (1ST 3 SPEC.),82951,HCPCS,301,RC,,both,128.65,115.79,Cigna,Default,Percent of Total Billed Charges,75.9,,,,75.9,104.98
GLUCOSE TLRNCE (1ST 3 SPEC.),82951,HCPCS,301,RC,,both,128.65,115.79,United Healthcare,Default,Fee Schedule,104.98,,,,75.9,104.98
GLUCOSE TOL SR HOUR 4,82952,HCPCS,301,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
GLUCOSE TOL SR HOUR 4,82952,HCPCS,301,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
GLUCOSE TOL SR HOUR 4,82952,HCPCS,301,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
GLUCOSE TOL SR HOUR 5,82952,HCPCS,301,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
GLUCOSE TOL SR HOUR 5,82952,HCPCS,301,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
GLUCOSE TOL SR HOUR 5,82952,HCPCS,301,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
"LACTIC ACID, ARTERIAL",83605,HCPCS,301,RC,,both,120.83,108.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.58,,,,71.29,98.6
"LACTIC ACID, ARTERIAL",83605,HCPCS,301,RC,,both,120.83,108.75,Cigna,Default,Percent of Total Billed Charges,71.29,,,,71.29,98.6
"LACTIC ACID, ARTERIAL",83605,HCPCS,301,RC,,both,120.83,108.75,United Healthcare,Default,Fee Schedule,98.6,,,,71.29,98.6
"LACTIC ACID, VENOUS",83605,HCPCS,301,RC,,both,97.45,87.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.22,,,,57.5,79.52
"LACTIC ACID, VENOUS",83605,HCPCS,301,RC,,both,97.45,87.71,Cigna,Default,Percent of Total Billed Charges,57.5,,,,57.5,79.52
"LACTIC ACID, VENOUS",83605,HCPCS,301,RC,,both,97.45,87.71,United Healthcare,Default,Fee Schedule,79.52,,,,57.5,79.52
LDH SERUM,83615,HCPCS,301,RC,,both,64.34,57.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.04,,,,37.96,52.5
LDH SERUM,83615,HCPCS,301,RC,,both,64.34,57.91,Cigna,Default,Percent of Total Billed Charges,37.96,,,,37.96,52.5
LDH SERUM,83615,HCPCS,301,RC,,both,64.34,57.91,United Healthcare,Default,Fee Schedule,52.5,,,,37.96,52.5
LDH BODY FLUID,83615,HCPCS,301,RC,,both,64.34,57.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.04,,,,37.96,52.5
LDH BODY FLUID,83615,HCPCS,301,RC,,both,64.34,57.91,Cigna,Default,Percent of Total Billed Charges,37.96,,,,37.96,52.5
LDH BODY FLUID,83615,HCPCS,301,RC,,both,64.34,57.91,United Healthcare,Default,Fee Schedule,52.5,,,,37.96,52.5
LACTOFERIN STOOL,83630,HCPCS,300,RC,,both,96.06,86.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.24,,,,56.68,78.38
LACTOFERIN STOOL,83630,HCPCS,300,RC,,both,96.06,86.45,Cigna,Default,Percent of Total Billed Charges,56.68,,,,56.68,78.38
LACTOFERIN STOOL,83630,HCPCS,300,RC,,both,96.06,86.45,United Healthcare,Default,Fee Schedule,78.38,,,,56.68,78.38
"VIRAL SMEAR, SHELL VIAL",87254,HCPCS,300,RC,,both,178.38,160.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.87,,,,105.24,145.56
"VIRAL SMEAR, SHELL VIAL",87254,HCPCS,300,RC,,both,178.38,160.54,Cigna,Default,Percent of Total Billed Charges,105.24,,,,105.24,145.56
"VIRAL SMEAR, SHELL VIAL",87254,HCPCS,300,RC,,both,178.38,160.54,United Healthcare,Default,Fee Schedule,145.56,,,,105.24,145.56
PHOSPHORUS URINE,84105,HCPCS,301,RC,,both,107.24,96.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.07,,,,63.27,87.51
PHOSPHORUS URINE,84105,HCPCS,301,RC,,both,107.24,96.52,Cigna,Default,Percent of Total Billed Charges,63.27,,,,63.27,87.51
PHOSPHORUS URINE,84105,HCPCS,301,RC,,both,107.24,96.52,United Healthcare,Default,Fee Schedule,87.51,,,,63.27,87.51
PHOSPHORUS SERUM,84100,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
PHOSPHORUS SERUM,84100,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
PHOSPHORUS SERUM,84100,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
PHOPHORUS 24 HR URINE,84105,HCPCS,301,RC,,both,50.16,45.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.11,,,,29.59,40.93
PHOPHORUS 24 HR URINE,84105,HCPCS,301,RC,,both,50.16,45.14,Cigna,Default,Percent of Total Billed Charges,29.59,,,,29.59,40.93
PHOPHORUS 24 HR URINE,84105,HCPCS,301,RC,,both,50.16,45.14,United Healthcare,Default,Fee Schedule,40.93,,,,29.59,40.93
POTASSIUM URINE,84133,HCPCS,301,RC,,both,53.29,47.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.3,,,,31.44,43.48
POTASSIUM URINE,84133,HCPCS,301,RC,,both,53.29,47.96,Cigna,Default,Percent of Total Billed Charges,31.44,,,,31.44,43.48
POTASSIUM URINE,84133,HCPCS,301,RC,,both,53.29,47.96,United Healthcare,Default,Fee Schedule,43.48,,,,31.44,43.48
POTASSIUM 24 HR URINE,84133,HCPCS,301,RC,,both,53.29,47.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.3,,,,31.44,43.48
POTASSIUM 24 HR URINE,84133,HCPCS,301,RC,,both,53.29,47.96,Cigna,Default,Percent of Total Billed Charges,31.44,,,,31.44,43.48
POTASSIUM 24 HR URINE,84133,HCPCS,301,RC,,both,53.29,47.96,United Healthcare,Default,Fee Schedule,43.48,,,,31.44,43.48
POTASSIUM BLOOD,84132,HCPCS,301,RC,,both,51.25,46.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.88,,,,30.24,41.82
POTASSIUM BLOOD,84132,HCPCS,301,RC,,both,51.25,46.13,Cigna,Default,Percent of Total Billed Charges,30.24,,,,30.24,41.82
POTASSIUM BLOOD,84132,HCPCS,301,RC,,both,51.25,46.13,United Healthcare,Default,Fee Schedule,41.82,,,,30.24,41.82
FULL ARTERIAL PROFILE 3,84132,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
FULL ARTERIAL PROFILE 3,84132,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
FULL ARTERIAL PROFILE 3,84132,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
PREALBUMIN,84134,HCPCS,301,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
PREALBUMIN,84134,HCPCS,301,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
PREALBUMIN,84134,HCPCS,301,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
POTASSIUM BLOOD GAS,84132,HCPCS,301,RC,,both,51.25,46.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.88,,,,30.24,41.82
POTASSIUM BLOOD GAS,84132,HCPCS,301,RC,,both,51.25,46.13,Cigna,Default,Percent of Total Billed Charges,30.24,,,,30.24,41.82
POTASSIUM BLOOD GAS,84132,HCPCS,301,RC,,both,51.25,46.13,United Healthcare,Default,Fee Schedule,41.82,,,,30.24,41.82
ANDROSTENDIONE,82157,HCPCS,300,RC,,both,130.25,117.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.18,,,,76.85,106.28
ANDROSTENDIONE,82157,HCPCS,300,RC,,both,130.25,117.23,Cigna,Default,Percent of Total Billed Charges,76.85,,,,76.85,106.28
ANDROSTENDIONE,82157,HCPCS,300,RC,,both,130.25,117.23,United Healthcare,Default,Fee Schedule,106.28,,,,76.85,106.28
"LYSOZYME, SERUM OR BODY FLUID",85549,HCPCS,300,RC,,both,59,53.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.3,,,,34.81,48.14
"LYSOZYME, SERUM OR BODY FLUID",85549,HCPCS,300,RC,,both,59,53.1,Cigna,Default,Percent of Total Billed Charges,34.81,,,,34.81,48.14
"LYSOZYME, SERUM OR BODY FLUID",85549,HCPCS,300,RC,,both,59,53.1,United Healthcare,Default,Fee Schedule,48.14,,,,34.81,48.14
OSMOLALITY SERUM MEASURED,83930,HCPCS,301,RC,,both,30.34,27.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.24,,,,17.9,24.76
OSMOLALITY SERUM MEASURED,83930,HCPCS,301,RC,,both,30.34,27.31,Cigna,Default,Percent of Total Billed Charges,17.9,,,,17.9,24.76
OSMOLALITY SERUM MEASURED,83930,HCPCS,301,RC,,both,30.34,27.31,United Healthcare,Default,Fee Schedule,24.76,,,,17.9,24.76
OSMOLALITY URINE MEASURED,83935,HCPCS,301,RC,,both,43.83,39.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.68,,,,25.86,35.77
OSMOLALITY URINE MEASURED,83935,HCPCS,301,RC,,both,43.83,39.45,Cigna,Default,Percent of Total Billed Charges,25.86,,,,25.86,35.77
OSMOLALITY URINE MEASURED,83935,HCPCS,301,RC,,both,43.83,39.45,United Healthcare,Default,Fee Schedule,35.77,,,,25.86,35.77
PH BODY FLUID,83986,HCPCS,301,RC,,both,57.58,51.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.31,,,,33.97,46.99
PH BODY FLUID,83986,HCPCS,301,RC,,both,57.58,51.82,Cigna,Default,Percent of Total Billed Charges,33.97,,,,33.97,46.99
PH BODY FLUID,83986,HCPCS,301,RC,,both,57.58,51.82,United Healthcare,Default,Fee Schedule,46.99,,,,33.97,46.99
NICKLE URINE 24 HOUR,83885,HCPCS,301,RC,,both,1168.86,1051.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,818.2,,,,689.63,953.79
NICKLE URINE 24 HOUR,83885,HCPCS,301,RC,,both,1168.86,1051.97,Cigna,Default,Percent of Total Billed Charges,689.63,,,,689.63,953.79
NICKLE URINE 24 HOUR,83885,HCPCS,301,RC,,both,1168.86,1051.97,United Healthcare,Default,Fee Schedule,953.79,,,,689.63,953.79
AST SERUM,84450,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
AST SERUM,84450,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
AST SERUM,84450,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
ALT SERUM,84460,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
ALT SERUM,84460,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
ALT SERUM,84460,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
ESTROGEN SERUM FRACTION,82671,HCPCS,301,RC,,both,207.01,186.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.91,,,,122.14,168.92
ESTROGEN SERUM FRACTION,82671,HCPCS,301,RC,,both,207.01,186.31,Cigna,Default,Percent of Total Billed Charges,122.14,,,,122.14,168.92
ESTROGEN SERUM FRACTION,82671,HCPCS,301,RC,,both,207.01,186.31,United Healthcare,Default,Fee Schedule,168.92,,,,122.14,168.92
GAMMA GT,82977,HCPCS,301,RC,,both,48.87,43.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.21,,,,28.83,39.88
GAMMA GT,82977,HCPCS,301,RC,,both,48.87,43.98,Cigna,Default,Percent of Total Billed Charges,28.83,,,,28.83,39.88
GAMMA GT,82977,HCPCS,301,RC,,both,48.87,43.98,United Healthcare,Default,Fee Schedule,39.88,,,,28.83,39.88
FULL ARTERIAL PROFILE 2,84295,HCPCS,301,RC,,both,43,38.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.1,,,,25.37,35.09
FULL ARTERIAL PROFILE 2,84295,HCPCS,301,RC,,both,43,38.7,Cigna,Default,Percent of Total Billed Charges,25.37,,,,25.37,35.09
FULL ARTERIAL PROFILE 2,84295,HCPCS,301,RC,,both,43,38.7,United Healthcare,Default,Fee Schedule,35.09,,,,25.37,35.09
SODIUM BLOOD,84295,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
SODIUM BLOOD,84295,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
SODIUM BLOOD,84295,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
SODIUM BF,84302,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
SODIUM BF,84302,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
SODIUM BF,84302,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
SODIUM BLOOD GAS,84295,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
SODIUM BLOOD GAS,84295,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
SODIUM BLOOD GAS,84295,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
COMPLEMENT TOTAL (CH50),86162,HCPCS,300,RC,,both,106.45,95.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.52,,,,62.81,86.86
COMPLEMENT TOTAL (CH50),86162,HCPCS,300,RC,,both,106.45,95.81,Cigna,Default,Percent of Total Billed Charges,62.81,,,,62.81,86.86
COMPLEMENT TOTAL (CH50),86162,HCPCS,300,RC,,both,106.45,95.81,United Healthcare,Default,Fee Schedule,86.86,,,,62.81,86.86
PROTEIN TOTAL,84155,HCPCS,301,RC,,both,98.16,88.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.71,,,,57.91,80.1
PROTEIN TOTAL,84155,HCPCS,301,RC,,both,98.16,88.34,Cigna,Default,Percent of Total Billed Charges,57.91,,,,57.91,80.1
PROTEIN TOTAL,84155,HCPCS,301,RC,,both,98.16,88.34,United Healthcare,Default,Fee Schedule,80.1,,,,57.91,80.1
TOTAL PROTEIN REF LAB,84155,HCPCS,301,RC,,both,45.8,41.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.06,,,,27.02,37.37
TOTAL PROTEIN REF LAB,84155,HCPCS,301,RC,,both,45.8,41.22,Cigna,Default,Percent of Total Billed Charges,27.02,,,,27.02,37.37
TOTAL PROTEIN REF LAB,84155,HCPCS,301,RC,,both,45.8,41.22,United Healthcare,Default,Fee Schedule,37.37,,,,27.02,37.37
URIC ACID SERUM,84550,HCPCS,301,RC,,both,57.37,51.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.16,,,,33.85,46.81
URIC ACID SERUM,84550,HCPCS,301,RC,,both,57.37,51.63,Cigna,Default,Percent of Total Billed Charges,33.85,,,,33.85,46.81
URIC ACID SERUM,84550,HCPCS,301,RC,,both,57.37,51.63,United Healthcare,Default,Fee Schedule,46.81,,,,33.85,46.81
URIC ACID BF/URINE,84560,HCPCS,301,RC,,both,48.43,43.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.9,,,,28.57,39.52
URIC ACID BF/URINE,84560,HCPCS,301,RC,,both,48.43,43.59,Cigna,Default,Percent of Total Billed Charges,28.57,,,,28.57,39.52
URIC ACID BF/URINE,84560,HCPCS,301,RC,,both,48.43,43.59,United Healthcare,Default,Fee Schedule,39.52,,,,28.57,39.52
URIC ACID 24 HR URINE,84560,HCPCS,301,RC,,both,48.43,43.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.9,,,,28.57,39.52
URIC ACID 24 HR URINE,84560,HCPCS,301,RC,,both,48.43,43.59,Cigna,Default,Percent of Total Billed Charges,28.57,,,,28.57,39.52
URIC ACID 24 HR URINE,84560,HCPCS,301,RC,,both,48.43,43.59,United Healthcare,Default,Fee Schedule,39.52,,,,28.57,39.52
BLEEDING TIME,85002,HCPCS,300,RC,,both,114.52,103.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.16,,,,67.57,93.45
BLEEDING TIME,85002,HCPCS,300,RC,,both,114.52,103.07,Cigna,Default,Percent of Total Billed Charges,67.57,,,,67.57,93.45
BLEEDING TIME,85002,HCPCS,300,RC,,both,114.52,103.07,United Healthcare,Default,Fee Schedule,93.45,,,,67.57,93.45
BETA-D-GLYCAN,87449,HCPCS,300,RC,,both,470.57,423.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,329.4,,,,277.64,383.99
BETA-D-GLYCAN,87449,HCPCS,300,RC,,both,470.57,423.51,Cigna,Default,Percent of Total Billed Charges,277.64,,,,277.64,383.99
BETA-D-GLYCAN,87449,HCPCS,300,RC,,both,470.57,423.51,United Healthcare,Default,Fee Schedule,383.99,,,,277.64,383.99
JAK2 EXON 12,81403,HCPCS,310,RC,,both,1186.46,1067.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,830.52,,,,700.01,968.15
JAK2 EXON 12,81403,HCPCS,310,RC,,both,1186.46,1067.81,Cigna,Default,Percent of Total Billed Charges,700.01,,,,700.01,968.15
JAK2 EXON 12,81403,HCPCS,310,RC,,both,1186.46,1067.81,United Healthcare,Default,Fee Schedule,968.15,,,,700.01,968.15
TPMT GENETICS,81401,HCPCS,310,RC,,both,1120.27,1008.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,784.19,,,,660.96,914.14
TPMT GENETICS,81401,HCPCS,310,RC,,both,1120.27,1008.24,Cigna,Default,Percent of Total Billed Charges,660.96,,,,660.96,914.14
TPMT GENETICS,81401,HCPCS,310,RC,,both,1120.27,1008.24,United Healthcare,Default,Fee Schedule,914.14,,,,660.96,914.14
KRAS VAREXON,81403,HCPCS,310,RC,,both,376.34,338.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.44,,,,222.04,307.09
KRAS VAREXON,81403,HCPCS,310,RC,,both,376.34,338.71,Cigna,Default,Percent of Total Billed Charges,222.04,,,,222.04,307.09
KRAS VAREXON,81403,HCPCS,310,RC,,both,376.34,338.71,United Healthcare,Default,Fee Schedule,307.09,,,,222.04,307.09
KRAS GENE ANALYSIS,81275,HCPCS,310,RC,,both,376.34,338.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.44,,,,222.04,307.09
KRAS GENE ANALYSIS,81275,HCPCS,310,RC,,both,376.34,338.71,Cigna,Default,Percent of Total Billed Charges,222.04,,,,222.04,307.09
KRAS GENE ANALYSIS,81275,HCPCS,310,RC,,both,376.34,338.71,United Healthcare,Default,Fee Schedule,307.09,,,,222.04,307.09
HEMOCHROMATOSIS HFE 3 MUTATIONS,81256,HCPCS,310,RC,,both,278.72,250.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.1,,,,164.44,227.44
HEMOCHROMATOSIS HFE 3 MUTATIONS,81256,HCPCS,310,RC,,both,278.72,250.85,Cigna,Default,Percent of Total Billed Charges,164.44,,,,164.44,227.44
HEMOCHROMATOSIS HFE 3 MUTATIONS,81256,HCPCS,310,RC,,both,278.72,250.85,United Healthcare,Default,Fee Schedule,227.44,,,,164.44,227.44
IBD SGI DIAGNOSTIC,81479,HCPCS,310,RC,,both,88.13,79.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.69,,,,52,71.91
IBD SGI DIAGNOSTIC,81479,HCPCS,310,RC,,both,88.13,79.32,Cigna,Default,Percent of Total Billed Charges,52,,,,52,71.91
IBD SGI DIAGNOSTIC,81479,HCPCS,310,RC,,both,88.13,79.32,United Healthcare,Default,Fee Schedule,71.91,,,,52,71.91
MTHFR,81291,HCPCS,310,RC,,both,270.38,243.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,189.27,,,,159.52,220.63
MTHFR,81291,HCPCS,310,RC,,both,270.38,243.34,Cigna,Default,Percent of Total Billed Charges,159.52,,,,159.52,220.63
MTHFR,81291,HCPCS,310,RC,,both,270.38,243.34,United Healthcare,Default,Fee Schedule,220.63,,,,159.52,220.63
PROTHROMBIN GENE MUTATION,81240,HCPCS,310,RC,,both,297.03,267.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.92,,,,175.25,242.38
PROTHROMBIN GENE MUTATION,81240,HCPCS,310,RC,,both,297.03,267.33,Cigna,Default,Percent of Total Billed Charges,175.25,,,,175.25,242.38
PROTHROMBIN GENE MUTATION,81240,HCPCS,310,RC,,both,297.03,267.33,United Healthcare,Default,Fee Schedule,242.38,,,,175.25,242.38
FACTOR V LEIDEN I,81241,HCPCS,310,RC,,both,251.67,226.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.17,,,,148.49,205.36
FACTOR V LEIDEN I,81241,HCPCS,310,RC,,both,251.67,226.5,Cigna,Default,Percent of Total Billed Charges,148.49,,,,148.49,205.36
FACTOR V LEIDEN I,81241,HCPCS,310,RC,,both,251.67,226.5,United Healthcare,Default,Fee Schedule,205.36,,,,148.49,205.36
JAK 2 GENE ANALYSIS,81270,HCPCS,310,RC,,both,421.32,379.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,294.92,,,,248.58,343.8
JAK 2 GENE ANALYSIS,81270,HCPCS,310,RC,,both,421.32,379.19,Cigna,Default,Percent of Total Billed Charges,248.58,,,,248.58,343.8
JAK 2 GENE ANALYSIS,81270,HCPCS,310,RC,,both,421.32,379.19,United Healthcare,Default,Fee Schedule,343.8,,,,248.58,343.8
CYTOGENETICS DNA PROBE FISH MDS,88271,HCPCS,311,RC,,both,295.62,266.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,206.93,,,,174.42,241.23
CYTOGENETICS DNA PROBE FISH MDS,88271,HCPCS,311,RC,,both,295.62,266.06,Cigna,Default,Percent of Total Billed Charges,174.42,,,,174.42,241.23
CYTOGENETICS DNA PROBE FISH MDS,88271,HCPCS,311,RC,,both,295.62,266.06,United Healthcare,Default,Fee Schedule,241.23,,,,174.42,241.23
MOLECULAR CYTOGENETICS DNA PROBE,88271,HCPCS,311,RC,,both,300.71,270.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.5,,,,177.42,245.38
MOLECULAR CYTOGENETICS DNA PROBE,88271,HCPCS,311,RC,,both,300.71,270.64,Cigna,Default,Percent of Total Billed Charges,177.42,,,,177.42,245.38
MOLECULAR CYTOGENETICS DNA PROBE,88271,HCPCS,311,RC,,both,300.71,270.64,United Healthcare,Default,Fee Schedule,245.38,,,,177.42,245.38
INSITU HYBRID MORPHOMETRIC MANUAL,88368,HCPCS,310,RC,,both,800.53,720.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,560.37,,,,472.31,653.23
INSITU HYBRID MORPHOMETRIC MANUAL,88368,HCPCS,310,RC,,both,800.53,720.48,Cigna,Default,Percent of Total Billed Charges,472.31,,,,472.31,653.23
INSITU HYBRID MORPHOMETRIC MANUAL,88368,HCPCS,310,RC,,both,800.53,720.48,United Healthcare,Default,Fee Schedule,653.23,,,,472.31,653.23
FACTOR VIII RELATED AG,85244,HCPCS,300,RC,,both,146.33,131.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.43,,,,86.33,119.41
FACTOR VIII RELATED AG,85244,HCPCS,300,RC,,both,146.33,131.7,Cigna,Default,Percent of Total Billed Charges,86.33,,,,86.33,119.41
FACTOR VIII RELATED AG,85244,HCPCS,300,RC,,both,146.33,131.7,United Healthcare,Default,Fee Schedule,119.41,,,,86.33,119.41
MOLECULAR CYTOGENETICS FISH 10-30,88273,HCPCS,311,RC,,both,173.6,156.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.52,,,,102.42,141.66
MOLECULAR CYTOGENETICS FISH 10-30,88273,HCPCS,311,RC,,both,173.6,156.24,Cigna,Default,Percent of Total Billed Charges,102.42,,,,102.42,141.66
MOLECULAR CYTOGENETICS FISH 10-30,88273,HCPCS,311,RC,,both,173.6,156.24,United Healthcare,Default,Fee Schedule,141.66,,,,102.42,141.66
INSITU HYBRID MORPHOMETRIC AUTO,88364,HCPCS,310,RC,,both,407,366.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,284.9,,,,240.13,332.11
INSITU HYBRID MORPHOMETRIC AUTO,88364,HCPCS,310,RC,,both,407,366.3,Cigna,Default,Percent of Total Billed Charges,240.13,,,,240.13,332.11
INSITU HYBRID MORPHOMETRIC AUTO,88364,HCPCS,310,RC,,both,407,366.3,United Healthcare,Default,Fee Schedule,332.11,,,,240.13,332.11
MICRODISSECTION NAMUAL,88381,HCPCS,310,RC,,both,67.4,60.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.18,,,,39.77,55
MICRODISSECTION NAMUAL,88381,HCPCS,310,RC,,both,67.4,60.66,Cigna,Default,Percent of Total Billed Charges,39.77,,,,39.77,55
MICRODISSECTION NAMUAL,88381,HCPCS,310,RC,,both,67.4,60.66,United Healthcare,Default,Fee Schedule,55,,,,39.77,55
ALK MORPHOMETRIC ANALYSIS,88368,HCPCS,310,RC,,both,742.42,668.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,519.69,,,,438.03,605.81
ALK MORPHOMETRIC ANALYSIS,88368,HCPCS,310,RC,,both,742.42,668.18,Cigna,Default,Percent of Total Billed Charges,438.03,,,,438.03,605.81
ALK MORPHOMETRIC ANALYSIS,88368,HCPCS,310,RC,,both,742.42,668.18,United Healthcare,Default,Fee Schedule,605.81,,,,438.03,605.81
EGFR GENE ANALYSIS,81235,HCPCS,310,RC,,both,613.59,552.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,429.51,,,,362.02,500.69
EGFR GENE ANALYSIS,81235,HCPCS,310,RC,,both,613.59,552.23,Cigna,Default,Percent of Total Billed Charges,362.02,,,,362.02,500.69
EGFR GENE ANALYSIS,81235,HCPCS,310,RC,,both,613.59,552.23,United Healthcare,Default,Fee Schedule,500.69,,,,362.02,500.69
MSI ANALYSIS,81301,HCPCS,310,RC,,both,516.82,465.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,361.77,,,,304.92,421.73
MSI ANALYSIS,81301,HCPCS,310,RC,,both,516.82,465.14,Cigna,Default,Percent of Total Billed Charges,304.92,,,,304.92,421.73
MSI ANALYSIS,81301,HCPCS,310,RC,,both,516.82,465.14,United Healthcare,Default,Fee Schedule,421.73,,,,304.92,421.73
DGP IGG,83516,HCPCS,300,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
DGP IGG,83516,HCPCS,300,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
DGP IGG,83516,HCPCS,300,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
BCR ABL BY PCR,81206,HCPCS,310,RC,,both,1268.13,1141.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,887.69,,,,748.2,1034.79
BCR ABL BY PCR,81206,HCPCS,310,RC,,both,1268.13,1141.32,Cigna,Default,Percent of Total Billed Charges,748.2,,,,748.2,1034.79
BCR ABL BY PCR,81206,HCPCS,310,RC,,both,1268.13,1141.32,United Healthcare,Default,Fee Schedule,1034.79,,,,748.2,1034.79
BRCA 1 AND 2,81162,HCPCS,310,RC,,both,6207.57,5586.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4345.3,,,,3662.47,5065.38
BRCA 1 AND 2,81162,HCPCS,310,RC,,both,6207.57,5586.81,Cigna,Default,Percent of Total Billed Charges,3662.47,,,,3662.47,5065.38
BRCA 1 AND 2,81162,HCPCS,310,RC,,both,6207.57,5586.81,United Healthcare,Default,Fee Schedule,5065.38,,,,3662.47,5065.38
ERYTHROPOIETIN,82668,HCPCS,301,RC,,both,115.45,103.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.82,,,,68.12,94.21
ERYTHROPOIETIN,82668,HCPCS,301,RC,,both,115.45,103.91,Cigna,Default,Percent of Total Billed Charges,68.12,,,,68.12,94.21
ERYTHROPOIETIN,82668,HCPCS,301,RC,,both,115.45,103.91,United Healthcare,Default,Fee Schedule,94.21,,,,68.12,94.21
MOLECULAR CYTO DNA PROBE-MAYO,88271,HCPCS,311,RC,,both,1981.18,1783.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1386.83,,,,1168.9,1616.64
MOLECULAR CYTO DNA PROBE-MAYO,88271,HCPCS,311,RC,,both,1981.18,1783.06,Cigna,Default,Percent of Total Billed Charges,1168.9,,,,1168.9,1616.64
MOLECULAR CYTO DNA PROBE-MAYO,88271,HCPCS,311,RC,,both,1981.18,1783.06,United Healthcare,Default,Fee Schedule,1616.64,,,,1168.9,1616.64
CYTO DNA PROBE BALLF,88271,HCPCS,311,RC,,both,512.66,461.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,358.86,,,,302.47,418.33
CYTO DNA PROBE BALLF,88271,HCPCS,311,RC,,both,512.66,461.39,Cigna,Default,Percent of Total Billed Charges,302.47,,,,302.47,418.33
CYTO DNA PROBE BALLF,88271,HCPCS,311,RC,,both,512.66,461.39,United Healthcare,Default,Fee Schedule,418.33,,,,302.47,418.33
HPV DNA IGH RISK TYPES,G0476,HCPCS,311,RC,,both,119.03,107.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.32,,,,70.23,97.13
HPV DNA IGH RISK TYPES,G0476,HCPCS,311,RC,,both,119.03,107.13,Cigna,Default,Percent of Total Billed Charges,70.23,,,,70.23,97.13
HPV DNA IGH RISK TYPES,G0476,HCPCS,311,RC,,both,119.03,107.13,United Healthcare,Default,Fee Schedule,97.13,,,,70.23,97.13
ARCHIVAL TISSUE MOLECULAR,88363,HCPCS,310,RC,,both,43.83,39.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.68,,,,25.86,35.77
ARCHIVAL TISSUE MOLECULAR,88363,HCPCS,310,RC,,both,43.83,39.45,Cigna,Default,Percent of Total Billed Charges,25.86,,,,25.86,35.77
ARCHIVAL TISSUE MOLECULAR,88363,HCPCS,310,RC,,both,43.83,39.45,United Healthcare,Default,Fee Schedule,35.77,,,,25.86,35.77
FISH PLASMA CELL MAYO,88271,HCPCS,311,RC,,both,803.33,723,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,562.33,,,,473.96,655.52
FISH PLASMA CELL MAYO,88271,HCPCS,311,RC,,both,803.33,723,Cigna,Default,Percent of Total Billed Charges,473.96,,,,473.96,655.52
FISH PLASMA CELL MAYO,88271,HCPCS,311,RC,,both,803.33,723,United Healthcare,Default,Fee Schedule,655.52,,,,473.96,655.52
VON WILLIBRAND FACTOR COLLAGEN BINDING A,85246,HCPCS,311,RC,,both,577.2,519.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,404.04,,,,340.55,471
VON WILLIBRAND FACTOR COLLAGEN BINDING A,85246,HCPCS,311,RC,,both,577.2,519.48,Cigna,Default,Percent of Total Billed Charges,340.55,,,,340.55,471
VON WILLIBRAND FACTOR COLLAGEN BINDING A,85246,HCPCS,311,RC,,both,577.2,519.48,United Healthcare,Default,Fee Schedule,471,,,,340.55,471
GBM GLOM BASEMENT MEMBRANE,83516,HCPCS,301,RC,,both,19.04,17.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.33,,,,11.23,15.54
GBM GLOM BASEMENT MEMBRANE,83516,HCPCS,301,RC,,both,19.04,17.14,Cigna,Default,Percent of Total Billed Charges,11.23,,,,11.23,15.54
GBM GLOM BASEMENT MEMBRANE,83516,HCPCS,301,RC,,both,19.04,17.14,United Healthcare,Default,Fee Schedule,15.54,,,,11.23,15.54
MISC MOL CYTO DNA PROBE,88271,HCPCS,311,RC,,both,71.6,64.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.12,,,,42.24,58.43
MISC MOL CYTO DNA PROBE,88271,HCPCS,311,RC,,both,71.6,64.44,Cigna,Default,Percent of Total Billed Charges,42.24,,,,42.24,58.43
MISC MOL CYTO DNA PROBE,88271,HCPCS,311,RC,,both,71.6,64.44,United Healthcare,Default,Fee Schedule,58.43,,,,42.24,58.43
EOSINOPHIL COUNT NASAL,89190,HCPCS,300,RC,,both,51.95,46.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.36,,,,30.65,42.39
EOSINOPHIL COUNT NASAL,89190,HCPCS,300,RC,,both,51.95,46.76,Cigna,Default,Percent of Total Billed Charges,30.65,,,,30.65,42.39
EOSINOPHIL COUNT NASAL,89190,HCPCS,300,RC,,both,51.95,46.76,United Healthcare,Default,Fee Schedule,42.39,,,,30.65,42.39
EOSINOPHILS URINE,81015,HCPCS,300,RC,,both,10.67,9.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.47,,,,6.3,8.71
EOSINOPHILS URINE,81015,HCPCS,300,RC,,both,10.67,9.6,Cigna,Default,Percent of Total Billed Charges,6.3,,,,6.3,8.71
EOSINOPHILS URINE,81015,HCPCS,300,RC,,both,10.67,9.6,United Healthcare,Default,Fee Schedule,8.71,,,,6.3,8.71
URINE MICROSCOPIC,81015,HCPCS,300,RC,,both,14.9,13.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.43,,,,8.79,12.16
URINE MICROSCOPIC,81015,HCPCS,300,RC,,both,14.9,13.41,Cigna,Default,Percent of Total Billed Charges,8.79,,,,8.79,12.16
URINE MICROSCOPIC,81015,HCPCS,300,RC,,both,14.9,13.41,United Healthcare,Default,Fee Schedule,12.16,,,,8.79,12.16
HEPARIN ANTI-XA,85520,HCPCS,300,RC,,both,75.56,68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.89,,,,44.58,61.66
HEPARIN ANTI-XA,85520,HCPCS,300,RC,,both,75.56,68,Cigna,Default,Percent of Total Billed Charges,44.58,,,,44.58,61.66
HEPARIN ANTI-XA,85520,HCPCS,300,RC,,both,75.56,68,United Healthcare,Default,Fee Schedule,61.66,,,,44.58,61.66
FIBRINOGEN,85384,HCPCS,300,RC,,both,125.28,112.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.7,,,,73.92,102.23
FIBRINOGEN,85384,HCPCS,300,RC,,both,125.28,112.75,Cigna,Default,Percent of Total Billed Charges,73.92,,,,73.92,102.23
FIBRINOGEN,85384,HCPCS,300,RC,,both,125.28,112.75,United Healthcare,Default,Fee Schedule,102.23,,,,73.92,102.23
FACTOR VWF GPIBM,85397,HCPCS,305,RC,,both,340.1,306.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,238.07,,,,200.66,277.52
FACTOR VWF GPIBM,85397,HCPCS,305,RC,,both,340.1,306.09,Cigna,Default,Percent of Total Billed Charges,200.66,,,,200.66,277.52
FACTOR VWF GPIBM,85397,HCPCS,305,RC,,both,340.1,306.09,United Healthcare,Default,Fee Schedule,277.52,,,,200.66,277.52
HEMATOCRIT X,85014,HCPCS,300,RC,,both,17.7,15.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.39,,,,10.44,14.44
HEMATOCRIT X,85014,HCPCS,300,RC,,both,17.7,15.93,Cigna,Default,Percent of Total Billed Charges,10.44,,,,10.44,14.44
HEMATOCRIT X,85014,HCPCS,300,RC,,both,17.7,15.93,United Healthcare,Default,Fee Schedule,14.44,,,,10.44,14.44
HEMOGLOBIN X,85018,HCPCS,300,RC,,both,35.99,32.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.19,,,,21.23,29.37
HEMOGLOBIN X,85018,HCPCS,300,RC,,both,35.99,32.39,Cigna,Default,Percent of Total Billed Charges,21.23,,,,21.23,29.37
HEMOGLOBIN X,85018,HCPCS,300,RC,,both,35.99,32.39,United Healthcare,Default,Fee Schedule,29.37,,,,21.23,29.37
HEMOGLOBIN - PLASMA,83051,HCPCS,300,RC,,both,102.25,92.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.58,,,,60.33,83.44
HEMOGLOBIN - PLASMA,83051,HCPCS,300,RC,,both,102.25,92.03,Cigna,Default,Percent of Total Billed Charges,60.33,,,,60.33,83.44
HEMOGLOBIN - PLASMA,83051,HCPCS,300,RC,,both,102.25,92.03,United Healthcare,Default,Fee Schedule,83.44,,,,60.33,83.44
HEMOGLOBIN BLOOD GAS,85018,HCPCS,300,RC,,both,35.99,32.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.19,,,,21.23,29.37
HEMOGLOBIN BLOOD GAS,85018,HCPCS,300,RC,,both,35.99,32.39,Cigna,Default,Percent of Total Billed Charges,21.23,,,,21.23,29.37
HEMOGLOBIN BLOOD GAS,85018,HCPCS,300,RC,,both,35.99,32.39,United Healthcare,Default,Fee Schedule,29.37,,,,21.23,29.37
WBC X,85048,HCPCS,300,RC,,both,26.69,24.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.68,,,,15.75,21.78
WBC X,85048,HCPCS,300,RC,,both,26.69,24.02,Cigna,Default,Percent of Total Billed Charges,15.75,,,,15.75,21.78
WBC X,85048,HCPCS,300,RC,,both,26.69,24.02,United Healthcare,Default,Fee Schedule,21.78,,,,15.75,21.78
LEUK ALKA PHOS(LAP),85540,HCPCS,300,RC,,both,52.5,47.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.75,,,,30.98,42.84
LEUK ALKA PHOS(LAP),85540,HCPCS,300,RC,,both,52.5,47.25,Cigna,Default,Percent of Total Billed Charges,30.98,,,,30.98,42.84
LEUK ALKA PHOS(LAP),85540,HCPCS,300,RC,,both,52.5,47.25,United Healthcare,Default,Fee Schedule,42.84,,,,30.98,42.84
PLATELET COUNT X,85049,HCPCS,300,RC,,both,30.06,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.74,24.53
PLATELET COUNT X,85049,HCPCS,300,RC,,both,30.06,27.05,Cigna,Default,Percent of Total Billed Charges,17.74,,,,17.74,24.53
PLATELET COUNT X,85049,HCPCS,300,RC,,both,30.06,27.05,United Healthcare,Default,Fee Schedule,24.53,,,,17.74,24.53
PLATELET COUNT-MAN,85032,HCPCS,300,RC,,both,70.89,63.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.62,,,,41.83,57.85
PLATELET COUNT-MAN,85032,HCPCS,300,RC,,both,70.89,63.8,Cigna,Default,Percent of Total Billed Charges,41.83,,,,41.83,57.85
PLATELET COUNT-MAN,85032,HCPCS,300,RC,,both,70.89,63.8,United Healthcare,Default,Fee Schedule,57.85,,,,41.83,57.85
WBC COUNT MANUAL,85032,HCPCS,305,RC,,both,46.25,41.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.38,,,,27.29,37.74
WBC COUNT MANUAL,85032,HCPCS,305,RC,,both,46.25,41.63,Cigna,Default,Percent of Total Billed Charges,27.29,,,,27.29,37.74
WBC COUNT MANUAL,85032,HCPCS,305,RC,,both,46.25,41.63,United Healthcare,Default,Fee Schedule,37.74,,,,27.29,37.74
PLASMA FROZEN WITHIN 24 HOURS,P9059,HCPCS,390,RC,,both,259.33,233.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,181.53,,,,153,211.61
PLASMA FROZEN WITHIN 24 HOURS,P9059,HCPCS,390,RC,,both,259.33,233.4,Cigna,Default,Percent of Total Billed Charges,153,,,,153,211.61
PLASMA FROZEN WITHIN 24 HOURS,P9059,HCPCS,390,RC,,both,259.33,233.4,United Healthcare,Default,Fee Schedule,211.61,,,,153,211.61
RENIN LEVEL,84244,HCPCS,301,RC,,both,113.75,102.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.62,,,,67.11,92.82
RENIN LEVEL,84244,HCPCS,301,RC,,both,113.75,102.38,Cigna,Default,Percent of Total Billed Charges,67.11,,,,67.11,92.82
RENIN LEVEL,84244,HCPCS,301,RC,,both,113.75,102.38,United Healthcare,Default,Fee Schedule,92.82,,,,67.11,92.82
SOLUBLE TRANSFERRIN RECEPTOR,84238,HCPCS,300,RC,,both,82.85,74.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58,,,,48.88,67.61
SOLUBLE TRANSFERRIN RECEPTOR,84238,HCPCS,300,RC,,both,82.85,74.57,Cigna,Default,Percent of Total Billed Charges,48.88,,,,48.88,67.61
SOLUBLE TRANSFERRIN RECEPTOR,84238,HCPCS,300,RC,,both,82.85,74.57,United Healthcare,Default,Fee Schedule,67.61,,,,48.88,67.61
HEXAGONAL PHASE PHOSPHOLIPID,85597,HCPCS,305,RC,,both,74.72,67.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.3,,,,44.08,60.97
HEXAGONAL PHASE PHOSPHOLIPID,85597,HCPCS,305,RC,,both,74.72,67.25,Cigna,Default,Percent of Total Billed Charges,44.08,,,,44.08,60.97
HEXAGONAL PHASE PHOSPHOLIPID,85597,HCPCS,305,RC,,both,74.72,67.25,United Healthcare,Default,Fee Schedule,60.97,,,,44.08,60.97
PT(PROTHROMBIN TIME),85610,HCPCS,300,RC,,both,54.53,49.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.17,,,,32.17,44.5
PT(PROTHROMBIN TIME),85610,HCPCS,300,RC,,both,54.53,49.08,Cigna,Default,Percent of Total Billed Charges,32.17,,,,32.17,44.5
PT(PROTHROMBIN TIME),85610,HCPCS,300,RC,,both,54.53,49.08,United Healthcare,Default,Fee Schedule,44.5,,,,32.17,44.5
THROMBIN TIME,85670,HCPCS,300,RC,,both,56.45,50.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.52,,,,33.31,46.06
THROMBIN TIME,85670,HCPCS,300,RC,,both,56.45,50.81,Cigna,Default,Percent of Total Billed Charges,33.31,,,,33.31,46.06
THROMBIN TIME,85670,HCPCS,300,RC,,both,56.45,50.81,United Healthcare,Default,Fee Schedule,46.06,,,,33.31,46.06
DILUTE RUSSELL VIPER VENOM TIME,85613,HCPCS,300,RC,,both,91.91,82.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.34,,,,54.23,75
DILUTE RUSSELL VIPER VENOM TIME,85613,HCPCS,300,RC,,both,91.91,82.72,Cigna,Default,Percent of Total Billed Charges,54.23,,,,54.23,75
DILUTE RUSSELL VIPER VENOM TIME,85613,HCPCS,300,RC,,both,91.91,82.72,United Healthcare,Default,Fee Schedule,75,,,,54.23,75
PT MIXING STUDY,85611,HCPCS,300,RC,,both,19.38,17.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.57,,,,11.43,15.81
PT MIXING STUDY,85611,HCPCS,300,RC,,both,19.38,17.44,Cigna,Default,Percent of Total Billed Charges,11.43,,,,11.43,15.81
PT MIXING STUDY,85611,HCPCS,300,RC,,both,19.38,17.44,United Healthcare,Default,Fee Schedule,15.81,,,,11.43,15.81
PTT PARTL THRMBPLSTN,85730,HCPCS,300,RC,,both,88.34,79.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.84,,,,52.12,72.09
PTT PARTL THRMBPLSTN,85730,HCPCS,300,RC,,both,88.34,79.51,Cigna,Default,Percent of Total Billed Charges,52.12,,,,52.12,72.09
PTT PARTL THRMBPLSTN,85730,HCPCS,300,RC,,both,88.34,79.51,United Healthcare,Default,Fee Schedule,72.09,,,,52.12,72.09
APC RESISTANCE PROFILE,85307,HCPCS,300,RC,,both,109.26,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.16
APC RESISTANCE PROFILE,85307,HCPCS,300,RC,,both,109.26,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.16
APC RESISTANCE PROFILE,85307,HCPCS,300,RC,,both,109.26,98.33,United Healthcare,Default,Fee Schedule,89.16,,,,64.46,89.16
APTT MIXING STUDY,85732,HCPCS,300,RC,,both,31.74,28.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.22,,,,18.73,25.9
APTT MIXING STUDY,85732,HCPCS,300,RC,,both,31.74,28.57,Cigna,Default,Percent of Total Billed Charges,18.73,,,,18.73,25.9
APTT MIXING STUDY,85732,HCPCS,300,RC,,both,31.74,28.57,United Healthcare,Default,Fee Schedule,25.9,,,,18.73,25.9
VISCOSITY,85810,HCPCS,300,RC,,both,74.13,66.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.89,,,,43.74,60.49
VISCOSITY,85810,HCPCS,300,RC,,both,74.13,66.72,Cigna,Default,Percent of Total Billed Charges,43.74,,,,43.74,60.49
VISCOSITY,85810,HCPCS,300,RC,,both,74.13,66.72,United Healthcare,Default,Fee Schedule,60.49,,,,43.74,60.49
SYPHILIS AB BY TPPA,86780,HCPCS,300,RC,,both,127.49,114.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.24,,,,75.22,104.03
SYPHILIS AB BY TPPA,86780,HCPCS,300,RC,,both,127.49,114.74,Cigna,Default,Percent of Total Billed Charges,75.22,,,,75.22,104.03
SYPHILIS AB BY TPPA,86780,HCPCS,300,RC,,both,127.49,114.74,United Healthcare,Default,Fee Schedule,104.03,,,,75.22,104.03
RETICULOCYTE COUNT,85045,HCPCS,300,RC,,both,102.25,92.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.58,,,,60.33,83.44
RETICULOCYTE COUNT,85045,HCPCS,300,RC,,both,102.25,92.03,Cigna,Default,Percent of Total Billed Charges,60.33,,,,60.33,83.44
RETICULOCYTE COUNT,85045,HCPCS,300,RC,,both,102.25,92.03,United Healthcare,Default,Fee Schedule,83.44,,,,60.33,83.44
RA FACTOR-FLUID,86430,HCPCS,300,RC,,both,73.07,65.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.15,,,,43.11,59.63
RA FACTOR-FLUID,86430,HCPCS,300,RC,,both,73.07,65.76,Cigna,Default,Percent of Total Billed Charges,43.11,,,,43.11,59.63
RA FACTOR-FLUID,86430,HCPCS,300,RC,,both,73.07,65.76,United Healthcare,Default,Fee Schedule,59.63,,,,43.11,59.63
SCL-70 AB,86235,HCPCS,302,RC,,both,21.55,19.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.08,,,,12.71,17.58
SCL-70 AB,86235,HCPCS,302,RC,,both,21.55,19.4,Cigna,Default,Percent of Total Billed Charges,12.71,,,,12.71,17.58
SCL-70 AB,86235,HCPCS,302,RC,,both,21.55,19.4,United Healthcare,Default,Fee Schedule,17.58,,,,12.71,17.58
SED RATE ESR,85652,HCPCS,300,RC,,both,53.44,48.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.41,,,,31.53,43.61
SED RATE ESR,85652,HCPCS,300,RC,,both,53.44,48.1,Cigna,Default,Percent of Total Billed Charges,31.53,,,,31.53,43.61
SED RATE ESR,85652,HCPCS,300,RC,,both,53.44,48.1,United Healthcare,Default,Fee Schedule,43.61,,,,31.53,43.61
SPERM ANTIBODIES,89325,HCPCS,300,RC,,both,286.75,258.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,200.72,,,,169.18,233.99
SPERM ANTIBODIES,89325,HCPCS,300,RC,,both,286.75,258.08,Cigna,Default,Percent of Total Billed Charges,169.18,,,,169.18,233.99
SPERM ANTIBODIES,89325,HCPCS,300,RC,,both,286.75,258.08,United Healthcare,Default,Fee Schedule,233.99,,,,169.18,233.99
SICKLE CELL SCREEN,85660,HCPCS,300,RC,,both,17.56,15.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.29,,,,10.36,14.33
SICKLE CELL SCREEN,85660,HCPCS,300,RC,,both,17.56,15.8,Cigna,Default,Percent of Total Billed Charges,10.36,,,,10.36,14.33
SICKLE CELL SCREEN,85660,HCPCS,300,RC,,both,17.56,15.8,United Healthcare,Default,Fee Schedule,14.33,,,,10.36,14.33
ANTI PM/SCL-100,83516,HCPCS,301,RC,,both,319.06,287.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.34,,,,188.25,260.35
ANTI PM/SCL-100,83516,HCPCS,301,RC,,both,319.06,287.15,Cigna,Default,Percent of Total Billed Charges,188.25,,,,188.25,260.35
ANTI PM/SCL-100,83516,HCPCS,301,RC,,both,319.06,287.15,United Healthcare,Default,Fee Schedule,260.35,,,,188.25,260.35
RPR QUANT,86593,HCPCS,300,RC,,both,66.57,59.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.6,,,,39.28,54.32
RPR QUANT,86593,HCPCS,300,RC,,both,66.57,59.91,Cigna,Default,Percent of Total Billed Charges,39.28,,,,39.28,54.32
RPR QUANT,86593,HCPCS,300,RC,,both,66.57,59.91,United Healthcare,Default,Fee Schedule,54.32,,,,39.28,54.32
RPR QUAL,86592,HCPCS,300,RC,,both,50,45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35,,,,29.5,40.8
RPR QUAL,86592,HCPCS,300,RC,,both,50,45,Cigna,Default,Percent of Total Billed Charges,29.5,,,,29.5,40.8
RPR QUAL,86592,HCPCS,300,RC,,both,50,45,United Healthcare,Default,Fee Schedule,40.8,,,,29.5,40.8
RSV,87420,HCPCS,300,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
RSV,87420,HCPCS,300,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
RSV,87420,HCPCS,300,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
ACYLCARNITES PLASMA QUANT,82017,HCPCS,300,RC,,both,372,334.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.4,,,,219.48,303.55
ACYLCARNITES PLASMA QUANT,82017,HCPCS,300,RC,,both,372,334.8,Cigna,Default,Percent of Total Billed Charges,219.48,,,,219.48,303.55
ACYLCARNITES PLASMA QUANT,82017,HCPCS,300,RC,,both,372,334.8,United Healthcare,Default,Fee Schedule,303.55,,,,219.48,303.55
AMINO ACID QUANT PLASMA,82139,HCPCS,300,RC,,both,596,536.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,417.2,,,,351.64,486.34
AMINO ACID QUANT PLASMA,82139,HCPCS,300,RC,,both,596,536.4,Cigna,Default,Percent of Total Billed Charges,351.64,,,,351.64,486.34
AMINO ACID QUANT PLASMA,82139,HCPCS,300,RC,,both,596,536.4,United Healthcare,Default,Fee Schedule,486.34,,,,351.64,486.34
MONO TEST,86308,HCPCS,300,RC,,both,75.25,67.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.68,,,,44.4,61.4
MONO TEST,86308,HCPCS,300,RC,,both,75.25,67.73,Cigna,Default,Percent of Total Billed Charges,44.4,,,,44.4,61.4
MONO TEST,86308,HCPCS,300,RC,,both,75.25,67.73,United Healthcare,Default,Fee Schedule,61.4,,,,44.4,61.4
HETEROPHILE ANTIBODY,86308,HCPCS,300,RC,,both,27,24.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.9,,,,15.93,22.03
HETEROPHILE ANTIBODY,86308,HCPCS,300,RC,,both,27,24.3,Cigna,Default,Percent of Total Billed Charges,15.93,,,,15.93,22.03
HETEROPHILE ANTIBODY,86308,HCPCS,300,RC,,both,27,24.3,United Healthcare,Default,Fee Schedule,22.03,,,,15.93,22.03
ASO TITER,83883,HCPCS,300,RC,,both,241.02,216.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.71,,,,142.2,196.67
ASO TITER,83883,HCPCS,300,RC,,both,241.02,216.92,Cigna,Default,Percent of Total Billed Charges,142.2,,,,142.2,196.67
ASO TITER,83883,HCPCS,300,RC,,both,241.02,216.92,United Healthcare,Default,Fee Schedule,196.67,,,,142.2,196.67
RAJI CELL ASSAY,86332,HCPCS,300,RC,,both,131.5,118.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.05,,,,77.58,107.3
RAJI CELL ASSAY,86332,HCPCS,300,RC,,both,131.5,118.35,Cigna,Default,Percent of Total Billed Charges,77.58,,,,77.58,107.3
RAJI CELL ASSAY,86332,HCPCS,300,RC,,both,131.5,118.35,United Healthcare,Default,Fee Schedule,107.3,,,,77.58,107.3
FEBRILE AGGLUTININS,86000,HCPCS,300,RC,,both,31.5,28.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.05,,,,18.58,25.7
FEBRILE AGGLUTININS,86000,HCPCS,300,RC,,both,31.5,28.35,Cigna,Default,Percent of Total Billed Charges,18.58,,,,18.58,25.7
FEBRILE AGGLUTININS,86000,HCPCS,300,RC,,both,31.5,28.35,United Healthcare,Default,Fee Schedule,25.7,,,,18.58,25.7
RAST TEST (ALLERGEN),86003,HCPCS,300,RC,,both,32.06,28.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.44,,,,18.92,26.16
RAST TEST (ALLERGEN),86003,HCPCS,300,RC,,both,32.06,28.85,Cigna,Default,Percent of Total Billed Charges,18.92,,,,18.92,26.16
RAST TEST (ALLERGEN),86003,HCPCS,300,RC,,both,32.06,28.85,United Healthcare,Default,Fee Schedule,26.16,,,,18.92,26.16
IMMUNODI FUSION,86331,HCPCS,300,RC,,both,14.25,12.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.98,,,,8.41,11.63
IMMUNODI FUSION,86331,HCPCS,300,RC,,both,14.25,12.83,Cigna,Default,Percent of Total Billed Charges,8.41,,,,8.41,11.63
IMMUNODI FUSION,86331,HCPCS,300,RC,,both,14.25,12.83,United Healthcare,Default,Fee Schedule,11.63,,,,8.41,11.63
GALACTOSE ALPHA ALLERGEN,86003,HCPCS,302,RC,,both,83.38,75.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.37,,,,49.19,68.04
GALACTOSE ALPHA ALLERGEN,86003,HCPCS,302,RC,,both,83.38,75.04,Cigna,Default,Percent of Total Billed Charges,49.19,,,,49.19,68.04
GALACTOSE ALPHA ALLERGEN,86003,HCPCS,302,RC,,both,83.38,75.04,United Healthcare,Default,Fee Schedule,68.04,,,,49.19,68.04
ALLERGEN PENICILLIN,86003,HCPCS,300,RC,,both,83.38,75.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.37,,,,49.19,68.04
ALLERGEN PENICILLIN,86003,HCPCS,300,RC,,both,83.38,75.04,Cigna,Default,Percent of Total Billed Charges,49.19,,,,49.19,68.04
ALLERGEN PENICILLIN,86003,HCPCS,300,RC,,both,83.38,75.04,United Healthcare,Default,Fee Schedule,68.04,,,,49.19,68.04
ALLERGEN APPLE,86003,HCPCS,300,RC,,both,83.38,75.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.37,,,,49.19,68.04
ALLERGEN APPLE,86003,HCPCS,300,RC,,both,83.38,75.04,Cigna,Default,Percent of Total Billed Charges,49.19,,,,49.19,68.04
ALLERGEN APPLE,86003,HCPCS,300,RC,,both,83.38,75.04,United Healthcare,Default,Fee Schedule,68.04,,,,49.19,68.04
ALLERGENS BRAZIL NUT,86003,HCPCS,300,RC,,both,83.38,75.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.37,,,,49.19,68.04
ALLERGENS BRAZIL NUT,86003,HCPCS,300,RC,,both,83.38,75.04,Cigna,Default,Percent of Total Billed Charges,49.19,,,,49.19,68.04
ALLERGENS BRAZIL NUT,86003,HCPCS,300,RC,,both,83.38,75.04,United Healthcare,Default,Fee Schedule,68.04,,,,49.19,68.04
ALLERGENS PISTACHIO,86003,HCPCS,300,RC,,both,32.06,28.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.44,,,,18.92,26.16
ALLERGENS PISTACHIO,86003,HCPCS,300,RC,,both,32.06,28.85,Cigna,Default,Percent of Total Billed Charges,18.92,,,,18.92,26.16
ALLERGENS PISTACHIO,86003,HCPCS,300,RC,,both,32.06,28.85,United Healthcare,Default,Fee Schedule,26.16,,,,18.92,26.16
RBC LEUKOCYTES REDUCED,P9016,HCPCS,390,RC,,both,673.13,605.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,471.19,,,,397.15,549.27
RBC LEUKOCYTES REDUCED,P9016,HCPCS,390,RC,,both,673.13,605.82,Cigna,Default,Percent of Total Billed Charges,397.15,,,,397.15,549.27
RBC LEUKOCYTES REDUCED,P9016,HCPCS,390,RC,,both,673.13,605.82,United Healthcare,Default,Fee Schedule,549.27,,,,397.15,549.27
RBC LEUKOREDUCED IRRADIATED,P9040,HCPCS,390,RC,,both,977.26,879.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,684.08,,,,576.58,797.44
RBC LEUKOREDUCED IRRADIATED,P9040,HCPCS,390,RC,,both,977.26,879.53,Cigna,Default,Percent of Total Billed Charges,576.58,,,,576.58,797.44
RBC LEUKOREDUCED IRRADIATED,P9040,HCPCS,390,RC,,both,977.26,879.53,United Healthcare,Default,Fee Schedule,797.44,,,,576.58,797.44
RA TITER QUANT,86431,HCPCS,300,RC,,both,78.35,70.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.84,,,,46.23,63.93
RA TITER QUANT,86431,HCPCS,300,RC,,both,78.35,70.52,Cigna,Default,Percent of Total Billed Charges,46.23,,,,46.23,63.93
RA TITER QUANT,86431,HCPCS,300,RC,,both,78.35,70.52,United Healthcare,Default,Fee Schedule,63.93,,,,46.23,63.93
RA FACTOR QUAL,86430,HCPCS,300,RC,,both,73.07,65.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.15,,,,43.11,59.63
RA FACTOR QUAL,86430,HCPCS,300,RC,,both,73.07,65.76,Cigna,Default,Percent of Total Billed Charges,43.11,,,,43.11,59.63
RA FACTOR QUAL,86430,HCPCS,300,RC,,both,73.07,65.76,United Healthcare,Default,Fee Schedule,59.63,,,,43.11,59.63
RBC CHOLINESTERASE,82482,HCPCS,301,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
RBC CHOLINESTERASE,82482,HCPCS,301,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
RBC CHOLINESTERASE,82482,HCPCS,301,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
COLD AGGLUTININS,86157,HCPCS,300,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
COLD AGGLUTININS,86157,HCPCS,300,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
COLD AGGLUTININS,86157,HCPCS,300,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
COPPER SERUM,82525,HCPCS,301,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
COPPER SERUM,82525,HCPCS,301,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
COPPER SERUM,82525,HCPCS,301,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
SELENIUM,84255,HCPCS,301,RC,,both,112.03,100.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.42,,,,66.1,91.42
SELENIUM,84255,HCPCS,301,RC,,both,112.03,100.83,Cigna,Default,Percent of Total Billed Charges,66.1,,,,66.1,91.42
SELENIUM,84255,HCPCS,301,RC,,both,112.03,100.83,United Healthcare,Default,Fee Schedule,91.42,,,,66.1,91.42
COPPER URINE,82525,HCPCS,301,RC,,both,146.06,131.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.24,,,,86.18,119.18
COPPER URINE,82525,HCPCS,301,RC,,both,146.06,131.45,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.18
COPPER URINE,82525,HCPCS,301,RC,,both,146.06,131.45,United Healthcare,Default,Fee Schedule,119.18,,,,86.18,119.18
FREE FATTY ACIDS SERUM,82725,HCPCS,300,RC,,both,98,88.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.6,,,,57.82,79.97
FREE FATTY ACIDS SERUM,82725,HCPCS,300,RC,,both,98,88.2,Cigna,Default,Percent of Total Billed Charges,57.82,,,,57.82,79.97
FREE FATTY ACIDS SERUM,82725,HCPCS,300,RC,,both,98,88.2,United Healthcare,Default,Fee Schedule,79.97,,,,57.82,79.97
URINE DIPSTICK,81002,HCPCS,300,RC,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
URINE DIPSTICK,81002,HCPCS,300,RC,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
URINE DIPSTICK,81002,HCPCS,300,RC,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
MUMPS ANTIBODY IGG,86735,HCPCS,300,RC,,both,41.19,37.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.83,,,,24.3,33.61
MUMPS ANTIBODY IGG,86735,HCPCS,300,RC,,both,41.19,37.07,Cigna,Default,Percent of Total Billed Charges,24.3,,,,24.3,33.61
MUMPS ANTIBODY IGG,86735,HCPCS,300,RC,,both,41.19,37.07,United Healthcare,Default,Fee Schedule,33.61,,,,24.3,33.61
PREG TEST(UCG)UR,84703,HCPCS,301,RC,,both,110.15,99.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.1,,,,64.99,89.88
PREG TEST(UCG)UR,84703,HCPCS,301,RC,,both,110.15,99.14,Cigna,Default,Percent of Total Billed Charges,64.99,,,,64.99,89.88
PREG TEST(UCG)UR,84703,HCPCS,301,RC,,both,110.15,99.14,United Healthcare,Default,Fee Schedule,89.88,,,,64.99,89.88
PREG TEST (HCG) SER,84703,HCPCS,301,RC,,both,110.15,99.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.1,,,,64.99,89.88
PREG TEST (HCG) SER,84703,HCPCS,301,RC,,both,110.15,99.14,Cigna,Default,Percent of Total Billed Charges,64.99,,,,64.99,89.88
PREG TEST (HCG) SER,84703,HCPCS,301,RC,,both,110.15,99.14,United Healthcare,Default,Fee Schedule,89.88,,,,64.99,89.88
URINALYSIS C/S IF INDICATED,81003,HCPCS,300,RC,,both,41.28,37.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.9,,,,24.36,33.68
URINALYSIS C/S IF INDICATED,81003,HCPCS,300,RC,,both,41.28,37.15,Cigna,Default,Percent of Total Billed Charges,24.36,,,,24.36,33.68
URINALYSIS C/S IF INDICATED,81003,HCPCS,300,RC,,both,41.28,37.15,United Healthcare,Default,Fee Schedule,33.68,,,,24.36,33.68
URINE VOLUME,81050,HCPCS,300,RC,,both,23.6,21.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.52,,,,13.92,19.26
URINE VOLUME,81050,HCPCS,300,RC,,both,23.6,21.24,Cigna,Default,Percent of Total Billed Charges,13.92,,,,13.92,19.26
URINE VOLUME,81050,HCPCS,300,RC,,both,23.6,21.24,United Healthcare,Default,Fee Schedule,19.26,,,,13.92,19.26
PINWORMS TAPE TEST,87172,HCPCS,300,RC,,both,56.18,50.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.33,,,,33.15,45.84
PINWORMS TAPE TEST,87172,HCPCS,300,RC,,both,56.18,50.56,Cigna,Default,Percent of Total Billed Charges,33.15,,,,33.15,45.84
PINWORMS TAPE TEST,87172,HCPCS,300,RC,,both,56.18,50.56,United Healthcare,Default,Fee Schedule,45.84,,,,33.15,45.84
PARASITE MACROSCOPIC,87169,HCPCS,306,RC,,both,27.97,25.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.58,,,,16.5,22.82
PARASITE MACROSCOPIC,87169,HCPCS,306,RC,,both,27.97,25.17,Cigna,Default,Percent of Total Billed Charges,16.5,,,,16.5,22.82
PARASITE MACROSCOPIC,87169,HCPCS,306,RC,,both,27.97,25.17,United Healthcare,Default,Fee Schedule,22.82,,,,16.5,22.82
"PLATELETS, PHERESIS",P9035,HCPCS,390,RC,,both,1986.75,1788.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1390.72,,,,1172.18,1621.19
"PLATELETS, PHERESIS",P9035,HCPCS,390,RC,,both,1986.75,1788.08,Cigna,Default,Percent of Total Billed Charges,1172.18,,,,1172.18,1621.19
"PLATELETS, PHERESIS",P9035,HCPCS,390,RC,,both,1986.75,1788.08,United Healthcare,Default,Fee Schedule,1621.19,,,,1172.18,1621.19
GIARDIA AG,87329,HCPCS,300,RC,,both,87.92,79.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.54,,,,51.87,71.74
GIARDIA AG,87329,HCPCS,300,RC,,both,87.92,79.13,Cigna,Default,Percent of Total Billed Charges,51.87,,,,51.87,71.74
GIARDIA AG,87329,HCPCS,300,RC,,both,87.92,79.13,United Healthcare,Default,Fee Schedule,71.74,,,,51.87,71.74
METHANOL BLOOD,84600,HCPCS,301,RC,,both,56.25,50.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.38,,,,33.19,45.9
METHANOL BLOOD,84600,HCPCS,301,RC,,both,56.25,50.63,Cigna,Default,Percent of Total Billed Charges,33.19,,,,33.19,45.9
METHANOL BLOOD,84600,HCPCS,301,RC,,both,56.25,50.63,United Healthcare,Default,Fee Schedule,45.9,,,,33.19,45.9
METHYLMALONIC ACID,83921,HCPCS,301,RC,,both,181.47,163.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.03,,,,107.07,148.08
METHYLMALONIC ACID,83921,HCPCS,301,RC,,both,181.47,163.32,Cigna,Default,Percent of Total Billed Charges,107.07,,,,107.07,148.08
METHYLMALONIC ACID,83921,HCPCS,301,RC,,both,181.47,163.32,United Healthcare,Default,Fee Schedule,148.08,,,,107.07,148.08
BLD OCCULT - COLORECTAL SCREENING,82270,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
BLD OCCULT - COLORECTAL SCREENING,82270,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
BLD OCCULT - COLORECTAL SCREENING,82270,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
BLD OCCULT - OTHER SOURCES THAN FEC,82271,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
BLD OCCULT - OTHER SOURCES THAN FEC,82271,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
BLD OCCULT - OTHER SOURCES THAN FEC,82271,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
BLD OCCULT - FECES NONSCREENING,82272,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
BLD OCCULT - FECES NONSCREENING,82272,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
BLD OCCULT - FECES NONSCREENING,82272,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
BLD OCCULT FECAL IMMUNO CHEMICAL,82274,HCPCS,300,RC,QW,both,116.69,105.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.68,,,,68.85,95.22
BLD OCCULT FECAL IMMUNO CHEMICAL,82274,HCPCS,300,RC,QW,both,116.69,105.02,Cigna,Default,Percent of Total Billed Charges,68.85,,,,68.85,95.22
BLD OCCULT FECAL IMMUNO CHEMICAL,82274,HCPCS,300,RC,QW,both,116.69,105.02,United Healthcare,Default,Fee Schedule,95.22,,,,68.85,95.22
BLD OCCULT FECAL IMMUNO DIAGNOSTIC,82274,HCPCS,300,RC,,both,76.34,68.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.44,,,,45.04,62.29
BLD OCCULT FECAL IMMUNO DIAGNOSTIC,82274,HCPCS,300,RC,,both,76.34,68.71,Cigna,Default,Percent of Total Billed Charges,45.04,,,,45.04,62.29
BLD OCCULT FECAL IMMUNO DIAGNOSTIC,82274,HCPCS,300,RC,,both,76.34,68.71,United Healthcare,Default,Fee Schedule,62.29,,,,45.04,62.29
TRICHROME STAIN,87209,HCPCS,300,RC,,both,94.38,84.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.07,,,,55.68,77.01
TRICHROME STAIN,87209,HCPCS,300,RC,,both,94.38,84.94,Cigna,Default,Percent of Total Billed Charges,55.68,,,,55.68,77.01
TRICHROME STAIN,87209,HCPCS,300,RC,,both,94.38,84.94,United Healthcare,Default,Fee Schedule,77.01,,,,55.68,77.01
GRAM STAIN,87205,HCPCS,306,RC,,both,62.16,55.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.51,,,,36.67,50.72
GRAM STAIN,87205,HCPCS,306,RC,,both,62.16,55.94,Cigna,Default,Percent of Total Billed Charges,36.67,,,,36.67,50.72
GRAM STAIN,87205,HCPCS,306,RC,,both,62.16,55.94,United Healthcare,Default,Fee Schedule,50.72,,,,36.67,50.72
CHLAMYDIA TRACH OMATIS DFA,87270,HCPCS,300,RC,,both,92.13,82.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.49,,,,54.36,75.18
CHLAMYDIA TRACH OMATIS DFA,87270,HCPCS,300,RC,,both,92.13,82.92,Cigna,Default,Percent of Total Billed Charges,54.36,,,,54.36,75.18
CHLAMYDIA TRACH OMATIS DFA,87270,HCPCS,300,RC,,both,92.13,82.92,United Healthcare,Default,Fee Schedule,75.18,,,,54.36,75.18
OVA & PARASITE SMEAR-DIRECT,87177,HCPCS,300,RC,,both,55.05,49.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.54,,,,32.48,44.92
OVA & PARASITE SMEAR-DIRECT,87177,HCPCS,300,RC,,both,55.05,49.55,Cigna,Default,Percent of Total Billed Charges,32.48,,,,32.48,44.92
OVA & PARASITE SMEAR-DIRECT,87177,HCPCS,300,RC,,both,55.05,49.55,United Healthcare,Default,Fee Schedule,44.92,,,,32.48,44.92
FLUORESCENT TECHNIQUE CRYPTOSPORIDM,87272,HCPCS,300,RC,,both,45.5,40.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.85,,,,26.84,37.13
FLUORESCENT TECHNIQUE CRYPTOSPORIDM,87272,HCPCS,300,RC,,both,45.5,40.95,Cigna,Default,Percent of Total Billed Charges,26.84,,,,26.84,37.13
FLUORESCENT TECHNIQUE CRYPTOSPORIDM,87272,HCPCS,300,RC,,both,45.5,40.95,United Healthcare,Default,Fee Schedule,37.13,,,,26.84,37.13
FLUORES NONINFECT AGENT AB;EA,86255,HCPCS,300,RC,,both,101.25,91.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.88,,,,59.74,82.62
FLUORES NONINFECT AGENT AB;EA,86255,HCPCS,300,RC,,both,101.25,91.13,Cigna,Default,Percent of Total Billed Charges,59.74,,,,59.74,82.62
FLUORES NONINFECT AGENT AB;EA,86255,HCPCS,300,RC,,both,101.25,91.13,United Healthcare,Default,Fee Schedule,82.62,,,,59.74,82.62
FLUORES NONINFECT AGENT TITER,86256,HCPCS,300,RC,,both,101.25,91.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.88,,,,59.74,82.62
FLUORES NONINFECT AGENT TITER,86256,HCPCS,300,RC,,both,101.25,91.13,Cigna,Default,Percent of Total Billed Charges,59.74,,,,59.74,82.62
FLUORES NONINFECT AGENT TITER,86256,HCPCS,300,RC,,both,101.25,91.13,United Healthcare,Default,Fee Schedule,82.62,,,,59.74,82.62
"SMOOTH MUSCLE AB, IGG",86255,HCPCS,300,RC,,both,57.33,51.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.13,,,,33.82,46.78
"SMOOTH MUSCLE AB, IGG",86255,HCPCS,300,RC,,both,57.33,51.6,Cigna,Default,Percent of Total Billed Charges,33.82,,,,33.82,46.78
"SMOOTH MUSCLE AB, IGG",86255,HCPCS,300,RC,,both,57.33,51.6,United Healthcare,Default,Fee Schedule,46.78,,,,33.82,46.78
SMOOTH MUSCLE TITER,86256,HCPCS,300,RC,,both,59.27,53.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.49,,,,34.97,48.36
SMOOTH MUSCLE TITER,86256,HCPCS,300,RC,,both,59.27,53.34,Cigna,Default,Percent of Total Billed Charges,34.97,,,,34.97,48.36
SMOOTH MUSCLE TITER,86256,HCPCS,300,RC,,both,59.27,53.34,United Healthcare,Default,Fee Schedule,48.36,,,,34.97,48.36
RETUCULIN AB IGA,86255,HCPCS,300,RC,,both,97.46,87.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.22,,,,57.5,79.53
RETUCULIN AB IGA,86255,HCPCS,300,RC,,both,97.46,87.71,Cigna,Default,Percent of Total Billed Charges,57.5,,,,57.5,79.53
RETUCULIN AB IGA,86255,HCPCS,300,RC,,both,97.46,87.71,United Healthcare,Default,Fee Schedule,79.53,,,,57.5,79.53
AGNA 1,86255,HCPCS,302,RC,,both,219.8,197.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.86,,,,129.68,179.36
AGNA 1,86255,HCPCS,302,RC,,both,219.8,197.82,Cigna,Default,Percent of Total Billed Charges,129.68,,,,129.68,179.36
AGNA 1,86255,HCPCS,302,RC,,both,219.8,197.82,United Healthcare,Default,Fee Schedule,179.36,,,,129.68,179.36
AMPHIPHYSIN,86255,HCPCS,302,RC,,both,219.8,197.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.86,,,,129.68,179.36
AMPHIPHYSIN,86255,HCPCS,302,RC,,both,219.8,197.82,Cigna,Default,Percent of Total Billed Charges,129.68,,,,129.68,179.36
AMPHIPHYSIN,86255,HCPCS,302,RC,,both,219.8,197.82,United Healthcare,Default,Fee Schedule,179.36,,,,129.68,179.36
ANNA 1,86255,HCPCS,302,RC,,both,219.8,197.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.86,,,,129.68,179.36
ANNA 1,86255,HCPCS,302,RC,,both,219.8,197.82,Cigna,Default,Percent of Total Billed Charges,129.68,,,,129.68,179.36
ANNA 1,86255,HCPCS,302,RC,,both,219.8,197.82,United Healthcare,Default,Fee Schedule,179.36,,,,129.68,179.36
ANNA 2,86255,HCPCS,302,RC,,both,219.8,197.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.86,,,,129.68,179.36
ANNA 2,86255,HCPCS,302,RC,,both,219.8,197.82,Cigna,Default,Percent of Total Billed Charges,129.68,,,,129.68,179.36
ANNA 2,86255,HCPCS,302,RC,,both,219.8,197.82,United Healthcare,Default,Fee Schedule,179.36,,,,129.68,179.36
ANNA 3,86255,HCPCS,302,RC,,both,219.8,197.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.86,,,,129.68,179.36
ANNA 3,86255,HCPCS,302,RC,,both,219.8,197.82,Cigna,Default,Percent of Total Billed Charges,129.68,,,,129.68,179.36
ANNA 3,86255,HCPCS,302,RC,,both,219.8,197.82,United Healthcare,Default,Fee Schedule,179.36,,,,129.68,179.36
CRMP 5 IGG,86255,HCPCS,302,RC,,both,219.8,197.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.86,,,,129.68,179.36
CRMP 5 IGG,86255,HCPCS,302,RC,,both,219.8,197.82,Cigna,Default,Percent of Total Billed Charges,129.68,,,,129.68,179.36
CRMP 5 IGG,86255,HCPCS,302,RC,,both,219.8,197.82,United Healthcare,Default,Fee Schedule,179.36,,,,129.68,179.36
PCA 1,86255,HCPCS,302,RC,,both,226.39,203.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.47,,,,133.57,184.73
PCA 1,86255,HCPCS,302,RC,,both,226.39,203.75,Cigna,Default,Percent of Total Billed Charges,133.57,,,,133.57,184.73
PCA 1,86255,HCPCS,302,RC,,both,226.39,203.75,United Healthcare,Default,Fee Schedule,184.73,,,,133.57,184.73
PCA 2,86255,HCPCS,302,RC,,both,226.39,203.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.47,,,,133.57,184.73
PCA 2,86255,HCPCS,302,RC,,both,226.39,203.75,Cigna,Default,Percent of Total Billed Charges,133.57,,,,133.57,184.73
PCA 2,86255,HCPCS,302,RC,,both,226.39,203.75,United Healthcare,Default,Fee Schedule,184.73,,,,133.57,184.73
PCA TR,86255,HCPCS,302,RC,,both,226.39,203.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.47,,,,133.57,184.73
PCA TR,86255,HCPCS,302,RC,,both,226.39,203.75,Cigna,Default,Percent of Total Billed Charges,133.57,,,,133.57,184.73
PCA TR,86255,HCPCS,302,RC,,both,226.39,203.75,United Healthcare,Default,Fee Schedule,184.73,,,,133.57,184.73
ENDOMYSIAL AB,86255,HCPCS,302,RC,,both,178.93,161.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.25,,,,105.57,146.01
ENDOMYSIAL AB,86255,HCPCS,302,RC,,both,178.93,161.04,Cigna,Default,Percent of Total Billed Charges,105.57,,,,105.57,146.01
ENDOMYSIAL AB,86255,HCPCS,302,RC,,both,178.93,161.04,United Healthcare,Default,Fee Schedule,146.01,,,,105.57,146.01
VALIUM (DIAZEPAM),80154,HCPCS,301,RC,,both,96,86.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.2,,,,56.64,78.34
VALIUM (DIAZEPAM),80154,HCPCS,301,RC,,both,96,86.4,Cigna,Default,Percent of Total Billed Charges,56.64,,,,56.64,78.34
VALIUM (DIAZEPAM),80154,HCPCS,301,RC,,both,96,86.4,United Healthcare,Default,Fee Schedule,78.34,,,,56.64,78.34
SENSI ENZYME DIRECT,87185,HCPCS,306,RC,,both,9.85,8.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.9,,,,5.81,8.04
SENSI ENZYME DIRECT,87185,HCPCS,306,RC,,both,9.85,8.87,Cigna,Default,Percent of Total Billed Charges,5.81,,,,5.81,8.04
SENSI ENZYME DIRECT,87185,HCPCS,306,RC,,both,9.85,8.87,United Healthcare,Default,Fee Schedule,8.04,,,,5.81,8.04
SENSITIVITY ORGANISM 1,87184,HCPCS,300,RC,,both,88.46,79.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.92,,,,52.19,72.18
SENSITIVITY ORGANISM 1,87184,HCPCS,300,RC,,both,88.46,79.61,Cigna,Default,Percent of Total Billed Charges,52.19,,,,52.19,72.18
SENSITIVITY ORGANISM 1,87184,HCPCS,300,RC,,both,88.46,79.61,United Healthcare,Default,Fee Schedule,72.18,,,,52.19,72.18
REF SUSCEPTIBILITY,87186,HCPCS,300,RC,,both,81.17,73.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.82,,,,47.89,66.23
REF SUSCEPTIBILITY,87186,HCPCS,300,RC,,both,81.17,73.05,Cigna,Default,Percent of Total Billed Charges,47.89,,,,47.89,66.23
REF SUSCEPTIBILITY,87186,HCPCS,300,RC,,both,81.17,73.05,United Healthcare,Default,Fee Schedule,66.23,,,,47.89,66.23
SENSITIVITY ORGANISM 2,87184,HCPCS,300,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
SENSITIVITY ORGANISM 2,87184,HCPCS,300,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
SENSITIVITY ORGANISM 2,87184,HCPCS,300,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
SENSITIVITY ORGANISM 3,87184,HCPCS,300,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
SENSITIVITY ORGANISM 3,87184,HCPCS,300,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
SENSITIVITY ORGANISM 3,87184,HCPCS,300,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
SENSITIVITY ORGANISM 4,87184,HCPCS,300,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
SENSITIVITY ORGANISM 4,87184,HCPCS,300,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
SENSITIVITY ORGANISM 4,87184,HCPCS,300,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
SUSCEPT SLOW GROWER,87186,HCPCS,306,RC,,both,759.52,683.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,531.66,,,,448.12,619.77
SUSCEPT SLOW GROWER,87186,HCPCS,306,RC,,both,759.52,683.57,Cigna,Default,Percent of Total Billed Charges,448.12,,,,448.12,619.77
SUSCEPT SLOW GROWER,87186,HCPCS,306,RC,,both,759.52,683.57,United Healthcare,Default,Fee Schedule,619.77,,,,448.12,619.77
Monkeypox PCR,87593,HCPCS,306,RC,,both,305.91,275.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,214.14,,,,180.49,249.62
Monkeypox PCR,87593,HCPCS,306,RC,,both,305.91,275.32,Cigna,Default,Percent of Total Billed Charges,180.49,,,,180.49,249.62
Monkeypox PCR,87593,HCPCS,306,RC,,both,305.91,275.32,United Healthcare,Default,Fee Schedule,249.62,,,,180.49,249.62
CULTURE-STREP ONLY,87081,HCPCS,300,RC,,both,83.27,74.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.29,,,,49.13,67.95
CULTURE-STREP ONLY,87081,HCPCS,300,RC,,both,83.27,74.94,Cigna,Default,Percent of Total Billed Charges,49.13,,,,49.13,67.95
CULTURE-STREP ONLY,87081,HCPCS,300,RC,,both,83.27,74.94,United Healthcare,Default,Fee Schedule,67.95,,,,49.13,67.95
SUSCEPTIBILITY 1,87186,HCPCS,306,RC,,both,81.17,73.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.82,,,,47.89,66.23
SUSCEPTIBILITY 1,87186,HCPCS,306,RC,,both,81.17,73.05,Cigna,Default,Percent of Total Billed Charges,47.89,,,,47.89,66.23
SUSCEPTIBILITY 1,87186,HCPCS,306,RC,,both,81.17,73.05,United Healthcare,Default,Fee Schedule,66.23,,,,47.89,66.23
SUSCEPTIBILITY 2,87186,HCPCS,306,RC,,both,99.46,89.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.62,,,,58.68,81.16
SUSCEPTIBILITY 2,87186,HCPCS,306,RC,,both,99.46,89.51,Cigna,Default,Percent of Total Billed Charges,58.68,,,,58.68,81.16
SUSCEPTIBILITY 2,87186,HCPCS,306,RC,,both,99.46,89.51,United Healthcare,Default,Fee Schedule,81.16,,,,58.68,81.16
SUSCEPTIBILITY 3,87186,HCPCS,306,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
SUSCEPTIBILITY 3,87186,HCPCS,306,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
SUSCEPTIBILITY 3,87186,HCPCS,306,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
SUSCEPTIBILITY 4,87186,HCPCS,306,RC,,both,72.25,65.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.58,,,,42.63,58.96
SUSCEPTIBILITY 4,87186,HCPCS,306,RC,,both,72.25,65.03,Cigna,Default,Percent of Total Billed Charges,42.63,,,,42.63,58.96
SUSCEPTIBILITY 4,87186,HCPCS,306,RC,,both,72.25,65.03,United Healthcare,Default,Fee Schedule,58.96,,,,42.63,58.96
SENSITIVITY REFERRED,87181,HCPCS,306,RC,,both,54.86,49.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.4,,,,32.37,44.77
SENSITIVITY REFERRED,87181,HCPCS,306,RC,,both,54.86,49.37,Cigna,Default,Percent of Total Billed Charges,32.37,,,,32.37,44.77
SENSITIVITY REFERRED,87181,HCPCS,306,RC,,both,54.86,49.37,United Healthcare,Default,Fee Schedule,44.77,,,,32.37,44.77
BETA-2-MICRGLBLN SER,82232,HCPCS,301,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
BETA-2-MICRGLBLN SER,82232,HCPCS,301,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
BETA-2-MICRGLBLN SER,82232,HCPCS,301,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
STREP A ANTIGEN,87880,HCPCS,300,RC,,both,70.89,63.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.62,,,,41.83,57.85
STREP A ANTIGEN,87880,HCPCS,300,RC,,both,70.89,63.8,Cigna,Default,Percent of Total Billed Charges,41.83,,,,41.83,57.85
STREP A ANTIGEN,87880,HCPCS,300,RC,,both,70.89,63.8,United Healthcare,Default,Fee Schedule,57.85,,,,41.83,57.85
CULTURE-EXUDATE/WND,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-EXUDATE/WND,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-EXUDATE/WND,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-TISSUE,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-TISSUE,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-TISSUE,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-ANAEROBIC,87075,HCPCS,300,RC,,both,145.05,130.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.54,,,,85.58,118.36
CULTURE-ANAEROBIC,87075,HCPCS,300,RC,,both,145.05,130.55,Cigna,Default,Percent of Total Billed Charges,85.58,,,,85.58,118.36
CULTURE-ANAEROBIC,87075,HCPCS,300,RC,,both,145.05,130.55,United Healthcare,Default,Fee Schedule,118.36,,,,85.58,118.36
CULTURE BLOOD 1,87040,HCPCS,300,RC,,both,171.77,154.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.24,,,,101.34,140.16
CULTURE BLOOD 1,87040,HCPCS,300,RC,,both,171.77,154.59,Cigna,Default,Percent of Total Billed Charges,101.34,,,,101.34,140.16
CULTURE BLOOD 1,87040,HCPCS,300,RC,,both,171.77,154.59,United Healthcare,Default,Fee Schedule,140.16,,,,101.34,140.16
CULTURE BLOOD 2,87040,HCPCS,300,RC,,both,116.58,104.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.61,,,,68.78,95.13
CULTURE BLOOD 2,87040,HCPCS,300,RC,,both,116.58,104.92,Cigna,Default,Percent of Total Billed Charges,68.78,,,,68.78,95.13
CULTURE BLOOD 2,87040,HCPCS,300,RC,,both,116.58,104.92,United Healthcare,Default,Fee Schedule,95.13,,,,68.78,95.13
CULTURE-GC,87081,HCPCS,300,RC,,both,38.25,34.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.78,,,,22.57,31.21
CULTURE-GC,87081,HCPCS,300,RC,,both,38.25,34.43,Cigna,Default,Percent of Total Billed Charges,22.57,,,,22.57,31.21
CULTURE-GC,87081,HCPCS,300,RC,,both,38.25,34.43,United Healthcare,Default,Fee Schedule,31.21,,,,22.57,31.21
CULTURE-BRONC WASH,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-BRONC WASH,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-BRONC WASH,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-MRSA PRE OP,87081,HCPCS,306,RC,,both,101.13,91.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.79,,,,59.67,82.52
CULTURE-MRSA PRE OP,87081,HCPCS,306,RC,,both,101.13,91.02,Cigna,Default,Percent of Total Billed Charges,59.67,,,,59.67,82.52
CULTURE-MRSA PRE OP,87081,HCPCS,306,RC,,both,101.13,91.02,United Healthcare,Default,Fee Schedule,82.52,,,,59.67,82.52
CULTURE MRSA SURVEILLANCE,87081,HCPCS,300,RC,,both,83.27,74.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.29,,,,49.13,67.95
CULTURE MRSA SURVEILLANCE,87081,HCPCS,300,RC,,both,83.27,74.94,Cigna,Default,Percent of Total Billed Charges,49.13,,,,49.13,67.95
CULTURE MRSA SURVEILLANCE,87081,HCPCS,300,RC,,both,83.27,74.94,United Healthcare,Default,Fee Schedule,67.95,,,,49.13,67.95
CULTURE - LEGIONELLA,87081,HCPCS,300,RC,,both,87.1,78.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.97,,,,51.39,71.07
CULTURE - LEGIONELLA,87081,HCPCS,300,RC,,both,87.1,78.39,Cigna,Default,Percent of Total Billed Charges,51.39,,,,51.39,71.07
CULTURE - LEGIONELLA,87081,HCPCS,300,RC,,both,87.1,78.39,United Healthcare,Default,Fee Schedule,71.07,,,,51.39,71.07
CULTURE VRE,87081,HCPCS,300,RC,,both,83.27,74.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.29,,,,49.13,67.95
CULTURE VRE,87081,HCPCS,300,RC,,both,83.27,74.94,Cigna,Default,Percent of Total Billed Charges,49.13,,,,49.13,67.95
CULTURE VRE,87081,HCPCS,300,RC,,both,83.27,74.94,United Healthcare,Default,Fee Schedule,67.95,,,,49.13,67.95
FROZEN COMPONENT THAWING,86927,HCPCS,300,RC,,both,764.69,688.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,535.28,,,,451.17,623.99
FROZEN COMPONENT THAWING,86927,HCPCS,300,RC,,both,764.69,688.22,Cigna,Default,Percent of Total Billed Charges,451.17,,,,451.17,623.99
FROZEN COMPONENT THAWING,86927,HCPCS,300,RC,,both,764.69,688.22,United Healthcare,Default,Fee Schedule,623.99,,,,451.17,623.99
CULTURE UROGENITAL,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE UROGENITAL,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE UROGENITAL,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE VRE SCREEN,87081,HCPCS,300,RC,,both,83.27,74.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.29,,,,49.13,67.95
CULTURE VRE SCREEN,87081,HCPCS,300,RC,,both,83.27,74.94,Cigna,Default,Percent of Total Billed Charges,49.13,,,,49.13,67.95
CULTURE VRE SCREEN,87081,HCPCS,300,RC,,both,83.27,74.94,United Healthcare,Default,Fee Schedule,67.95,,,,49.13,67.95
CULTURE-SPUTUM,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-SPUTUM,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-SPUTUM,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-SPINAL FLUID,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-SPINAL FLUID,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-SPINAL FLUID,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-EAR,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-EAR,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-EAR,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-EYE,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-EYE,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-EYE,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-URINE,87086,HCPCS,306,RC,,both,94.88,85.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.42,,,,55.98,77.42
CULTURE-URINE,87086,HCPCS,306,RC,,both,94.88,85.39,Cigna,Default,Percent of Total Billed Charges,55.98,,,,55.98,77.42
CULTURE-URINE,87086,HCPCS,306,RC,,both,94.88,85.39,United Healthcare,Default,Fee Schedule,77.42,,,,55.98,77.42
CULTURE-THROAT,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-THROAT,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-THROAT,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-NOSE,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-NOSE,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-NOSE,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
BASIC MET PANEL,80048,HCPCS,301,RC,,both,126.81,114.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.77,,,,74.82,103.48
BASIC MET PANEL,80048,HCPCS,301,RC,,both,126.81,114.13,Cigna,Default,Percent of Total Billed Charges,74.82,,,,74.82,103.48
BASIC MET PANEL,80048,HCPCS,301,RC,,both,126.81,114.13,United Healthcare,Default,Fee Schedule,103.48,,,,74.82,103.48
ANTI-GBM PANEL (GBM ELISA),83516,HCPCS,300,RC,,both,182.75,164.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.92,,,,107.82,149.12
ANTI-GBM PANEL (GBM ELISA),83516,HCPCS,300,RC,,both,182.75,164.48,Cigna,Default,Percent of Total Billed Charges,107.82,,,,107.82,149.12
ANTI-GBM PANEL (GBM ELISA),83516,HCPCS,300,RC,,both,182.75,164.48,United Healthcare,Default,Fee Schedule,149.12,,,,107.82,149.12
COMP MET PANEL,80053,HCPCS,301,RC,,both,183.42,165.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.39,,,,108.22,149.67
COMP MET PANEL,80053,HCPCS,301,RC,,both,183.42,165.08,Cigna,Default,Percent of Total Billed Charges,108.22,,,,108.22,149.67
COMP MET PANEL,80053,HCPCS,301,RC,,both,183.42,165.08,United Healthcare,Default,Fee Schedule,149.67,,,,108.22,149.67
IM. ASSAY NOT INFECTIOUS AG OR AB,83516,HCPCS,300,RC,,both,63.25,56.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.28,,,,37.32,51.61
IM. ASSAY NOT INFECTIOUS AG OR AB,83516,HCPCS,300,RC,,both,63.25,56.93,Cigna,Default,Percent of Total Billed Charges,37.32,,,,37.32,51.61
IM. ASSAY NOT INFECTIOUS AG OR AB,83516,HCPCS,300,RC,,both,63.25,56.93,United Healthcare,Default,Fee Schedule,51.61,,,,37.32,51.61
RNA POLYMERASE III IGG,83520,HCPCS,301,RC,,both,146.06,131.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.24,,,,86.18,119.18
RNA POLYMERASE III IGG,83520,HCPCS,301,RC,,both,146.06,131.45,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.18
RNA POLYMERASE III IGG,83520,HCPCS,301,RC,,both,146.06,131.45,United Healthcare,Default,Fee Schedule,119.18,,,,86.18,119.18
GLUTAMIC ACID DECARBOXYIASE AB,83516,HCPCS,300,RC,,both,91.63,82.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.14,,,,54.06,74.77
GLUTAMIC ACID DECARBOXYIASE AB,83516,HCPCS,300,RC,,both,91.63,82.47,Cigna,Default,Percent of Total Billed Charges,54.06,,,,54.06,74.77
GLUTAMIC ACID DECARBOXYIASE AB,83516,HCPCS,300,RC,,both,91.63,82.47,United Healthcare,Default,Fee Schedule,74.77,,,,54.06,74.77
HISTONE AB,83516,HCPCS,301,RC,,both,70.9,63.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.63,,,,41.83,57.85
HISTONE AB,83516,HCPCS,301,RC,,both,70.9,63.81,Cigna,Default,Percent of Total Billed Charges,41.83,,,,41.83,57.85
HISTONE AB,83516,HCPCS,301,RC,,both,70.9,63.81,United Healthcare,Default,Fee Schedule,57.85,,,,41.83,57.85
COPEPTIN PROAVP,84588,HCPCS,301,RC,,both,304,273.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,212.8,,,,179.36,248.06
COPEPTIN PROAVP,84588,HCPCS,301,RC,,both,304,273.6,Cigna,Default,Percent of Total Billed Charges,179.36,,,,179.36,248.06
COPEPTIN PROAVP,84588,HCPCS,301,RC,,both,304,273.6,United Healthcare,Default,Fee Schedule,248.06,,,,179.36,248.06
17 KETOSTEROIDS (TOTAL),83586,HCPCS,301,RC,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
17 KETOSTEROIDS (TOTAL),83586,HCPCS,301,RC,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
17 KETOSTEROIDS (TOTAL),83586,HCPCS,301,RC,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
17 HYDROXYPROGESTERONE,83498,HCPCS,301,RC,,both,94.75,85.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.32,,,,55.9,77.32
17 HYDROXYPROGESTERONE,83498,HCPCS,301,RC,,both,94.75,85.28,Cigna,Default,Percent of Total Billed Charges,55.9,,,,55.9,77.32
17 HYDROXYPROGESTERONE,83498,HCPCS,301,RC,,both,94.75,85.28,United Healthcare,Default,Fee Schedule,77.32,,,,55.9,77.32
BLOOD DRAW - CAPILLARY,36416,HCPCS,300,RC,,both,17.7,15.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.39,,,,10.44,14.44
BLOOD DRAW - CAPILLARY,36416,HCPCS,300,RC,,both,17.7,15.93,Cigna,Default,Percent of Total Billed Charges,10.44,,,,10.44,14.44
BLOOD DRAW - CAPILLARY,36416,HCPCS,300,RC,,both,17.7,15.93,United Healthcare,Default,Fee Schedule,14.44,,,,10.44,14.44
BLOOD DRAWING,36415,HCPCS,300,RC,,both,17.2,15.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.04,,,,10.15,14.04
BLOOD DRAWING,36415,HCPCS,300,RC,,both,17.2,15.48,Cigna,Default,Percent of Total Billed Charges,10.15,,,,10.15,14.04
BLOOD DRAWING,36415,HCPCS,300,RC,,both,17.2,15.48,United Healthcare,Default,Fee Schedule,14.04,,,,10.15,14.04
COLLECTION FEE,72,RC,,,,both,31.97,28.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.38,,,,18.86,26.09
COLLECTION FEE,72,RC,,,,both,31.97,28.77,Cigna,Default,Percent of Total Billed Charges,18.86,,,,18.86,26.09
COLLECTION FEE,72,RC,,,,both,31.97,28.77,United Healthcare,Default,Fee Schedule,26.09,,,,18.86,26.09
BLOOD TYPING PHENOTYPE SEROLOGIC,86906,HCPCS,305,RC,,both,220.94,198.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.66,,,,130.35,180.29
BLOOD TYPING PHENOTYPE SEROLOGIC,86906,HCPCS,305,RC,,both,220.94,198.85,Cigna,Default,Percent of Total Billed Charges,130.35,,,,130.35,180.29
BLOOD TYPING PHENOTYPE SEROLOGIC,86906,HCPCS,305,RC,,both,220.94,198.85,United Healthcare,Default,Fee Schedule,180.29,,,,130.35,180.29
MELTZER-LYONS TEST,43756,HCPCS,750,RC,,both,46.25,41.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.38,,,,27.29,37.74
MELTZER-LYONS TEST,43756,HCPCS,750,RC,,both,46.25,41.63,Cigna,Default,Percent of Total Billed Charges,27.29,,,,27.29,37.74
MELTZER-LYONS TEST,43756,HCPCS,750,RC,,both,46.25,41.63,United Healthcare,Default,Fee Schedule,37.74,,,,27.29,37.74
CK-MB,82553,HCPCS,301,RC,,both,142.87,128.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.01,,,,84.29,116.58
CK-MB,82553,HCPCS,301,RC,,both,142.87,128.58,Cigna,Default,Percent of Total Billed Charges,84.29,,,,84.29,116.58
CK-MB,82553,HCPCS,301,RC,,both,142.87,128.58,United Healthcare,Default,Fee Schedule,116.58,,,,84.29,116.58
CK ISOENZYMES,82552,HCPCS,301,RC,,both,76.68,69.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.68,,,,45.24,62.57
CK ISOENZYMES,82552,HCPCS,301,RC,,both,76.68,69.01,Cigna,Default,Percent of Total Billed Charges,45.24,,,,45.24,62.57
CK ISOENZYMES,82552,HCPCS,301,RC,,both,76.68,69.01,United Healthcare,Default,Fee Schedule,62.57,,,,45.24,62.57
MYCOPLASMA PN IgG,86738,HCPCS,300,RC,,both,54.51,49.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.16,,,,32.16,44.48
MYCOPLASMA PN IgG,86738,HCPCS,300,RC,,both,54.51,49.06,Cigna,Default,Percent of Total Billed Charges,32.16,,,,32.16,44.48
MYCOPLASMA PN IgG,86738,HCPCS,300,RC,,both,54.51,49.06,United Healthcare,Default,Fee Schedule,44.48,,,,32.16,44.48
MYOGLOBIN-SERUM,83874,HCPCS,301,RC,,both,155.96,140.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.17,,,,92.02,127.26
MYOGLOBIN-SERUM,83874,HCPCS,301,RC,,both,155.96,140.36,Cigna,Default,Percent of Total Billed Charges,92.02,,,,92.02,127.26
MYOGLOBIN-SERUM,83874,HCPCS,301,RC,,both,155.96,140.36,United Healthcare,Default,Fee Schedule,127.26,,,,92.02,127.26
PROCAINMIDE & NAPA,80192,HCPCS,301,RC,,both,88,79.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.6,,,,51.92,71.81
PROCAINMIDE & NAPA,80192,HCPCS,301,RC,,both,88,79.2,Cigna,Default,Percent of Total Billed Charges,51.92,,,,51.92,71.81
PROCAINMIDE & NAPA,80192,HCPCS,301,RC,,both,88,79.2,United Healthcare,Default,Fee Schedule,71.81,,,,51.92,71.81
PRIMIDONE-MYSOLINE,80188,HCPCS,301,RC,,both,88,79.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.6,,,,51.92,71.81
PRIMIDONE-MYSOLINE,80188,HCPCS,301,RC,,both,88,79.2,Cigna,Default,Percent of Total Billed Charges,51.92,,,,51.92,71.81
PRIMIDONE-MYSOLINE,80188,HCPCS,301,RC,,both,88,79.2,United Healthcare,Default,Fee Schedule,71.81,,,,51.92,71.81
SEMEN ANALYSIS,89320,HCPCS,300,RC,,both,76.25,68.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.38,,,,44.99,62.22
SEMEN ANALYSIS,89320,HCPCS,300,RC,,both,76.25,68.63,Cigna,Default,Percent of Total Billed Charges,44.99,,,,44.99,62.22
SEMEN ANALYSIS,89320,HCPCS,300,RC,,both,76.25,68.63,United Healthcare,Default,Fee Schedule,62.22,,,,44.99,62.22
PHLEBOTOMY THERAPEUTIC,99195,HCPCS,940,RC,,both,332.95,299.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.06,,,,196.44,271.69
PHLEBOTOMY THERAPEUTIC,99195,HCPCS,940,RC,,both,332.95,299.66,Cigna,Default,Percent of Total Billed Charges,196.44,,,,196.44,271.69
PHLEBOTOMY THERAPEUTIC,99195,HCPCS,940,RC,,both,332.95,299.66,United Healthcare,Default,Fee Schedule,271.69,,,,196.44,271.69
RED CELL SEPERATION AB SCREEN,390,RC,,,,both,214.14,192.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.9,,,,126.34,174.74
RED CELL SEPERATION AB SCREEN,390,RC,,,,both,214.14,192.73,Cigna,Default,Percent of Total Billed Charges,126.34,,,,126.34,174.74
RED CELL SEPERATION AB SCREEN,390,RC,,,,both,214.14,192.73,United Healthcare,Default,Fee Schedule,174.74,,,,126.34,174.74
EBV QUANT PCR,87799,HCPCS,306,RC,,both,310.37,279.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,217.26,,,,183.12,253.26
EBV QUANT PCR,87799,HCPCS,306,RC,,both,310.37,279.33,Cigna,Default,Percent of Total Billed Charges,183.12,,,,183.12,253.26
EBV QUANT PCR,87799,HCPCS,306,RC,,both,310.37,279.33,United Healthcare,Default,Fee Schedule,253.26,,,,183.12,253.26
EBV ABS-EA,86663,HCPCS,300,RC,,both,53.36,48.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.35,,,,31.48,43.54
EBV ABS-EA,86663,HCPCS,300,RC,,both,53.36,48.02,Cigna,Default,Percent of Total Billed Charges,31.48,,,,31.48,43.54
EBV ABS-EA,86663,HCPCS,300,RC,,both,53.36,48.02,United Healthcare,Default,Fee Schedule,43.54,,,,31.48,43.54
HANTA VIRUS IgG,86790,HCPCS,300,RC,,both,94.75,85.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.32,,,,55.9,77.32
HANTA VIRUS IgG,86790,HCPCS,300,RC,,both,94.75,85.28,Cigna,Default,Percent of Total Billed Charges,55.9,,,,55.9,77.32
HANTA VIRUS IgG,86790,HCPCS,300,RC,,both,94.75,85.28,United Healthcare,Default,Fee Schedule,77.32,,,,55.9,77.32
WEST NILE VIRUS ABS,86789,HCPCS,300,RC,,both,200,180,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140,,,,118,163.2
WEST NILE VIRUS ABS,86789,HCPCS,300,RC,,both,200,180,Cigna,Default,Percent of Total Billed Charges,118,,,,118,163.2
WEST NILE VIRUS ABS,86789,HCPCS,300,RC,,both,200,180,United Healthcare,Default,Fee Schedule,163.2,,,,118,163.2
HTLV I/II ANTIBODIES,86790,HCPCS,300,RC,,both,40.46,36.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.32,,,,23.87,33.02
HTLV I/II ANTIBODIES,86790,HCPCS,300,RC,,both,40.46,36.41,Cigna,Default,Percent of Total Billed Charges,23.87,,,,23.87,33.02
HTLV I/II ANTIBODIES,86790,HCPCS,300,RC,,both,40.46,36.41,United Healthcare,Default,Fee Schedule,33.02,,,,23.87,33.02
PARAINFLUENZA IGG,86790,HCPCS,302,RC,,both,48.25,43.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.78,,,,28.47,39.37
PARAINFLUENZA IGG,86790,HCPCS,302,RC,,both,48.25,43.43,Cigna,Default,Percent of Total Billed Charges,28.47,,,,28.47,39.37
PARAINFLUENZA IGG,86790,HCPCS,302,RC,,both,48.25,43.43,United Healthcare,Default,Fee Schedule,39.37,,,,28.47,39.37
UROVYSION,88120,HCPCS,300,RC,,both,1155,1039.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,808.5,,,,681.45,942.48
UROVYSION,88120,HCPCS,300,RC,,both,1155,1039.5,Cigna,Default,Percent of Total Billed Charges,681.45,,,,681.45,942.48
UROVYSION,88120,HCPCS,300,RC,,both,1155,1039.5,United Healthcare,Default,Fee Schedule,942.48,,,,681.45,942.48
BETA 2 GLYCOPROT IGA,86146,HCPCS,300,RC,,both,381.75,343.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.22,,,,225.23,311.51
BETA 2 GLYCOPROT IGA,86146,HCPCS,300,RC,,both,381.75,343.58,Cigna,Default,Percent of Total Billed Charges,225.23,,,,225.23,311.51
BETA 2 GLYCOPROT IGA,86146,HCPCS,300,RC,,both,381.75,343.58,United Healthcare,Default,Fee Schedule,311.51,,,,225.23,311.51
BETA 2 GLYCOPROT IGG,86146,HCPCS,300,RC,,both,381.75,343.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.22,,,,225.23,311.51
BETA 2 GLYCOPROT IGG,86146,HCPCS,300,RC,,both,381.75,343.58,Cigna,Default,Percent of Total Billed Charges,225.23,,,,225.23,311.51
BETA 2 GLYCOPROT IGG,86146,HCPCS,300,RC,,both,381.75,343.58,United Healthcare,Default,Fee Schedule,311.51,,,,225.23,311.51
BETA 2 GLYCOPROT IGM,86146,HCPCS,300,RC,,both,381.75,343.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,267.22,,,,225.23,311.51
BETA 2 GLYCOPROT IGM,86146,HCPCS,300,RC,,both,381.75,343.58,Cigna,Default,Percent of Total Billed Charges,225.23,,,,225.23,311.51
BETA 2 GLYCOPROT IGM,86146,HCPCS,300,RC,,both,381.75,343.58,United Healthcare,Default,Fee Schedule,311.51,,,,225.23,311.51
CROSSMATCH AHG,86922,HCPCS,300,RC,,both,99,89.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.3,,,,58.41,80.78
CROSSMATCH AHG,86922,HCPCS,300,RC,,both,99,89.1,Cigna,Default,Percent of Total Billed Charges,58.41,,,,58.41,80.78
CROSSMATCH AHG,86922,HCPCS,300,RC,,both,99,89.1,United Healthcare,Default,Fee Schedule,80.78,,,,58.41,80.78
CROSSMATCH UNIT 2,86920,HCPCS,300,RC,,both,376.19,338.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.33,,,,221.95,306.97
CROSSMATCH UNIT 2,86920,HCPCS,300,RC,,both,376.19,338.57,Cigna,Default,Percent of Total Billed Charges,221.95,,,,221.95,306.97
CROSSMATCH UNIT 2,86920,HCPCS,300,RC,,both,376.19,338.57,United Healthcare,Default,Fee Schedule,306.97,,,,221.95,306.97
CROSSMATCH UNIT 3,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 3,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 3,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH UNIT 4,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 4,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 4,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH UNIT 5,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 5,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 5,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH UNIT 6,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 6,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 6,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH,86920,HCPCS,300,RC,,both,376.19,338.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.33,,,,221.95,306.97
CROSSMATCH,86920,HCPCS,300,RC,,both,376.19,338.57,Cigna,Default,Percent of Total Billed Charges,221.95,,,,221.95,306.97
CROSSMATCH,86920,HCPCS,300,RC,,both,376.19,338.57,United Healthcare,Default,Fee Schedule,306.97,,,,221.95,306.97
CROSSMATCH UNIT 12,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 12,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 12,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
BLD TYPG RH ONLY,86901,HCPCS,300,RC,,both,108.26,97.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.78,,,,63.87,88.34
BLD TYPG RH ONLY,86901,HCPCS,300,RC,,both,108.26,97.43,Cigna,Default,Percent of Total Billed Charges,63.87,,,,63.87,88.34
BLD TYPG RH ONLY,86901,HCPCS,300,RC,,both,108.26,97.43,United Healthcare,Default,Fee Schedule,88.34,,,,63.87,88.34
CROSSMATCH UNIT 7,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 7,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 7,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH UNIT 8,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 8,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 8,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH 37C,86921,HCPCS,300,RC,,both,84.25,75.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.98,,,,49.71,68.75
CROSSMATCH 37C,86921,HCPCS,300,RC,,both,84.25,75.83,Cigna,Default,Percent of Total Billed Charges,49.71,,,,49.71,68.75
CROSSMATCH 37C,86921,HCPCS,300,RC,,both,84.25,75.83,United Healthcare,Default,Fee Schedule,68.75,,,,49.71,68.75
CROSSMATCH UNIT 9,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 9,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 9,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH UNIT 10,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 10,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 10,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
CROSSMATCH UNIT 11,86920,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
CROSSMATCH UNIT 11,86920,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
CROSSMATCH UNIT 11,86920,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
ANTIBODY SCREEN,86850,HCPCS,300,RC,,both,174.36,156.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.05,,,,102.87,142.28
ANTIBODY SCREEN,86850,HCPCS,300,RC,,both,174.36,156.92,Cigna,Default,Percent of Total Billed Charges,102.87,,,,102.87,142.28
ANTIBODY SCREEN,86850,HCPCS,300,RC,,both,174.36,156.92,United Healthcare,Default,Fee Schedule,142.28,,,,102.87,142.28
RBC ENZYME TREATMENT,86971,HCPCS,300,RC,,both,146.06,131.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.24,,,,86.18,119.18
RBC ENZYME TREATMENT,86971,HCPCS,300,RC,,both,146.06,131.45,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.18
RBC ENZYME TREATMENT,86971,HCPCS,300,RC,,both,146.06,131.45,United Healthcare,Default,Fee Schedule,119.18,,,,86.18,119.18
PLATELET CROSSMATCH MACE 1,86805,HCPCS,300,RC,,both,244.65,220.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.26,,,,144.34,199.63
PLATELET CROSSMATCH MACE 1,86805,HCPCS,300,RC,,both,244.65,220.19,Cigna,Default,Percent of Total Billed Charges,144.34,,,,144.34,199.63
PLATELET CROSSMATCH MACE 1,86805,HCPCS,300,RC,,both,244.65,220.19,United Healthcare,Default,Fee Schedule,199.63,,,,144.34,199.63
PLATELET CROSSMATCH MACE 2,86922,HCPCS,300,RC,,both,384.25,345.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.98,,,,226.71,313.55
PLATELET CROSSMATCH MACE 2,86922,HCPCS,300,RC,,both,384.25,345.83,Cigna,Default,Percent of Total Billed Charges,226.71,,,,226.71,313.55
PLATELET CROSSMATCH MACE 2,86922,HCPCS,300,RC,,both,384.25,345.83,United Healthcare,Default,Fee Schedule,313.55,,,,226.71,313.55
DIRECT COOMBS TEST,86880,HCPCS,300,RC,,both,109.54,98.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.68,,,,64.63,89.38
DIRECT COOMBS TEST,86880,HCPCS,300,RC,,both,109.54,98.59,Cigna,Default,Percent of Total Billed Charges,64.63,,,,64.63,89.38
DIRECT COOMBS TEST,86880,HCPCS,300,RC,,both,109.54,98.59,United Healthcare,Default,Fee Schedule,89.38,,,,64.63,89.38
ECHINOCOCCUS AB,86682,HCPCS,300,RC,,both,87,78.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.9,,,,51.33,70.99
ECHINOCOCCUS AB,86682,HCPCS,300,RC,,both,87,78.3,Cigna,Default,Percent of Total Billed Charges,51.33,,,,51.33,70.99
ECHINOCOCCUS AB,86682,HCPCS,300,RC,,both,87,78.3,United Healthcare,Default,Fee Schedule,70.99,,,,51.33,70.99
ALDOSTERNE URINE,82088,HCPCS,301,RC,,both,136.79,123.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.75,,,,80.71,111.62
ALDOSTERNE URINE,82088,HCPCS,301,RC,,both,136.79,123.11,Cigna,Default,Percent of Total Billed Charges,80.71,,,,80.71,111.62
ALDOSTERNE URINE,82088,HCPCS,301,RC,,both,136.79,123.11,United Healthcare,Default,Fee Schedule,111.62,,,,80.71,111.62
ALKALINE PHOSPHATASE,84075,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
ALKALINE PHOSPHATASE,84075,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
ALKALINE PHOSPHATASE,84075,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
ALK PHOS ISOS,84080,HCPCS,301,RC,,both,125.41,112.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.79,,,,73.99,102.33
ALK PHOS ISOS,84080,HCPCS,301,RC,,both,125.41,112.87,Cigna,Default,Percent of Total Billed Charges,73.99,,,,73.99,102.33
ALK PHOS ISOS,84080,HCPCS,301,RC,,both,125.41,112.87,United Healthcare,Default,Fee Schedule,102.33,,,,73.99,102.33
ARBOVIRUS PANEL California,86651,HCPCS,300,RC,,both,51.25,46.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.88,,,,30.24,41.82
ARBOVIRUS PANEL California,86651,HCPCS,300,RC,,both,51.25,46.13,Cigna,Default,Percent of Total Billed Charges,30.24,,,,30.24,41.82
ARBOVIRUS PANEL California,86651,HCPCS,300,RC,,both,51.25,46.13,United Healthcare,Default,Fee Schedule,41.82,,,,30.24,41.82
INTRINSIC FACTOR BLOCK ANTIBODY,86340,HCPCS,306,RC,,both,140.08,126.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.06,,,,82.65,114.31
INTRINSIC FACTOR BLOCK ANTIBODY,86340,HCPCS,306,RC,,both,140.08,126.07,Cigna,Default,Percent of Total Billed Charges,82.65,,,,82.65,114.31
INTRINSIC FACTOR BLOCK ANTIBODY,86340,HCPCS,306,RC,,both,140.08,126.07,United Healthcare,Default,Fee Schedule,114.31,,,,82.65,114.31
ARTERIAL BLD GAS EPOC,82803,HCPCS,301,RC,,both,256.28,230.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,179.4,,,,151.21,209.12
ARTERIAL BLD GAS EPOC,82803,HCPCS,301,RC,,both,256.28,230.65,Cigna,Default,Percent of Total Billed Charges,151.21,,,,151.21,209.12
ARTERIAL BLD GAS EPOC,82803,HCPCS,301,RC,,both,256.28,230.65,United Healthcare,Default,Fee Schedule,209.12,,,,151.21,209.12
TB IDENTIFICATION,87149,HCPCS,300,RC,,both,128.65,115.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.06,,,,75.9,104.98
TB IDENTIFICATION,87149,HCPCS,300,RC,,both,128.65,115.79,Cigna,Default,Percent of Total Billed Charges,75.9,,,,75.9,104.98
TB IDENTIFICATION,87149,HCPCS,300,RC,,both,128.65,115.79,United Healthcare,Default,Fee Schedule,104.98,,,,75.9,104.98
BACTERIAL ID 1,87077,HCPCS,300,RC,,both,70.78,63.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.55,,,,41.76,57.76
BACTERIAL ID 1,87077,HCPCS,300,RC,,both,70.78,63.7,Cigna,Default,Percent of Total Billed Charges,41.76,,,,41.76,57.76
BACTERIAL ID 1,87077,HCPCS,300,RC,,both,70.78,63.7,United Healthcare,Default,Fee Schedule,57.76,,,,41.76,57.76
REF BACTERIAL ID(MULTI-STEP),87077,HCPCS,300,RC,,both,136.33,122.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.43,,,,80.43,111.25
REF BACTERIAL ID(MULTI-STEP),87077,HCPCS,300,RC,,both,136.33,122.7,Cigna,Default,Percent of Total Billed Charges,80.43,,,,80.43,111.25
REF BACTERIAL ID(MULTI-STEP),87077,HCPCS,300,RC,,both,136.33,122.7,United Healthcare,Default,Fee Schedule,111.25,,,,80.43,111.25
BACTERIAL ID 2,87077,HCPCS,300,RC,,both,70.78,63.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.55,,,,41.76,57.76
BACTERIAL ID 2,87077,HCPCS,300,RC,,both,70.78,63.7,Cigna,Default,Percent of Total Billed Charges,41.76,,,,41.76,57.76
BACTERIAL ID 2,87077,HCPCS,300,RC,,both,70.78,63.7,United Healthcare,Default,Fee Schedule,57.76,,,,41.76,57.76
BACTERIAL ID 3,87077,HCPCS,300,RC,,both,63,56.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.1,,,,37.17,51.41
BACTERIAL ID 3,87077,HCPCS,300,RC,,both,63,56.7,Cigna,Default,Percent of Total Billed Charges,37.17,,,,37.17,51.41
BACTERIAL ID 3,87077,HCPCS,300,RC,,both,63,56.7,United Healthcare,Default,Fee Schedule,51.41,,,,37.17,51.41
BACTERIAL ID 4,87077,HCPCS,300,RC,,both,63,56.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.1,,,,37.17,51.41
BACTERIAL ID 4,87077,HCPCS,300,RC,,both,63,56.7,Cigna,Default,Percent of Total Billed Charges,37.17,,,,37.17,51.41
BACTERIAL ID 4,87077,HCPCS,300,RC,,both,63,56.7,United Healthcare,Default,Fee Schedule,51.41,,,,37.17,51.41
ANAEROBIC BACT ID,87076,HCPCS,306,RC,,both,21.15,19.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.8,,,,12.48,17.26
ANAEROBIC BACT ID,87076,HCPCS,306,RC,,both,21.15,19.04,Cigna,Default,Percent of Total Billed Charges,12.48,,,,12.48,17.26
ANAEROBIC BACT ID,87076,HCPCS,306,RC,,both,21.15,19.04,United Healthcare,Default,Fee Schedule,17.26,,,,12.48,17.26
PARIETAL CELL AB IGG,83516,HCPCS,306,RC,,both,195.7,176.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.99,,,,115.46,159.69
PARIETAL CELL AB IGG,83516,HCPCS,306,RC,,both,195.7,176.13,Cigna,Default,Percent of Total Billed Charges,115.46,,,,115.46,159.69
PARIETAL CELL AB IGG,83516,HCPCS,306,RC,,both,195.7,176.13,United Healthcare,Default,Fee Schedule,159.69,,,,115.46,159.69
CULTURE-FUNGUS,87102,HCPCS,300,RC,,both,55.05,49.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.54,,,,32.48,44.92
CULTURE-FUNGUS,87102,HCPCS,300,RC,,both,55.05,49.55,Cigna,Default,Percent of Total Billed Charges,32.48,,,,32.48,44.92
CULTURE-FUNGUS,87102,HCPCS,300,RC,,both,55.05,49.55,United Healthcare,Default,Fee Schedule,44.92,,,,32.48,44.92
FUNGUS MOLD ID,87107,HCPCS,306,RC,,both,143.2,128.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.24,,,,84.49,116.85
FUNGUS MOLD ID,87107,HCPCS,306,RC,,both,143.2,128.88,Cigna,Default,Percent of Total Billed Charges,84.49,,,,84.49,116.85
FUNGUS MOLD ID,87107,HCPCS,306,RC,,both,143.2,128.88,United Healthcare,Default,Fee Schedule,116.85,,,,84.49,116.85
FUNGUS ID PANEL,87107,HCPCS,306,RC,,both,218.38,196.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.87,,,,128.84,178.2
FUNGUS ID PANEL,87107,HCPCS,306,RC,,both,218.38,196.54,Cigna,Default,Percent of Total Billed Charges,128.84,,,,128.84,178.2
FUNGUS ID PANEL,87107,HCPCS,306,RC,,both,218.38,196.54,United Healthcare,Default,Fee Schedule,178.2,,,,128.84,178.2
ID DNA/RNA SEQUENCING,87153,HCPCS,306,RC,,both,439.97,395.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.98,,,,259.58,359.02
ID DNA/RNA SEQUENCING,87153,HCPCS,306,RC,,both,439.97,395.97,Cigna,Default,Percent of Total Billed Charges,259.58,,,,259.58,359.02
ID DNA/RNA SEQUENCING,87153,HCPCS,306,RC,,both,439.97,395.97,United Healthcare,Default,Fee Schedule,359.02,,,,259.58,359.02
ASPERGUILLUS AB TITER,86606,HCPCS,300,RC,,both,115.03,103.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.52,,,,67.87,93.86
ASPERGUILLUS AB TITER,86606,HCPCS,300,RC,,both,115.03,103.53,Cigna,Default,Percent of Total Billed Charges,67.87,,,,67.87,93.86
ASPERGUILLUS AB TITER,86606,HCPCS,300,RC,,both,115.03,103.53,United Healthcare,Default,Fee Schedule,93.86,,,,67.87,93.86
5' NUCLEOTIDASE,83915,HCPCS,300,RC,,both,263.42,237.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.39,,,,155.42,214.95
5' NUCLEOTIDASE,83915,HCPCS,300,RC,,both,263.42,237.08,Cigna,Default,Percent of Total Billed Charges,155.42,,,,155.42,214.95
5' NUCLEOTIDASE,83915,HCPCS,300,RC,,both,263.42,237.08,United Healthcare,Default,Fee Schedule,214.95,,,,155.42,214.95
D-XYLOSE,84620,HCPCS,301,RC,,both,123.75,111.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.62,,,,73.01,100.98
D-XYLOSE,84620,HCPCS,301,RC,,both,123.75,111.38,Cigna,Default,Percent of Total Billed Charges,73.01,,,,73.01,100.98
D-XYLOSE,84620,HCPCS,301,RC,,both,123.75,111.38,United Healthcare,Default,Fee Schedule,100.98,,,,73.01,100.98
TSH,84443,HCPCS,301,RC,,both,143.96,129.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.77,,,,84.94,117.47
TSH,84443,HCPCS,301,RC,,both,143.96,129.56,Cigna,Default,Percent of Total Billed Charges,84.94,,,,84.94,117.47
TSH,84443,HCPCS,301,RC,,both,143.96,129.56,United Healthcare,Default,Fee Schedule,117.47,,,,84.94,117.47
THYROID STIMULATING IMMUNOGLOBULIN,84445,HCPCS,301,RC,,both,210.39,189.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.27,,,,124.13,171.68
THYROID STIMULATING IMMUNOGLOBULIN,84445,HCPCS,301,RC,,both,210.39,189.35,Cigna,Default,Percent of Total Billed Charges,124.13,,,,124.13,171.68
THYROID STIMULATING IMMUNOGLOBULIN,84445,HCPCS,301,RC,,both,210.39,189.35,United Healthcare,Default,Fee Schedule,171.68,,,,124.13,171.68
THYROTROPIN REC AB,83520,HCPCS,301,RC,,both,99.43,89.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.6,,,,58.66,81.13
THYROTROPIN REC AB,83520,HCPCS,301,RC,,both,99.43,89.49,Cigna,Default,Percent of Total Billed Charges,58.66,,,,58.66,81.13
THYROTROPIN REC AB,83520,HCPCS,301,RC,,both,99.43,89.49,United Healthcare,Default,Fee Schedule,81.13,,,,58.66,81.13
CATECHLMNS/FRACT URINE,82384,HCPCS,301,RC,,both,124.98,112.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.49,,,,73.74,101.98
CATECHLMNS/FRACT URINE,82384,HCPCS,301,RC,,both,124.98,112.48,Cigna,Default,Percent of Total Billed Charges,73.74,,,,73.74,101.98
CATECHLMNS/FRACT URINE,82384,HCPCS,301,RC,,both,124.98,112.48,United Healthcare,Default,Fee Schedule,101.98,,,,73.74,101.98
CATECHLMNS/PLASMA,82384,HCPCS,301,RC,,both,124.98,112.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.49,,,,73.74,101.98
CATECHLMNS/PLASMA,82384,HCPCS,301,RC,,both,124.98,112.48,Cigna,Default,Percent of Total Billed Charges,73.74,,,,73.74,101.98
CATECHLMNS/PLASMA,82384,HCPCS,301,RC,,both,124.98,112.48,United Healthcare,Default,Fee Schedule,101.98,,,,73.74,101.98
ANA SCREEN,86038,HCPCS,300,RC,,both,112.55,101.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.78,,,,66.4,91.84
ANA SCREEN,86038,HCPCS,300,RC,,both,112.55,101.3,Cigna,Default,Percent of Total Billed Charges,66.4,,,,66.4,91.84
ANA SCREEN,86038,HCPCS,300,RC,,both,112.55,101.3,United Healthcare,Default,Fee Schedule,91.84,,,,66.4,91.84
ANA TITER,86039,HCPCS,300,RC,,both,95.76,86.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.03,,,,56.5,78.14
ANA TITER,86039,HCPCS,300,RC,,both,95.76,86.18,Cigna,Default,Percent of Total Billed Charges,56.5,,,,56.5,78.14
ANA TITER,86039,HCPCS,300,RC,,both,95.76,86.18,United Healthcare,Default,Fee Schedule,78.14,,,,56.5,78.14
METHEMOGLOBIN QUANT,83050,HCPCS,301,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
METHEMOGLOBIN QUANT,83050,HCPCS,301,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
METHEMOGLOBIN QUANT,83050,HCPCS,301,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
ANCA IgG,86255,HCPCS,300,RC,,both,158.15,142.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.31,129.05
ANCA IgG,86255,HCPCS,300,RC,,both,158.15,142.34,Cigna,Default,Percent of Total Billed Charges,93.31,,,,93.31,129.05
ANCA IgG,86255,HCPCS,300,RC,,both,158.15,142.34,United Healthcare,Default,Fee Schedule,129.05,,,,93.31,129.05
ANCA TITER,86256,HCPCS,300,RC,,both,63.49,57.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.44,,,,37.46,51.81
ANCA TITER,86256,HCPCS,300,RC,,both,63.49,57.14,Cigna,Default,Percent of Total Billed Charges,37.46,,,,37.46,51.81
ANCA TITER,86256,HCPCS,300,RC,,both,63.49,57.14,United Healthcare,Default,Fee Schedule,51.81,,,,37.46,51.81
METANEPHRINE 24 HR UR,83835,HCPCS,301,RC,,both,91.85,82.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.3,,,,54.19,74.95
METANEPHRINE 24 HR UR,83835,HCPCS,301,RC,,both,91.85,82.67,Cigna,Default,Percent of Total Billed Charges,54.19,,,,54.19,74.95
METANEPHRINE 24 HR UR,83835,HCPCS,301,RC,,both,91.85,82.67,United Healthcare,Default,Fee Schedule,74.95,,,,54.19,74.95
CHYMOTRYPSIN STOOL,84311,HCPCS,301,RC,,both,452.1,406.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.47,,,,266.74,368.91
CHYMOTRYPSIN STOOL,84311,HCPCS,301,RC,,both,452.1,406.89,Cigna,Default,Percent of Total Billed Charges,266.74,,,,266.74,368.91
CHYMOTRYPSIN STOOL,84311,HCPCS,301,RC,,both,452.1,406.89,United Healthcare,Default,Fee Schedule,368.91,,,,266.74,368.91
CMV AB IGG,86644,HCPCS,300,RC,,both,92,82.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.4,,,,54.28,75.07
CMV AB IGG,86644,HCPCS,300,RC,,both,92,82.8,Cigna,Default,Percent of Total Billed Charges,54.28,,,,54.28,75.07
CMV AB IGG,86644,HCPCS,300,RC,,both,92,82.8,United Healthcare,Default,Fee Schedule,75.07,,,,54.28,75.07
AB CMV IGM,86645,HCPCS,300,RC,,both,91.91,82.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.34,,,,54.23,75
AB CMV IGM,86645,HCPCS,300,RC,,both,91.91,82.72,Cigna,Default,Percent of Total Billed Charges,54.23,,,,54.23,75
AB CMV IGM,86645,HCPCS,300,RC,,both,91.91,82.72,United Healthcare,Default,Fee Schedule,75,,,,54.23,75
CONCENTRATION AFB,87015,HCPCS,306,RC,,both,37.35,33.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.14,,,,22.04,30.48
CONCENTRATION AFB,87015,HCPCS,306,RC,,both,37.35,33.62,Cigna,Default,Percent of Total Billed Charges,22.04,,,,22.04,30.48
CONCENTRATION AFB,87015,HCPCS,306,RC,,both,37.35,33.62,United Healthcare,Default,Fee Schedule,30.48,,,,22.04,30.48
ACID FAST STAIN,87206,HCPCS,306,RC,,both,30.06,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.74,24.53
ACID FAST STAIN,87206,HCPCS,306,RC,,both,30.06,27.05,Cigna,Default,Percent of Total Billed Charges,17.74,,,,17.74,24.53
ACID FAST STAIN,87206,HCPCS,306,RC,,both,30.06,27.05,United Healthcare,Default,Fee Schedule,24.53,,,,17.74,24.53
CULTURE-AFB,87116,HCPCS,306,RC,,both,247.57,222.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.3,,,,146.07,202.02
CULTURE-AFB,87116,HCPCS,306,RC,,both,247.57,222.81,Cigna,Default,Percent of Total Billed Charges,146.07,,,,146.07,202.02
CULTURE-AFB,87116,HCPCS,306,RC,,both,247.57,222.81,United Healthcare,Default,Fee Schedule,202.02,,,,146.07,202.02
AMINOLEVULINIC ACID URINE,82135,HCPCS,301,RC,,both,91.75,82.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.22,,,,54.13,74.87
AMINOLEVULINIC ACID URINE,82135,HCPCS,301,RC,,both,91.75,82.58,Cigna,Default,Percent of Total Billed Charges,54.13,,,,54.13,74.87
AMINOLEVULINIC ACID URINE,82135,HCPCS,301,RC,,both,91.75,82.58,United Healthcare,Default,Fee Schedule,74.87,,,,54.13,74.87
"PORPHYRINS, URINE",84120,HCPCS,301,RC,,both,109.19,98.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.43,,,,64.42,89.1
"PORPHYRINS, URINE",84120,HCPCS,301,RC,,both,109.19,98.27,Cigna,Default,Percent of Total Billed Charges,64.42,,,,64.42,89.1
"PORPHYRINS, URINE",84120,HCPCS,301,RC,,both,109.19,98.27,United Healthcare,Default,Fee Schedule,89.1,,,,64.42,89.1
PORPHOBILINOGEN URINE,84110,HCPCS,301,RC,,both,78.64,70.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.05,,,,46.4,64.17
PORPHOBILINOGEN URINE,84110,HCPCS,301,RC,,both,78.64,70.78,Cigna,Default,Percent of Total Billed Charges,46.4,,,,46.4,64.17
PORPHOBILINOGEN URINE,84110,HCPCS,301,RC,,both,78.64,70.78,United Healthcare,Default,Fee Schedule,64.17,,,,46.4,64.17
BK VIRUS PCR PLASMA,87799,HCPCS,301,RC,,both,695.27,625.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,486.69,,,,410.21,567.34
BK VIRUS PCR PLASMA,87799,HCPCS,301,RC,,both,695.27,625.74,Cigna,Default,Percent of Total Billed Charges,410.21,,,,410.21,567.34
BK VIRUS PCR PLASMA,87799,HCPCS,301,RC,,both,695.27,625.74,United Healthcare,Default,Fee Schedule,567.34,,,,410.21,567.34
LEFLUNOMODE,80193,HCPCS,301,RC,,both,524.64,472.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,367.25,,,,309.54,428.11
LEFLUNOMODE,80193,HCPCS,301,RC,,both,524.64,472.18,Cigna,Default,Percent of Total Billed Charges,309.54,,,,309.54,428.11
LEFLUNOMODE,80193,HCPCS,301,RC,,both,524.64,472.18,United Healthcare,Default,Fee Schedule,428.11,,,,309.54,428.11
ALPHAFETOPROT MATRNL,82105,HCPCS,301,RC,,both,91.85,82.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.3,,,,54.19,74.95
ALPHAFETOPROT MATRNL,82105,HCPCS,301,RC,,both,91.85,82.67,Cigna,Default,Percent of Total Billed Charges,54.19,,,,54.19,74.95
ALPHAFETOPROT MATRNL,82105,HCPCS,301,RC,,both,91.85,82.67,United Healthcare,Default,Fee Schedule,74.95,,,,54.19,74.95
ALDOSTERNE SERUM,82088,HCPCS,301,RC,,both,136.79,123.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.75,,,,80.71,111.62
ALDOSTERNE SERUM,82088,HCPCS,301,RC,,both,136.79,123.11,Cigna,Default,Percent of Total Billed Charges,80.71,,,,80.71,111.62
ALDOSTERNE SERUM,82088,HCPCS,301,RC,,both,136.79,123.11,United Healthcare,Default,Fee Schedule,111.62,,,,80.71,111.62
ALPHA 1 ANTITRYPSIN,82103,HCPCS,301,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
ALPHA 1 ANTITRYPSIN,82103,HCPCS,301,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
ALPHA 1 ANTITRYPSIN,82103,HCPCS,301,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
ALPHA 1 ANTITRYPSIN - PHENOTYPE,82104,HCPCS,301,RC,,both,183.42,165.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.39,,,,108.22,149.67
ALPHA 1 ANTITRYPSIN - PHENOTYPE,82104,HCPCS,301,RC,,both,183.42,165.08,Cigna,Default,Percent of Total Billed Charges,108.22,,,,108.22,149.67
ALPHA 1 ANTITRYPSIN - PHENOTYPE,82104,HCPCS,301,RC,,both,183.42,165.08,United Healthcare,Default,Fee Schedule,149.67,,,,108.22,149.67
STOOL ALPHA 1 ANTITRYPSIN,82103,HCPCS,301,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
STOOL ALPHA 1 ANTITRYPSIN,82103,HCPCS,301,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
STOOL ALPHA 1 ANTITRYPSIN,82103,HCPCS,301,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
ALPHA FETOPROTEIN L3,82107,HCPCS,301,RC,,both,277.25,249.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,194.08,,,,163.58,226.24
ALPHA FETOPROTEIN L3,82107,HCPCS,301,RC,,both,277.25,249.53,Cigna,Default,Percent of Total Billed Charges,163.58,,,,163.58,226.24
ALPHA FETOPROTEIN L3,82107,HCPCS,301,RC,,both,277.25,249.53,United Healthcare,Default,Fee Schedule,226.24,,,,163.58,226.24
ALPHA FETOPROT TM,82105,HCPCS,301,RC,,both,91.85,82.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.3,,,,54.19,74.95
ALPHA FETOPROT TM,82105,HCPCS,301,RC,,both,91.85,82.67,Cigna,Default,Percent of Total Billed Charges,54.19,,,,54.19,74.95
ALPHA FETOPROT TM,82105,HCPCS,301,RC,,both,91.85,82.67,United Healthcare,Default,Fee Schedule,74.95,,,,54.19,74.95
AMOEBIC AB TITER,86753,HCPCS,300,RC,,both,185.5,166.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.85,,,,109.44,151.37
AMOEBIC AB TITER,86753,HCPCS,300,RC,,both,185.5,166.95,Cigna,Default,Percent of Total Billed Charges,109.44,,,,109.44,151.37
AMOEBIC AB TITER,86753,HCPCS,300,RC,,both,185.5,166.95,United Healthcare,Default,Fee Schedule,151.37,,,,109.44,151.37
INTRACONAZOLE,80299,HCPCS,301,RC,,both,126.68,114.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.68,,,,74.74,103.37
INTRACONAZOLE,80299,HCPCS,301,RC,,both,126.68,114.01,Cigna,Default,Percent of Total Billed Charges,74.74,,,,74.74,103.37
INTRACONAZOLE,80299,HCPCS,301,RC,,both,126.68,114.01,United Healthcare,Default,Fee Schedule,103.37,,,,74.74,103.37
AMIODARONE,80299,HCPCS,301,RC,,both,76.25,68.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.38,,,,44.99,62.22
AMIODARONE,80299,HCPCS,301,RC,,both,76.25,68.63,Cigna,Default,Percent of Total Billed Charges,44.99,,,,44.99,62.22
AMIODARONE,80299,HCPCS,301,RC,,both,76.25,68.63,United Healthcare,Default,Fee Schedule,62.22,,,,44.99,62.22
BLASTOMYCES AB-BY CF,86612,HCPCS,300,RC,,both,85.5,76.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.85,,,,50.44,69.77
BLASTOMYCES AB-BY CF,86612,HCPCS,300,RC,,both,85.5,76.95,Cigna,Default,Percent of Total Billed Charges,50.44,,,,50.44,69.77
BLASTOMYCES AB-BY CF,86612,HCPCS,300,RC,,both,85.5,76.95,United Healthcare,Default,Fee Schedule,69.77,,,,50.44,69.77
VARICELLA ZOSTER IGG,86787,HCPCS,300,RC,,both,41.28,37.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.9,,,,24.36,33.68
VARICELLA ZOSTER IGG,86787,HCPCS,300,RC,,both,41.28,37.15,Cigna,Default,Percent of Total Billed Charges,24.36,,,,24.36,33.68
VARICELLA ZOSTER IGG,86787,HCPCS,300,RC,,both,41.28,37.15,United Healthcare,Default,Fee Schedule,33.68,,,,24.36,33.68
VARICELLA ZOSTER IGM,86787,HCPCS,300,RC,,both,41.28,37.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.9,,,,24.36,33.68
VARICELLA ZOSTER IGM,86787,HCPCS,300,RC,,both,41.28,37.15,Cigna,Default,Percent of Total Billed Charges,24.36,,,,24.36,33.68
VARICELLA ZOSTER IGM,86787,HCPCS,300,RC,,both,41.28,37.15,United Healthcare,Default,Fee Schedule,33.68,,,,24.36,33.68
HERPES SIMPLX IGM TYPE I,86695,HCPCS,300,RC,,both,87,78.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.9,,,,51.33,70.99
HERPES SIMPLX IGM TYPE I,86695,HCPCS,300,RC,,both,87,78.3,Cigna,Default,Percent of Total Billed Charges,51.33,,,,51.33,70.99
HERPES SIMPLX IGM TYPE I,86695,HCPCS,300,RC,,both,87,78.3,United Healthcare,Default,Fee Schedule,70.99,,,,51.33,70.99
HERP SIMPLX IGG  I AND 2,86695,HCPCS,300,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
HERP SIMPLX IGG  I AND 2,86695,HCPCS,300,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
HERP SIMPLX IGG  I AND 2,86695,HCPCS,300,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
HSV 2 GLYCOPROTEIN G AB IGG,86696,HCPCS,300,RC,,both,183.13,164.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.19,,,,108.05,149.43
HSV 2 GLYCOPROTEIN G AB IGG,86696,HCPCS,300,RC,,both,183.13,164.82,Cigna,Default,Percent of Total Billed Charges,108.05,,,,108.05,149.43
HSV 2 GLYCOPROTEIN G AB IGG,86696,HCPCS,300,RC,,both,183.13,164.82,United Healthcare,Default,Fee Schedule,149.43,,,,108.05,149.43
HERPES SIMPLX IGM TYPES 1 AND 2,86694,HCPCS,302,RC,,both,71.6,64.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.12,,,,42.24,58.43
HERPES SIMPLX IGM TYPES 1 AND 2,86694,HCPCS,302,RC,,both,71.6,64.44,Cigna,Default,Percent of Total Billed Charges,42.24,,,,42.24,58.43
HERPES SIMPLX IGM TYPES 1 AND 2,86694,HCPCS,302,RC,,both,71.6,64.44,United Healthcare,Default,Fee Schedule,58.43,,,,42.24,58.43
VDRL,86592,HCPCS,300,RC,,both,38.48,34.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.94,,,,22.7,31.4
VDRL,86592,HCPCS,300,RC,,both,38.48,34.63,Cigna,Default,Percent of Total Billed Charges,22.7,,,,22.7,31.4
VDRL,86592,HCPCS,300,RC,,both,38.48,34.63,United Healthcare,Default,Fee Schedule,31.4,,,,22.7,31.4
PH VENOUS BLOOD,82800,HCPCS,301,RC,,both,57.58,51.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.31,,,,33.97,46.99
PH VENOUS BLOOD,82800,HCPCS,301,RC,,both,57.58,51.82,Cigna,Default,Percent of Total Billed Charges,33.97,,,,33.97,46.99
PH VENOUS BLOOD,82800,HCPCS,301,RC,,both,57.58,51.82,United Healthcare,Default,Fee Schedule,46.99,,,,33.97,46.99
PRSTTC ACD PHOS,84066,HCPCS,301,RC,,both,72.47,65.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.73,,,,42.76,59.14
PRSTTC ACD PHOS,84066,HCPCS,301,RC,,both,72.47,65.22,Cigna,Default,Percent of Total Billed Charges,42.76,,,,42.76,59.14
PRSTTC ACD PHOS,84066,HCPCS,301,RC,,both,72.47,65.22,United Healthcare,Default,Fee Schedule,59.14,,,,42.76,59.14
ALLOGENIC ADSORPTION,86978,HCPCS,301,RC,,both,264,237.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.8,,,,155.76,215.42
ALLOGENIC ADSORPTION,86978,HCPCS,301,RC,,both,264,237.6,Cigna,Default,Percent of Total Billed Charges,155.76,,,,155.76,215.42
ALLOGENIC ADSORPTION,86978,HCPCS,301,RC,,both,264,237.6,United Healthcare,Default,Fee Schedule,215.42,,,,155.76,215.42
ELCTRPHRSS URINE PROTEIN,84166,HCPCS,301,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
ELCTRPHRSS URINE PROTEIN,84166,HCPCS,301,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
ELCTRPHRSS URINE PROTEIN,84166,HCPCS,301,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
ELCTRPHRSS-PROTEIN SERU,84165,HCPCS,301,RC,,both,105.78,95.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.05,,,,62.41,86.32
ELCTRPHRSS-PROTEIN SERU,84165,HCPCS,301,RC,,both,105.78,95.2,Cigna,Default,Percent of Total Billed Charges,62.41,,,,62.41,86.32
ELCTRPHRSS-PROTEIN SERU,84165,HCPCS,301,RC,,both,105.78,95.2,United Healthcare,Default,Fee Schedule,86.32,,,,62.41,86.32
FREE LIGHT CHAINS SERUM,83883,HCPCS,301,RC,,both,241.02,216.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.71,,,,142.2,196.67
FREE LIGHT CHAINS SERUM,83883,HCPCS,301,RC,,both,241.02,216.92,Cigna,Default,Percent of Total Billed Charges,142.2,,,,142.2,196.67
FREE LIGHT CHAINS SERUM,83883,HCPCS,301,RC,,both,241.02,216.92,United Healthcare,Default,Fee Schedule,196.67,,,,142.2,196.67
FREE LIGHT CHAINS K/L SERUM,83883,HCPCS,301,RC,,both,123.24,110.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.27,,,,72.71,100.56
FREE LIGHT CHAINS K/L SERUM,83883,HCPCS,301,RC,,both,123.24,110.92,Cigna,Default,Percent of Total Billed Charges,72.71,,,,72.71,100.56
FREE LIGHT CHAINS K/L SERUM,83883,HCPCS,301,RC,,both,123.24,110.92,United Healthcare,Default,Fee Schedule,100.56,,,,72.71,100.56
FREE LITE CHAINS - KAPPA URINE,83883,HCPCS,300,RC,,both,123.24,110.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.27,,,,72.71,100.56
FREE LITE CHAINS - KAPPA URINE,83883,HCPCS,300,RC,,both,123.24,110.92,Cigna,Default,Percent of Total Billed Charges,72.71,,,,72.71,100.56
FREE LITE CHAINS - KAPPA URINE,83883,HCPCS,300,RC,,both,123.24,110.92,United Healthcare,Default,Fee Schedule,100.56,,,,72.71,100.56
FREE LITE CHAINS  LAMBDA URINE,83883,HCPCS,300,RC,,both,123.24,110.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.27,,,,72.71,100.56
FREE LITE CHAINS  LAMBDA URINE,83883,HCPCS,300,RC,,both,123.24,110.92,Cigna,Default,Percent of Total Billed Charges,72.71,,,,72.71,100.56
FREE LITE CHAINS  LAMBDA URINE,83883,HCPCS,300,RC,,both,123.24,110.92,United Healthcare,Default,Fee Schedule,100.56,,,,72.71,100.56
ELECTROPHORESIS URINE RANDOM,84166,HCPCS,301,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
ELECTROPHORESIS URINE RANDOM,84166,HCPCS,301,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
ELECTROPHORESIS URINE RANDOM,84166,HCPCS,301,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
FROZ PROG RECEPTOR,84234,HCPCS,301,RC,,both,266.29,239.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.4,,,,157.11,217.29
FROZ PROG RECEPTOR,84234,HCPCS,301,RC,,both,266.29,239.66,Cigna,Default,Percent of Total Billed Charges,157.11,,,,157.11,217.29
FROZ PROG RECEPTOR,84234,HCPCS,301,RC,,both,266.29,239.66,United Healthcare,Default,Fee Schedule,217.29,,,,157.11,217.29
ESTRGN-TOTL SER/UR,82672,HCPCS,301,RC,,both,288.25,259.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.78,,,,170.07,235.21
ESTRGN-TOTL SER/UR,82672,HCPCS,301,RC,,both,288.25,259.43,Cigna,Default,Percent of Total Billed Charges,170.07,,,,170.07,235.21
ESTRGN-TOTL SER/UR,82672,HCPCS,301,RC,,both,288.25,259.43,United Healthcare,Default,Fee Schedule,235.21,,,,170.07,235.21
CORTISOL BLOOD (TOTAL),82533,HCPCS,301,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
CORTISOL BLOOD (TOTAL),82533,HCPCS,301,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
CORTISOL BLOOD (TOTAL),82533,HCPCS,301,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
FREE CORTISOL SERUM,82530,HCPCS,301,RC,,both,85.68,77.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.98,,,,50.55,69.91
FREE CORTISOL SERUM,82530,HCPCS,301,RC,,both,85.68,77.11,Cigna,Default,Percent of Total Billed Charges,50.55,,,,50.55,69.91
FREE CORTISOL SERUM,82530,HCPCS,301,RC,,both,85.68,77.11,United Healthcare,Default,Fee Schedule,69.91,,,,50.55,69.91
CORTISOL SALIVA,82533,HCPCS,301,RC,,both,141.81,127.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.27,,,,83.67,115.72
CORTISOL SALIVA,82533,HCPCS,301,RC,,both,141.81,127.63,Cigna,Default,Percent of Total Billed Charges,83.67,,,,83.67,115.72
CORTISOL SALIVA,82533,HCPCS,301,RC,,both,141.81,127.63,United Healthcare,Default,Fee Schedule,115.72,,,,83.67,115.72
CHLAMYDIA BY LCR,87491,HCPCS,300,RC,,both,124.16,111.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.91,,,,73.25,101.31
CHLAMYDIA BY LCR,87491,HCPCS,300,RC,,both,124.16,111.74,Cigna,Default,Percent of Total Billed Charges,73.25,,,,73.25,101.31
CHLAMYDIA BY LCR,87491,HCPCS,300,RC,,both,124.16,111.74,United Healthcare,Default,Fee Schedule,101.31,,,,73.25,101.31
COCCIDIOIDES AB BY CF,86635,HCPCS,300,RC,,both,80.44,72.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.31,,,,47.46,65.64
COCCIDIOIDES AB BY CF,86635,HCPCS,300,RC,,both,80.44,72.4,Cigna,Default,Percent of Total Billed Charges,47.46,,,,47.46,65.64
COCCIDIOIDES AB BY CF,86635,HCPCS,300,RC,,both,80.44,72.4,United Healthcare,Default,Fee Schedule,65.64,,,,47.46,65.64
COXSACKIE A VIRUS AB A7,86658,HCPCS,300,RC,,both,46.25,41.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.38,,,,27.29,37.74
COXSACKIE A VIRUS AB A7,86658,HCPCS,300,RC,,both,46.25,41.63,Cigna,Default,Percent of Total Billed Charges,27.29,,,,27.29,37.74
COXSACKIE A VIRUS AB A7,86658,HCPCS,300,RC,,both,46.25,41.63,United Healthcare,Default,Fee Schedule,37.74,,,,27.29,37.74
LIPASE-SERUM,83690,HCPCS,301,RC,,both,103.6,93.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.52,,,,61.12,84.54
LIPASE-SERUM,83690,HCPCS,301,RC,,both,103.6,93.24,Cigna,Default,Percent of Total Billed Charges,61.12,,,,61.12,84.54
LIPASE-SERUM,83690,HCPCS,301,RC,,both,103.6,93.24,United Healthcare,Default,Fee Schedule,84.54,,,,61.12,84.54
COXSACKIE B VIRUS AB B1,86658,HCPCS,300,RC,,both,44.5,40.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.15,,,,26.26,36.31
COXSACKIE B VIRUS AB B1,86658,HCPCS,300,RC,,both,44.5,40.05,Cigna,Default,Percent of Total Billed Charges,26.26,,,,26.26,36.31
COXSACKIE B VIRUS AB B1,86658,HCPCS,300,RC,,both,44.5,40.05,United Healthcare,Default,Fee Schedule,36.31,,,,26.26,36.31
LIPID PROFILE,80061,HCPCS,301,RC,,both,129.4,116.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.58,,,,76.35,105.59
LIPID PROFILE,80061,HCPCS,301,RC,,both,129.4,116.46,Cigna,Default,Percent of Total Billed Charges,76.35,,,,76.35,105.59
LIPID PROFILE,80061,HCPCS,301,RC,,both,129.4,116.46,United Healthcare,Default,Fee Schedule,105.59,,,,76.35,105.59
GENERAL HEALTH PANEL,80050,HCPCS,301,RC,,both,383.69,345.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.58,,,,226.38,313.09
GENERAL HEALTH PANEL,80050,HCPCS,301,RC,,both,383.69,345.32,Cigna,Default,Percent of Total Billed Charges,226.38,,,,226.38,313.09
GENERAL HEALTH PANEL,80050,HCPCS,301,RC,,both,383.69,345.32,United Healthcare,Default,Fee Schedule,313.09,,,,226.38,313.09
LITHIUM,80178,HCPCS,301,RC,,both,82.09,73.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.46,,,,48.43,66.99
LITHIUM,80178,HCPCS,301,RC,,both,82.09,73.88,Cigna,Default,Percent of Total Billed Charges,48.43,,,,48.43,66.99
LITHIUM,80178,HCPCS,301,RC,,both,82.09,73.88,United Healthcare,Default,Fee Schedule,66.99,,,,48.43,66.99
MERCURY QUANTITATIVE,83825,HCPCS,301,RC,,both,105.04,94.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.53,,,,61.97,85.71
MERCURY QUANTITATIVE,83825,HCPCS,301,RC,,both,105.04,94.54,Cigna,Default,Percent of Total Billed Charges,61.97,,,,61.97,85.71
MERCURY QUANTITATIVE,83825,HCPCS,301,RC,,both,105.04,94.54,United Healthcare,Default,Fee Schedule,85.71,,,,61.97,85.71
IODINE SPOT URINE,83789,HCPCS,301,RC,,both,146.06,131.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.24,,,,86.18,119.18
IODINE SPOT URINE,83789,HCPCS,301,RC,,both,146.06,131.45,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.18
IODINE SPOT URINE,83789,HCPCS,301,RC,,both,146.06,131.45,United Healthcare,Default,Fee Schedule,119.18,,,,86.18,119.18
GLYCOHEMOGLOBIN,83036,HCPCS,301,RC,,both,94.88,85.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.42,,,,55.98,77.42
GLYCOHEMOGLOBIN,83036,HCPCS,301,RC,,both,94.88,85.39,Cigna,Default,Percent of Total Billed Charges,55.98,,,,55.98,77.42
GLYCOHEMOGLOBIN,83036,HCPCS,301,RC,,both,94.88,85.39,United Healthcare,Default,Fee Schedule,77.42,,,,55.98,77.42
HUMAN GROWTH HORMONE,83003,HCPCS,301,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
HUMAN GROWTH HORMONE,83003,HCPCS,301,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
HUMAN GROWTH HORMONE,83003,HCPCS,301,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
ELCTRPHRSS LIPO,83700,HCPCS,301,RC,,both,342,307.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,239.4,,,,201.78,279.07
ELCTRPHRSS LIPO,83700,HCPCS,301,RC,,both,342,307.8,Cigna,Default,Percent of Total Billed Charges,201.78,,,,201.78,279.07
ELCTRPHRSS LIPO,83700,HCPCS,301,RC,,both,342,307.8,United Healthcare,Default,Fee Schedule,279.07,,,,201.78,279.07
PROTEIN 24 HR URINE,84155,HCPCS,301,RC,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
PROTEIN 24 HR URINE,84155,HCPCS,301,RC,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
PROTEIN 24 HR URINE,84155,HCPCS,301,RC,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
FREE ERYTHRCT PROTOPORPH,84202,HCPCS,301,RC,,both,79,71.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.3,,,,46.61,64.46
FREE ERYTHRCT PROTOPORPH,84202,HCPCS,301,RC,,both,79,71.1,Cigna,Default,Percent of Total Billed Charges,46.61,,,,46.61,64.46
FREE ERYTHRCT PROTOPORPH,84202,HCPCS,301,RC,,both,79,71.1,United Healthcare,Default,Fee Schedule,64.46,,,,46.61,64.46
FOLIC ACID,82746,HCPCS,301,RC,,both,85.11,76.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.58,,,,50.21,69.45
FOLIC ACID,82746,HCPCS,301,RC,,both,85.11,76.6,Cigna,Default,Percent of Total Billed Charges,50.21,,,,50.21,69.45
FOLIC ACID,82746,HCPCS,301,RC,,both,85.11,76.6,United Healthcare,Default,Fee Schedule,69.45,,,,50.21,69.45
T3 REVERSE,84482,HCPCS,301,RC,,both,71.9,64.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.33,,,,42.42,58.67
T3 REVERSE,84482,HCPCS,301,RC,,both,71.9,64.71,Cigna,Default,Percent of Total Billed Charges,42.42,,,,42.42,58.67
T3 REVERSE,84482,HCPCS,301,RC,,both,71.9,64.71,United Healthcare,Default,Fee Schedule,58.67,,,,42.42,58.67
T3 (TRIIODOTHYRONINE),84480,HCPCS,301,RC,,both,113.75,102.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.62,,,,67.11,92.82
T3 (TRIIODOTHYRONINE),84480,HCPCS,301,RC,,both,113.75,102.38,Cigna,Default,Percent of Total Billed Charges,67.11,,,,67.11,92.82
T3 (TRIIODOTHYRONINE),84480,HCPCS,301,RC,,both,113.75,102.38,United Healthcare,Default,Fee Schedule,92.82,,,,67.11,92.82
HISTOPLASMA AB (ID),86698,HCPCS,300,RC,,both,55.9,50.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.13,,,,32.98,45.61
HISTOPLASMA AB (ID),86698,HCPCS,300,RC,,both,55.9,50.31,Cigna,Default,Percent of Total Billed Charges,32.98,,,,32.98,45.61
HISTOPLASMA AB (ID),86698,HCPCS,300,RC,,both,55.9,50.31,United Healthcare,Default,Fee Schedule,45.61,,,,32.98,45.61
HISTOPLASMA AG URINE,87385,HCPCS,300,RC,,both,179.77,161.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.84,,,,106.06,146.69
HISTOPLASMA AG URINE,87385,HCPCS,300,RC,,both,179.77,161.79,Cigna,Default,Percent of Total Billed Charges,106.06,,,,106.06,146.69
HISTOPLASMA AG URINE,87385,HCPCS,300,RC,,both,179.77,161.79,United Healthcare,Default,Fee Schedule,146.69,,,,106.06,146.69
HISTOPLASMA AG SERUM,87385,HCPCS,300,RC,,both,179.77,161.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.84,,,,106.06,146.69
HISTOPLASMA AG SERUM,87385,HCPCS,300,RC,,both,179.77,161.79,Cigna,Default,Percent of Total Billed Charges,106.06,,,,106.06,146.69
HISTOPLASMA AG SERUM,87385,HCPCS,300,RC,,both,179.77,161.79,United Healthcare,Default,Fee Schedule,146.69,,,,106.06,146.69
THYROID PEROXIDASE AB,86376,HCPCS,300,RC,,both,98.04,88.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.63,,,,57.84,80
THYROID PEROXIDASE AB,86376,HCPCS,300,RC,,both,98.04,88.24,Cigna,Default,Percent of Total Billed Charges,57.84,,,,57.84,80
THYROID PEROXIDASE AB,86376,HCPCS,300,RC,,both,98.04,88.24,United Healthcare,Default,Fee Schedule,80,,,,57.84,80
MICROSOME LIV/KID AB,86376,HCPCS,300,RC,,both,78.76,70.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.13,,,,46.47,64.27
MICROSOME LIV/KID AB,86376,HCPCS,300,RC,,both,78.76,70.88,Cigna,Default,Percent of Total Billed Charges,46.47,,,,46.47,64.27
MICROSOME LIV/KID AB,86376,HCPCS,300,RC,,both,78.76,70.88,United Healthcare,Default,Fee Schedule,64.27,,,,46.47,64.27
GENTAMYCIN RANDOM,80170,HCPCS,301,RC,,both,116.85,105.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.8,,,,68.94,95.35
GENTAMYCIN RANDOM,80170,HCPCS,301,RC,,both,116.85,105.17,Cigna,Default,Percent of Total Billed Charges,68.94,,,,68.94,95.35
GENTAMYCIN RANDOM,80170,HCPCS,301,RC,,both,116.85,105.17,United Healthcare,Default,Fee Schedule,95.35,,,,68.94,95.35
GENTAMYCIN THROUGH,80170,HCPCS,301,RC,,both,176.68,159.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.68,,,,104.24,144.17
GENTAMYCIN THROUGH,80170,HCPCS,301,RC,,both,176.68,159.01,Cigna,Default,Percent of Total Billed Charges,104.24,,,,104.24,144.17
GENTAMYCIN THROUGH,80170,HCPCS,301,RC,,both,176.68,159.01,United Healthcare,Default,Fee Schedule,144.17,,,,104.24,144.17
GENTAMYCIN PEAK,80170,HCPCS,301,RC,,both,116.85,105.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.8,,,,68.94,95.35
GENTAMYCIN PEAK,80170,HCPCS,301,RC,,both,116.85,105.17,Cigna,Default,Percent of Total Billed Charges,68.94,,,,68.94,95.35
GENTAMYCIN PEAK,80170,HCPCS,301,RC,,both,116.85,105.17,United Healthcare,Default,Fee Schedule,95.35,,,,68.94,95.35
INSULIN 2 HOUR,83525,HCPCS,300,RC,,both,91.5,82.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.05,,,,53.98,74.66
INSULIN 2 HOUR,83525,HCPCS,300,RC,,both,91.5,82.35,Cigna,Default,Percent of Total Billed Charges,53.98,,,,53.98,74.66
INSULIN 2 HOUR,83525,HCPCS,300,RC,,both,91.5,82.35,United Healthcare,Default,Fee Schedule,74.66,,,,53.98,74.66
LEPTIN,83520,HCPCS,300,RC,,both,154.49,139.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.14,,,,91.15,126.06
LEPTIN,83520,HCPCS,300,RC,,both,154.49,139.04,Cigna,Default,Percent of Total Billed Charges,91.15,,,,91.15,126.06
LEPTIN,83520,HCPCS,300,RC,,both,154.49,139.04,United Healthcare,Default,Fee Schedule,126.06,,,,91.15,126.06
INFLUENZA A AB IgG,86710,HCPCS,300,RC,,both,121.06,108.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.74,,,,71.43,98.78
INFLUENZA A AB IgG,86710,HCPCS,300,RC,,both,121.06,108.95,Cigna,Default,Percent of Total Billed Charges,71.43,,,,71.43,98.78
INFLUENZA A AB IgG,86710,HCPCS,300,RC,,both,121.06,108.95,United Healthcare,Default,Fee Schedule,98.78,,,,71.43,98.78
TRYPTASE,83520,HCPCS,300,RC,,both,77.87,70.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.51,,,,45.94,63.54
TRYPTASE,83520,HCPCS,300,RC,,both,77.87,70.08,Cigna,Default,Percent of Total Billed Charges,45.94,,,,45.94,63.54
TRYPTASE,83520,HCPCS,300,RC,,both,77.87,70.08,United Healthcare,Default,Fee Schedule,63.54,,,,45.94,63.54
INSULIN SERUM,83525,HCPCS,300,RC,,both,102.79,92.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.95,,,,60.65,83.88
INSULIN SERUM,83525,HCPCS,300,RC,,both,102.79,92.51,Cigna,Default,Percent of Total Billed Charges,60.65,,,,60.65,83.88
INSULIN SERUM,83525,HCPCS,300,RC,,both,102.79,92.51,United Healthcare,Default,Fee Schedule,83.88,,,,60.65,83.88
FREE INSULIN (TOTAL ),83527,HCPCS,301,RC,,both,50,45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35,,,,29.5,40.8
FREE INSULIN (TOTAL ),83527,HCPCS,301,RC,,both,50,45,Cigna,Default,Percent of Total Billed Charges,29.5,,,,29.5,40.8
FREE INSULIN (TOTAL ),83527,HCPCS,301,RC,,both,50,45,United Healthcare,Default,Fee Schedule,40.8,,,,29.5,40.8
FREE PLASMA METANEPHRINES,83835,HCPCS,301,RC,,both,311.5,280.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,218.05,,,,183.78,254.18
FREE PLASMA METANEPHRINES,83835,HCPCS,301,RC,,both,311.5,280.35,Cigna,Default,Percent of Total Billed Charges,183.78,,,,183.78,254.18
FREE PLASMA METANEPHRINES,83835,HCPCS,301,RC,,both,311.5,280.35,United Healthcare,Default,Fee Schedule,254.18,,,,183.78,254.18
INTRINSIC FACTOR,86340,HCPCS,302,RC,,both,84.54,76.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.18,,,,49.88,68.98
INTRINSIC FACTOR,86340,HCPCS,302,RC,,both,84.54,76.09,Cigna,Default,Percent of Total Billed Charges,49.88,,,,49.88,68.98
INTRINSIC FACTOR,86340,HCPCS,302,RC,,both,84.54,76.09,United Healthcare,Default,Fee Schedule,68.98,,,,49.88,68.98
HOMOVANILLIC ACID,83150,HCPCS,300,RC,,both,91,81.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.7,,,,53.69,74.26
HOMOVANILLIC ACID,83150,HCPCS,300,RC,,both,91,81.9,Cigna,Default,Percent of Total Billed Charges,53.69,,,,53.69,74.26
HOMOVANILLIC ACID,83150,HCPCS,300,RC,,both,91,81.9,United Healthcare,Default,Fee Schedule,74.26,,,,53.69,74.26
INSULIN ABS,86337,HCPCS,300,RC,,both,218.25,196.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.78,,,,128.77,178.09
INSULIN ABS,86337,HCPCS,300,RC,,both,218.25,196.43,Cigna,Default,Percent of Total Billed Charges,128.77,,,,128.77,178.09
INSULIN ABS,86337,HCPCS,300,RC,,both,218.25,196.43,United Healthcare,Default,Fee Schedule,178.09,,,,128.77,178.09
ACETYCHOLINE RECEPTOR BINDING AB,83519,HCPCS,300,RC,,both,248.16,223.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.71,,,,146.41,202.5
ACETYCHOLINE RECEPTOR BINDING AB,83519,HCPCS,300,RC,,both,248.16,223.34,Cigna,Default,Percent of Total Billed Charges,146.41,,,,146.41,202.5
ACETYCHOLINE RECEPTOR BINDING AB,83519,HCPCS,300,RC,,both,248.16,223.34,United Healthcare,Default,Fee Schedule,202.5,,,,146.41,202.5
ACETYCHOLINE RECEPTOR BLOCKING AB,83519,HCPCS,300,RC,,both,111.81,100.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.27,,,,65.97,91.24
ACETYCHOLINE RECEPTOR BLOCKING AB,83519,HCPCS,300,RC,,both,111.81,100.63,Cigna,Default,Percent of Total Billed Charges,65.97,,,,65.97,91.24
ACETYCHOLINE RECEPTOR BLOCKING AB,83519,HCPCS,300,RC,,both,111.81,100.63,United Healthcare,Default,Fee Schedule,91.24,,,,65.97,91.24
MANNOSE BINDING LECTIN,83520,HCPCS,300,RC,,both,187.62,168.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.33,,,,110.7,153.1
MANNOSE BINDING LECTIN,83520,HCPCS,300,RC,,both,187.62,168.86,Cigna,Default,Percent of Total Billed Charges,110.7,,,,110.7,153.1
MANNOSE BINDING LECTIN,83520,HCPCS,300,RC,,both,187.62,168.86,United Healthcare,Default,Fee Schedule,153.1,,,,110.7,153.1
CYTOKINES,83520,HCPCS,302,RC,,both,87,78.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.9,,,,51.33,70.99
CYTOKINES,83520,HCPCS,302,RC,,both,87,78.3,Cigna,Default,Percent of Total Billed Charges,51.33,,,,51.33,70.99
CYTOKINES,83520,HCPCS,302,RC,,both,87,78.3,United Healthcare,Default,Fee Schedule,70.99,,,,51.33,70.99
VOLTAGE GATED CALCIUM CHANNEL,83519,HCPCS,300,RC,,both,249.96,224.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.97,,,,147.48,203.97
VOLTAGE GATED CALCIUM CHANNEL,83519,HCPCS,300,RC,,both,249.96,224.96,Cigna,Default,Percent of Total Billed Charges,147.48,,,,147.48,203.97
VOLTAGE GATED CALCIUM CHANNEL,83519,HCPCS,300,RC,,both,249.96,224.96,United Healthcare,Default,Fee Schedule,203.97,,,,147.48,203.97
ACETYCHOLINE REC MODULATING AB,83519,HCPCS,300,RC,,both,222.01,199.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.41,,,,130.99,181.16
ACETYCHOLINE REC MODULATING AB,83519,HCPCS,300,RC,,both,222.01,199.81,Cigna,Default,Percent of Total Billed Charges,130.99,,,,130.99,181.16
ACETYCHOLINE REC MODULATING AB,83519,HCPCS,300,RC,,both,222.01,199.81,United Healthcare,Default,Fee Schedule,181.16,,,,130.99,181.16
ANTI MULLERIAN HORMONE,83520,HCPCS,300,RC,,both,229.07,206.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.35,,,,135.15,186.92
ANTI MULLERIAN HORMONE,83520,HCPCS,300,RC,,both,229.07,206.16,Cigna,Default,Percent of Total Billed Charges,135.15,,,,135.15,186.92
ANTI MULLERIAN HORMONE,83520,HCPCS,300,RC,,both,229.07,206.16,United Healthcare,Default,Fee Schedule,186.92,,,,135.15,186.92
MUSK AUTOANTIBODY,83519,HCPCS,300,RC,,both,1974.74,1777.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1382.32,,,,1165.1,1611.39
MUSK AUTOANTIBODY,83519,HCPCS,300,RC,,both,1974.74,1777.27,Cigna,Default,Percent of Total Billed Charges,1165.1,,,,1165.1,1611.39
MUSK AUTOANTIBODY,83519,HCPCS,300,RC,,both,1974.74,1777.27,United Healthcare,Default,Fee Schedule,1611.39,,,,1165.1,1611.39
ACHR GANG NEURON AB,83519,HCPCS,300,RC,,both,248.16,223.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.71,,,,146.41,202.5
ACHR GANG NEURON AB,83519,HCPCS,300,RC,,both,248.16,223.34,Cigna,Default,Percent of Total Billed Charges,146.41,,,,146.41,202.5
ACHR GANG NEURON AB,83519,HCPCS,300,RC,,both,248.16,223.34,United Healthcare,Default,Fee Schedule,202.5,,,,146.41,202.5
NEURONAL VGKC AUTO AB,83519,HCPCS,300,RC,,both,255.6,230.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,178.92,,,,150.8,208.57
NEURONAL VGKC AUTO AB,83519,HCPCS,300,RC,,both,255.6,230.04,Cigna,Default,Percent of Total Billed Charges,150.8,,,,150.8,208.57
NEURONAL VGKC AUTO AB,83519,HCPCS,300,RC,,both,255.6,230.04,United Healthcare,Default,Fee Schedule,208.57,,,,150.8,208.57
STRIATIONAL AB,83520,HCPCS,301,RC,,both,237.52,213.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.26,,,,140.14,193.82
STRIATIONAL AB,83520,HCPCS,301,RC,,both,237.52,213.77,Cigna,Default,Percent of Total Billed Charges,140.14,,,,140.14,193.82
STRIATIONAL AB,83520,HCPCS,301,RC,,both,237.52,213.77,United Healthcare,Default,Fee Schedule,193.82,,,,140.14,193.82
PHENOBARBITOL,80184,HCPCS,301,RC,,both,123.24,110.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.27,,,,72.71,100.56
PHENOBARBITOL,80184,HCPCS,301,RC,,both,123.24,110.92,Cigna,Default,Percent of Total Billed Charges,72.71,,,,72.71,100.56
PHENOBARBITOL,80184,HCPCS,301,RC,,both,123.24,110.92,United Healthcare,Default,Fee Schedule,100.56,,,,72.71,100.56
TEGRETOL (CARBAM),80156,HCPCS,301,RC,,both,145.05,130.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.54,,,,85.58,118.36
TEGRETOL (CARBAM),80156,HCPCS,301,RC,,both,145.05,130.55,Cigna,Default,Percent of Total Billed Charges,85.58,,,,85.58,118.36
TEGRETOL (CARBAM),80156,HCPCS,301,RC,,both,145.05,130.55,United Healthcare,Default,Fee Schedule,118.36,,,,85.58,118.36
CARBAMAZEPINE FREE,80157,HCPCS,301,RC,,both,86.29,77.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.4,,,,50.91,70.41
CARBAMAZEPINE FREE,80157,HCPCS,301,RC,,both,86.29,77.66,Cigna,Default,Percent of Total Billed Charges,50.91,,,,50.91,70.41
CARBAMAZEPINE FREE,80157,HCPCS,301,RC,,both,86.29,77.66,United Healthcare,Default,Fee Schedule,70.41,,,,50.91,70.41
"DILANTIN, FREE",80186,HCPCS,301,RC,,both,109.17,98.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.42,,,,64.41,89.08
"DILANTIN, FREE",80186,HCPCS,301,RC,,both,109.17,98.25,Cigna,Default,Percent of Total Billed Charges,64.41,,,,64.41,89.08
"DILANTIN, FREE",80186,HCPCS,301,RC,,both,109.17,98.25,United Healthcare,Default,Fee Schedule,89.08,,,,64.41,89.08
DILANTIN,80185,HCPCS,301,RC,,both,141.78,127.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.25,,,,83.65,115.69
DILANTIN,80185,HCPCS,301,RC,,both,141.78,127.6,Cigna,Default,Percent of Total Billed Charges,83.65,,,,83.65,115.69
DILANTIN,80185,HCPCS,301,RC,,both,141.78,127.6,United Healthcare,Default,Fee Schedule,115.69,,,,83.65,115.69
SIROLIMUS,80195,HCPCS,301,RC,,both,152.69,137.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.88,,,,90.09,124.6
SIROLIMUS,80195,HCPCS,301,RC,,both,152.69,137.42,Cigna,Default,Percent of Total Billed Charges,90.09,,,,90.09,124.6
SIROLIMUS,80195,HCPCS,301,RC,,both,152.69,137.42,United Healthcare,Default,Fee Schedule,124.6,,,,90.09,124.6
TACROLIMUS(FK 506),80197,HCPCS,301,RC,,both,242.4,218.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.68,,,,143.02,197.8
TACROLIMUS(FK 506),80197,HCPCS,301,RC,,both,242.4,218.16,Cigna,Default,Percent of Total Billed Charges,143.02,,,,143.02,197.8
TACROLIMUS(FK 506),80197,HCPCS,301,RC,,both,242.4,218.16,United Healthcare,Default,Fee Schedule,197.8,,,,143.02,197.8
TOX SCREEN URINE,80307,HCPCS,301,RC,,both,119.1,107.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.37,,,,70.27,97.19
TOX SCREEN URINE,80307,HCPCS,301,RC,,both,119.1,107.19,Cigna,Default,Percent of Total Billed Charges,70.27,,,,70.27,97.19
TOX SCREEN URINE,80307,HCPCS,301,RC,,both,119.1,107.19,United Healthcare,Default,Fee Schedule,97.19,,,,70.27,97.19
TOXOPLASMOSIS ABS IgG,86777,HCPCS,300,RC,,both,87.98,79.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.59,,,,51.91,71.79
TOXOPLASMOSIS ABS IgG,86777,HCPCS,300,RC,,both,87.98,79.18,Cigna,Default,Percent of Total Billed Charges,51.91,,,,51.91,71.79
TOXOPLASMOSIS ABS IgG,86777,HCPCS,300,RC,,both,87.98,79.18,United Healthcare,Default,Fee Schedule,71.79,,,,51.91,71.79
TETANUS AB,86317,HCPCS,300,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
TETANUS AB,86317,HCPCS,300,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
TETANUS AB,86317,HCPCS,300,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
DIPHTHERIA AB,86317,HCPCS,300,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
DIPHTHERIA AB,86317,HCPCS,300,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
DIPHTHERIA AB,86317,HCPCS,300,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
PNEUMOCOCCAL AB,86317,HCPCS,300,RC,,both,8.73,7.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.11,,,,5.15,7.12
PNEUMOCOCCAL AB,86317,HCPCS,300,RC,,both,8.73,7.86,Cigna,Default,Percent of Total Billed Charges,5.15,,,,5.15,7.12
PNEUMOCOCCAL AB,86317,HCPCS,300,RC,,both,8.73,7.86,United Healthcare,Default,Fee Schedule,7.12,,,,5.15,7.12
5 HIAA SEROTONIN,83497,HCPCS,301,RC,,both,58.99,53.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.29,,,,34.8,48.14
5 HIAA SEROTONIN,83497,HCPCS,301,RC,,both,58.99,53.09,Cigna,Default,Percent of Total Billed Charges,34.8,,,,34.8,48.14
5 HIAA SEROTONIN,83497,HCPCS,301,RC,,both,58.99,53.09,United Healthcare,Default,Fee Schedule,48.14,,,,34.8,48.14
17 HYDROXYPROGESTERONE,83498,HCPCS,301,RC,,both,73.1,65.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.17,,,,43.13,59.65
17 HYDROXYPROGESTERONE,83498,HCPCS,301,RC,,both,73.1,65.79,Cigna,Default,Percent of Total Billed Charges,43.13,,,,43.13,59.65
17 HYDROXYPROGESTERONE,83498,HCPCS,301,RC,,both,73.1,65.79,United Healthcare,Default,Fee Schedule,59.65,,,,43.13,59.65
VMA 24 HR URINE,84585,HCPCS,301,RC,,both,121.82,109.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.27,,,,71.87,99.41
VMA 24 HR URINE,84585,HCPCS,301,RC,,both,121.82,109.64,Cigna,Default,Percent of Total Billed Charges,71.87,,,,71.87,99.41
VMA 24 HR URINE,84585,HCPCS,301,RC,,both,121.82,109.64,United Healthcare,Default,Fee Schedule,99.41,,,,71.87,99.41
CULTURE - VIRAL,87252,HCPCS,300,RC,,both,115.99,104.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.19,,,,68.43,94.65
CULTURE - VIRAL,87252,HCPCS,300,RC,,both,115.99,104.39,Cigna,Default,Percent of Total Billed Charges,68.43,,,,68.43,94.65
CULTURE - VIRAL,87252,HCPCS,300,RC,,both,115.99,104.39,United Healthcare,Default,Fee Schedule,94.65,,,,68.43,94.65
VIRUS ISOLATION,87253,HCPCS,300,RC,,both,61,54.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.7,,,,35.99,49.78
VIRUS ISOLATION,87253,HCPCS,300,RC,,both,61,54.9,Cigna,Default,Percent of Total Billed Charges,35.99,,,,35.99,49.78
VIRUS ISOLATION,87253,HCPCS,300,RC,,both,61,54.9,United Healthcare,Default,Fee Schedule,49.78,,,,35.99,49.78
IRON,83540,HCPCS,300,RC,,both,53.93,48.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.75,,,,31.82,44.01
IRON,83540,HCPCS,300,RC,,both,53.93,48.54,Cigna,Default,Percent of Total Billed Charges,31.82,,,,31.82,44.01
IRON,83540,HCPCS,300,RC,,both,53.93,48.54,United Healthcare,Default,Fee Schedule,44.01,,,,31.82,44.01
HPV DNA,87624,HCPCS,300,RC,,both,171.35,154.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,119.94,,,,101.1,139.82
HPV DNA,87624,HCPCS,300,RC,,both,171.35,154.22,Cigna,Default,Percent of Total Billed Charges,101.1,,,,101.1,139.82
HPV DNA,87624,HCPCS,300,RC,,both,171.35,154.22,United Healthcare,Default,Fee Schedule,139.82,,,,101.1,139.82
ZINC,84630,HCPCS,301,RC,,both,66.57,59.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.6,,,,39.28,54.32
ZINC,84630,HCPCS,301,RC,,both,66.57,59.91,Cigna,Default,Percent of Total Billed Charges,39.28,,,,39.28,54.32
ZINC,84630,HCPCS,301,RC,,both,66.57,59.91,United Healthcare,Default,Fee Schedule,54.32,,,,39.28,54.32
ZINC RBC,84630,HCPCS,301,RC,,both,334.81,301.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,234.37,,,,197.54,273.2
ZINC RBC,84630,HCPCS,301,RC,,both,334.81,301.33,Cigna,Default,Percent of Total Billed Charges,197.54,,,,197.54,273.2
ZINC RBC,84630,HCPCS,301,RC,,both,334.81,301.33,United Healthcare,Default,Fee Schedule,273.2,,,,197.54,273.2
CARNITINE QUATITATIVE,82379,HCPCS,301,RC,,both,112,100.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.4,,,,66.08,91.39
CARNITINE QUATITATIVE,82379,HCPCS,301,RC,,both,112,100.8,Cigna,Default,Percent of Total Billed Charges,66.08,,,,66.08,91.39
CARNITINE QUATITATIVE,82379,HCPCS,301,RC,,both,112,100.8,United Healthcare,Default,Fee Schedule,91.39,,,,66.08,91.39
CEA,82378,HCPCS,301,RC,,both,175.58,158.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.91,,,,103.59,143.27
CEA,82378,HCPCS,301,RC,,both,175.58,158.02,Cigna,Default,Percent of Total Billed Charges,103.59,,,,103.59,143.27
CEA,82378,HCPCS,301,RC,,both,175.58,158.02,United Healthcare,Default,Fee Schedule,143.27,,,,103.59,143.27
ESTRIOL,82677,HCPCS,301,RC,,both,81.73,73.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.21,,,,48.22,66.69
ESTRIOL,82677,HCPCS,301,RC,,both,81.73,73.56,Cigna,Default,Percent of Total Billed Charges,48.22,,,,48.22,66.69
ESTRIOL,82677,HCPCS,301,RC,,both,81.73,73.56,United Healthcare,Default,Fee Schedule,66.69,,,,48.22,66.69
ESTRADIOL,82670,HCPCS,301,RC,,both,90.18,81.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.13,,,,53.21,73.59
ESTRADIOL,82670,HCPCS,301,RC,,both,90.18,81.16,Cigna,Default,Percent of Total Billed Charges,53.21,,,,53.21,73.59
ESTRADIOL,82670,HCPCS,301,RC,,both,90.18,81.16,United Healthcare,Default,Fee Schedule,73.59,,,,53.21,73.59
INHIBIN-MATERNAL SERUM,86336,HCPCS,302,RC,,both,92.13,82.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.49,,,,54.36,75.18
INHIBIN-MATERNAL SERUM,86336,HCPCS,302,RC,,both,92.13,82.92,Cigna,Default,Percent of Total Billed Charges,54.36,,,,54.36,75.18
INHIBIN-MATERNAL SERUM,86336,HCPCS,302,RC,,both,92.13,82.92,United Healthcare,Default,Fee Schedule,75.18,,,,54.36,75.18
INHIBIN B,83520,HCPCS,301,RC,,both,256.45,230.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,179.52,,,,151.31,209.26
INHIBIN B,83520,HCPCS,301,RC,,both,256.45,230.81,Cigna,Default,Percent of Total Billed Charges,151.31,,,,151.31,209.26
INHIBIN B,83520,HCPCS,301,RC,,both,256.45,230.81,United Healthcare,Default,Fee Schedule,209.26,,,,151.31,209.26
PROTEIN URINE,84156,HCPCS,301,RC,,both,61.79,55.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.25,,,,36.46,50.42
PROTEIN URINE,84156,HCPCS,301,RC,,both,61.79,55.61,Cigna,Default,Percent of Total Billed Charges,36.46,,,,36.46,50.42
PROTEIN URINE,84156,HCPCS,301,RC,,both,61.79,55.61,United Healthcare,Default,Fee Schedule,50.42,,,,36.46,50.42
"PROTEIN, CSF",84157,HCPCS,301,RC,,both,60.05,54.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.04,,,,35.43,49
"PROTEIN, CSF",84157,HCPCS,301,RC,,both,60.05,54.05,Cigna,Default,Percent of Total Billed Charges,35.43,,,,35.43,49
"PROTEIN, CSF",84157,HCPCS,301,RC,,both,60.05,54.05,United Healthcare,Default,Fee Schedule,49,,,,35.43,49
PROTEIN BODY FLUID,84157,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
PROTEIN BODY FLUID,84157,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
PROTEIN BODY FLUID,84157,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
MICROALBUMIN URINE,82043,HCPCS,301,RC,,both,84.27,75.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.99,,,,49.72,68.76
MICROALBUMIN URINE,82043,HCPCS,301,RC,,both,84.27,75.84,Cigna,Default,Percent of Total Billed Charges,49.72,,,,49.72,68.76
MICROALBUMIN URINE,82043,HCPCS,301,RC,,both,84.27,75.84,United Healthcare,Default,Fee Schedule,68.76,,,,49.72,68.76
"MICROALBUMIN , QUANTITATIVE",82043,HCPCS,301,RC,,both,46.25,41.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.38,,,,27.29,37.74
"MICROALBUMIN , QUANTITATIVE",82043,HCPCS,301,RC,,both,46.25,41.63,Cigna,Default,Percent of Total Billed Charges,27.29,,,,27.29,37.74
"MICROALBUMIN , QUANTITATIVE",82043,HCPCS,301,RC,,both,46.25,41.63,United Healthcare,Default,Fee Schedule,37.74,,,,27.29,37.74
CELL COUNT BODY FL,89050,HCPCS,300,RC,,both,97.07,87.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.95,,,,57.27,79.21
CELL COUNT BODY FL,89050,HCPCS,300,RC,,both,97.07,87.36,Cigna,Default,Percent of Total Billed Charges,57.27,,,,57.27,79.21
CELL COUNT BODY FL,89050,HCPCS,300,RC,,both,97.07,87.36,United Healthcare,Default,Fee Schedule,79.21,,,,57.27,79.21
CERULOPLASMIN,82390,HCPCS,301,RC,,both,94.67,85.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.27,,,,55.86,77.25
CERULOPLASMIN,82390,HCPCS,301,RC,,both,94.67,85.2,Cigna,Default,Percent of Total Billed Charges,55.86,,,,55.86,77.25
CERULOPLASMIN,82390,HCPCS,301,RC,,both,94.67,85.2,United Healthcare,Default,Fee Schedule,77.25,,,,55.86,77.25
IGF BINDING PROTEINS,82397,HCPCS,301,RC,,both,51.5,46.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.05,,,,30.38,42.02
IGF BINDING PROTEINS,82397,HCPCS,301,RC,,both,51.5,46.35,Cigna,Default,Percent of Total Billed Charges,30.38,,,,30.38,42.02
IGF BINDING PROTEINS,82397,HCPCS,301,RC,,both,51.5,46.35,United Healthcare,Default,Fee Schedule,42.02,,,,30.38,42.02
VASCULAR ENDOTHELIAL GROWTH FACTOR,82397,HCPCS,301,RC,,both,224.72,202.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,157.3,,,,132.58,183.37
VASCULAR ENDOTHELIAL GROWTH FACTOR,82397,HCPCS,301,RC,,both,224.72,202.25,Cigna,Default,Percent of Total Billed Charges,132.58,,,,132.58,183.37
VASCULAR ENDOTHELIAL GROWTH FACTOR,82397,HCPCS,301,RC,,both,224.72,202.25,United Healthcare,Default,Fee Schedule,183.37,,,,132.58,183.37
CYCLOSPORINE,80158,HCPCS,300,RC,,both,158.15,142.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.7,,,,93.31,129.05
CYCLOSPORINE,80158,HCPCS,300,RC,,both,158.15,142.34,Cigna,Default,Percent of Total Billed Charges,93.31,,,,93.31,129.05
CYCLOSPORINE,80158,HCPCS,300,RC,,both,158.15,142.34,United Healthcare,Default,Fee Schedule,129.05,,,,93.31,129.05
E HISTOLYTICA AG DETCTN,87337,HCPCS,300,RC,,both,61.75,55.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.22,,,,36.43,50.39
E HISTOLYTICA AG DETCTN,87337,HCPCS,300,RC,,both,61.75,55.58,Cigna,Default,Percent of Total Billed Charges,36.43,,,,36.43,50.39
E HISTOLYTICA AG DETCTN,87337,HCPCS,300,RC,,both,61.75,55.58,United Healthcare,Default,Fee Schedule,50.39,,,,36.43,50.39
RBC PRETREATMENT DENSITY GRADIENT,86972,HCPCS,300,RC,,both,159.54,143.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.68,,,,94.13,130.18
RBC PRETREATMENT DENSITY GRADIENT,86972,HCPCS,300,RC,,both,159.54,143.59,Cigna,Default,Percent of Total Billed Charges,94.13,,,,94.13,130.18
RBC PRETREATMENT DENSITY GRADIENT,86972,HCPCS,300,RC,,both,159.54,143.59,United Healthcare,Default,Fee Schedule,130.18,,,,94.13,130.18
RBC CHEMICAL TREATMENT,86970,HCPCS,300,RC,,both,111.4,100.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.98,,,,65.73,90.9
RBC CHEMICAL TREATMENT,86970,HCPCS,300,RC,,both,111.4,100.26,Cigna,Default,Percent of Total Billed Charges,65.73,,,,65.73,90.9
RBC CHEMICAL TREATMENT,86970,HCPCS,300,RC,,both,111.4,100.26,United Healthcare,Default,Fee Schedule,90.9,,,,65.73,90.9
ADSORPTION,86978,HCPCS,300,RC,,both,75.82,68.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.07,,,,44.73,61.87
ADSORPTION,86978,HCPCS,300,RC,,both,75.82,68.24,Cigna,Default,Percent of Total Billed Charges,44.73,,,,44.73,61.87
ADSORPTION,86978,HCPCS,300,RC,,both,75.82,68.24,United Healthcare,Default,Fee Schedule,61.87,,,,44.73,61.87
"ELUTION, ANTIBODY",86860,HCPCS,300,RC,,both,365.59,329.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.91,,,,215.7,298.32
"ELUTION, ANTIBODY",86860,HCPCS,300,RC,,both,365.59,329.03,Cigna,Default,Percent of Total Billed Charges,215.7,,,,215.7,298.32
"ELUTION, ANTIBODY",86860,HCPCS,300,RC,,both,365.59,329.03,United Healthcare,Default,Fee Schedule,298.32,,,,215.7,298.32
ANTIBODY ID,86870,HCPCS,300,RC,,both,255.6,230.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,178.92,,,,150.8,208.57
ANTIBODY ID,86870,HCPCS,300,RC,,both,255.6,230.04,Cigna,Default,Percent of Total Billed Charges,150.8,,,,150.8,208.57
ANTIBODY ID,86870,HCPCS,300,RC,,both,255.6,230.04,United Healthcare,Default,Fee Schedule,208.57,,,,150.8,208.57
B2 GLYCOPROTEIN 1 AB - IGG,86146,HCPCS,302,RC,,both,25.45,22.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.82,,,,15.02,20.77
B2 GLYCOPROTEIN 1 AB - IGG,86146,HCPCS,302,RC,,both,25.45,22.91,Cigna,Default,Percent of Total Billed Charges,15.02,,,,15.02,20.77
B2 GLYCOPROTEIN 1 AB - IGG,86146,HCPCS,302,RC,,both,25.45,22.91,United Healthcare,Default,Fee Schedule,20.77,,,,15.02,20.77
CARDIOLIPIN AB-IgG,86147,HCPCS,300,RC,,both,109.54,98.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.68,,,,64.63,89.38
CARDIOLIPIN AB-IgG,86147,HCPCS,300,RC,,both,109.54,98.59,Cigna,Default,Percent of Total Billed Charges,64.63,,,,64.63,89.38
CARDIOLIPIN AB-IgG,86147,HCPCS,300,RC,,both,109.54,98.59,United Healthcare,Default,Fee Schedule,89.38,,,,64.63,89.38
PHOSPHATIDYLSERINE AB - IGG,86148,HCPCS,300,RC,,both,84.25,75.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.98,,,,49.71,68.75
PHOSPHATIDYLSERINE AB - IGG,86148,HCPCS,300,RC,,both,84.25,75.83,Cigna,Default,Percent of Total Billed Charges,49.71,,,,49.71,68.75
PHOSPHATIDYLSERINE AB - IGG,86148,HCPCS,300,RC,,both,84.25,75.83,United Healthcare,Default,Fee Schedule,68.75,,,,49.71,68.75
CBC-AUTOMATED DIFFERENTIAL,85025,HCPCS,300,RC,,both,94.06,84.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.84,,,,55.5,76.75
CBC-AUTOMATED DIFFERENTIAL,85025,HCPCS,300,RC,,both,94.06,84.65,Cigna,Default,Percent of Total Billed Charges,55.5,,,,55.5,76.75
CBC-AUTOMATED DIFFERENTIAL,85025,HCPCS,300,RC,,both,94.06,84.65,United Healthcare,Default,Fee Schedule,76.75,,,,55.5,76.75
MANUAL DIFFERENTIAL,85007,HCPCS,300,RC,,both,22.19,19.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.53,,,,13.09,18.11
MANUAL DIFFERENTIAL,85007,HCPCS,300,RC,,both,22.19,19.97,Cigna,Default,Percent of Total Billed Charges,13.09,,,,13.09,18.11
MANUAL DIFFERENTIAL,85007,HCPCS,300,RC,,both,22.19,19.97,United Healthcare,Default,Fee Schedule,18.11,,,,13.09,18.11
HEMOGRAM,85027,HCPCS,300,RC,,both,58.99,53.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.29,,,,34.8,48.14
HEMOGRAM,85027,HCPCS,300,RC,,both,58.99,53.09,Cigna,Default,Percent of Total Billed Charges,34.8,,,,34.8,48.14
HEMOGRAM,85027,HCPCS,300,RC,,both,58.99,53.09,United Healthcare,Default,Fee Schedule,48.14,,,,34.8,48.14
SMITH ANTIBODY IGG,86235,HCPCS,302,RC,,both,21.43,19.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15,,,,12.64,17.49
SMITH ANTIBODY IGG,86235,HCPCS,302,RC,,both,21.43,19.29,Cigna,Default,Percent of Total Billed Charges,12.64,,,,12.64,17.49
SMITH ANTIBODY IGG,86235,HCPCS,302,RC,,both,21.43,19.29,United Healthcare,Default,Fee Schedule,17.49,,,,12.64,17.49
RNP AB,86235,HCPCS,302,RC,,both,24.8,22.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.36,,,,14.63,20.24
RNP AB,86235,HCPCS,302,RC,,both,24.8,22.32,Cigna,Default,Percent of Total Billed Charges,14.63,,,,14.63,20.24
RNP AB,86235,HCPCS,302,RC,,both,24.8,22.32,United Healthcare,Default,Fee Schedule,20.24,,,,14.63,20.24
FACTOR 7 ASSAY,85230,HCPCS,300,RC,,both,146.33,131.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.43,,,,86.33,119.41
FACTOR 7 ASSAY,85230,HCPCS,300,RC,,both,146.33,131.7,Cigna,Default,Percent of Total Billed Charges,86.33,,,,86.33,119.41
FACTOR 7 ASSAY,85230,HCPCS,300,RC,,both,146.33,131.7,United Healthcare,Default,Fee Schedule,119.41,,,,86.33,119.41
SSA ANTIBODIES IGG,86235,HCPCS,302,RC,,both,21.43,19.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15,,,,12.64,17.49
SSA ANTIBODIES IGG,86235,HCPCS,302,RC,,both,21.43,19.29,Cigna,Default,Percent of Total Billed Charges,12.64,,,,12.64,17.49
SSA ANTIBODIES IGG,86235,HCPCS,302,RC,,both,21.43,19.29,United Healthcare,Default,Fee Schedule,17.49,,,,12.64,17.49
SSB ABS IGG,86235,HCPCS,302,RC,,both,21.43,19.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15,,,,12.64,17.49
SSB ABS IGG,86235,HCPCS,302,RC,,both,21.43,19.29,Cigna,Default,Percent of Total Billed Charges,12.64,,,,12.64,17.49
SSB ABS IGG,86235,HCPCS,302,RC,,both,21.43,19.29,United Healthcare,Default,Fee Schedule,17.49,,,,12.64,17.49
"JO-1 ANTIBODY, IGG",86235,HCPCS,302,RC,,both,21.65,19.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.16,,,,12.77,17.67
"JO-1 ANTIBODY, IGG",86235,HCPCS,302,RC,,both,21.65,19.49,Cigna,Default,Percent of Total Billed Charges,12.77,,,,12.77,17.67
"JO-1 ANTIBODY, IGG",86235,HCPCS,302,RC,,both,21.65,19.49,United Healthcare,Default,Fee Schedule,17.67,,,,12.77,17.67
FACT VIII ASSAY,85240,HCPCS,300,RC,,both,96.06,86.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.24,,,,56.68,78.38
FACT VIII ASSAY,85240,HCPCS,300,RC,,both,96.06,86.45,Cigna,Default,Percent of Total Billed Charges,56.68,,,,56.68,78.38
FACT VIII ASSAY,85240,HCPCS,300,RC,,both,96.06,86.45,United Healthcare,Default,Fee Schedule,78.38,,,,56.68,78.38
FACTOR II ASSAY,85210,HCPCS,300,RC,,both,92.41,83.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.69,,,,54.52,75.41
FACTOR II ASSAY,85210,HCPCS,300,RC,,both,92.41,83.17,Cigna,Default,Percent of Total Billed Charges,54.52,,,,54.52,75.41
FACTOR II ASSAY,85210,HCPCS,300,RC,,both,92.41,83.17,United Healthcare,Default,Fee Schedule,75.41,,,,54.52,75.41
CHROMATIN,86235,HCPCS,302,RC,,both,23.6,21.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.52,,,,13.92,19.26
CHROMATIN,86235,HCPCS,302,RC,,both,23.6,21.24,Cigna,Default,Percent of Total Billed Charges,13.92,,,,13.92,19.26
CHROMATIN,86235,HCPCS,302,RC,,both,23.6,21.24,United Healthcare,Default,Fee Schedule,19.26,,,,13.92,19.26
SM/RNP AB,86235,HCPCS,302,RC,,both,21.43,19.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15,,,,12.64,17.49
SM/RNP AB,86235,HCPCS,302,RC,,both,21.43,19.29,Cigna,Default,Percent of Total Billed Charges,12.64,,,,12.64,17.49
SM/RNP AB,86235,HCPCS,302,RC,,both,21.43,19.29,United Healthcare,Default,Fee Schedule,17.49,,,,12.64,17.49
ANTI XA,85130,HCPCS,305,RC,,both,251.96,226.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.37,,,,148.66,205.6
ANTI XA,85130,HCPCS,305,RC,,both,251.96,226.76,Cigna,Default,Percent of Total Billed Charges,148.66,,,,148.66,205.6
ANTI XA,85130,HCPCS,305,RC,,both,251.96,226.76,United Healthcare,Default,Fee Schedule,205.6,,,,148.66,205.6
FACTOR 5 ASSAY,85220,HCPCS,300,RC,,both,146.33,131.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.43,,,,86.33,119.41
FACTOR 5 ASSAY,85220,HCPCS,300,RC,,both,146.33,131.7,Cigna,Default,Percent of Total Billed Charges,86.33,,,,86.33,119.41
FACTOR 5 ASSAY,85220,HCPCS,300,RC,,both,146.33,131.7,United Healthcare,Default,Fee Schedule,119.41,,,,86.33,119.41
INFLUENZA B ANTIBODY IGG,86710,HCPCS,300,RC,,both,73.86,66.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.7,,,,43.58,60.27
INFLUENZA B ANTIBODY IGG,86710,HCPCS,300,RC,,both,73.86,66.47,Cigna,Default,Percent of Total Billed Charges,43.58,,,,43.58,60.27
INFLUENZA B ANTIBODY IGG,86710,HCPCS,300,RC,,both,73.86,66.47,United Healthcare,Default,Fee Schedule,60.27,,,,43.58,60.27
T4 FREE,84439,HCPCS,301,RC,,both,125.28,112.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.7,,,,73.92,102.23
T4 FREE,84439,HCPCS,301,RC,,both,125.28,112.75,Cigna,Default,Percent of Total Billed Charges,73.92,,,,73.92,102.23
T4 FREE,84439,HCPCS,301,RC,,both,125.28,112.75,United Healthcare,Default,Fee Schedule,102.23,,,,73.92,102.23
DIALYSIS FREE T4,84439,HCPCS,301,RC,,both,94.94,85.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.46,,,,56.01,77.47
DIALYSIS FREE T4,84439,HCPCS,301,RC,,both,94.94,85.45,Cigna,Default,Percent of Total Billed Charges,56.01,,,,56.01,77.47
DIALYSIS FREE T4,84439,HCPCS,301,RC,,both,94.94,85.45,United Healthcare,Default,Fee Schedule,77.47,,,,56.01,77.47
DIGOXIN,80162,HCPCS,301,RC,,both,135.24,121.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.67,,,,79.79,110.36
DIGOXIN,80162,HCPCS,301,RC,,both,135.24,121.72,Cigna,Default,Percent of Total Billed Charges,79.79,,,,79.79,110.36
DIGOXIN,80162,HCPCS,301,RC,,both,135.24,121.72,United Healthcare,Default,Fee Schedule,110.36,,,,79.79,110.36
STOOL PH,83986,HCPCS,300,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
STOOL PH,83986,HCPCS,300,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
STOOL PH,83986,HCPCS,300,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
CALPROTECTIN FECAL,83993,HCPCS,300,RC,,both,589.86,530.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,412.9,,,,348.02,481.33
CALPROTECTIN FECAL,83993,HCPCS,300,RC,,both,589.86,530.87,Cigna,Default,Percent of Total Billed Charges,348.02,,,,348.02,481.33
CALPROTECTIN FECAL,83993,HCPCS,300,RC,,both,589.86,530.87,United Healthcare,Default,Fee Schedule,481.33,,,,348.02,481.33
THEOPHYLLINE,80198,HCPCS,301,RC,,both,140.28,126.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.2,,,,82.77,114.47
THEOPHYLLINE,80198,HCPCS,301,RC,,both,140.28,126.25,Cigna,Default,Percent of Total Billed Charges,82.77,,,,82.77,114.47
THEOPHYLLINE,80198,HCPCS,301,RC,,both,140.28,126.25,United Healthcare,Default,Fee Schedule,114.47,,,,82.77,114.47
THIAMINE (VIT B1),84425,HCPCS,301,RC,,both,152.69,137.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.88,,,,90.09,124.6
THIAMINE (VIT B1),84425,HCPCS,301,RC,,both,152.69,137.42,Cigna,Default,Percent of Total Billed Charges,90.09,,,,90.09,124.6
THIAMINE (VIT B1),84425,HCPCS,301,RC,,both,152.69,137.42,United Healthcare,Default,Fee Schedule,124.6,,,,90.09,124.6
NIACIN,84591,HCPCS,301,RC,,both,310.37,279.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,217.26,,,,183.12,253.26
NIACIN,84591,HCPCS,301,RC,,both,310.37,279.33,Cigna,Default,Percent of Total Billed Charges,183.12,,,,183.12,253.26
NIACIN,84591,HCPCS,301,RC,,both,310.37,279.33,United Healthcare,Default,Fee Schedule,253.26,,,,183.12,253.26
URINALYSIS/MICROSCOPIC CS IF INDICATED,81001,HCPCS,300,RC,,both,63.08,56.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.16,,,,37.22,51.47
URINALYSIS/MICROSCOPIC CS IF INDICATED,81001,HCPCS,300,RC,,both,63.08,56.77,Cigna,Default,Percent of Total Billed Charges,37.22,,,,37.22,51.47
URINALYSIS/MICROSCOPIC CS IF INDICATED,81001,HCPCS,300,RC,,both,63.08,56.77,United Healthcare,Default,Fee Schedule,51.47,,,,37.22,51.47
MYOGLOBIN-URINE,83874,HCPCS,301,RC,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
MYOGLOBIN-URINE,83874,HCPCS,301,RC,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
MYOGLOBIN-URINE,83874,HCPCS,301,RC,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
BLOOD TYPING ABO ONLY,86900,HCPCS,300,RC,,both,204.27,183.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.99,,,,120.52,166.68
BLOOD TYPING ABO ONLY,86900,HCPCS,300,RC,,both,204.27,183.84,Cigna,Default,Percent of Total Billed Charges,120.52,,,,120.52,166.68
BLOOD TYPING ABO ONLY,86900,HCPCS,300,RC,,both,204.27,183.84,United Healthcare,Default,Fee Schedule,166.68,,,,120.52,166.68
NEIS GONOR BY LCR,87591,HCPCS,300,RC,,both,124.16,111.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.91,,,,73.25,101.31
NEIS GONOR BY LCR,87591,HCPCS,300,RC,,both,124.16,111.74,Cigna,Default,Percent of Total Billed Charges,73.25,,,,73.25,101.31
NEIS GONOR BY LCR,87591,HCPCS,300,RC,,both,124.16,111.74,United Healthcare,Default,Fee Schedule,101.31,,,,73.25,101.31
MYCOPLASMA PNEUMO PCR,87581,HCPCS,306,RC,,both,107.81,97.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.47,,,,63.61,87.97
MYCOPLASMA PNEUMO PCR,87581,HCPCS,306,RC,,both,107.81,97.03,Cigna,Default,Percent of Total Billed Charges,63.61,,,,63.61,87.97
MYCOPLASMA PNEUMO PCR,87581,HCPCS,306,RC,,both,107.81,97.03,United Healthcare,Default,Fee Schedule,87.97,,,,63.61,87.97
HERPES VIRUS6 PCR,87532,HCPCS,306,RC,,both,268.5,241.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.95,,,,158.42,219.1
HERPES VIRUS6 PCR,87532,HCPCS,306,RC,,both,268.5,241.65,Cigna,Default,Percent of Total Billed Charges,158.42,,,,158.42,219.1
HERPES VIRUS6 PCR,87532,HCPCS,306,RC,,both,268.5,241.65,United Healthcare,Default,Fee Schedule,219.1,,,,158.42,219.1
M TUBERCULOSIS PCR,87556,HCPCS,306,RC,,both,519.08,467.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,363.36,,,,306.26,423.57
M TUBERCULOSIS PCR,87556,HCPCS,306,RC,,both,519.08,467.17,Cigna,Default,Percent of Total Billed Charges,306.26,,,,306.26,423.57
M TUBERCULOSIS PCR,87556,HCPCS,306,RC,,both,519.08,467.17,United Healthcare,Default,Fee Schedule,423.57,,,,306.26,423.57
TRIGLYCERIDES,84478,HCPCS,301,RC,,both,57.8,52.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.46,,,,34.1,47.16
TRIGLYCERIDES,84478,HCPCS,301,RC,,both,57.8,52.02,Cigna,Default,Percent of Total Billed Charges,34.1,,,,34.1,47.16
TRIGLYCERIDES,84478,HCPCS,301,RC,,both,57.8,52.02,United Healthcare,Default,Fee Schedule,47.16,,,,34.1,47.16
WESTERN BLOT,86689,HCPCS,300,RC,,both,167.12,150.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.98,,,,98.6,136.37
WESTERN BLOT,86689,HCPCS,300,RC,,both,167.12,150.41,Cigna,Default,Percent of Total Billed Charges,98.6,,,,98.6,136.37
WESTERN BLOT,86689,HCPCS,300,RC,,both,167.12,150.41,United Healthcare,Default,Fee Schedule,136.37,,,,98.6,136.37
TROPONIN,84484,HCPCS,301,RC,,both,172.31,155.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.62,,,,101.66,140.6
TROPONIN,84484,HCPCS,301,RC,,both,172.31,155.08,Cigna,Default,Percent of Total Billed Charges,101.66,,,,101.66,140.6
TROPONIN,84484,HCPCS,301,RC,,both,172.31,155.08,United Healthcare,Default,Fee Schedule,140.6,,,,101.66,140.6
TOX-DAV5 NONDOT,80307,HCPCS,301,RC,,both,139.31,125.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.52,,,,82.19,113.68
TOX-DAV5 NONDOT,80307,HCPCS,301,RC,,both,139.31,125.38,Cigna,Default,Percent of Total Billed Charges,82.19,,,,82.19,113.68
TOX-DAV5 NONDOT,80307,HCPCS,301,RC,,both,139.31,125.38,United Healthcare,Default,Fee Schedule,113.68,,,,82.19,113.68
TOX DAU DOT,80307,HCPCS,301,RC,,both,139.31,125.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.52,,,,82.19,113.68
TOX DAU DOT,80307,HCPCS,301,RC,,both,139.31,125.38,Cigna,Default,Percent of Total Billed Charges,82.19,,,,82.19,113.68
TOX DAU DOT,80307,HCPCS,301,RC,,both,139.31,125.38,United Healthcare,Default,Fee Schedule,113.68,,,,82.19,113.68
HMC NEW EMPLOYEE DRUG SCREEN,80307,HCPCS,301,RC,,both,13.75,12.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.62,,,,8.11,11.22
HMC NEW EMPLOYEE DRUG SCREEN,80307,HCPCS,301,RC,,both,13.75,12.38,Cigna,Default,Percent of Total Billed Charges,8.11,,,,8.11,11.22
HMC NEW EMPLOYEE DRUG SCREEN,80307,HCPCS,301,RC,,both,13.75,12.38,United Healthcare,Default,Fee Schedule,11.22,,,,8.11,11.22
OLIGOCLONAL BANDS,83916,HCPCS,301,RC,,both,39.5,35.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.65,,,,23.3,32.23
OLIGOCLONAL BANDS,83916,HCPCS,301,RC,,both,39.5,35.55,Cigna,Default,Percent of Total Billed Charges,23.3,,,,23.3,32.23
OLIGOCLONAL BANDS,83916,HCPCS,301,RC,,both,39.5,35.55,United Healthcare,Default,Fee Schedule,32.23,,,,23.3,32.23
TOX-DAU 7,80307,HCPCS,301,RC,,both,81.17,73.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.82,,,,47.89,66.23
TOX-DAU 7,80307,HCPCS,301,RC,,both,81.17,73.05,Cigna,Default,Percent of Total Billed Charges,47.89,,,,47.89,66.23
TOX-DAU 7,80307,HCPCS,301,RC,,both,81.17,73.05,United Healthcare,Default,Fee Schedule,66.23,,,,47.89,66.23
WET MOUNT/KOH PREP,87210,HCPCS,300,RC,,both,51.95,46.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.36,,,,30.65,42.39
WET MOUNT/KOH PREP,87210,HCPCS,300,RC,,both,51.95,46.76,Cigna,Default,Percent of Total Billed Charges,30.65,,,,30.65,42.39
WET MOUNT/KOH PREP,87210,HCPCS,300,RC,,both,51.95,46.76,United Healthcare,Default,Fee Schedule,42.39,,,,30.65,42.39
T4 TOTAL,84436,HCPCS,301,RC,,both,84.54,76.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.18,,,,49.88,68.98
T4 TOTAL,84436,HCPCS,301,RC,,both,84.54,76.09,Cigna,Default,Percent of Total Billed Charges,49.88,,,,49.88,68.98
T4 TOTAL,84436,HCPCS,301,RC,,both,84.54,76.09,United Healthcare,Default,Fee Schedule,68.98,,,,49.88,68.98
FERRITIN,82728,HCPCS,301,RC,,both,128.69,115.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.08,,,,75.93,105.01
FERRITIN,82728,HCPCS,301,RC,,both,128.69,115.82,Cigna,Default,Percent of Total Billed Charges,75.93,,,,75.93,105.01
FERRITIN,82728,HCPCS,301,RC,,both,128.69,115.82,United Healthcare,Default,Fee Schedule,105.01,,,,75.93,105.01
PSA SCREENING,84153,HCPCS,301,RC,,both,145.5,130.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.85,,,,85.84,118.73
PSA SCREENING,84153,HCPCS,301,RC,,both,145.5,130.95,Cigna,Default,Percent of Total Billed Charges,85.84,,,,85.84,118.73
PSA SCREENING,84153,HCPCS,301,RC,,both,145.5,130.95,United Healthcare,Default,Fee Schedule,118.73,,,,85.84,118.73
FREE AND TOTAL PSA,84154,HCPCS,301,RC,,both,125.41,112.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.79,,,,73.99,102.33
FREE AND TOTAL PSA,84154,HCPCS,301,RC,,both,125.41,112.87,Cigna,Default,Percent of Total Billed Charges,73.99,,,,73.99,102.33
FREE AND TOTAL PSA,84154,HCPCS,301,RC,,both,125.41,112.87,United Healthcare,Default,Fee Schedule,102.33,,,,73.99,102.33
PRO 2 PSA,86316,HCPCS,302,RC,,both,131.74,118.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.22,,,,77.73,107.5
PRO 2 PSA,86316,HCPCS,302,RC,,both,131.74,118.57,Cigna,Default,Percent of Total Billed Charges,77.73,,,,77.73,107.5
PRO 2 PSA,86316,HCPCS,302,RC,,both,131.74,118.57,United Healthcare,Default,Fee Schedule,107.5,,,,77.73,107.5
DNU   C DIFF TOXIN A & B,87324,HCPCS,300,RC,,both,140.25,126.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.18,,,,82.75,114.44
DNU   C DIFF TOXIN A & B,87324,HCPCS,300,RC,,both,140.25,126.23,Cigna,Default,Percent of Total Billed Charges,82.75,,,,82.75,114.44
DNU   C DIFF TOXIN A & B,87324,HCPCS,300,RC,,both,140.25,126.23,United Healthcare,Default,Fee Schedule,114.44,,,,82.75,114.44
DNU         C DIFFICILE CYTOTOXIN ASSAY,87230,HCPCS,300,RC,,both,84.5,76.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.15,,,,49.86,68.95
DNU         C DIFFICILE CYTOTOXIN ASSAY,87230,HCPCS,300,RC,,both,84.5,76.05,Cigna,Default,Percent of Total Billed Charges,49.86,,,,49.86,68.95
DNU         C DIFFICILE CYTOTOXIN ASSAY,87230,HCPCS,300,RC,,both,84.5,76.05,United Healthcare,Default,Fee Schedule,68.95,,,,49.86,68.95
GLUCAGON,82943,HCPCS,301,RC,,both,109.26,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.16
GLUCAGON,82943,HCPCS,301,RC,,both,109.26,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.16
GLUCAGON,82943,HCPCS,301,RC,,both,109.26,98.33,United Healthcare,Default,Fee Schedule,89.16,,,,64.46,89.16
QUINIDINE,80194,HCPCS,301,RC,,both,79,71.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.3,,,,46.61,64.46
QUINIDINE,80194,HCPCS,301,RC,,both,79,71.1,Cigna,Default,Percent of Total Billed Charges,46.61,,,,46.61,64.46
QUINIDINE,80194,HCPCS,301,RC,,both,79,71.1,United Healthcare,Default,Fee Schedule,64.46,,,,46.61,64.46
ALDOLASE,82085,HCPCS,301,RC,,both,58.99,53.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.29,,,,34.8,48.14
ALDOLASE,82085,HCPCS,301,RC,,both,58.99,53.09,Cigna,Default,Percent of Total Billed Charges,34.8,,,,34.8,48.14
ALDOLASE,82085,HCPCS,301,RC,,both,58.99,53.09,United Healthcare,Default,Fee Schedule,48.14,,,,34.8,48.14
AMMONIA,82140,HCPCS,301,RC,,both,81.17,73.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.82,,,,47.89,66.23
AMMONIA,82140,HCPCS,301,RC,,both,81.17,73.05,Cigna,Default,Percent of Total Billed Charges,47.89,,,,47.89,66.23
AMMONIA,82140,HCPCS,301,RC,,both,81.17,73.05,United Healthcare,Default,Fee Schedule,66.23,,,,47.89,66.23
AMINO ACID PLASMA QT 6 OR MORE,82139,HCPCS,300,RC,,both,128.5,115.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.95,,,,75.82,104.86
AMINO ACID PLASMA QT 6 OR MORE,82139,HCPCS,300,RC,,both,128.5,115.65,Cigna,Default,Percent of Total Billed Charges,75.82,,,,75.82,104.86
AMINO ACID PLASMA QT 6 OR MORE,82139,HCPCS,300,RC,,both,128.5,115.65,United Healthcare,Default,Fee Schedule,104.86,,,,75.82,104.86
ELISA,86701,HCPCS,300,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
ELISA,86701,HCPCS,300,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
ELISA,86701,HCPCS,300,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
HIV 1/2 AB,86703,HCPCS,300,RC,,both,53.5,48.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.45,,,,31.56,43.66
HIV 1/2 AB,86703,HCPCS,300,RC,,both,53.5,48.15,Cigna,Default,Percent of Total Billed Charges,31.56,,,,31.56,43.66
HIV 1/2 AB,86703,HCPCS,300,RC,,both,53.5,48.15,United Healthcare,Default,Fee Schedule,43.66,,,,31.56,43.66
HIV 1/2 ANTIGEN ANTIBODY,87389,HCPCS,306,RC,,both,119.77,107.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.84,,,,70.66,97.73
HIV 1/2 ANTIGEN ANTIBODY,87389,HCPCS,306,RC,,both,119.77,107.79,Cigna,Default,Percent of Total Billed Charges,70.66,,,,70.66,97.73
HIV 1/2 ANTIGEN ANTIBODY,87389,HCPCS,306,RC,,both,119.77,107.79,United Healthcare,Default,Fee Schedule,97.73,,,,70.66,97.73
HLAB27,81373,HCPCS,310,RC,,both,112.22,101,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.55,,,,66.21,91.57
HLAB27,81373,HCPCS,310,RC,,both,112.22,101,Cigna,Default,Percent of Total Billed Charges,66.21,,,,66.21,91.57
HLAB27,81373,HCPCS,310,RC,,both,112.22,101,United Healthcare,Default,Fee Schedule,91.57,,,,66.21,91.57
HOMOCYSTEINE,83090,HCPCS,301,RC,,both,163.59,147.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.51,,,,96.52,133.49
HOMOCYSTEINE,83090,HCPCS,301,RC,,both,163.59,147.23,Cigna,Default,Percent of Total Billed Charges,96.52,,,,96.52,133.49
HOMOCYSTEINE,83090,HCPCS,301,RC,,both,163.59,147.23,United Healthcare,Default,Fee Schedule,133.49,,,,96.52,133.49
HISTAMINE URINE,83088,HCPCS,301,RC,,both,80,72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56,,,,47.2,65.28
HISTAMINE URINE,83088,HCPCS,301,RC,,both,80,72,Cigna,Default,Percent of Total Billed Charges,47.2,,,,47.2,65.28
HISTAMINE URINE,83088,HCPCS,301,RC,,both,80,72,United Healthcare,Default,Fee Schedule,65.28,,,,47.2,65.28
PROTOPORPHYRINS FRACT WB,82542,HCPCS,301,RC,,both,326.25,293.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.38,,,,192.49,266.22
PROTOPORPHYRINS FRACT WB,82542,HCPCS,301,RC,,both,326.25,293.63,Cigna,Default,Percent of Total Billed Charges,192.49,,,,192.49,266.22
PROTOPORPHYRINS FRACT WB,82542,HCPCS,301,RC,,both,326.25,293.63,United Healthcare,Default,Fee Schedule,266.22,,,,192.49,266.22
FSH,83001,HCPCS,301,RC,,both,139.6,125.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.72,,,,82.36,113.91
FSH,83001,HCPCS,301,RC,,both,139.6,125.64,Cigna,Default,Percent of Total Billed Charges,82.36,,,,82.36,113.91
FSH,83001,HCPCS,301,RC,,both,139.6,125.64,United Healthcare,Default,Fee Schedule,113.91,,,,82.36,113.91
CULTURE-E COLI 0157,87046,HCPCS,300,RC,,both,63.25,56.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.28,,,,37.32,51.61
CULTURE-E COLI 0157,87046,HCPCS,300,RC,,both,63.25,56.93,Cigna,Default,Percent of Total Billed Charges,37.32,,,,37.32,51.61
CULTURE-E COLI 0157,87046,HCPCS,300,RC,,both,63.25,56.93,United Healthcare,Default,Fee Schedule,51.61,,,,37.32,51.61
CONCENTRATION STEC,87015,HCPCS,306,RC,,both,22.76,20.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.93,,,,13.43,18.57
CONCENTRATION STEC,87015,HCPCS,306,RC,,both,22.76,20.48,Cigna,Default,Percent of Total Billed Charges,13.43,,,,13.43,18.57
CONCENTRATION STEC,87015,HCPCS,306,RC,,both,22.76,20.48,United Healthcare,Default,Fee Schedule,18.57,,,,13.43,18.57
SHIGA TOXIN 1,87427,HCPCS,306,RC,,both,73.23,65.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.26,,,,43.21,59.76
SHIGA TOXIN 1,87427,HCPCS,306,RC,,both,73.23,65.91,Cigna,Default,Percent of Total Billed Charges,43.21,,,,43.21,59.76
SHIGA TOXIN 1,87427,HCPCS,306,RC,,both,73.23,65.91,United Healthcare,Default,Fee Schedule,59.76,,,,43.21,59.76
SHIGA TOXIN 2,87427,HCPCS,306,RC,,both,73.23,65.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.26,,,,43.21,59.76
SHIGA TOXIN 2,87427,HCPCS,306,RC,,both,73.23,65.91,Cigna,Default,Percent of Total Billed Charges,43.21,,,,43.21,59.76
SHIGA TOXIN 2,87427,HCPCS,306,RC,,both,73.23,65.91,United Healthcare,Default,Fee Schedule,59.76,,,,43.21,59.76
CULTURE-SALMONELLA/SHIGELLA,87045,HCPCS,300,RC,,both,114.52,103.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.16,,,,67.57,93.45
CULTURE-SALMONELLA/SHIGELLA,87045,HCPCS,300,RC,,both,114.52,103.07,Cigna,Default,Percent of Total Billed Charges,67.57,,,,67.57,93.45
CULTURE-SALMONELLA/SHIGELLA,87045,HCPCS,300,RC,,both,114.52,103.07,United Healthcare,Default,Fee Schedule,93.45,,,,67.57,93.45
ELCTRPHRSS HGB,83020,HCPCS,301,RC,,both,196.91,177.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.84,,,,116.18,160.68
ELCTRPHRSS HGB,83020,HCPCS,301,RC,,both,196.91,177.22,Cigna,Default,Percent of Total Billed Charges,116.18,,,,116.18,160.68
ELCTRPHRSS HGB,83020,HCPCS,301,RC,,both,196.91,177.22,United Healthcare,Default,Fee Schedule,160.68,,,,116.18,160.68
"CHROMATOGRAPHY, HGB",83021,HCPCS,301,RC,,both,52.25,47.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.58,,,,30.83,42.64
"CHROMATOGRAPHY, HGB",83021,HCPCS,301,RC,,both,52.25,47.03,Cigna,Default,Percent of Total Billed Charges,30.83,,,,30.83,42.64
"CHROMATOGRAPHY, HGB",83021,HCPCS,301,RC,,both,52.25,47.03,United Healthcare,Default,Fee Schedule,42.64,,,,30.83,42.64
LEGIONELLA AB SCREEN,86713,HCPCS,300,RC,,both,98.88,88.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.22,,,,58.34,80.69
LEGIONELLA AB SCREEN,86713,HCPCS,300,RC,,both,98.88,88.99,Cigna,Default,Percent of Total Billed Charges,58.34,,,,58.34,80.69
LEGIONELLA AB SCREEN,86713,HCPCS,300,RC,,both,98.88,88.99,United Healthcare,Default,Fee Schedule,80.69,,,,58.34,80.69
LEGIONELLA PCR,87801,HCPCS,300,RC,,both,328.72,295.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,230.1,,,,193.94,268.24
LEGIONELLA PCR,87801,HCPCS,300,RC,,both,328.72,295.85,Cigna,Default,Percent of Total Billed Charges,193.94,,,,193.94,268.24
LEGIONELLA PCR,87801,HCPCS,300,RC,,both,328.72,295.85,United Healthcare,Default,Fee Schedule,268.24,,,,193.94,268.24
CT/GC AMPLIFIED DETECTION,87801,HCPCS,300,RC,,both,113.75,102.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.62,,,,67.11,92.82
CT/GC AMPLIFIED DETECTION,87801,HCPCS,300,RC,,both,113.75,102.38,Cigna,Default,Percent of Total Billed Charges,67.11,,,,67.11,92.82
CT/GC AMPLIFIED DETECTION,87801,HCPCS,300,RC,,both,113.75,102.38,United Healthcare,Default,Fee Schedule,92.82,,,,67.11,92.82
B PERTUSSIS PCR,87801,HCPCS,300,RC,,both,274.83,247.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,192.38,,,,162.15,224.26
B PERTUSSIS PCR,87801,HCPCS,300,RC,,both,274.83,247.35,Cigna,Default,Percent of Total Billed Charges,162.15,,,,162.15,224.26
B PERTUSSIS PCR,87801,HCPCS,300,RC,,both,274.83,247.35,United Healthcare,Default,Fee Schedule,224.26,,,,162.15,224.26
CULTURE CHLAMYDIA,87110,HCPCS,300,RC,,both,127.63,114.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.34,,,,75.3,104.15
CULTURE CHLAMYDIA,87110,HCPCS,300,RC,,both,127.63,114.87,Cigna,Default,Percent of Total Billed Charges,75.3,,,,75.3,104.15
CULTURE CHLAMYDIA,87110,HCPCS,300,RC,,both,127.63,114.87,United Healthcare,Default,Fee Schedule,104.15,,,,75.3,104.15
INFLUENZA A/B ANTIGEN,87804,HCPCS,300,RC,,both,112.35,101.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.64,,,,66.29,91.68
INFLUENZA A/B ANTIGEN,87804,HCPCS,300,RC,,both,112.35,101.12,Cigna,Default,Percent of Total Billed Charges,66.29,,,,66.29,91.68
INFLUENZA A/B ANTIGEN,87804,HCPCS,300,RC,,both,112.35,101.12,United Healthcare,Default,Fee Schedule,91.68,,,,66.29,91.68
CHLAMYDIA AB PANEL-IGM(C. TRACOMATIS),86632,HCPCS,300,RC,,both,52.5,47.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.75,,,,30.98,42.84
CHLAMYDIA AB PANEL-IGM(C. TRACOMATIS),86632,HCPCS,300,RC,,both,52.5,47.25,Cigna,Default,Percent of Total Billed Charges,30.98,,,,30.98,42.84
CHLAMYDIA AB PANEL-IGM(C. TRACOMATIS),86632,HCPCS,300,RC,,both,52.5,47.25,United Healthcare,Default,Fee Schedule,42.84,,,,30.98,42.84
CAMPYLOBACTER ANTIGEN,87899,HCPCS,300,RC,,both,84.52,76.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.16,,,,49.87,68.97
CAMPYLOBACTER ANTIGEN,87899,HCPCS,300,RC,,both,84.52,76.07,Cigna,Default,Percent of Total Billed Charges,49.87,,,,49.87,68.97
CAMPYLOBACTER ANTIGEN,87899,HCPCS,300,RC,,both,84.52,76.07,United Healthcare,Default,Fee Schedule,68.97,,,,49.87,68.97
CITRATE URINE,82507,HCPCS,301,RC,,both,112.35,101.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.64,,,,66.29,91.68
CITRATE URINE,82507,HCPCS,301,RC,,both,112.35,101.12,Cigna,Default,Percent of Total Billed Charges,66.29,,,,66.29,91.68
CITRATE URINE,82507,HCPCS,301,RC,,both,112.35,101.12,United Healthcare,Default,Fee Schedule,91.68,,,,66.29,91.68
FREE TESTOSTERONE-FEMALE,84402,HCPCS,301,RC,,both,102.25,92.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.58,,,,60.33,83.44
FREE TESTOSTERONE-FEMALE,84402,HCPCS,301,RC,,both,102.25,92.03,Cigna,Default,Percent of Total Billed Charges,60.33,,,,60.33,83.44
FREE TESTOSTERONE-FEMALE,84402,HCPCS,301,RC,,both,102.25,92.03,United Healthcare,Default,Fee Schedule,83.44,,,,60.33,83.44
TESTOSTERONE TOTAL,84403,HCPCS,301,RC,,both,159.54,143.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.68,,,,94.13,130.18
TESTOSTERONE TOTAL,84403,HCPCS,301,RC,,both,159.54,143.59,Cigna,Default,Percent of Total Billed Charges,94.13,,,,94.13,130.18
TESTOSTERONE TOTAL,84403,HCPCS,301,RC,,both,159.54,143.59,United Healthcare,Default,Fee Schedule,130.18,,,,94.13,130.18
SEX HORMONE BINDING GLOBULIN,84270,HCPCS,301,RC,,both,82.31,74.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.62,,,,48.56,67.16
SEX HORMONE BINDING GLOBULIN,84270,HCPCS,301,RC,,both,82.31,74.08,Cigna,Default,Percent of Total Billed Charges,48.56,,,,48.56,67.16
SEX HORMONE BINDING GLOBULIN,84270,HCPCS,301,RC,,both,82.31,74.08,United Healthcare,Default,Fee Schedule,67.16,,,,48.56,67.16
SEMEN POST VAS,89321,HCPCS,300,RC,,both,59.92,53.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.94,,,,35.35,48.89
SEMEN POST VAS,89321,HCPCS,300,RC,,both,59.92,53.93,Cigna,Default,Percent of Total Billed Charges,35.35,,,,35.35,48.89
SEMEN POST VAS,89321,HCPCS,300,RC,,both,59.92,53.93,United Healthcare,Default,Fee Schedule,48.89,,,,35.35,48.89
LEUTENIZ HRMN(LH),83002,HCPCS,301,RC,,both,107.86,97.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.5,,,,63.64,88.01
LEUTENIZ HRMN(LH),83002,HCPCS,301,RC,,both,107.86,97.07,Cigna,Default,Percent of Total Billed Charges,63.64,,,,63.64,88.01
LEUTENIZ HRMN(LH),83002,HCPCS,301,RC,,both,107.86,97.07,United Healthcare,Default,Fee Schedule,88.01,,,,63.64,88.01
GONADOTROPIN RELEASING HORMONE,83727,HCPCS,301,RC,,both,599.5,539.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.65,,,,353.7,489.19
GONADOTROPIN RELEASING HORMONE,83727,HCPCS,301,RC,,both,599.5,539.55,Cigna,Default,Percent of Total Billed Charges,353.7,,,,353.7,489.19
GONADOTROPIN RELEASING HORMONE,83727,HCPCS,301,RC,,both,599.5,539.55,United Healthcare,Default,Fee Schedule,489.19,,,,353.7,489.19
VANCOMYCIN TROUGH,80202,HCPCS,301,RC,,both,309.19,278.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.43,,,,182.42,252.3
VANCOMYCIN TROUGH,80202,HCPCS,301,RC,,both,309.19,278.27,Cigna,Default,Percent of Total Billed Charges,182.42,,,,182.42,252.3
VANCOMYCIN TROUGH,80202,HCPCS,301,RC,,both,309.19,278.27,United Healthcare,Default,Fee Schedule,252.3,,,,182.42,252.3
VANCOMYCIN PEAK,80202,HCPCS,301,RC,,both,225.76,203.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.03,,,,133.2,184.22
VANCOMYCIN PEAK,80202,HCPCS,301,RC,,both,225.76,203.18,Cigna,Default,Percent of Total Billed Charges,133.2,,,,133.2,184.22
VANCOMYCIN PEAK,80202,HCPCS,301,RC,,both,225.76,203.18,United Healthcare,Default,Fee Schedule,184.22,,,,133.2,184.22
VASO INTESTNL POLYPEPTD,84586,HCPCS,301,RC,,both,201.77,181.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.24,,,,119.04,164.64
VASO INTESTNL POLYPEPTD,84586,HCPCS,301,RC,,both,201.77,181.59,Cigna,Default,Percent of Total Billed Charges,119.04,,,,119.04,164.64
VASO INTESTNL POLYPEPTD,84586,HCPCS,301,RC,,both,201.77,181.59,United Healthcare,Default,Fee Schedule,164.64,,,,119.04,164.64
BHCG-QUANT,84702,HCPCS,301,RC,,both,84.54,76.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.18,,,,49.88,68.98
BHCG-QUANT,84702,HCPCS,301,RC,,both,84.54,76.09,Cigna,Default,Percent of Total Billed Charges,49.88,,,,49.88,68.98
BHCG-QUANT,84702,HCPCS,301,RC,,both,84.54,76.09,United Healthcare,Default,Fee Schedule,68.98,,,,49.88,68.98
BHCG TUMOR MARKER,84702,HCPCS,301,RC,,both,84.54,76.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.18,,,,49.88,68.98
BHCG TUMOR MARKER,84702,HCPCS,301,RC,,both,84.54,76.09,Cigna,Default,Percent of Total Billed Charges,49.88,,,,49.88,68.98
BHCG TUMOR MARKER,84702,HCPCS,301,RC,,both,84.54,76.09,United Healthcare,Default,Fee Schedule,68.98,,,,49.88,68.98
ALCOHOL ETOH,82077,HCPCS,301,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
ALCOHOL ETOH,82077,HCPCS,301,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
ALCOHOL ETOH,82077,HCPCS,301,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
CHAIN OF CUSTODY URINE ALCOHOL,80320,HCPCS,301,RC,,both,40.37,36.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.26,,,,23.82,32.94
CHAIN OF CUSTODY URINE ALCOHOL,80320,HCPCS,301,RC,,both,40.37,36.33,Cigna,Default,Percent of Total Billed Charges,23.82,,,,23.82,32.94
CHAIN OF CUSTODY URINE ALCOHOL,80320,HCPCS,301,RC,,both,40.37,36.33,United Healthcare,Default,Fee Schedule,32.94,,,,23.82,32.94
LEAD LEVEL,83655,HCPCS,301,RC,,both,76.34,68.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.44,,,,45.04,62.29
LEAD LEVEL,83655,HCPCS,301,RC,,both,76.34,68.71,Cigna,Default,Percent of Total Billed Charges,45.04,,,,45.04,62.29
LEAD LEVEL,83655,HCPCS,301,RC,,both,76.34,68.71,United Healthcare,Default,Fee Schedule,62.29,,,,45.04,62.29
HAPTOGLOBIN,83010,HCPCS,301,RC,,both,79.76,71.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.83,,,,47.06,65.08
HAPTOGLOBIN,83010,HCPCS,301,RC,,both,79.76,71.78,Cigna,Default,Percent of Total Billed Charges,47.06,,,,47.06,65.08
HAPTOGLOBIN,83010,HCPCS,301,RC,,both,79.76,71.78,United Healthcare,Default,Fee Schedule,65.08,,,,47.06,65.08
CULTURE-BODY FLUID,87070,HCPCS,300,RC,,both,122.15,109.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.07,99.67
CULTURE-BODY FLUID,87070,HCPCS,300,RC,,both,122.15,109.94,Cigna,Default,Percent of Total Billed Charges,72.07,,,,72.07,99.67
CULTURE-BODY FLUID,87070,HCPCS,300,RC,,both,122.15,109.94,United Healthcare,Default,Fee Schedule,99.67,,,,72.07,99.67
CULTURE-CAMPYLOBACTR,87046,HCPCS,300,RC,,both,92.71,83.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.9,,,,54.7,75.65
CULTURE-CAMPYLOBACTR,87046,HCPCS,300,RC,,both,92.71,83.44,Cigna,Default,Percent of Total Billed Charges,54.7,,,,54.7,75.65
CULTURE-CAMPYLOBACTR,87046,HCPCS,300,RC,,both,92.71,83.44,United Healthcare,Default,Fee Schedule,75.65,,,,54.7,75.65
AMIKACIN,80150,HCPCS,301,RC,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
AMIKACIN,80150,HCPCS,301,RC,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
AMIKACIN,80150,HCPCS,301,RC,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
AMITRIPTYLINE LEVL,80335,HCPCS,301,RC,,both,93.54,84.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.48,,,,55.19,76.33
AMITRIPTYLINE LEVL,80335,HCPCS,301,RC,,both,93.54,84.19,Cigna,Default,Percent of Total Billed Charges,55.19,,,,55.19,76.33
AMITRIPTYLINE LEVL,80335,HCPCS,301,RC,,both,93.54,84.19,United Healthcare,Default,Fee Schedule,76.33,,,,55.19,76.33
NORTRIPTYLINE,80335,HCPCS,301,RC,,both,60.86,54.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.6,,,,35.91,49.66
NORTRIPTYLINE,80335,HCPCS,301,RC,,both,60.86,54.77,Cigna,Default,Percent of Total Billed Charges,35.91,,,,35.91,49.66
NORTRIPTYLINE,80335,HCPCS,301,RC,,both,60.86,54.77,United Healthcare,Default,Fee Schedule,49.66,,,,35.91,49.66
HEP C AB,86803,HCPCS,300,RC,,both,87.35,78.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.14,,,,51.54,71.28
HEP C AB,86803,HCPCS,300,RC,,both,87.35,78.62,Cigna,Default,Percent of Total Billed Charges,51.54,,,,51.54,71.28
HEP C AB,86803,HCPCS,300,RC,,both,87.35,78.62,United Healthcare,Default,Fee Schedule,71.28,,,,51.54,71.28
HEP C GENOTYPE,87902,HCPCS,300,RC,,both,497.16,447.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,348.01,,,,293.32,405.68
HEP C GENOTYPE,87902,HCPCS,300,RC,,both,497.16,447.44,Cigna,Default,Percent of Total Billed Charges,293.32,,,,293.32,405.68
HEP C GENOTYPE,87902,HCPCS,300,RC,,both,497.16,447.44,United Healthcare,Default,Fee Schedule,405.68,,,,293.32,405.68
HEP DELTA ANTIBODY,86692,HCPCS,300,RC,,both,134.25,120.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.98,,,,79.21,109.55
HEP DELTA ANTIBODY,86692,HCPCS,300,RC,,both,134.25,120.83,Cigna,Default,Percent of Total Billed Charges,79.21,,,,79.21,109.55
HEP DELTA ANTIBODY,86692,HCPCS,300,RC,,both,134.25,120.83,United Healthcare,Default,Fee Schedule,109.55,,,,79.21,109.55
HEP A AB TOTAL,86708,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
HEP A AB TOTAL,86708,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
HEP A AB TOTAL,86708,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
HEP A IGG,86708,HCPCS,302,RC,,both,73.03,65.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.12,,,,43.09,59.59
HEP A IGG,86708,HCPCS,302,RC,,both,73.03,65.73,Cigna,Default,Percent of Total Billed Charges,43.09,,,,43.09,59.59
HEP A IGG,86708,HCPCS,302,RC,,both,73.03,65.73,United Healthcare,Default,Fee Schedule,59.59,,,,43.09,59.59
HEP A IGM,86709,HCPCS,302,RC,,both,41.28,37.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.9,,,,24.36,33.68
HEP A IGM,86709,HCPCS,302,RC,,both,41.28,37.15,Cigna,Default,Percent of Total Billed Charges,24.36,,,,24.36,33.68
HEP A IGM,86709,HCPCS,302,RC,,both,41.28,37.15,United Healthcare,Default,Fee Schedule,33.68,,,,24.36,33.68
HEP B CORE AB TOTAL,86704,HCPCS,300,RC,,both,84.54,76.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.18,,,,49.88,68.98
HEP B CORE AB TOTAL,86704,HCPCS,300,RC,,both,84.54,76.09,Cigna,Default,Percent of Total Billed Charges,49.88,,,,49.88,68.98
HEP B CORE AB TOTAL,86704,HCPCS,300,RC,,both,84.54,76.09,United Healthcare,Default,Fee Schedule,68.98,,,,49.88,68.98
HEPATITIS B CORE AB - IGM,86705,HCPCS,300,RC,,both,107.14,96.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75,,,,63.21,87.43
HEPATITIS B CORE AB - IGM,86705,HCPCS,300,RC,,both,107.14,96.43,Cigna,Default,Percent of Total Billed Charges,63.21,,,,63.21,87.43
HEPATITIS B CORE AB - IGM,86705,HCPCS,300,RC,,both,107.14,96.43,United Healthcare,Default,Fee Schedule,87.43,,,,63.21,87.43
PTH-PARTHYRD HRMN,83970,HCPCS,301,RC,,both,247.56,222.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.29,,,,146.06,202.01
PTH-PARTHYRD HRMN,83970,HCPCS,301,RC,,both,247.56,222.8,Cigna,Default,Percent of Total Billed Charges,146.06,,,,146.06,202.01
PTH-PARTHYRD HRMN,83970,HCPCS,301,RC,,both,247.56,222.8,United Healthcare,Default,Fee Schedule,202.01,,,,146.06,202.01
HEPARIN IND PLTLT AB,86022,HCPCS,300,RC,,both,257.25,231.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.08,,,,151.78,209.92
HEPARIN IND PLTLT AB,86022,HCPCS,300,RC,,both,257.25,231.53,Cigna,Default,Percent of Total Billed Charges,151.78,,,,151.78,209.92
HEPARIN IND PLTLT AB,86022,HCPCS,300,RC,,both,257.25,231.53,United Healthcare,Default,Fee Schedule,209.92,,,,151.78,209.92
IMMUNOGLOBULIN G,82784,HCPCS,301,RC,,both,62.07,55.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.45,,,,36.62,50.65
IMMUNOGLOBULIN G,82784,HCPCS,301,RC,,both,62.07,55.86,Cigna,Default,Percent of Total Billed Charges,36.62,,,,36.62,50.65
IMMUNOGLOBULIN G,82784,HCPCS,301,RC,,both,62.07,55.86,United Healthcare,Default,Fee Schedule,50.65,,,,36.62,50.65
IGG SUBCLASS 1,82787,HCPCS,301,RC,,both,43,38.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.1,,,,25.37,35.09
IGG SUBCLASS 1,82787,HCPCS,301,RC,,both,43,38.7,Cigna,Default,Percent of Total Billed Charges,25.37,,,,25.37,35.09
IGG SUBCLASS 1,82787,HCPCS,301,RC,,both,43,38.7,United Healthcare,Default,Fee Schedule,35.09,,,,25.37,35.09
IGG SUBCLASS 2,82787,HCPCS,301,RC,,both,43,38.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.1,,,,25.37,35.09
IGG SUBCLASS 2,82787,HCPCS,301,RC,,both,43,38.7,Cigna,Default,Percent of Total Billed Charges,25.37,,,,25.37,35.09
IGG SUBCLASS 2,82787,HCPCS,301,RC,,both,43,38.7,United Healthcare,Default,Fee Schedule,35.09,,,,25.37,35.09
IGG SUBCLASS 3,82787,HCPCS,301,RC,,both,43,38.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.1,,,,25.37,35.09
IGG SUBCLASS 3,82787,HCPCS,301,RC,,both,43,38.7,Cigna,Default,Percent of Total Billed Charges,25.37,,,,25.37,35.09
IGG SUBCLASS 3,82787,HCPCS,301,RC,,both,43,38.7,United Healthcare,Default,Fee Schedule,35.09,,,,25.37,35.09
IGG SUBCLASS 4,82787,HCPCS,301,RC,,both,43,38.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.1,,,,25.37,35.09
IGG SUBCLASS 4,82787,HCPCS,301,RC,,both,43,38.7,Cigna,Default,Percent of Total Billed Charges,25.37,,,,25.37,35.09
IGG SUBCLASS 4,82787,HCPCS,301,RC,,both,43,38.7,United Healthcare,Default,Fee Schedule,35.09,,,,25.37,35.09
IMMUNOGLOBULIN A,82784,HCPCS,301,RC,,both,62.07,55.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.45,,,,36.62,50.65
IMMUNOGLOBULIN A,82784,HCPCS,301,RC,,both,62.07,55.86,Cigna,Default,Percent of Total Billed Charges,36.62,,,,36.62,50.65
IMMUNOGLOBULIN A,82784,HCPCS,301,RC,,both,62.07,55.86,United Healthcare,Default,Fee Schedule,50.65,,,,36.62,50.65
IMMUNOGLOBULIN D,82784,HCPCS,301,RC,,both,91.07,81.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.75,,,,53.73,74.31
IMMUNOGLOBULIN D,82784,HCPCS,301,RC,,both,91.07,81.96,Cigna,Default,Percent of Total Billed Charges,53.73,,,,53.73,74.31
IMMUNOGLOBULIN D,82784,HCPCS,301,RC,,both,91.07,81.96,United Healthcare,Default,Fee Schedule,74.31,,,,53.73,74.31
ELCTRPHRSS-IMMUNO,86334,HCPCS,300,RC,,both,162.5,146.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.75,,,,95.88,132.6
ELCTRPHRSS-IMMUNO,86334,HCPCS,300,RC,,both,162.5,146.25,Cigna,Default,Percent of Total Billed Charges,95.88,,,,95.88,132.6
ELCTRPHRSS-IMMUNO,86334,HCPCS,300,RC,,both,162.5,146.25,United Healthcare,Default,Fee Schedule,132.6,,,,95.88,132.6
IMMUNOELPHSIS-NOT BLOOD,86335,HCPCS,300,RC,,both,182.12,163.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.48,,,,107.45,148.61
IMMUNOELPHSIS-NOT BLOOD,86335,HCPCS,300,RC,,both,182.12,163.91,Cigna,Default,Percent of Total Billed Charges,107.45,,,,107.45,148.61
IMMUNOELPHSIS-NOT BLOOD,86335,HCPCS,300,RC,,both,182.12,163.91,United Healthcare,Default,Fee Schedule,148.61,,,,107.45,148.61
ALLERGENS ADULT FOOD,86003,HCPCS,302,RC,,both,22.4,20.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.68,,,,13.22,18.28
ALLERGENS ADULT FOOD,86003,HCPCS,302,RC,,both,22.4,20.16,Cigna,Default,Percent of Total Billed Charges,13.22,,,,13.22,18.28
ALLERGENS ADULT FOOD,86003,HCPCS,302,RC,,both,22.4,20.16,United Healthcare,Default,Fee Schedule,18.28,,,,13.22,18.28
IMMUNOGLOBULIN E,82785,HCPCS,301,RC,,both,90.18,81.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.13,,,,53.21,73.59
IMMUNOGLOBULIN E,82785,HCPCS,301,RC,,both,90.18,81.16,Cigna,Default,Percent of Total Billed Charges,53.21,,,,53.21,73.59
IMMUNOGLOBULIN E,82785,HCPCS,301,RC,,both,90.18,81.16,United Healthcare,Default,Fee Schedule,73.59,,,,53.21,73.59
IMMUNOGLOBULIN M,82784,HCPCS,301,RC,,both,62.07,55.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.45,,,,36.62,50.65
IMMUNOGLOBULIN M,82784,HCPCS,301,RC,,both,62.07,55.86,Cigna,Default,Percent of Total Billed Charges,36.62,,,,36.62,50.65
IMMUNOGLOBULIN M,82784,HCPCS,301,RC,,both,62.07,55.86,United Healthcare,Default,Fee Schedule,50.65,,,,36.62,50.65
IMIPRAMINE,80174,HCPCS,301,RC,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
IMIPRAMINE,80174,HCPCS,301,RC,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
IMIPRAMINE,80174,HCPCS,301,RC,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
ALLERGENS UPPER RESP,82785,HCPCS,301,RC,,both,42.17,37.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.52,,,,24.88,34.41
ALLERGENS UPPER RESP,82785,HCPCS,301,RC,,both,42.17,37.95,Cigna,Default,Percent of Total Billed Charges,24.88,,,,24.88,34.41
ALLERGENS UPPER RESP,82785,HCPCS,301,RC,,both,42.17,37.95,United Healthcare,Default,Fee Schedule,34.41,,,,24.88,34.41
IFE URINE QUALITATIVE,86335,HCPCS,300,RC,,both,125.84,113.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.09,,,,74.25,102.69
IFE URINE QUALITATIVE,86335,HCPCS,300,RC,,both,125.84,113.26,Cigna,Default,Percent of Total Billed Charges,74.25,,,,74.25,102.69
IFE URINE QUALITATIVE,86335,HCPCS,300,RC,,both,125.84,113.26,United Healthcare,Default,Fee Schedule,102.69,,,,74.25,102.69
ALLERGENS COMMON FOOD,86003,HCPCS,300,RC,,both,22.4,20.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.68,,,,13.22,18.28
ALLERGENS COMMON FOOD,86003,HCPCS,300,RC,,both,22.4,20.16,Cigna,Default,Percent of Total Billed Charges,13.22,,,,13.22,18.28
ALLERGENS COMMON FOOD,86003,HCPCS,300,RC,,both,22.4,20.16,United Healthcare,Default,Fee Schedule,18.28,,,,13.22,18.28
ALLERGENS FOOD PROFILE,82785,HCPCS,301,RC,,both,42.17,37.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.52,,,,24.88,34.41
ALLERGENS FOOD PROFILE,82785,HCPCS,301,RC,,both,42.17,37.95,Cigna,Default,Percent of Total Billed Charges,24.88,,,,24.88,34.41
ALLERGENS FOOD PROFILE,82785,HCPCS,301,RC,,both,42.17,37.95,United Healthcare,Default,Fee Schedule,34.41,,,,24.88,34.41
ALLERGENS CHILDHOOD MARCH PROFILE,82785,HCPCS,301,RC,,both,42.17,37.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.52,,,,24.88,34.41
ALLERGENS CHILDHOOD MARCH PROFILE,82785,HCPCS,301,RC,,both,42.17,37.95,Cigna,Default,Percent of Total Billed Charges,24.88,,,,24.88,34.41
ALLERGENS CHILDHOOD MARCH PROFILE,82785,HCPCS,301,RC,,both,42.17,37.95,United Healthcare,Default,Fee Schedule,34.41,,,,24.88,34.41
ROTAVIRUS,87425,HCPCS,300,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
ROTAVIRUS,87425,HCPCS,300,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
ROTAVIRUS,87425,HCPCS,300,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
H PYLORI ANTIBODY,86677,HCPCS,300,RC,,both,114.61,103.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.23,,,,67.62,93.52
H PYLORI ANTIBODY,86677,HCPCS,300,RC,,both,114.61,103.15,Cigna,Default,Percent of Total Billed Charges,67.62,,,,67.62,93.52
H PYLORI ANTIBODY,86677,HCPCS,300,RC,,both,114.61,103.15,United Healthcare,Default,Fee Schedule,93.52,,,,67.62,93.52
H PYLORI AG FECES,87338,HCPCS,300,RC,,both,182.34,164.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.64,,,,107.58,148.79
H PYLORI AG FECES,87338,HCPCS,300,RC,,both,182.34,164.11,Cigna,Default,Percent of Total Billed Charges,107.58,,,,107.58,148.79
H PYLORI AG FECES,87338,HCPCS,300,RC,,both,182.34,164.11,United Healthcare,Default,Fee Schedule,148.79,,,,107.58,148.79
H PYLORI IGM,86677,HCPCS,300,RC,,both,411.96,370.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,288.37,,,,243.06,336.16
H PYLORI IGM,86677,HCPCS,300,RC,,both,411.96,370.76,Cigna,Default,Percent of Total Billed Charges,243.06,,,,243.06,336.16
H PYLORI IGM,86677,HCPCS,300,RC,,both,411.96,370.76,United Healthcare,Default,Fee Schedule,336.16,,,,243.06,336.16
CALCITONIN,82308,HCPCS,301,RC,,both,257,231.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,179.9,,,,151.63,209.71
CALCITONIN,82308,HCPCS,301,RC,,both,257,231.3,Cigna,Default,Percent of Total Billed Charges,151.63,,,,151.63,209.71
CALCITONIN,82308,HCPCS,301,RC,,both,257,231.3,United Healthcare,Default,Fee Schedule,209.71,,,,151.63,209.71
CA 27-29,86300,HCPCS,300,RC,,both,162.5,146.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.75,,,,95.88,132.6
CA 27-29,86300,HCPCS,300,RC,,both,162.5,146.25,Cigna,Default,Percent of Total Billed Charges,95.88,,,,95.88,132.6
CA 27-29,86300,HCPCS,300,RC,,both,162.5,146.25,United Healthcare,Default,Fee Schedule,132.6,,,,95.88,132.6
CA-125,86304,HCPCS,300,RC,,both,165.88,149.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.12,,,,97.87,135.36
CA-125,86304,HCPCS,300,RC,,both,165.88,149.29,Cigna,Default,Percent of Total Billed Charges,97.87,,,,97.87,135.36
CA-125,86304,HCPCS,300,RC,,both,165.88,149.29,United Healthcare,Default,Fee Schedule,135.36,,,,97.87,135.36
CA-15-3,86300,HCPCS,300,RC,,both,162.5,146.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.75,,,,95.88,132.6
CA-15-3,86300,HCPCS,300,RC,,both,162.5,146.25,Cigna,Default,Percent of Total Billed Charges,95.88,,,,95.88,132.6
CA-15-3,86300,HCPCS,300,RC,,both,162.5,146.25,United Healthcare,Default,Fee Schedule,132.6,,,,95.88,132.6
DS DNA,86225,HCPCS,302,RC,,both,18.26,16.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.78,,,,10.77,14.9
DS DNA,86225,HCPCS,302,RC,,both,18.26,16.43,Cigna,Default,Percent of Total Billed Charges,10.77,,,,10.77,14.9
DS DNA,86225,HCPCS,302,RC,,both,18.26,16.43,United Healthcare,Default,Fee Schedule,14.9,,,,10.77,14.9
PROGESTERONE,84144,HCPCS,301,RC,,both,133.06,119.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.14,,,,78.51,108.58
PROGESTERONE,84144,HCPCS,301,RC,,both,133.06,119.75,Cigna,Default,Percent of Total Billed Charges,78.51,,,,78.51,108.58
PROGESTERONE,84144,HCPCS,301,RC,,both,133.06,119.75,United Healthcare,Default,Fee Schedule,108.58,,,,78.51,108.58
PREGNENOLONE,84140,HCPCS,301,RC,,both,62,55.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.4,,,,36.58,50.59
PREGNENOLONE,84140,HCPCS,301,RC,,both,62,55.8,Cigna,Default,Percent of Total Billed Charges,36.58,,,,36.58,50.59
PREGNENOLONE,84140,HCPCS,301,RC,,both,62,55.8,United Healthcare,Default,Fee Schedule,50.59,,,,36.58,50.59
HEMOSIDERIN-URINE QUAL,83070,HCPCS,301,RC,,both,43.5,39.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.45,,,,25.66,35.5
HEMOSIDERIN-URINE QUAL,83070,HCPCS,301,RC,,both,43.5,39.15,Cigna,Default,Percent of Total Billed Charges,25.66,,,,25.66,35.5
HEMOSIDERIN-URINE QUAL,83070,HCPCS,301,RC,,both,43.5,39.15,United Healthcare,Default,Fee Schedule,35.5,,,,25.66,35.5
ENTAM HISTLYT AB,86753,HCPCS,300,RC,,both,92,82.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.4,,,,54.28,75.07
ENTAM HISTLYT AB,86753,HCPCS,300,RC,,both,92,82.8,Cigna,Default,Percent of Total Billed Charges,54.28,,,,54.28,75.07
ENTAM HISTLYT AB,86753,HCPCS,300,RC,,both,92,82.8,United Healthcare,Default,Fee Schedule,75.07,,,,54.28,75.07
CARBON MONOXIDE,82375,HCPCS,301,RC,,both,26.69,24.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.68,,,,15.75,21.78
CARBON MONOXIDE,82375,HCPCS,301,RC,,both,26.69,24.02,Cigna,Default,Percent of Total Billed Charges,15.75,,,,15.75,21.78
CARBON MONOXIDE,82375,HCPCS,301,RC,,both,26.69,24.02,United Healthcare,Default,Fee Schedule,21.78,,,,15.75,21.78
C-REACTIVE PROTEIN HS,86141,HCPCS,300,RC,,both,111.39,100.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.97,,,,65.72,90.89
C-REACTIVE PROTEIN HS,86141,HCPCS,300,RC,,both,111.39,100.25,Cigna,Default,Percent of Total Billed Charges,65.72,,,,65.72,90.89
C-REACTIVE PROTEIN HS,86141,HCPCS,300,RC,,both,111.39,100.25,United Healthcare,Default,Fee Schedule,90.89,,,,65.72,90.89
HDL-CHOL DIRECT,83718,HCPCS,301,RC,,both,57.58,51.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.31,,,,33.97,46.99
HDL-CHOL DIRECT,83718,HCPCS,301,RC,,both,57.58,51.82,Cigna,Default,Percent of Total Billed Charges,33.97,,,,33.97,46.99
HDL-CHOL DIRECT,83718,HCPCS,301,RC,,both,57.58,51.82,United Healthcare,Default,Fee Schedule,46.99,,,,33.97,46.99
SACCHAROMYCES CERVISIAE AB IGG,86671,HCPCS,300,RC,,both,81.75,73.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.22,,,,48.23,66.71
SACCHAROMYCES CERVISIAE AB IGG,86671,HCPCS,300,RC,,both,81.75,73.58,Cigna,Default,Percent of Total Billed Charges,48.23,,,,48.23,66.71
SACCHAROMYCES CERVISIAE AB IGG,86671,HCPCS,300,RC,,both,81.75,73.58,United Healthcare,Default,Fee Schedule,66.71,,,,48.23,66.71
SACCHAROMYCES CERVISIAE AB IGA,86671,HCPCS,300,RC,,both,81.75,73.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.22,,,,48.23,66.71
SACCHAROMYCES CERVISIAE AB IGA,86671,HCPCS,300,RC,,both,81.75,73.58,Cigna,Default,Percent of Total Billed Charges,48.23,,,,48.23,66.71
SACCHAROMYCES CERVISIAE AB IGA,86671,HCPCS,300,RC,,both,81.75,73.58,United Healthcare,Default,Fee Schedule,66.71,,,,48.23,66.71
RUBELLA,86762,HCPCS,300,RC,,both,35.67,32.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.97,,,,21.05,29.11
RUBELLA,86762,HCPCS,300,RC,,both,35.67,32.1,Cigna,Default,Percent of Total Billed Charges,21.05,,,,21.05,29.11
RUBELLA,86762,HCPCS,300,RC,,both,35.67,32.1,United Healthcare,Default,Fee Schedule,29.11,,,,21.05,29.11
RUBEOLA IGM,86765,HCPCS,300,RC,,both,72.47,65.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.73,,,,42.76,59.14
RUBEOLA IGM,86765,HCPCS,300,RC,,both,72.47,65.22,Cigna,Default,Percent of Total Billed Charges,42.76,,,,42.76,59.14
RUBEOLA IGM,86765,HCPCS,300,RC,,both,72.47,65.22,United Healthcare,Default,Fee Schedule,59.14,,,,42.76,59.14
RUBEOLA,86765,HCPCS,300,RC,,both,72.47,65.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.73,,,,42.76,59.14
RUBEOLA,86765,HCPCS,300,RC,,both,72.47,65.22,Cigna,Default,Percent of Total Billed Charges,42.76,,,,42.76,59.14
RUBEOLA,86765,HCPCS,300,RC,,both,72.47,65.22,United Healthcare,Default,Fee Schedule,59.14,,,,42.76,59.14
SALICYLATE,80179,HCPCS,301,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
SALICYLATE,80179,HCPCS,301,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
SALICYLATE,80179,HCPCS,301,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
NICOTINE URINE,80323,HCPCS,300,RC,,both,108.88,97.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.22,,,,64.24,88.85
NICOTINE URINE,80323,HCPCS,300,RC,,both,108.88,97.99,Cigna,Default,Percent of Total Billed Charges,64.24,,,,64.24,88.85
NICOTINE URINE,80323,HCPCS,300,RC,,both,108.88,97.99,United Healthcare,Default,Fee Schedule,88.85,,,,64.24,88.85
NICOTINE SERUM,80323,HCPCS,301,RC,,both,127.81,115.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.47,,,,75.41,104.29
NICOTINE SERUM,80323,HCPCS,301,RC,,both,127.81,115.03,Cigna,Default,Percent of Total Billed Charges,75.41,,,,75.41,104.29
NICOTINE SERUM,80323,HCPCS,301,RC,,both,127.81,115.03,United Healthcare,Default,Fee Schedule,104.29,,,,75.41,104.29
NMR LIPO PROIFILE,83704,HCPCS,301,RC,,both,189,170.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.3,,,,111.51,154.22
NMR LIPO PROIFILE,83704,HCPCS,301,RC,,both,189,170.1,Cigna,Default,Percent of Total Billed Charges,111.51,,,,111.51,154.22
NMR LIPO PROIFILE,83704,HCPCS,301,RC,,both,189,170.1,United Healthcare,Default,Fee Schedule,154.22,,,,111.51,154.22
C3 COMPLEMENT,86160,HCPCS,300,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
C3 COMPLEMENT,86160,HCPCS,300,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
C3 COMPLEMENT,86160,HCPCS,300,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
CYCLIC CITR PEPTIDE AB IGG,86200,HCPCS,300,RC,,both,127.52,114.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.26,,,,75.24,104.06
CYCLIC CITR PEPTIDE AB IGG,86200,HCPCS,300,RC,,both,127.52,114.77,Cigna,Default,Percent of Total Billed Charges,75.24,,,,75.24,104.06
CYCLIC CITR PEPTIDE AB IGG,86200,HCPCS,300,RC,,both,127.52,114.77,United Healthcare,Default,Fee Schedule,104.06,,,,75.24,104.06
COMPLEMENT COMPONENT 1 FUNCTIONAL,86161,HCPCS,300,RC,,both,207.57,186.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.3,,,,122.47,169.38
COMPLEMENT COMPONENT 1 FUNCTIONAL,86161,HCPCS,300,RC,,both,207.57,186.81,Cigna,Default,Percent of Total Billed Charges,122.47,,,,122.47,169.38
COMPLEMENT COMPONENT 1 FUNCTIONAL,86161,HCPCS,300,RC,,both,207.57,186.81,United Healthcare,Default,Fee Schedule,169.38,,,,122.47,169.38
COMPLEMENT 2,86160,HCPCS,300,RC,,both,115.45,103.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.82,,,,68.12,94.21
COMPLEMENT 2,86160,HCPCS,300,RC,,both,115.45,103.91,Cigna,Default,Percent of Total Billed Charges,68.12,,,,68.12,94.21
COMPLEMENT 2,86160,HCPCS,300,RC,,both,115.45,103.91,United Healthcare,Default,Fee Schedule,94.21,,,,68.12,94.21
COMPLEMENT 4,86160,HCPCS,300,RC,,both,79.76,71.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.83,,,,47.06,65.08
COMPLEMENT 4,86160,HCPCS,300,RC,,both,79.76,71.78,Cigna,Default,Percent of Total Billed Charges,47.06,,,,47.06,65.08
COMPLEMENT 4,86160,HCPCS,300,RC,,both,79.76,71.78,United Healthcare,Default,Fee Schedule,65.08,,,,47.06,65.08
C1 ESTERASE INHIBITOR FUNCTIONAL,83520,HCPCS,301,RC,,both,182.58,164.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.81,,,,107.72,148.99
C1 ESTERASE INHIBITOR FUNCTIONAL,83520,HCPCS,301,RC,,both,182.58,164.32,Cigna,Default,Percent of Total Billed Charges,107.72,,,,107.72,148.99
C1 ESTERASE INHIBITOR FUNCTIONAL,83520,HCPCS,301,RC,,both,182.58,164.32,United Healthcare,Default,Fee Schedule,148.99,,,,107.72,148.99
C1 ESTERASE INHIBITOR LEVEL,83883,HCPCS,301,RC,,both,241.02,216.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.71,,,,142.2,196.67
C1 ESTERASE INHIBITOR LEVEL,83883,HCPCS,301,RC,,both,241.02,216.92,Cigna,Default,Percent of Total Billed Charges,142.2,,,,142.2,196.67
C1 ESTERASE INHIBITOR LEVEL,83883,HCPCS,301,RC,,both,241.02,216.92,United Healthcare,Default,Fee Schedule,196.67,,,,142.2,196.67
C1Q COMPLEMENT,86160,HCPCS,302,RC,,both,127.81,115.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.47,,,,75.41,104.29
C1Q COMPLEMENT,86160,HCPCS,302,RC,,both,127.81,115.03,Cigna,Default,Percent of Total Billed Charges,75.41,,,,75.41,104.29
C1Q COMPLEMENT,86160,HCPCS,302,RC,,both,127.81,115.03,United Healthcare,Default,Fee Schedule,104.29,,,,75.41,104.29
ANTITHROMBIN III,85300,HCPCS,300,RC,,both,146.15,131.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.3,,,,86.23,119.26
ANTITHROMBIN III,85300,HCPCS,300,RC,,both,146.15,131.54,Cigna,Default,Percent of Total Billed Charges,86.23,,,,86.23,119.26
ANTITHROMBIN III,85300,HCPCS,300,RC,,both,146.15,131.54,United Healthcare,Default,Fee Schedule,119.26,,,,86.23,119.26
ANTITHROMBIN 3 ANTIGEN,85301,HCPCS,305,RC,,both,103.37,93.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.36,,,,60.99,84.35
ANTITHROMBIN 3 ANTIGEN,85301,HCPCS,305,RC,,both,103.37,93.03,Cigna,Default,Percent of Total Billed Charges,60.99,,,,60.99,84.35
ANTITHROMBIN 3 ANTIGEN,85301,HCPCS,305,RC,,both,103.37,93.03,United Healthcare,Default,Fee Schedule,84.35,,,,60.99,84.35
CA-19-9,86301,HCPCS,300,RC,,both,154.87,139.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.41,,,,91.37,126.37
CA-19-9,86301,HCPCS,300,RC,,both,154.87,139.38,Cigna,Default,Percent of Total Billed Charges,91.37,,,,91.37,126.37
CA-19-9,86301,HCPCS,300,RC,,both,154.87,139.38,United Healthcare,Default,Fee Schedule,126.37,,,,91.37,126.37
HEP B SUR AB,86706,HCPCS,300,RC,,both,72.47,65.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.73,,,,42.76,59.14
HEP B SUR AB,86706,HCPCS,300,RC,,both,72.47,65.22,Cigna,Default,Percent of Total Billed Charges,42.76,,,,42.76,59.14
HEP B SUR AB,86706,HCPCS,300,RC,,both,72.47,65.22,United Healthcare,Default,Fee Schedule,59.14,,,,42.76,59.14
HEP B SURFACE AB QUANT,86706,HCPCS,300,RC,,both,103.19,92.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.23,,,,60.88,84.2
HEP B SURFACE AB QUANT,86706,HCPCS,300,RC,,both,103.19,92.87,Cigna,Default,Percent of Total Billed Charges,60.88,,,,60.88,84.2
HEP B SURFACE AB QUANT,86706,HCPCS,300,RC,,both,103.19,92.87,United Healthcare,Default,Fee Schedule,84.2,,,,60.88,84.2
TOBRAMYCIN,80200,HCPCS,301,RC,,both,148.32,133.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.82,,,,87.51,121.03
TOBRAMYCIN,80200,HCPCS,301,RC,,both,148.32,133.49,Cigna,Default,Percent of Total Billed Charges,87.51,,,,87.51,121.03
TOBRAMYCIN,80200,HCPCS,301,RC,,both,148.32,133.49,United Healthcare,Default,Fee Schedule,121.03,,,,87.51,121.03
LEGIONELLA ANTIGEN,87449,HCPCS,300,RC,,both,102.25,92.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.58,,,,60.33,83.44
LEGIONELLA ANTIGEN,87449,HCPCS,300,RC,,both,102.25,92.03,Cigna,Default,Percent of Total Billed Charges,60.33,,,,60.33,83.44
LEGIONELLA ANTIGEN,87449,HCPCS,300,RC,,both,102.25,92.03,United Healthcare,Default,Fee Schedule,83.44,,,,60.33,83.44
BLASTOMYCES ANTIGEN,87449,HCPCS,306,RC,,both,398,358.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,278.6,,,,234.82,324.77
BLASTOMYCES ANTIGEN,87449,HCPCS,306,RC,,both,398,358.2,Cigna,Default,Percent of Total Billed Charges,234.82,,,,234.82,324.77
BLASTOMYCES ANTIGEN,87449,HCPCS,306,RC,,both,398,358.2,United Healthcare,Default,Fee Schedule,324.77,,,,234.82,324.77
STREP PNEUMO AG,87899,HCPCS,306,RC,,both,120.54,108.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.38,,,,71.12,98.36
STREP PNEUMO AG,87899,HCPCS,306,RC,,both,120.54,108.49,Cigna,Default,Percent of Total Billed Charges,71.12,,,,71.12,98.36
STREP PNEUMO AG,87899,HCPCS,306,RC,,both,120.54,108.49,United Healthcare,Default,Fee Schedule,98.36,,,,71.12,98.36
GASTRIN,82941,HCPCS,301,RC,,both,94.67,85.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.27,,,,55.86,77.25
GASTRIN,82941,HCPCS,301,RC,,both,94.67,85.2,Cigna,Default,Percent of Total Billed Charges,55.86,,,,55.86,77.25
GASTRIN,82941,HCPCS,301,RC,,both,94.67,85.2,United Healthcare,Default,Fee Schedule,77.25,,,,55.86,77.25
VITAMIN B12,82607,HCPCS,301,RC,,both,130.87,117.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.61,,,,77.21,106.79
VITAMIN B12,82607,HCPCS,301,RC,,both,130.87,117.78,Cigna,Default,Percent of Total Billed Charges,77.21,,,,77.21,106.79
VITAMIN B12,82607,HCPCS,301,RC,,both,130.87,117.78,United Healthcare,Default,Fee Schedule,106.79,,,,77.21,106.79
CAROTENE,82380,HCPCS,301,RC,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
CAROTENE,82380,HCPCS,301,RC,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
CAROTENE,82380,HCPCS,301,RC,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
ABG WITH MEASURED SO2,82805,HCPCS,301,RC,,both,170.23,153.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,119.16,,,,100.44,138.91
ABG WITH MEASURED SO2,82805,HCPCS,301,RC,,both,170.23,153.21,Cigna,Default,Percent of Total Billed Charges,100.44,,,,100.44,138.91
ABG WITH MEASURED SO2,82805,HCPCS,301,RC,,both,170.23,153.21,United Healthcare,Default,Fee Schedule,138.91,,,,100.44,138.91
SYPHILIS IGG,86780,HCPCS,302,RC,,both,20.92,18.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.64,,,,12.34,17.07
SYPHILIS IGG,86780,HCPCS,302,RC,,both,20.92,18.83,Cigna,Default,Percent of Total Billed Charges,12.34,,,,12.34,17.07
SYPHILIS IGG,86780,HCPCS,302,RC,,both,20.92,18.83,United Healthcare,Default,Fee Schedule,17.07,,,,12.34,17.07
BENCE-JONES SCREEN,86325,HCPCS,302,RC,,both,61.75,55.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.22,,,,36.43,50.39
BENCE-JONES SCREEN,86325,HCPCS,302,RC,,both,61.75,55.58,Cigna,Default,Percent of Total Billed Charges,36.43,,,,36.43,50.39
BENCE-JONES SCREEN,86325,HCPCS,302,RC,,both,61.75,55.58,United Healthcare,Default,Fee Schedule,50.39,,,,36.43,50.39
C DIFF ANTIGEN,87324,HCPCS,300,RC,,both,46.25,41.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.38,,,,27.29,37.74
C DIFF ANTIGEN,87324,HCPCS,300,RC,,both,46.25,41.63,Cigna,Default,Percent of Total Billed Charges,27.29,,,,27.29,37.74
C DIFF ANTIGEN,87324,HCPCS,300,RC,,both,46.25,41.63,United Healthcare,Default,Fee Schedule,37.74,,,,27.29,37.74
ASPERGILLUS ANTIGEN,87305,HCPCS,300,RC,,both,151.01,135.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.71,,,,89.1,123.22
ASPERGILLUS ANTIGEN,87305,HCPCS,300,RC,,both,151.01,135.91,Cigna,Default,Percent of Total Billed Charges,89.1,,,,89.1,123.22
ASPERGILLUS ANTIGEN,87305,HCPCS,300,RC,,both,151.01,135.91,United Healthcare,Default,Fee Schedule,123.22,,,,89.1,123.22
OXALATE,83945,HCPCS,301,RC,,both,72.47,65.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.73,,,,42.76,59.14
OXALATE,83945,HCPCS,301,RC,,both,72.47,65.22,Cigna,Default,Percent of Total Billed Charges,42.76,,,,42.76,59.14
OXALATE,83945,HCPCS,301,RC,,both,72.47,65.22,United Healthcare,Default,Fee Schedule,59.14,,,,42.76,59.14
BORDATELLA PERTUSSIS IGG,86615,HCPCS,300,RC,,both,53.75,48.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.62,,,,31.71,43.86
BORDATELLA PERTUSSIS IGG,86615,HCPCS,300,RC,,both,53.75,48.38,Cigna,Default,Percent of Total Billed Charges,31.71,,,,31.71,43.86
BORDATELLA PERTUSSIS IGG,86615,HCPCS,300,RC,,both,53.75,48.38,United Healthcare,Default,Fee Schedule,43.86,,,,31.71,43.86
BORDATELLA PERTUSSIS IGM,86615,HCPCS,300,RC,,both,53.75,48.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.62,,,,31.71,43.86
BORDATELLA PERTUSSIS IGM,86615,HCPCS,300,RC,,both,53.75,48.38,Cigna,Default,Percent of Total Billed Charges,31.71,,,,31.71,43.86
BORDATELLA PERTUSSIS IGM,86615,HCPCS,300,RC,,both,53.75,48.38,United Healthcare,Default,Fee Schedule,43.86,,,,31.71,43.86
LYME DISEASE AB,86618,HCPCS,300,RC,,both,113.75,102.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.62,,,,67.11,92.82
LYME DISEASE AB,86618,HCPCS,300,RC,,both,113.75,102.38,Cigna,Default,Percent of Total Billed Charges,67.11,,,,67.11,92.82
LYME DISEASE AB,86618,HCPCS,300,RC,,both,113.75,102.38,United Healthcare,Default,Fee Schedule,92.82,,,,67.11,92.82
B PERTUSSIS IGA,86615,HCPCS,300,RC,,both,53.75,48.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.62,,,,31.71,43.86
B PERTUSSIS IGA,86615,HCPCS,300,RC,,both,53.75,48.38,Cigna,Default,Percent of Total Billed Charges,31.71,,,,31.71,43.86
B PERTUSSIS IGA,86615,HCPCS,300,RC,,both,53.75,48.38,United Healthcare,Default,Fee Schedule,43.86,,,,31.71,43.86
LYME DISEASE WESTERN BLOT,86617,HCPCS,300,RC,,both,136.52,122.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.56,,,,80.55,111.4
LYME DISEASE WESTERN BLOT,86617,HCPCS,300,RC,,both,136.52,122.87,Cigna,Default,Percent of Total Billed Charges,80.55,,,,80.55,111.4
LYME DISEASE WESTERN BLOT,86617,HCPCS,300,RC,,both,136.52,122.87,United Healthcare,Default,Fee Schedule,111.4,,,,80.55,111.4
B HENSLAE CAT SCRATCH IGG AND IGM,86611,HCPCS,300,RC,,both,39.28,35.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.5,,,,23.18,32.05
B HENSLAE CAT SCRATCH IGG AND IGM,86611,HCPCS,300,RC,,both,39.28,35.35,Cigna,Default,Percent of Total Billed Charges,23.18,,,,23.18,32.05
B HENSLAE CAT SCRATCH IGG AND IGM,86611,HCPCS,300,RC,,both,39.28,35.35,United Healthcare,Default,Fee Schedule,32.05,,,,23.18,32.05
BARTONELLA HENSLAE CAT SCRATCH IGM,86611,HCPCS,300,RC,,both,39.28,35.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.5,,,,23.18,32.05
BARTONELLA HENSLAE CAT SCRATCH IGM,86611,HCPCS,300,RC,,both,39.28,35.35,Cigna,Default,Percent of Total Billed Charges,23.18,,,,23.18,32.05
BARTONELLA HENSLAE CAT SCRATCH IGM,86611,HCPCS,300,RC,,both,39.28,35.35,United Healthcare,Default,Fee Schedule,32.05,,,,23.18,32.05
B PERTUSSIS IGG,86615,HCPCS,300,RC,,both,64.71,58.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.3,,,,38.18,52.8
B PERTUSSIS IGG,86615,HCPCS,300,RC,,both,64.71,58.24,Cigna,Default,Percent of Total Billed Charges,38.18,,,,38.18,52.8
B PERTUSSIS IGG,86615,HCPCS,300,RC,,both,64.71,58.24,United Healthcare,Default,Fee Schedule,52.8,,,,38.18,52.8
B PERTUSSIS IGM,86615,HCPCS,300,RC,,both,64.71,58.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.3,,,,38.18,52.8
B PERTUSSIS IGM,86615,HCPCS,300,RC,,both,64.71,58.24,Cigna,Default,Percent of Total Billed Charges,38.18,,,,38.18,52.8
B PERTUSSIS IGM,86615,HCPCS,300,RC,,both,64.71,58.24,United Healthcare,Default,Fee Schedule,52.8,,,,38.18,52.8
B PERTUSSIS IGA,86615,HCPCS,300,RC,,both,64.71,58.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.3,,,,38.18,52.8
B PERTUSSIS IGA,86615,HCPCS,300,RC,,both,64.71,58.24,Cigna,Default,Percent of Total Billed Charges,38.18,,,,38.18,52.8
B PERTUSSIS IGA,86615,HCPCS,300,RC,,both,64.71,58.24,United Healthcare,Default,Fee Schedule,52.8,,,,38.18,52.8
HEP B SUR AG,87340,HCPCS,300,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
HEP B SUR AG,87340,HCPCS,300,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
HEP B SUR AG,87340,HCPCS,300,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
CONFIRMATION HEP B S AG,87341,HCPCS,300,RC,,both,214.53,193.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,150.17,,,,126.57,175.06
CONFIRMATION HEP B S AG,87341,HCPCS,300,RC,,both,214.53,193.08,Cigna,Default,Percent of Total Billed Charges,126.57,,,,126.57,175.06
CONFIRMATION HEP B S AG,87341,HCPCS,300,RC,,both,214.53,193.08,United Healthcare,Default,Fee Schedule,175.06,,,,126.57,175.06
PROTEIN C ANTIGEN,85302,HCPCS,300,RC,,both,115.5,103.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.85,,,,68.14,94.25
PROTEIN C ANTIGEN,85302,HCPCS,300,RC,,both,115.5,103.95,Cigna,Default,Percent of Total Billed Charges,68.14,,,,68.14,94.25
PROTEIN C ANTIGEN,85302,HCPCS,300,RC,,both,115.5,103.95,United Healthcare,Default,Fee Schedule,94.25,,,,68.14,94.25
PROTEIN C FUNCTIONAL,85303,HCPCS,300,RC,,both,146.33,131.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.43,,,,86.33,119.41
PROTEIN C FUNCTIONAL,85303,HCPCS,300,RC,,both,146.33,131.7,Cigna,Default,Percent of Total Billed Charges,86.33,,,,86.33,119.41
PROTEIN C FUNCTIONAL,85303,HCPCS,300,RC,,both,146.33,131.7,United Healthcare,Default,Fee Schedule,119.41,,,,86.33,119.41
PROTEIN S TOTAL,85305,HCPCS,300,RC,,both,115.5,103.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.85,,,,68.14,94.25
PROTEIN S TOTAL,85305,HCPCS,300,RC,,both,115.5,103.95,Cigna,Default,Percent of Total Billed Charges,68.14,,,,68.14,94.25
PROTEIN S TOTAL,85305,HCPCS,300,RC,,both,115.5,103.95,United Healthcare,Default,Fee Schedule,94.25,,,,68.14,94.25
PROTEIN S FUNCTIONAL,85306,HCPCS,300,RC,,both,146.33,131.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.43,,,,86.33,119.41
PROTEIN S FUNCTIONAL,85306,HCPCS,300,RC,,both,146.33,131.7,Cigna,Default,Percent of Total Billed Charges,86.33,,,,86.33,119.41
PROTEIN S FUNCTIONAL,85306,HCPCS,300,RC,,both,146.33,131.7,United Healthcare,Default,Fee Schedule,119.41,,,,86.33,119.41
PROLACTIN,84146,HCPCS,301,RC,,both,111.23,100.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.86,,,,65.63,90.76
PROLACTIN,84146,HCPCS,301,RC,,both,111.23,100.11,Cigna,Default,Percent of Total Billed Charges,65.63,,,,65.63,90.76
PROLACTIN,84146,HCPCS,301,RC,,both,111.23,100.11,United Healthcare,Default,Fee Schedule,90.76,,,,65.63,90.76
PROCALCITONIN,84145,HCPCS,301,RC,,both,365.15,328.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.6,,,,215.44,297.96
PROCALCITONIN,84145,HCPCS,301,RC,,both,365.15,328.64,Cigna,Default,Percent of Total Billed Charges,215.44,,,,215.44,297.96
PROCALCITONIN,84145,HCPCS,301,RC,,both,365.15,328.64,United Healthcare,Default,Fee Schedule,297.96,,,,215.44,297.96
GABAPENTIN,80171,HCPCS,301,RC,,both,91,81.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.7,,,,53.69,74.26
GABAPENTIN,80171,HCPCS,301,RC,,both,91,81.9,Cigna,Default,Percent of Total Billed Charges,53.69,,,,53.69,74.26
GABAPENTIN,80171,HCPCS,301,RC,,both,91,81.9,United Healthcare,Default,Fee Schedule,74.26,,,,53.69,74.26
CHROMATOG - QUANT IMURAN,82491,HCPCS,301,RC,,both,330,297,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,231,,,,194.7,269.28
CHROMATOG - QUANT IMURAN,82491,HCPCS,301,RC,,both,330,297,Cigna,Default,Percent of Total Billed Charges,194.7,,,,194.7,269.28
CHROMATOG - QUANT IMURAN,82491,HCPCS,301,RC,,both,330,297,United Healthcare,Default,Fee Schedule,269.28,,,,194.7,269.28
CHOLINESTERASE SERUM,82480,HCPCS,301,RC,,both,24.75,22.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.32,,,,14.6,20.2
CHOLINESTERASE SERUM,82480,HCPCS,301,RC,,both,24.75,22.28,Cigna,Default,Percent of Total Billed Charges,14.6,,,,14.6,20.2
CHOLINESTERASE SERUM,82480,HCPCS,301,RC,,both,24.75,22.28,United Healthcare,Default,Fee Schedule,20.2,,,,14.6,20.2
CHILINESTERASE RBC,82482,HCPCS,301,RC,,both,51.75,46.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.22,,,,30.53,42.23
CHILINESTERASE RBC,82482,HCPCS,301,RC,,both,51.75,46.58,Cigna,Default,Percent of Total Billed Charges,30.53,,,,30.53,42.23
CHILINESTERASE RBC,82482,HCPCS,301,RC,,both,51.75,46.58,United Healthcare,Default,Fee Schedule,42.23,,,,30.53,42.23
6 MMPN,82542,HCPCS,301,RC,,both,139.89,125.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.92,,,,82.54,114.15
6 MMPN,82542,HCPCS,301,RC,,both,139.89,125.9,Cigna,Default,Percent of Total Billed Charges,82.54,,,,82.54,114.15
6 MMPN,82542,HCPCS,301,RC,,both,139.89,125.9,United Healthcare,Default,Fee Schedule,114.15,,,,82.54,114.15
6 TGN,82542,HCPCS,301,RC,,both,192.27,173.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,134.59,,,,113.44,156.89
6 TGN,82542,HCPCS,301,RC,,both,192.27,173.04,Cigna,Default,Percent of Total Billed Charges,113.44,,,,113.44,156.89
6 TGN,82542,HCPCS,301,RC,,both,192.27,173.04,United Healthcare,Default,Fee Schedule,156.89,,,,113.44,156.89
PROINSULIN,84206,HCPCS,300,RC,,both,66.07,59.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.25,,,,38.98,53.91
PROINSULIN,84206,HCPCS,300,RC,,both,66.07,59.46,Cigna,Default,Percent of Total Billed Charges,38.98,,,,38.98,53.91
PROINSULIN,84206,HCPCS,300,RC,,both,66.07,59.46,United Healthcare,Default,Fee Schedule,53.91,,,,38.98,53.91
SEROTONIN,84260,HCPCS,301,RC,,both,164.04,147.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.83,,,,96.78,133.86
SEROTONIN,84260,HCPCS,301,RC,,both,164.04,147.64,Cigna,Default,Percent of Total Billed Charges,96.78,,,,96.78,133.86
SEROTONIN,84260,HCPCS,301,RC,,both,164.04,147.64,United Healthcare,Default,Fee Schedule,133.86,,,,96.78,133.86
CRYSTODIGIN (DIGITOXIN),80299,HCPCS,300,RC,,both,100,90,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70,,,,59,81.6
CRYSTODIGIN (DIGITOXIN),80299,HCPCS,300,RC,,both,100,90,Cigna,Default,Percent of Total Billed Charges,59,,,,59,81.6
CRYSTODIGIN (DIGITOXIN),80299,HCPCS,300,RC,,both,100,90,United Healthcare,Default,Fee Schedule,81.6,,,,59,81.6
ZINC PROTOPROPHYRIN,84202,HCPCS,301,RC,,both,46.37,41.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.46,,,,27.36,37.84
ZINC PROTOPROPHYRIN,84202,HCPCS,301,RC,,both,46.37,41.73,Cigna,Default,Percent of Total Billed Charges,27.36,,,,27.36,37.84
ZINC PROTOPROPHYRIN,84202,HCPCS,301,RC,,both,46.37,41.73,United Healthcare,Default,Fee Schedule,37.84,,,,27.36,37.84
MYELIN BASIC-CSF,83873,HCPCS,301,RC,,both,84.25,75.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.98,,,,49.71,68.75
MYELIN BASIC-CSF,83873,HCPCS,301,RC,,both,84.25,75.83,Cigna,Default,Percent of Total Billed Charges,49.71,,,,49.71,68.75
MYELIN BASIC-CSF,83873,HCPCS,301,RC,,both,84.25,75.83,United Healthcare,Default,Fee Schedule,68.75,,,,49.71,68.75
LEPTOSPIRA AB,86720,HCPCS,300,RC,,both,83.25,74.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.28,,,,49.12,67.93
LEPTOSPIRA AB,86720,HCPCS,300,RC,,both,83.25,74.93,Cigna,Default,Percent of Total Billed Charges,49.12,,,,49.12,67.93
LEPTOSPIRA AB,86720,HCPCS,300,RC,,both,83.25,74.93,United Healthcare,Default,Fee Schedule,67.93,,,,49.12,67.93
17HYDROCORTSTRD,83491,HCPCS,301,RC,,both,100,90,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70,,,,59,81.6
17HYDROCORTSTRD,83491,HCPCS,301,RC,,both,100,90,Cigna,Default,Percent of Total Billed Charges,59,,,,59,81.6
17HYDROCORTSTRD,83491,HCPCS,301,RC,,both,100,90,United Healthcare,Default,Fee Schedule,81.6,,,,59,81.6
CALCIUM 24HR URINE,82340,HCPCS,301,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
CALCIUM 24HR URINE,82340,HCPCS,301,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
CALCIUM 24HR URINE,82340,HCPCS,301,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
FREE T3,84481,HCPCS,301,RC,,both,115.45,103.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.82,,,,68.12,94.21
FREE T3,84481,HCPCS,301,RC,,both,115.45,103.91,Cigna,Default,Percent of Total Billed Charges,68.12,,,,68.12,94.21
FREE T3,84481,HCPCS,301,RC,,both,115.45,103.91,United Healthcare,Default,Fee Schedule,94.21,,,,68.12,94.21
CLO-TEST,87077,HCPCS,300,RC,,both,94.67,85.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.27,,,,55.86,77.25
CLO-TEST,87077,HCPCS,300,RC,,both,94.67,85.2,Cigna,Default,Percent of Total Billed Charges,55.86,,,,55.86,77.25
CLO-TEST,87077,HCPCS,300,RC,,both,94.67,85.2,United Healthcare,Default,Fee Schedule,77.25,,,,55.86,77.25
H PYLORI DRUG ADMINISTRATION,83014,HCPCS,301,RC,,both,25.84,23.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.09,,,,15.25,21.09
H PYLORI DRUG ADMINISTRATION,83014,HCPCS,301,RC,,both,25.84,23.26,Cigna,Default,Percent of Total Billed Charges,15.25,,,,15.25,21.09
H PYLORI DRUG ADMINISTRATION,83014,HCPCS,301,RC,,both,25.84,23.26,United Healthcare,Default,Fee Schedule,21.09,,,,15.25,21.09
H PYLORI BREATH TEST,83013,HCPCS,301,RC,,both,142.41,128.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.69,,,,84.02,116.21
H PYLORI BREATH TEST,83013,HCPCS,301,RC,,both,142.41,128.17,Cigna,Default,Percent of Total Billed Charges,84.02,,,,84.02,116.21
H PYLORI BREATH TEST,83013,HCPCS,301,RC,,both,142.41,128.17,United Healthcare,Default,Fee Schedule,116.21,,,,84.02,116.21
IBD SGI DIAGNOSTIC,81479,HCPCS,310,RC,,both,99.01,89.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.31,,,,58.42,80.79
IBD SGI DIAGNOSTIC,81479,HCPCS,310,RC,,both,99.01,89.11,Cigna,Default,Percent of Total Billed Charges,58.42,,,,58.42,80.79
IBD SGI DIAGNOSTIC,81479,HCPCS,310,RC,,both,99.01,89.11,United Healthcare,Default,Fee Schedule,80.79,,,,58.42,80.79
C REACTIVE PROTEIN,86140,HCPCS,300,RC,,both,50.55,45.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.38,,,,29.82,41.25
C REACTIVE PROTEIN,86140,HCPCS,300,RC,,both,50.55,45.5,Cigna,Default,Percent of Total Billed Charges,29.82,,,,29.82,41.25
C REACTIVE PROTEIN,86140,HCPCS,300,RC,,both,50.55,45.5,United Healthcare,Default,Fee Schedule,41.25,,,,29.82,41.25
PROMETHEUS ASCA IGG,83520,HCPCS,300,RC,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
PROMETHEUS ASCA IGG,83520,HCPCS,300,RC,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
PROMETHEUS ASCA IGG,83520,HCPCS,300,RC,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
PROMETHEUS ASCA IGA,83520,HCPCS,300,RC,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
PROMETHEUS ASCA IGA,83520,HCPCS,300,RC,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
PROMETHEUS ASCA IGA,83520,HCPCS,300,RC,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
PROMETHEUS  IGA,81479,HCPCS,300,RC,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
PROMETHEUS  IGA,81479,HCPCS,300,RC,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
PROMETHEUS  IGA,81479,HCPCS,300,RC,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
PROMETHEUS ANTI OMPC IGA,83520,HCPCS,300,RC,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
PROMETHEUS ANTI OMPC IGA,83520,HCPCS,300,RC,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
PROMETHEUS ANTI OMPC IGA,83520,HCPCS,300,RC,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
PROMETHEUS ANTI CBIR1,83520,HCPCS,300,RC,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
PROMETHEUS ANTI CBIR1,83520,HCPCS,300,RC,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
PROMETHEUS ANTI CBIR1,83520,HCPCS,300,RC,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
PROMETHEUS FLAZ,83520,HCPCS,300,RC,,both,33.71,30.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.6,,,,19.89,27.51
PROMETHEUS FLAZ,83520,HCPCS,300,RC,,both,33.71,30.34,Cigna,Default,Percent of Total Billed Charges,19.89,,,,19.89,27.51
PROMETHEUS FLAZ,83520,HCPCS,300,RC,,both,33.71,30.34,United Healthcare,Default,Fee Schedule,27.51,,,,19.89,27.51
PROMETHEUS FLAX,83520,HCPCS,300,RC,,both,33.71,30.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.6,,,,19.89,27.51
PROMETHEUS FLAX,83520,HCPCS,300,RC,,both,33.71,30.34,Cigna,Default,Percent of Total Billed Charges,19.89,,,,19.89,27.51
PROMETHEUS FLAX,83520,HCPCS,300,RC,,both,33.71,30.34,United Healthcare,Default,Fee Schedule,27.51,,,,19.89,27.51
PROMETHEUS VEGF,82397,HCPCS,300,RC,,both,33.71,30.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.6,,,,19.89,27.51
PROMETHEUS VEGF,82397,HCPCS,300,RC,,both,33.71,30.34,Cigna,Default,Percent of Total Billed Charges,19.89,,,,19.89,27.51
PROMETHEUS VEGF,82397,HCPCS,300,RC,,both,33.71,30.34,United Healthcare,Default,Fee Schedule,27.51,,,,19.89,27.51
PROMETHEUS ICAM,82397,HCPCS,301,RC,,both,33.71,30.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.6,,,,19.89,27.51
PROMETHEUS ICAM,82397,HCPCS,301,RC,,both,33.71,30.34,Cigna,Default,Percent of Total Billed Charges,19.89,,,,19.89,27.51
PROMETHEUS ICAM,82397,HCPCS,301,RC,,both,33.71,30.34,United Healthcare,Default,Fee Schedule,27.51,,,,19.89,27.51
PROMETHEUS VCAM,82397,HCPCS,301,RC,,both,33.71,30.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.6,,,,19.89,27.51
PROMETHEUS VCAM,82397,HCPCS,301,RC,,both,33.71,30.34,Cigna,Default,Percent of Total Billed Charges,19.89,,,,19.89,27.51
PROMETHEUS VCAM,82397,HCPCS,301,RC,,both,33.71,30.34,United Healthcare,Default,Fee Schedule,27.51,,,,19.89,27.51
PROMETHEUS SAA,82397,HCPCS,301,RC,,both,33.71,30.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.6,,,,19.89,27.51
PROMETHEUS SAA,82397,HCPCS,301,RC,,both,33.71,30.34,Cigna,Default,Percent of Total Billed Charges,19.89,,,,19.89,27.51
PROMETHEUS SAA,82397,HCPCS,301,RC,,both,33.71,30.34,United Healthcare,Default,Fee Schedule,27.51,,,,19.89,27.51
PROMETHEUS PANCA,88346,HCPCS,312,RC,,both,408.96,368.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,286.27,,,,241.29,333.71
PROMETHEUS PANCA,88346,HCPCS,312,RC,,both,408.96,368.06,Cigna,Default,Percent of Total Billed Charges,241.29,,,,241.29,333.71
PROMETHEUS PANCA,88346,HCPCS,312,RC,,both,408.96,368.06,United Healthcare,Default,Fee Schedule,333.71,,,,241.29,333.71
PROMETHEUS DNASE SENSITIVITY,88350,HCPCS,312,RC,,both,408.96,368.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,286.27,,,,241.29,333.71
PROMETHEUS DNASE SENSITIVITY,88350,HCPCS,312,RC,,both,408.96,368.06,Cigna,Default,Percent of Total Billed Charges,241.29,,,,241.29,333.71
PROMETHEUS DNASE SENSITIVITY,88350,HCPCS,312,RC,,both,408.96,368.06,United Healthcare,Default,Fee Schedule,333.71,,,,241.29,333.71
ONCOHEME NGS,81450,HCPCS,310,RC,,both,6256.17,5630.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4379.32,,,,3691.14,5105.03
ONCOHEME NGS,81450,HCPCS,310,RC,,both,6256.17,5630.55,Cigna,Default,Percent of Total Billed Charges,3691.14,,,,3691.14,5105.03
ONCOHEME NGS,81450,HCPCS,310,RC,,both,6256.17,5630.55,United Healthcare,Default,Fee Schedule,5105.03,,,,3691.14,5105.03
QUAD 1 MARKER,81511,HCPCS,300,RC,,both,139.98,125.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.99,,,,82.59,114.22
QUAD 1 MARKER,81511,HCPCS,300,RC,,both,139.98,125.98,Cigna,Default,Percent of Total Billed Charges,82.59,,,,82.59,114.22
QUAD 1 MARKER,81511,HCPCS,300,RC,,both,139.98,125.98,United Healthcare,Default,Fee Schedule,114.22,,,,82.59,114.22
C-PEPTIDE,84681,HCPCS,301,RC,,both,107.86,97.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.5,,,,63.64,88.01
C-PEPTIDE,84681,HCPCS,301,RC,,both,107.86,97.07,Cigna,Default,Percent of Total Billed Charges,63.64,,,,63.64,88.01
C-PEPTIDE,84681,HCPCS,301,RC,,both,107.86,97.07,United Healthcare,Default,Fee Schedule,88.01,,,,63.64,88.01
VALPROIC ACID DEPAKENE,80164,HCPCS,301,RC,,both,142.59,128.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,99.81,,,,84.13,116.35
VALPROIC ACID DEPAKENE,80164,HCPCS,301,RC,,both,142.59,128.33,Cigna,Default,Percent of Total Billed Charges,84.13,,,,84.13,116.35
VALPROIC ACID DEPAKENE,80164,HCPCS,301,RC,,both,142.59,128.33,United Healthcare,Default,Fee Schedule,116.35,,,,84.13,116.35
AQUAPORIN-4 IGG,86255,HCPCS,301,RC,,both,973.5,876.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,681.45,,,,574.36,794.38
AQUAPORIN-4 IGG,86255,HCPCS,301,RC,,both,973.5,876.15,Cigna,Default,Percent of Total Billed Charges,574.36,,,,574.36,794.38
AQUAPORIN-4 IGG,86255,HCPCS,301,RC,,both,973.5,876.15,United Healthcare,Default,Fee Schedule,794.38,,,,574.36,794.38
MUELINE OLIGODENDROCYTE GLUCOPROTEIN,86255,HCPCS,301,RC,,both,1732.5,1559.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1212.75,,,,1022.18,1413.72
MUELINE OLIGODENDROCYTE GLUCOPROTEIN,86255,HCPCS,301,RC,,both,1732.5,1559.25,Cigna,Default,Percent of Total Billed Charges,1022.18,,,,1022.18,1413.72
MUELINE OLIGODENDROCYTE GLUCOPROTEIN,86255,HCPCS,301,RC,,both,1732.5,1559.25,United Healthcare,Default,Fee Schedule,1413.72,,,,1022.18,1413.72
CSF IGG,82784,HCPCS,301,RC,,both,15.51,13.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.86,,,,9.15,12.66
CSF IGG,82784,HCPCS,301,RC,,both,15.51,13.96,Cigna,Default,Percent of Total Billed Charges,9.15,,,,9.15,12.66
CSF IGG,82784,HCPCS,301,RC,,both,15.51,13.96,United Healthcare,Default,Fee Schedule,12.66,,,,9.15,12.66
ILIGOCLONAL BANDS CSF,83916,HCPCS,301,RC,,both,151.8,136.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.26,,,,89.56,123.87
ILIGOCLONAL BANDS CSF,83916,HCPCS,301,RC,,both,151.8,136.62,Cigna,Default,Percent of Total Billed Charges,89.56,,,,89.56,123.87
ILIGOCLONAL BANDS CSF,83916,HCPCS,301,RC,,both,151.8,136.62,United Healthcare,Default,Fee Schedule,123.87,,,,89.56,123.87
D-DIMER SEMI-QUANT,85378,HCPCS,300,RC,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
D-DIMER SEMI-QUANT,85378,HCPCS,300,RC,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
D-DIMER SEMI-QUANT,85378,HCPCS,300,RC,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
D-DIMER QUANTITATIVE,85379,HCPCS,300,RC,,both,159.77,143.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.84,,,,94.26,130.37
D-DIMER QUANTITATIVE,85379,HCPCS,300,RC,,both,159.77,143.79,Cigna,Default,Percent of Total Billed Charges,94.26,,,,94.26,130.37
D-DIMER QUANTITATIVE,85379,HCPCS,300,RC,,both,159.77,143.79,United Healthcare,Default,Fee Schedule,130.37,,,,94.26,130.37
FIBRIN SPLIT PRODUCTS,85362,HCPCS,300,RC,,both,39.82,35.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.87,,,,23.49,32.49
FIBRIN SPLIT PRODUCTS,85362,HCPCS,300,RC,,both,39.82,35.84,Cigna,Default,Percent of Total Billed Charges,23.49,,,,23.49,32.49
FIBRIN SPLIT PRODUCTS,85362,HCPCS,300,RC,,both,39.82,35.84,United Healthcare,Default,Fee Schedule,32.49,,,,23.49,32.49
"N-TELOPEPTIDE, URINE",82523,HCPCS,301,RC,,both,99.5,89.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.65,,,,58.7,81.19
"N-TELOPEPTIDE, URINE",82523,HCPCS,301,RC,,both,99.5,89.55,Cigna,Default,Percent of Total Billed Charges,58.7,,,,58.7,81.19
"N-TELOPEPTIDE, URINE",82523,HCPCS,301,RC,,both,99.5,89.55,United Healthcare,Default,Fee Schedule,81.19,,,,58.7,81.19
CORTISOL - URINE (FREE),82530,HCPCS,301,RC,,both,85.68,77.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.98,,,,50.55,69.91
CORTISOL - URINE (FREE),82530,HCPCS,301,RC,,both,85.68,77.11,Cigna,Default,Percent of Total Billed Charges,50.55,,,,50.55,69.91
CORTISOL - URINE (FREE),82530,HCPCS,301,RC,,both,85.68,77.11,United Healthcare,Default,Fee Schedule,69.91,,,,50.55,69.91
HEP BE AB,86707,HCPCS,300,RC,,both,108.04,97.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.63,,,,63.74,88.16
HEP BE AB,86707,HCPCS,300,RC,,both,108.04,97.24,Cigna,Default,Percent of Total Billed Charges,63.74,,,,63.74,88.16
HEP BE AB,86707,HCPCS,300,RC,,both,108.04,97.24,United Healthcare,Default,Fee Schedule,88.16,,,,63.74,88.16
HEP BE AG,87350,HCPCS,300,RC,,both,62.07,55.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.45,,,,36.62,50.65
HEP BE AG,87350,HCPCS,300,RC,,both,62.07,55.86,Cigna,Default,Percent of Total Billed Charges,36.62,,,,36.62,50.65
HEP BE AG,87350,HCPCS,300,RC,,both,62.07,55.86,United Healthcare,Default,Fee Schedule,50.65,,,,36.62,50.65
HEP BE AG,87350,HCPCS,300,RC,,both,69.75,62.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.82,,,,41.15,56.92
HEP BE AG,87350,HCPCS,300,RC,,both,69.75,62.78,Cigna,Default,Percent of Total Billed Charges,41.15,,,,41.15,56.92
HEP BE AG,87350,HCPCS,300,RC,,both,69.75,62.78,United Healthcare,Default,Fee Schedule,56.92,,,,41.15,56.92
VITAMIN B 6,84207,HCPCS,301,RC,,both,139.03,125.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.32,,,,82.03,113.45
VITAMIN B 6,84207,HCPCS,301,RC,,both,139.03,125.13,Cigna,Default,Percent of Total Billed Charges,82.03,,,,82.03,113.45
VITAMIN B 6,84207,HCPCS,301,RC,,both,139.03,125.13,United Healthcare,Default,Fee Schedule,113.45,,,,82.03,113.45
MAGNESIUM URINE,83735,HCPCS,301,RC,,both,78.53,70.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.97,,,,46.33,64.08
MAGNESIUM URINE,83735,HCPCS,301,RC,,both,78.53,70.68,Cigna,Default,Percent of Total Billed Charges,46.33,,,,46.33,64.08
MAGNESIUM URINE,83735,HCPCS,301,RC,,both,78.53,70.68,United Healthcare,Default,Fee Schedule,64.08,,,,46.33,64.08
MAGNESIUM SERUM,83735,HCPCS,301,RC,,both,78.53,70.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.97,,,,46.33,64.08
MAGNESIUM SERUM,83735,HCPCS,301,RC,,both,78.53,70.68,Cigna,Default,Percent of Total Billed Charges,46.33,,,,46.33,64.08
MAGNESIUM SERUM,83735,HCPCS,301,RC,,both,78.53,70.68,United Healthcare,Default,Fee Schedule,64.08,,,,46.33,64.08
MAGNESIUM 24 HR URINE,83735,HCPCS,301,RC,,both,35.39,31.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.77,,,,20.88,28.88
MAGNESIUM 24 HR URINE,83735,HCPCS,301,RC,,both,35.39,31.85,Cigna,Default,Percent of Total Billed Charges,20.88,,,,20.88,28.88
MAGNESIUM 24 HR URINE,83735,HCPCS,301,RC,,both,35.39,31.85,United Healthcare,Default,Fee Schedule,28.88,,,,20.88,28.88
MALARIA SMEAR,87207,HCPCS,300,RC,,both,42.25,38.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.58,,,,24.93,34.48
MALARIA SMEAR,87207,HCPCS,300,RC,,both,42.25,38.03,Cigna,Default,Percent of Total Billed Charges,24.93,,,,24.93,34.48
MALARIA SMEAR,87207,HCPCS,300,RC,,both,42.25,38.03,United Healthcare,Default,Fee Schedule,34.48,,,,24.93,34.48
TYPHUS AB IGG,86757,HCPCS,300,RC,,both,50,45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35,,,,29.5,40.8
TYPHUS AB IGG,86757,HCPCS,300,RC,,both,50,45,Cigna,Default,Percent of Total Billed Charges,29.5,,,,29.5,40.8
TYPHUS AB IGG,86757,HCPCS,300,RC,,both,50,45,United Healthcare,Default,Fee Schedule,40.8,,,,29.5,40.8
Q FEVER AB,86638,HCPCS,300,RC,,both,87,78.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.9,,,,51.33,70.99
Q FEVER AB,86638,HCPCS,300,RC,,both,87,78.3,Cigna,Default,Percent of Total Billed Charges,51.33,,,,51.33,70.99
Q FEVER AB,86638,HCPCS,300,RC,,both,87,78.3,United Healthcare,Default,Fee Schedule,70.99,,,,51.33,70.99
ROCKY MTN IGG,86757,HCPCS,300,RC,,both,94.67,85.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.27,,,,55.86,77.25
ROCKY MTN IGG,86757,HCPCS,300,RC,,both,94.67,85.2,Cigna,Default,Percent of Total Billed Charges,55.86,,,,55.86,77.25
ROCKY MTN IGG,86757,HCPCS,300,RC,,both,94.67,85.2,United Healthcare,Default,Fee Schedule,77.25,,,,55.86,77.25
BRUCELLA AB,86622,HCPCS,300,RC,,both,58,52.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.6,,,,34.22,47.33
BRUCELLA AB,86622,HCPCS,300,RC,,both,58,52.2,Cigna,Default,Percent of Total Billed Charges,34.22,,,,34.22,47.33
BRUCELLA AB,86622,HCPCS,300,RC,,both,58,52.2,United Healthcare,Default,Fee Schedule,47.33,,,,34.22,47.33
FRANCISELLA AB,86668,HCPCS,300,RC,,both,76.25,68.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.38,,,,44.99,62.22
FRANCISELLA AB,86668,HCPCS,300,RC,,both,76.25,68.63,Cigna,Default,Percent of Total Billed Charges,44.99,,,,44.99,62.22
FRANCISELLA AB,86668,HCPCS,300,RC,,both,76.25,68.63,United Healthcare,Default,Fee Schedule,62.22,,,,44.99,62.22
RENAL FAILURE INDICIES 2,84300,HCPCS,301,RC,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
RENAL FAILURE INDICIES 2,84300,HCPCS,301,RC,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
RENAL FAILURE INDICIES 2,84300,HCPCS,301,RC,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
SODIUM URINE,84300,HCPCS,301,RC,,both,61.07,54.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.75,,,,36.03,49.83
SODIUM URINE,84300,HCPCS,301,RC,,both,61.07,54.96,Cigna,Default,Percent of Total Billed Charges,36.03,,,,36.03,49.83
SODIUM URINE,84300,HCPCS,301,RC,,both,61.07,54.96,United Healthcare,Default,Fee Schedule,49.83,,,,36.03,49.83
SODIUM 24 HR URINE,84300,HCPCS,301,RC,,both,61.07,54.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.75,,,,36.03,49.83
SODIUM 24 HR URINE,84300,HCPCS,301,RC,,both,61.07,54.96,Cigna,Default,Percent of Total Billed Charges,36.03,,,,36.03,49.83
SODIUM 24 HR URINE,84300,HCPCS,301,RC,,both,61.07,54.96,United Healthcare,Default,Fee Schedule,49.83,,,,36.03,49.83
SOMATOSTATIN,84307,HCPCS,301,RC,,both,212,190.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,148.4,,,,125.08,172.99
SOMATOSTATIN,84307,HCPCS,301,RC,,both,212,190.8,Cigna,Default,Percent of Total Billed Charges,125.08,,,,125.08,172.99
SOMATOSTATIN,84307,HCPCS,301,RC,,both,212,190.8,United Healthcare,Default,Fee Schedule,172.99,,,,125.08,172.99
SOMATOMEDIN C,84305,HCPCS,300,RC,,both,105.62,95.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.93,,,,62.32,86.19
SOMATOMEDIN C,84305,HCPCS,300,RC,,both,105.62,95.06,Cigna,Default,Percent of Total Billed Charges,62.32,,,,62.32,86.19
SOMATOMEDIN C,84305,HCPCS,300,RC,,both,105.62,95.06,United Healthcare,Default,Fee Schedule,86.19,,,,62.32,86.19
VITAMIN B 2,84252,HCPCS,301,RC,,both,176.25,158.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.38,,,,103.99,143.82
VITAMIN B 2,84252,HCPCS,301,RC,,both,176.25,158.63,Cigna,Default,Percent of Total Billed Charges,103.99,,,,103.99,143.82
VITAMIN B 2,84252,HCPCS,301,RC,,both,176.25,158.63,United Healthcare,Default,Fee Schedule,143.82,,,,103.99,143.82
SPECIFIC GRAV URINE,81002,HCPCS,300,RC,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
SPECIFIC GRAV URINE,81002,HCPCS,300,RC,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
SPECIFIC GRAV URINE,81002,HCPCS,300,RC,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
PTH RELATED PEPTIDE,82542,HCPCS,301,RC,,both,179,161.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.3,,,,105.61,146.06
PTH RELATED PEPTIDE,82542,HCPCS,301,RC,,both,179,161.1,Cigna,Default,Percent of Total Billed Charges,105.61,,,,105.61,146.06
PTH RELATED PEPTIDE,82542,HCPCS,301,RC,,both,179,161.1,United Healthcare,Default,Fee Schedule,146.06,,,,105.61,146.06
URINE PH,81002,HCPCS,300,RC,,both,20.96,18.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.67,,,,12.37,17.1
URINE PH,81002,HCPCS,300,RC,,both,20.96,18.86,Cigna,Default,Percent of Total Billed Charges,12.37,,,,12.37,17.1
URINE PH,81002,HCPCS,300,RC,,both,20.96,18.86,United Healthcare,Default,Fee Schedule,17.1,,,,12.37,17.1
SPECFC GRAV BODY FL,84315,HCPCS,301,RC,,both,28.09,25.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.66,,,,16.57,22.92
SPECFC GRAV BODY FL,84315,HCPCS,301,RC,,both,28.09,25.28,Cigna,Default,Percent of Total Billed Charges,16.57,,,,16.57,22.92
SPECFC GRAV BODY FL,84315,HCPCS,301,RC,,both,28.09,25.28,United Healthcare,Default,Fee Schedule,22.92,,,,16.57,22.92
FACTOR INHIBITOR TEST,85335,HCPCS,300,RC,,both,160.21,144.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.15,,,,94.52,130.73
FACTOR INHIBITOR TEST,85335,HCPCS,300,RC,,both,160.21,144.19,Cigna,Default,Percent of Total Billed Charges,94.52,,,,94.52,130.73
FACTOR INHIBITOR TEST,85335,HCPCS,300,RC,,both,160.21,144.19,United Healthcare,Default,Fee Schedule,130.73,,,,94.52,130.73
LUPUS INHIBITOR,85300,HCPCS,300,RC,,both,146.15,131.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.3,,,,86.23,119.26
LUPUS INHIBITOR,85300,HCPCS,300,RC,,both,146.15,131.54,Cigna,Default,Percent of Total Billed Charges,86.23,,,,86.23,119.26
LUPUS INHIBITOR,85300,HCPCS,300,RC,,both,146.15,131.54,United Healthcare,Default,Fee Schedule,119.26,,,,86.23,119.26
CHLORIDE-URINE,82436,HCPCS,301,RC,,both,56.17,50.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.32,,,,33.14,45.83
CHLORIDE-URINE,82436,HCPCS,301,RC,,both,56.17,50.55,Cigna,Default,Percent of Total Billed Charges,33.14,,,,33.14,45.83
CHLORIDE-URINE,82436,HCPCS,301,RC,,both,56.17,50.55,United Healthcare,Default,Fee Schedule,45.83,,,,33.14,45.83
CHLORIDE 24 HR URINE,82436,HCPCS,301,RC,,both,94.12,84.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.88,,,,55.53,76.8
CHLORIDE 24 HR URINE,82436,HCPCS,301,RC,,both,94.12,84.71,Cigna,Default,Percent of Total Billed Charges,55.53,,,,55.53,76.8
CHLORIDE 24 HR URINE,82436,HCPCS,301,RC,,both,94.12,84.71,United Healthcare,Default,Fee Schedule,76.8,,,,55.53,76.8
CHLORIDE-SERUM,82435,HCPCS,301,RC,,both,33.81,30.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.67,,,,19.95,27.59
CHLORIDE-SERUM,82435,HCPCS,301,RC,,both,33.81,30.43,Cigna,Default,Percent of Total Billed Charges,19.95,,,,19.95,27.59
CHLORIDE-SERUM,82435,HCPCS,301,RC,,both,33.81,30.43,United Healthcare,Default,Fee Schedule,27.59,,,,19.95,27.59
CHLORIDE-BODY FLUID,82438,HCPCS,301,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
CHLORIDE-BODY FLUID,82438,HCPCS,301,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
CHLORIDE-BODY FLUID,82438,HCPCS,301,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
ANALYZE 20 - 25 CELLS CHROMOSOME,88264,HCPCS,310,RC,,both,384.25,345.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.98,,,,226.71,313.55
ANALYZE 20 - 25 CELLS CHROMOSOME,88264,HCPCS,310,RC,,both,384.25,345.83,Cigna,Default,Percent of Total Billed Charges,226.71,,,,226.71,313.55
ANALYZE 20 - 25 CELLS CHROMOSOME,88264,HCPCS,310,RC,,both,384.25,345.83,United Healthcare,Default,Fee Schedule,313.55,,,,226.71,313.55
CHROMOSOME ANALYSIS,88262,HCPCS,310,RC,,both,206.75,186.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.72,,,,121.98,168.71
CHROMOSOME ANALYSIS,88262,HCPCS,310,RC,,both,206.75,186.08,Cigna,Default,Percent of Total Billed Charges,121.98,,,,121.98,168.71
CHROMOSOME ANALYSIS,88262,HCPCS,310,RC,,both,206.75,186.08,United Healthcare,Default,Fee Schedule,168.71,,,,121.98,168.71
CELL COUNT/DIF BDYFL,89051,HCPCS,300,RC,,both,106.77,96.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.74,,,,62.99,87.12
CELL COUNT/DIF BDYFL,89051,HCPCS,300,RC,,both,106.77,96.09,Cigna,Default,Percent of Total Billed Charges,62.99,,,,62.99,87.12
CELL COUNT/DIF BDYFL,89051,HCPCS,300,RC,,both,106.77,96.09,United Healthcare,Default,Fee Schedule,87.12,,,,62.99,87.12
CHOLINESTERASE SERUM,82480,HCPCS,301,RC,,both,54,48.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.8,,,,31.86,44.06
CHOLINESTERASE SERUM,82480,HCPCS,301,RC,,both,54,48.6,Cigna,Default,Percent of Total Billed Charges,31.86,,,,31.86,44.06
CHOLINESTERASE SERUM,82480,HCPCS,301,RC,,both,54,48.6,United Healthcare,Default,Fee Schedule,44.06,,,,31.86,44.06
CRYOGLOBULIN QUAL/SEMI-QUANT,82595,HCPCS,301,RC,,both,41,36.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.7,,,,24.19,33.46
CRYOGLOBULIN QUAL/SEMI-QUANT,82595,HCPCS,301,RC,,both,41,36.9,Cigna,Default,Percent of Total Billed Charges,24.19,,,,24.19,33.46
CRYOGLOBULIN QUAL/SEMI-QUANT,82595,HCPCS,301,RC,,both,41,36.9,United Healthcare,Default,Fee Schedule,33.46,,,,24.19,33.46
CRYPTOCOCCUS AB,86641,HCPCS,300,RC,,both,100,90,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70,,,,59,81.6
CRYPTOCOCCUS AB,86641,HCPCS,300,RC,,both,100,90,Cigna,Default,Percent of Total Billed Charges,59,,,,59,81.6
CRYPTOCOCCUS AB,86641,HCPCS,300,RC,,both,100,90,United Healthcare,Default,Fee Schedule,81.6,,,,59,81.6
CRYOPRECIPITATE PER UNIT,P9012,HCPCS,390,RC,,both,242.71,218.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,169.9,,,,143.2,198.05
CRYOPRECIPITATE PER UNIT,P9012,HCPCS,390,RC,,both,242.71,218.44,Cigna,Default,Percent of Total Billed Charges,143.2,,,,143.2,198.05
CRYOPRECIPITATE PER UNIT,P9012,HCPCS,390,RC,,both,242.71,218.44,United Healthcare,Default,Fee Schedule,198.05,,,,143.2,198.05
CRYPTOSPORIDIUM AG,87328,HCPCS,300,RC,,both,87.92,79.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.54,,,,51.87,71.74
CRYPTOSPORIDIUM AG,87328,HCPCS,300,RC,,both,87.92,79.13,Cigna,Default,Percent of Total Billed Charges,51.87,,,,51.87,71.74
CRYPTOSPORIDIUM AG,87328,HCPCS,300,RC,,both,87.92,79.13,United Healthcare,Default,Fee Schedule,71.74,,,,51.87,71.74
THIORIDAZINE(MELLARIL),84022,HCPCS,301,RC,,both,79,71.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.3,,,,46.61,64.46
THIORIDAZINE(MELLARIL),84022,HCPCS,301,RC,,both,79,71.1,Cigna,Default,Percent of Total Billed Charges,46.61,,,,46.61,64.46
THIORIDAZINE(MELLARIL),84022,HCPCS,301,RC,,both,79,71.1,United Healthcare,Default,Fee Schedule,64.46,,,,46.61,64.46
NORTRIPTYLINE,80182,HCPCS,301,RC,,both,68.5,61.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.95,,,,40.42,55.9
NORTRIPTYLINE,80182,HCPCS,301,RC,,both,68.5,61.65,Cigna,Default,Percent of Total Billed Charges,40.42,,,,40.42,55.9
NORTRIPTYLINE,80182,HCPCS,301,RC,,both,68.5,61.65,United Healthcare,Default,Fee Schedule,55.9,,,,40.42,55.9
VITAMIN C,82180,HCPCS,301,RC,,both,62.07,55.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.45,,,,36.62,50.65
VITAMIN C,82180,HCPCS,301,RC,,both,62.07,55.86,Cigna,Default,Percent of Total Billed Charges,36.62,,,,36.62,50.65
VITAMIN C,82180,HCPCS,301,RC,,both,62.07,55.86,United Healthcare,Default,Fee Schedule,50.65,,,,36.62,50.65
VITAMIN D 25 HYDROXY,82306,HCPCS,301,RC,,both,190.85,171.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.6,,,,112.6,155.73
VITAMIN D 25 HYDROXY,82306,HCPCS,301,RC,,both,190.85,171.77,Cigna,Default,Percent of Total Billed Charges,112.6,,,,112.6,155.73
VITAMIN D 25 HYDROXY,82306,HCPCS,301,RC,,both,190.85,171.77,United Healthcare,Default,Fee Schedule,155.73,,,,112.6,155.73
VITAMIN D 125,82652,HCPCS,301,RC,,both,96.9,87.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.83,,,,57.17,79.07
VITAMIN D 125,82652,HCPCS,301,RC,,both,96.9,87.21,Cigna,Default,Percent of Total Billed Charges,57.17,,,,57.17,79.07
VITAMIN D 125,82652,HCPCS,301,RC,,both,96.9,87.21,United Healthcare,Default,Fee Schedule,79.07,,,,57.17,79.07
VITAMIN E,84446,HCPCS,300,RC,,both,75.27,67.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.69,,,,44.41,61.42
VITAMIN E,84446,HCPCS,300,RC,,both,75.27,67.74,Cigna,Default,Percent of Total Billed Charges,44.41,,,,44.41,61.42
VITAMIN E,84446,HCPCS,300,RC,,both,75.27,67.74,United Healthcare,Default,Fee Schedule,61.42,,,,44.41,61.42
VITAMIN A (RETINOL),84590,HCPCS,300,RC,,both,87.67,78.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.37,,,,51.73,71.54
VITAMIN A (RETINOL),84590,HCPCS,300,RC,,both,87.67,78.9,Cigna,Default,Percent of Total Billed Charges,51.73,,,,51.73,71.54
VITAMIN A (RETINOL),84590,HCPCS,300,RC,,both,87.67,78.9,United Healthcare,Default,Fee Schedule,71.54,,,,51.73,71.54
VITAMIN K1,84597,HCPCS,300,RC,,both,165.44,148.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.81,,,,97.61,135
VITAMIN K1,84597,HCPCS,300,RC,,both,165.44,148.9,Cigna,Default,Percent of Total Billed Charges,97.61,,,,97.61,135
VITAMIN K1,84597,HCPCS,300,RC,,both,165.44,148.9,United Healthcare,Default,Fee Schedule,135,,,,97.61,135
APOLIPOPROTEIN B,82172,HCPCS,301,RC,,both,80.62,72.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.43,,,,47.57,65.79
APOLIPOPROTEIN B,82172,HCPCS,301,RC,,both,80.62,72.56,Cigna,Default,Percent of Total Billed Charges,47.57,,,,47.57,65.79
APOLIPOPROTEIN B,82172,HCPCS,301,RC,,both,80.62,72.56,United Healthcare,Default,Fee Schedule,65.79,,,,47.57,65.79
5 A DIHYDROTESTOSTERONE,80327,HCPCS,301,RC,,both,110.64,99.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.45,,,,65.28,90.28
5 A DIHYDROTESTOSTERONE,80327,HCPCS,301,RC,,both,110.64,99.58,Cigna,Default,Percent of Total Billed Charges,65.28,,,,65.28,90.28
5 A DIHYDROTESTOSTERONE,80327,HCPCS,301,RC,,both,110.64,99.58,United Healthcare,Default,Fee Schedule,90.28,,,,65.28,90.28
VASOPRESSIN ADH,84588,HCPCS,301,RC,,both,157.02,141.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.91,,,,92.64,128.13
VASOPRESSIN ADH,84588,HCPCS,301,RC,,both,157.02,141.32,Cigna,Default,Percent of Total Billed Charges,92.64,,,,92.64,128.13
VASOPRESSIN ADH,84588,HCPCS,301,RC,,both,157.02,141.32,United Healthcare,Default,Fee Schedule,128.13,,,,92.64,128.13
DIHYDRODAMINE,82657,HCPCS,301,RC,,both,667.24,600.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,467.07,,,,393.67,544.47
DIHYDRODAMINE,82657,HCPCS,301,RC,,both,667.24,600.52,Cigna,Default,Percent of Total Billed Charges,393.67,,,,393.67,544.47
DIHYDRODAMINE,82657,HCPCS,301,RC,,both,667.24,600.52,United Healthcare,Default,Fee Schedule,544.47,,,,393.67,544.47
LDL-CHOL DIRECT,83721,HCPCS,301,RC,,both,57.58,51.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.31,,,,33.97,46.99
LDL-CHOL DIRECT,83721,HCPCS,301,RC,,both,57.58,51.82,Cigna,Default,Percent of Total Billed Charges,33.97,,,,33.97,46.99
LDL-CHOL DIRECT,83721,HCPCS,301,RC,,both,57.58,51.82,United Healthcare,Default,Fee Schedule,46.99,,,,33.97,46.99
ELASTASE STOOL,82656,HCPCS,301,RC,,both,262,235.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.4,,,,154.58,213.79
ELASTASE STOOL,82656,HCPCS,301,RC,,both,262,235.8,Cigna,Default,Percent of Total Billed Charges,154.58,,,,154.58,213.79
ELASTASE STOOL,82656,HCPCS,301,RC,,both,262,235.8,United Healthcare,Default,Fee Schedule,213.79,,,,154.58,213.79
LIDOCAINE,80176,HCPCS,301,RC,,both,79,71.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.3,,,,46.61,64.46
LIDOCAINE,80176,HCPCS,301,RC,,both,79,71.1,Cigna,Default,Percent of Total Billed Charges,46.61,,,,46.61,64.46
LIDOCAINE,80176,HCPCS,301,RC,,both,79,71.1,United Healthcare,Default,Fee Schedule,64.46,,,,46.61,64.46
THYROGLOBULIN,84432,HCPCS,301,RC,,both,88.77,79.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.14,,,,52.37,72.44
THYROGLOBULIN,84432,HCPCS,301,RC,,both,88.77,79.89,Cigna,Default,Percent of Total Billed Charges,52.37,,,,52.37,72.44
THYROGLOBULIN,84432,HCPCS,301,RC,,both,88.77,79.89,United Healthcare,Default,Fee Schedule,72.44,,,,52.37,72.44
RENAL PANEL,80069,HCPCS,301,RC,,both,141.35,127.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.94,,,,83.4,115.34
RENAL PANEL,80069,HCPCS,301,RC,,both,141.35,127.22,Cigna,Default,Percent of Total Billed Charges,83.4,,,,83.4,115.34
RENAL PANEL,80069,HCPCS,301,RC,,both,141.35,127.22,United Healthcare,Default,Fee Schedule,115.34,,,,83.4,115.34
APTT CIRCULATING INHIBITOR,85732,HCPCS,300,RC,,both,31.74,28.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.22,,,,18.73,25.9
APTT CIRCULATING INHIBITOR,85732,HCPCS,300,RC,,both,31.74,28.57,Cigna,Default,Percent of Total Billed Charges,18.73,,,,18.73,25.9
APTT CIRCULATING INHIBITOR,85732,HCPCS,300,RC,,both,31.74,28.57,United Healthcare,Default,Fee Schedule,25.9,,,,18.73,25.9
M TB DIRECT DETECT,87556,HCPCS,300,RC,,both,417.25,375.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.08,,,,246.18,340.48
M TB DIRECT DETECT,87556,HCPCS,300,RC,,both,417.25,375.53,Cigna,Default,Percent of Total Billed Charges,246.18,,,,246.18,340.48
M TB DIRECT DETECT,87556,HCPCS,300,RC,,both,417.25,375.53,United Healthcare,Default,Fee Schedule,340.48,,,,246.18,340.48
Tc99mm  Ceretec,636,RC,,,,both,632.75,569.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,442.92,,,,373.32,516.32
Tc99mm  Ceretec,636,RC,,,,both,632.75,569.48,Cigna,Default,Percent of Total Billed Charges,373.32,,,,373.32,516.32
Tc99mm  Ceretec,636,RC,,,,both,632.75,569.48,United Healthcare,Default,Fee Schedule,516.32,,,,373.32,516.32
DHEA SULFATE,82627,HCPCS,301,RC,,both,115.45,103.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.82,,,,68.12,94.21
DHEA SULFATE,82627,HCPCS,301,RC,,both,115.45,103.91,Cigna,Default,Percent of Total Billed Charges,68.12,,,,68.12,94.21
DHEA SULFATE,82627,HCPCS,301,RC,,both,115.45,103.91,United Healthcare,Default,Fee Schedule,94.21,,,,68.12,94.21
DHEA,82626,HCPCS,301,RC,,both,51.41,46.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.99,,,,30.33,41.95
DHEA,82626,HCPCS,301,RC,,both,51.41,46.27,Cigna,Default,Percent of Total Billed Charges,30.33,,,,30.33,41.95
DHEA,82626,HCPCS,301,RC,,both,51.41,46.27,United Healthcare,Default,Fee Schedule,41.95,,,,30.33,41.95
BETA HYDROXYBUTYRATE,82010,HCPCS,300,RC,,both,101.13,91.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.79,,,,59.67,82.52
BETA HYDROXYBUTYRATE,82010,HCPCS,300,RC,,both,101.13,91.02,Cigna,Default,Percent of Total Billed Charges,59.67,,,,59.67,82.52
BETA HYDROXYBUTYRATE,82010,HCPCS,300,RC,,both,101.13,91.02,United Healthcare,Default,Fee Schedule,82.52,,,,59.67,82.52
CALCIUM-IONIZED,82330,HCPCS,301,RC,,both,100.27,90.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.19,,,,59.16,81.82
CALCIUM-IONIZED,82330,HCPCS,301,RC,,both,100.27,90.24,Cigna,Default,Percent of Total Billed Charges,59.16,,,,59.16,81.82
CALCIUM-IONIZED,82330,HCPCS,301,RC,,both,100.27,90.24,United Healthcare,Default,Fee Schedule,81.82,,,,59.16,81.82
FULL ARTERIAL PROFILE 5,82330,HCPCS,301,RC,,both,59.25,53.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.48,,,,34.96,48.35
FULL ARTERIAL PROFILE 5,82330,HCPCS,301,RC,,both,59.25,53.33,Cigna,Default,Percent of Total Billed Charges,34.96,,,,34.96,48.35
FULL ARTERIAL PROFILE 5,82330,HCPCS,301,RC,,both,59.25,53.33,United Healthcare,Default,Fee Schedule,48.35,,,,34.96,48.35
ACID PHOSPHATASE TOTAL,84060,HCPCS,301,RC,,both,43.5,39.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.45,,,,25.66,35.5
ACID PHOSPHATASE TOTAL,84060,HCPCS,301,RC,,both,43.5,39.15,Cigna,Default,Percent of Total Billed Charges,25.66,,,,25.66,35.5
ACID PHOSPHATASE TOTAL,84060,HCPCS,301,RC,,both,43.5,39.15,United Healthcare,Default,Fee Schedule,35.5,,,,25.66,35.5
TISSUE TRANSGLUATMINASE IGG,83516,HCPCS,300,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
TISSUE TRANSGLUATMINASE IGG,83516,HCPCS,300,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
TISSUE TRANSGLUATMINASE IGG,83516,HCPCS,300,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
IMMASSAY QUANT BY RADPHARM,83520,HCPCS,300,RC,,both,88.5,79.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.95,,,,52.22,72.22
IMMASSAY QUANT BY RADPHARM,83520,HCPCS,300,RC,,both,88.5,79.65,Cigna,Default,Percent of Total Billed Charges,52.22,,,,52.22,72.22
IMMASSAY QUANT BY RADPHARM,83520,HCPCS,300,RC,,both,88.5,79.65,United Healthcare,Default,Fee Schedule,72.22,,,,52.22,72.22
TISSUE TRANGLUTAMINASE IGA,83516,HCPCS,300,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
TISSUE TRANGLUTAMINASE IGA,83516,HCPCS,300,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
TISSUE TRANGLUTAMINASE IGA,83516,HCPCS,300,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
"MITOCHONDRIAL AB, IGG",86255,HCPCS,300,RC,,both,66.06,59.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.24,,,,38.98,53.9
"MITOCHONDRIAL AB, IGG",86255,HCPCS,300,RC,,both,66.06,59.45,Cigna,Default,Percent of Total Billed Charges,38.98,,,,38.98,53.9
"MITOCHONDRIAL AB, IGG",86255,HCPCS,300,RC,,both,66.06,59.45,United Healthcare,Default,Fee Schedule,53.9,,,,38.98,53.9
GLIADIN AB IGA,83516,HCPCS,300,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
GLIADIN AB IGA,83516,HCPCS,300,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
GLIADIN AB IGA,83516,HCPCS,300,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
GLIADIN AB IGG,83516,HCPCS,300,RC,,both,67.98,61.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.47
GLIADIN AB IGG,83516,HCPCS,300,RC,,both,67.98,61.18,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.47
GLIADIN AB IGG,83516,HCPCS,300,RC,,both,67.98,61.18,United Healthcare,Default,Fee Schedule,55.47,,,,40.11,55.47
DGP IGA,83516,HCPCS,300,RC,,both,69.37,62.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.56,,,,40.93,56.61
DGP IGA,83516,HCPCS,300,RC,,both,69.37,62.43,Cigna,Default,Percent of Total Billed Charges,40.93,,,,40.93,56.61
DGP IGA,83516,HCPCS,300,RC,,both,69.37,62.43,United Healthcare,Default,Fee Schedule,56.61,,,,40.93,56.61
RIBOSOME P ANTIBODY IGG,86235,HCPCS,302,RC,,both,23.47,21.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.43,,,,13.85,19.15
RIBOSOME P ANTIBODY IGG,86235,HCPCS,302,RC,,both,23.47,21.12,Cigna,Default,Percent of Total Billed Charges,13.85,,,,13.85,19.15
RIBOSOME P ANTIBODY IGG,86235,HCPCS,302,RC,,both,23.47,21.12,United Healthcare,Default,Fee Schedule,19.15,,,,13.85,19.15
MYELIN ASSOC GLYCOPROTEIN AB IGM,83516,HCPCS,300,RC,,both,78.88,70.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.22,,,,46.54,64.37
MYELIN ASSOC GLYCOPROTEIN AB IGM,83516,HCPCS,300,RC,,both,78.88,70.99,Cigna,Default,Percent of Total Billed Charges,46.54,,,,46.54,64.37
MYELIN ASSOC GLYCOPROTEIN AB IGM,83516,HCPCS,300,RC,,both,78.88,70.99,United Healthcare,Default,Fee Schedule,64.37,,,,46.54,64.37
CENTROMERE AB,86235,HCPCS,302,RC,,both,22.28,20.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.6,,,,13.15,18.18
CENTROMERE AB,86235,HCPCS,302,RC,,both,22.28,20.05,Cigna,Default,Percent of Total Billed Charges,13.15,,,,13.15,18.18
CENTROMERE AB,86235,HCPCS,302,RC,,both,22.28,20.05,United Healthcare,Default,Fee Schedule,18.18,,,,13.15,18.18
ANTIMITOCHONDRIAL ABS,86256,HCPCS,300,RC,,both,35.37,31.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.76,,,,20.87,28.86
ANTIMITOCHONDRIAL ABS,86256,HCPCS,300,RC,,both,35.37,31.83,Cigna,Default,Percent of Total Billed Charges,20.87,,,,20.87,28.86
ANTIMITOCHONDRIAL ABS,86256,HCPCS,300,RC,,both,35.37,31.83,United Healthcare,Default,Fee Schedule,28.86,,,,20.87,28.86
MYCOPHENOLIC ACID,80180,HCPCS,300,RC,,both,100,90,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70,,,,59,81.6
MYCOPHENOLIC ACID,80180,HCPCS,300,RC,,both,100,90,Cigna,Default,Percent of Total Billed Charges,59,,,,59,81.6
MYCOPHENOLIC ACID,80180,HCPCS,300,RC,,both,100,90,United Healthcare,Default,Fee Schedule,81.6,,,,59,81.6
CLOMIPRAMINE LEVEL,80299,HCPCS,300,RC,,both,77.75,69.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.42,,,,45.87,63.44
CLOMIPRAMINE LEVEL,80299,HCPCS,300,RC,,both,77.75,69.98,Cigna,Default,Percent of Total Billed Charges,45.87,,,,45.87,63.44
CLOMIPRAMINE LEVEL,80299,HCPCS,300,RC,,both,77.75,69.98,United Healthcare,Default,Fee Schedule,63.44,,,,45.87,63.44
KEPPRA (LEVETIRACETAM),80177,HCPCS,301,RC,,both,150.28,135.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.2,,,,88.67,122.63
KEPPRA (LEVETIRACETAM),80177,HCPCS,301,RC,,both,150.28,135.25,Cigna,Default,Percent of Total Billed Charges,88.67,,,,88.67,122.63
KEPPRA (LEVETIRACETAM),80177,HCPCS,301,RC,,both,150.28,135.25,United Healthcare,Default,Fee Schedule,122.63,,,,88.67,122.63
TOPIRAMATE (TOPAMAX),80201,HCPCS,301,RC,,both,125.84,113.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.09,,,,74.25,102.69
TOPIRAMATE (TOPAMAX),80201,HCPCS,301,RC,,both,125.84,113.26,Cigna,Default,Percent of Total Billed Charges,74.25,,,,74.25,102.69
TOPIRAMATE (TOPAMAX),80201,HCPCS,301,RC,,both,125.84,113.26,United Healthcare,Default,Fee Schedule,102.69,,,,74.25,102.69
OXCARBAZEPINE (TRILEPTAL),80183,HCPCS,301,RC,,both,102.79,92.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.95,,,,60.65,83.88
OXCARBAZEPINE (TRILEPTAL),80183,HCPCS,301,RC,,both,102.79,92.51,Cigna,Default,Percent of Total Billed Charges,60.65,,,,60.65,83.88
OXCARBAZEPINE (TRILEPTAL),80183,HCPCS,301,RC,,both,102.79,92.51,United Healthcare,Default,Fee Schedule,83.88,,,,60.65,83.88
LAMOTRIGINE,80175,HCPCS,301,RC,,both,75.56,68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.89,,,,44.58,61.66
LAMOTRIGINE,80175,HCPCS,301,RC,,both,75.56,68,Cigna,Default,Percent of Total Billed Charges,44.58,,,,44.58,61.66
LAMOTRIGINE,80175,HCPCS,301,RC,,both,75.56,68,United Healthcare,Default,Fee Schedule,61.66,,,,44.58,61.66
LACOSAMIDE (VIMPAT),80339,HCPCS,301,RC,,both,491.55,442.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,344.08,,,,290.01,401.1
LACOSAMIDE (VIMPAT),80339,HCPCS,301,RC,,both,491.55,442.4,Cigna,Default,Percent of Total Billed Charges,290.01,,,,290.01,401.1
LACOSAMIDE (VIMPAT),80339,HCPCS,301,RC,,both,491.55,442.4,United Healthcare,Default,Fee Schedule,401.1,,,,290.01,401.1
CLOBAZAM,80339,HCPCS,301,RC,,both,297.95,268.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,208.56,,,,175.79,243.13
CLOBAZAM,80339,HCPCS,301,RC,,both,297.95,268.16,Cigna,Default,Percent of Total Billed Charges,175.79,,,,175.79,243.13
CLOBAZAM,80339,HCPCS,301,RC,,both,297.95,268.16,United Healthcare,Default,Fee Schedule,243.13,,,,175.79,243.13
RET PROTO ONCOGENE,81406,HCPCS,310,RC,,both,4258.44,3832.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2980.91,,,,2512.48,3474.89
RET PROTO ONCOGENE,81406,HCPCS,310,RC,,both,4258.44,3832.6,Cigna,Default,Percent of Total Billed Charges,2512.48,,,,2512.48,3474.89
RET PROTO ONCOGENE,81406,HCPCS,310,RC,,both,4258.44,3832.6,United Healthcare,Default,Fee Schedule,3474.89,,,,2512.48,3474.89
GLUCOSE 6 PHOSPHATE DEHYDROGENAS E,82955,HCPCS,300,RC,,both,52,46.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.4,,,,30.68,42.43
GLUCOSE 6 PHOSPHATE DEHYDROGENAS E,82955,HCPCS,300,RC,,both,52,46.8,Cigna,Default,Percent of Total Billed Charges,30.68,,,,30.68,42.43
GLUCOSE 6 PHOSPHATE DEHYDROGENAS E,82955,HCPCS,300,RC,,both,52,46.8,United Healthcare,Default,Fee Schedule,42.43,,,,30.68,42.43
URINE FAT,89125,HCPCS,300,RC,,both,43.5,39.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.45,,,,25.66,35.5
URINE FAT,89125,HCPCS,300,RC,,both,43.5,39.15,Cigna,Default,Percent of Total Billed Charges,25.66,,,,25.66,35.5
URINE FAT,89125,HCPCS,300,RC,,both,43.5,39.15,United Healthcare,Default,Fee Schedule,35.5,,,,25.66,35.5
GLUCOSE TOL UR ADDHR,82952,HCPCS,300,RC,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
GLUCOSE TOL UR ADDHR,82952,HCPCS,300,RC,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
GLUCOSE TOL UR ADDHR,82952,HCPCS,300,RC,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
FECAL FAT QUALITATIVE,82705,HCPCS,301,RC,,both,48.87,43.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.21,,,,28.83,39.88
FECAL FAT QUALITATIVE,82705,HCPCS,301,RC,,both,48.87,43.98,Cigna,Default,Percent of Total Billed Charges,28.83,,,,28.83,39.88
FECAL FAT QUALITATIVE,82705,HCPCS,301,RC,,both,48.87,43.98,United Healthcare,Default,Fee Schedule,39.88,,,,28.83,39.88
FECAL FAT (QUANT),82710,HCPCS,301,RC,,both,112.92,101.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.04,,,,66.62,92.14
FECAL FAT (QUANT),82710,HCPCS,301,RC,,both,112.92,101.63,Cigna,Default,Percent of Total Billed Charges,66.62,,,,66.62,92.14
FECAL FAT (QUANT),82710,HCPCS,301,RC,,both,112.92,101.63,United Healthcare,Default,Fee Schedule,92.14,,,,66.62,92.14
FECAL WBC,89055,HCPCS,300,RC,,both,57.33,51.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.13,,,,33.82,46.78
FECAL WBC,89055,HCPCS,300,RC,,both,57.33,51.6,Cigna,Default,Percent of Total Billed Charges,33.82,,,,33.82,46.78
FECAL WBC,89055,HCPCS,300,RC,,both,57.33,51.6,United Healthcare,Default,Fee Schedule,46.78,,,,33.82,46.78
STOOL-24 HR PROTOPORPHYR,84126,HCPCS,301,RC,,both,276.25,248.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,193.38,,,,162.99,225.42
STOOL-24 HR PROTOPORPHYR,84126,HCPCS,301,RC,,both,276.25,248.63,Cigna,Default,Percent of Total Billed Charges,162.99,,,,162.99,225.42
STOOL-24 HR PROTOPORPHYR,84126,HCPCS,301,RC,,both,276.25,248.63,United Healthcare,Default,Fee Schedule,225.42,,,,162.99,225.42
FECAL SODIUM,84302,HCPCS,301,RC,,both,24.5,22.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.15,,,,14.46,19.99
FECAL SODIUM,84302,HCPCS,301,RC,,both,24.5,22.05,Cigna,Default,Percent of Total Billed Charges,14.46,,,,14.46,19.99
FECAL SODIUM,84302,HCPCS,301,RC,,both,24.5,22.05,United Healthcare,Default,Fee Schedule,19.99,,,,14.46,19.99
FECAL POTASSIUM,84133,HCPCS,301,RC,,both,24.25,21.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.98,,,,14.31,19.79
FECAL POTASSIUM,84133,HCPCS,301,RC,,both,24.25,21.83,Cigna,Default,Percent of Total Billed Charges,14.31,,,,14.31,19.79
FECAL POTASSIUM,84133,HCPCS,301,RC,,both,24.25,21.83,United Healthcare,Default,Fee Schedule,19.79,,,,14.31,19.79
FECAL CHLORIDE,82438,HCPCS,301,RC,,both,24.25,21.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.98,,,,14.31,19.79
FECAL CHLORIDE,82438,HCPCS,301,RC,,both,24.25,21.83,Cigna,Default,Percent of Total Billed Charges,14.31,,,,14.31,19.79
FECAL CHLORIDE,82438,HCPCS,301,RC,,both,24.25,21.83,United Healthcare,Default,Fee Schedule,19.79,,,,14.31,19.79
LYME AB CSF,86618,HCPCS,300,RC,,both,101.25,91.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.88,,,,59.74,82.62
LYME AB CSF,86618,HCPCS,300,RC,,both,101.25,91.13,Cigna,Default,Percent of Total Billed Charges,59.74,,,,59.74,82.62
LYME AB CSF,86618,HCPCS,300,RC,,both,101.25,91.13,United Healthcare,Default,Fee Schedule,82.62,,,,59.74,82.62
TIBC / TRANSFERRIN,84466,HCPCS,301,RC,,both,105.78,95.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.05,,,,62.41,86.32
TIBC / TRANSFERRIN,84466,HCPCS,301,RC,,both,105.78,95.2,Cigna,Default,Percent of Total Billed Charges,62.41,,,,62.41,86.32
TIBC / TRANSFERRIN,84466,HCPCS,301,RC,,both,105.78,95.2,United Healthcare,Default,Fee Schedule,86.32,,,,62.41,86.32
ACETMNPHEN (TYLENOL),80143,HCPCS,301,RC,,both,105.04,94.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.53,,,,61.97,85.71
ACETMNPHEN (TYLENOL),80143,HCPCS,301,RC,,both,105.04,94.54,Cigna,Default,Percent of Total Billed Charges,61.97,,,,61.97,85.71
ACETMNPHEN (TYLENOL),80143,HCPCS,301,RC,,both,105.04,94.54,United Healthcare,Default,Fee Schedule,85.71,,,,61.97,85.71
ACETONE,82009,HCPCS,301,RC,,both,30.06,27.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.04,,,,17.74,24.53
ACETONE,82009,HCPCS,301,RC,,both,30.06,27.05,Cigna,Default,Percent of Total Billed Charges,17.74,,,,17.74,24.53
ACETONE,82009,HCPCS,301,RC,,both,30.06,27.05,United Healthcare,Default,Fee Schedule,24.53,,,,17.74,24.53
ACYICARNITINE QUANTITATIVE,82017,HCPCS,301,RC,,both,319.5,287.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.65,,,,188.5,260.71
ACYICARNITINE QUANTITATIVE,82017,HCPCS,301,RC,,both,319.5,287.55,Cigna,Default,Percent of Total Billed Charges,188.5,,,,188.5,260.71
ACYICARNITINE QUANTITATIVE,82017,HCPCS,301,RC,,both,319.5,287.55,United Healthcare,Default,Fee Schedule,260.71,,,,188.5,260.71
ACTH HORMONE,82024,HCPCS,301,RC,,both,187.62,168.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.33,,,,110.7,153.1
ACTH HORMONE,82024,HCPCS,301,RC,,both,187.62,168.86,Cigna,Default,Percent of Total Billed Charges,110.7,,,,110.7,153.1
ACTH HORMONE,82024,HCPCS,301,RC,,both,187.62,168.86,United Healthcare,Default,Fee Schedule,153.1,,,,110.7,153.1
ACTH STIMULATION,80400,HCPCS,301,RC,,both,301.01,270.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.71,,,,177.6,245.62
ACTH STIMULATION,80400,HCPCS,301,RC,,both,301.01,270.91,Cigna,Default,Percent of Total Billed Charges,177.6,,,,177.6,245.62
ACTH STIMULATION,80400,HCPCS,301,RC,,both,301.01,270.91,United Healthcare,Default,Fee Schedule,245.62,,,,177.6,245.62
RBC FOLATE,82747,HCPCS,301,RC,,both,102.25,92.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.58,,,,60.33,83.44
RBC FOLATE,82747,HCPCS,301,RC,,both,102.25,92.03,Cigna,Default,Percent of Total Billed Charges,60.33,,,,60.33,83.44
RBC FOLATE,82747,HCPCS,301,RC,,both,102.25,92.03,United Healthcare,Default,Fee Schedule,83.44,,,,60.33,83.44
CALCIUM UR QUANT,82340,HCPCS,301,RC,,both,20.79,18.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.55,,,,12.27,16.96
CALCIUM UR QUANT,82340,HCPCS,301,RC,,both,20.79,18.71,Cigna,Default,Percent of Total Billed Charges,12.27,,,,12.27,16.96
CALCIUM UR QUANT,82340,HCPCS,301,RC,,both,20.79,18.71,United Healthcare,Default,Fee Schedule,16.96,,,,12.27,16.96
CULTURE PERTUSS,87081,HCPCS,300,RC,,both,190.75,171.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,133.52,,,,112.54,155.65
CULTURE PERTUSS,87081,HCPCS,300,RC,,both,190.75,171.68,Cigna,Default,Percent of Total Billed Charges,112.54,,,,112.54,155.65
CULTURE PERTUSS,87081,HCPCS,300,RC,,both,190.75,171.68,United Healthcare,Default,Fee Schedule,155.65,,,,112.54,155.65
GASTRO PATHOGENS,87507,HCPCS,306,RC,,both,1073.98,966.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,751.79,,,,633.65,876.37
GASTRO PATHOGENS,87507,HCPCS,306,RC,,both,1073.98,966.58,Cigna,Default,Percent of Total Billed Charges,633.65,,,,633.65,876.37
GASTRO PATHOGENS,87507,HCPCS,306,RC,,both,1073.98,966.58,United Healthcare,Default,Fee Schedule,876.37,,,,633.65,876.37
ENTEROVIRUS PCR PLASMA,87498,HCPCS,306,RC,,both,214.8,193.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,150.36,,,,126.73,175.28
ENTEROVIRUS PCR PLASMA,87498,HCPCS,306,RC,,both,214.8,193.32,Cigna,Default,Percent of Total Billed Charges,126.73,,,,126.73,175.28
ENTEROVIRUS PCR PLASMA,87498,HCPCS,306,RC,,both,214.8,193.32,United Healthcare,Default,Fee Schedule,175.28,,,,126.73,175.28
GI PARASITE PANEL,87505,HCPCS,306,RC,,both,780,702,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,546,,,,460.2,636.48
GI PARASITE PANEL,87505,HCPCS,306,RC,,both,780,702,Cigna,Default,Percent of Total Billed Charges,460.2,,,,460.2,636.48
GI PARASITE PANEL,87505,HCPCS,306,RC,,both,780,702,United Healthcare,Default,Fee Schedule,636.48,,,,460.2,636.48
CMV QUANTITATIVE PCR,87497,HCPCS,306,RC,,both,353.91,318.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,247.74,,,,208.81,288.79
CMV QUANTITATIVE PCR,87497,HCPCS,306,RC,,both,353.91,318.52,Cigna,Default,Percent of Total Billed Charges,208.81,,,,208.81,288.79
CMV QUANTITATIVE PCR,87497,HCPCS,306,RC,,both,353.91,318.52,United Healthcare,Default,Fee Schedule,288.79,,,,208.81,288.79
STREP GRP A MOLECULAR,87651,HCPCS,306,RC,,both,131.96,118.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.37,,,,77.86,107.68
STREP GRP A MOLECULAR,87651,HCPCS,306,RC,,both,131.96,118.76,Cigna,Default,Percent of Total Billed Charges,77.86,,,,77.86,107.68
STREP GRP A MOLECULAR,87651,HCPCS,306,RC,,both,131.96,118.76,United Healthcare,Default,Fee Schedule,107.68,,,,77.86,107.68
C DIFFICILE TOXIC GENE,87493,HCPCS,306,RC,,both,195.22,175.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.65,,,,115.18,159.3
C DIFFICILE TOXIC GENE,87493,HCPCS,306,RC,,both,195.22,175.7,Cigna,Default,Percent of Total Billed Charges,115.18,,,,115.18,159.3
C DIFFICILE TOXIC GENE,87493,HCPCS,306,RC,,both,195.22,175.7,United Healthcare,Default,Fee Schedule,159.3,,,,115.18,159.3
HEPATITIS B VIRAL DNA,87517,HCPCS,306,RC,,both,344.37,309.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,241.06,,,,203.18,281.01
HEPATITIS B VIRAL DNA,87517,HCPCS,306,RC,,both,344.37,309.93,Cigna,Default,Percent of Total Billed Charges,203.18,,,,203.18,281.01
HEPATITIS B VIRAL DNA,87517,HCPCS,306,RC,,both,344.37,309.93,United Healthcare,Default,Fee Schedule,281.01,,,,203.18,281.01
HEPATITIS C RIBA,86804,HCPCS,300,RC,,both,234.81,211.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.37,,,,138.54,191.6
HEPATITIS C RIBA,86804,HCPCS,300,RC,,both,234.81,211.33,Cigna,Default,Percent of Total Billed Charges,138.54,,,,138.54,191.6
HEPATITIS C RIBA,86804,HCPCS,300,RC,,both,234.81,211.33,United Healthcare,Default,Fee Schedule,191.6,,,,138.54,191.6
CMV BY PCR,87496,HCPCS,300,RC,,both,166,149.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.2,,,,97.94,135.46
CMV BY PCR,87496,HCPCS,300,RC,,both,166,149.4,Cigna,Default,Percent of Total Billed Charges,97.94,,,,97.94,135.46
CMV BY PCR,87496,HCPCS,300,RC,,both,166,149.4,United Healthcare,Default,Fee Schedule,135.46,,,,97.94,135.46
HEPATITIS C RNA PCR QUA,87522,HCPCS,300,RC,,both,399.44,359.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.61,,,,235.67,325.94
HEPATITIS C RNA PCR QUA,87522,HCPCS,300,RC,,both,399.44,359.5,Cigna,Default,Percent of Total Billed Charges,235.67,,,,235.67,325.94
HEPATITIS C RNA PCR QUA,87522,HCPCS,300,RC,,both,399.44,359.5,United Healthcare,Default,Fee Schedule,325.94,,,,235.67,325.94
BK VIRUS URINE,87799,HCPCS,300,RC,,both,520.77,468.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,364.54,,,,307.25,424.95
BK VIRUS URINE,87799,HCPCS,300,RC,,both,520.77,468.69,Cigna,Default,Percent of Total Billed Charges,307.25,,,,307.25,424.95
BK VIRUS URINE,87799,HCPCS,300,RC,,both,520.77,468.69,United Healthcare,Default,Fee Schedule,424.95,,,,307.25,424.95
HERPES SIMPLEX BY PCR,87529,HCPCS,300,RC,,both,292.12,262.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,204.48,,,,172.35,238.37
HERPES SIMPLEX BY PCR,87529,HCPCS,300,RC,,both,292.12,262.91,Cigna,Default,Percent of Total Billed Charges,172.35,,,,172.35,238.37
HERPES SIMPLEX BY PCR,87529,HCPCS,300,RC,,both,292.12,262.91,United Healthcare,Default,Fee Schedule,238.37,,,,172.35,238.37
HEPATITIS PANEL ACUTE,80074,HCPCS,301,RC,,both,358.81,322.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,251.17,,,,211.7,292.79
HEPATITIS PANEL ACUTE,80074,HCPCS,301,RC,,both,358.81,322.93,Cigna,Default,Percent of Total Billed Charges,211.7,,,,211.7,292.79
HEPATITIS PANEL ACUTE,80074,HCPCS,301,RC,,both,358.81,322.93,United Healthcare,Default,Fee Schedule,292.79,,,,211.7,292.79
JC VIRUS,87798,HCPCS,300,RC,,both,476.38,428.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,333.47,,,,281.06,388.73
JC VIRUS,87798,HCPCS,300,RC,,both,476.38,428.74,Cigna,Default,Percent of Total Billed Charges,281.06,,,,281.06,388.73
JC VIRUS,87798,HCPCS,300,RC,,both,476.38,428.74,United Healthcare,Default,Fee Schedule,388.73,,,,281.06,388.73
HEP C RNA QUALITATIVE,87521,HCPCS,306,RC,,both,240,216,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168,,,,141.6,195.84
HEP C RNA QUALITATIVE,87521,HCPCS,306,RC,,both,240,216,Cigna,Default,Percent of Total Billed Charges,141.6,,,,141.6,195.84
HEP C RNA QUALITATIVE,87521,HCPCS,306,RC,,both,240,216,United Healthcare,Default,Fee Schedule,195.84,,,,141.6,195.84
B. PERTUSSIS/PARAPERTUSIS PCR,87798,HCPCS,306,RC,,both,298.95,269.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209.26,,,,176.38,243.94
B. PERTUSSIS/PARAPERTUSIS PCR,87798,HCPCS,306,RC,,both,298.95,269.06,Cigna,Default,Percent of Total Billed Charges,176.38,,,,176.38,243.94
B. PERTUSSIS/PARAPERTUSIS PCR,87798,HCPCS,306,RC,,both,298.95,269.06,United Healthcare,Default,Fee Schedule,243.94,,,,176.38,243.94
NOROVIRUS 1 PCR,87798,HCPCS,300,RC,,both,354.93,319.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,248.45,,,,209.41,289.62
NOROVIRUS 1 PCR,87798,HCPCS,300,RC,,both,354.93,319.44,Cigna,Default,Percent of Total Billed Charges,209.41,,,,209.41,289.62
NOROVIRUS 1 PCR,87798,HCPCS,300,RC,,both,354.93,319.44,United Healthcare,Default,Fee Schedule,289.62,,,,209.41,289.62
NOROVIRUS 2 PCR,87798,HCPCS,300,RC,,both,354.93,319.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,248.45,,,,209.41,289.62
NOROVIRUS 2 PCR,87798,HCPCS,300,RC,,both,354.93,319.44,Cigna,Default,Percent of Total Billed Charges,209.41,,,,209.41,289.62
NOROVIRUS 2 PCR,87798,HCPCS,300,RC,,both,354.93,319.44,United Healthcare,Default,Fee Schedule,289.62,,,,209.41,289.62
JC POLYOMA VIRUS PCR,87799,HCPCS,306,RC,,both,1100.36,990.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,770.25,,,,649.21,897.89
JC POLYOMA VIRUS PCR,87799,HCPCS,306,RC,,both,1100.36,990.32,Cigna,Default,Percent of Total Billed Charges,649.21,,,,649.21,897.89
JC POLYOMA VIRUS PCR,87799,HCPCS,306,RC,,both,1100.36,990.32,United Healthcare,Default,Fee Schedule,897.89,,,,649.21,897.89
CANDIDA NA PROBE,87480,HCPCS,306,RC,,both,51.43,46.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36,,,,30.34,41.97
CANDIDA NA PROBE,87480,HCPCS,306,RC,,both,51.43,46.29,Cigna,Default,Percent of Total Billed Charges,30.34,,,,30.34,41.97
CANDIDA NA PROBE,87480,HCPCS,306,RC,,both,51.43,46.29,United Healthcare,Default,Fee Schedule,41.97,,,,30.34,41.97
GARDNERELLA PROBE,87510,HCPCS,306,RC,,both,51.43,46.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36,,,,30.34,41.97
GARDNERELLA PROBE,87510,HCPCS,306,RC,,both,51.43,46.29,Cigna,Default,Percent of Total Billed Charges,30.34,,,,30.34,41.97
GARDNERELLA PROBE,87510,HCPCS,306,RC,,both,51.43,46.29,United Healthcare,Default,Fee Schedule,41.97,,,,30.34,41.97
TRICH VAG PROBE,87660,HCPCS,306,RC,,both,51.43,46.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36,,,,30.34,41.97
TRICH VAG PROBE,87660,HCPCS,306,RC,,both,51.43,46.29,Cigna,Default,Percent of Total Billed Charges,30.34,,,,30.34,41.97
TRICH VAG PROBE,87660,HCPCS,306,RC,,both,51.43,46.29,United Healthcare,Default,Fee Schedule,41.97,,,,30.34,41.97
HSV PCR NON CSF,87529,HCPCS,300,RC,,both,193.9,174.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.73,,,,114.4,158.22
HSV PCR NON CSF,87529,HCPCS,300,RC,,both,193.9,174.51,Cigna,Default,Percent of Total Billed Charges,114.4,,,,114.4,158.22
HSV PCR NON CSF,87529,HCPCS,300,RC,,both,193.9,174.51,United Healthcare,Default,Fee Schedule,158.22,,,,114.4,158.22
HSV PCR NON CSF CHARGE ONLY,87529,HCPCS,300,RC,,both,195.03,175.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.52,,,,115.07,159.14
HSV PCR NON CSF CHARGE ONLY,87529,HCPCS,300,RC,,both,195.03,175.53,Cigna,Default,Percent of Total Billed Charges,115.07,,,,115.07,159.14
HSV PCR NON CSF CHARGE ONLY,87529,HCPCS,300,RC,,both,195.03,175.53,United Healthcare,Default,Fee Schedule,159.14,,,,115.07,159.14
ZIKA VIRUS BY PCR,87798,HCPCS,306,RC,,both,803.33,723,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,562.33,,,,473.96,655.52
ZIKA VIRUS BY PCR,87798,HCPCS,306,RC,,both,803.33,723,Cigna,Default,Percent of Total Billed Charges,473.96,,,,473.96,655.52
ZIKA VIRUS BY PCR,87798,HCPCS,306,RC,,both,803.33,723,United Healthcare,Default,Fee Schedule,655.52,,,,473.96,655.52
ZIKA IGM,86790,HCPCS,302,RC,,both,547.72,492.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,383.4,,,,323.15,446.94
ZIKA IGM,86790,HCPCS,302,RC,,both,547.72,492.95,Cigna,Default,Percent of Total Billed Charges,323.15,,,,323.15,446.94
ZIKA IGM,86790,HCPCS,302,RC,,both,547.72,492.95,United Healthcare,Default,Fee Schedule,446.94,,,,323.15,446.94
CHLAM PNEUMO PROBE,87486,HCPCS,306,RC,,both,110.94,99.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.66,,,,65.45,90.53
CHLAM PNEUMO PROBE,87486,HCPCS,306,RC,,both,110.94,99.85,Cigna,Default,Percent of Total Billed Charges,65.45,,,,65.45,90.53
CHLAM PNEUMO PROBE,87486,HCPCS,306,RC,,both,110.94,99.85,United Healthcare,Default,Fee Schedule,90.53,,,,65.45,90.53
RESP VIRUS 12-25 TARGETS,87633,HCPCS,306,RC,,both,110.94,99.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.66,,,,65.45,90.53
RESP VIRUS 12-25 TARGETS,87633,HCPCS,306,RC,,both,110.94,99.85,Cigna,Default,Percent of Total Billed Charges,65.45,,,,65.45,90.53
RESP VIRUS 12-25 TARGETS,87633,HCPCS,306,RC,,both,110.94,99.85,United Healthcare,Default,Fee Schedule,90.53,,,,65.45,90.53
LEGIONELLA IGM AB,86713,HCPCS,300,RC,,both,81.17,73.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.82,,,,47.89,66.23
LEGIONELLA IGM AB,86713,HCPCS,300,RC,,both,81.17,73.05,Cigna,Default,Percent of Total Billed Charges,47.89,,,,47.89,66.23
LEGIONELLA IGM AB,86713,HCPCS,300,RC,,both,81.17,73.05,United Healthcare,Default,Fee Schedule,66.23,,,,47.89,66.23
T3 UPTAKE,84479,HCPCS,300,RC,,both,46.07,41.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.25,,,,27.18,37.59
T3 UPTAKE,84479,HCPCS,300,RC,,both,46.07,41.46,Cigna,Default,Percent of Total Billed Charges,27.18,,,,27.18,37.59
T3 UPTAKE,84479,HCPCS,300,RC,,both,46.07,41.46,United Healthcare,Default,Fee Schedule,37.59,,,,27.18,37.59
RBC ANTIGEN SCREEN/UNIT,86902,HCPCS,300,RC,,both,150.45,135.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.32,,,,88.77,122.77
RBC ANTIGEN SCREEN/UNIT,86902,HCPCS,300,RC,,both,150.45,135.41,Cigna,Default,Percent of Total Billed Charges,88.77,,,,88.77,122.77
RBC ANTIGEN SCREEN/UNIT,86902,HCPCS,300,RC,,both,150.45,135.41,United Healthcare,Default,Fee Schedule,122.77,,,,88.77,122.77
RBC ANTIGEN SCREEN/PATIENT,86905,HCPCS,300,RC,,both,150.45,135.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.32,,,,88.77,122.77
RBC ANTIGEN SCREEN/PATIENT,86905,HCPCS,300,RC,,both,150.45,135.41,Cigna,Default,Percent of Total Billed Charges,88.77,,,,88.77,122.77
RBC ANTIGEN SCREEN/PATIENT,86905,HCPCS,300,RC,,both,150.45,135.41,United Healthcare,Default,Fee Schedule,122.77,,,,88.77,122.77
RBC ANTIGEN TIER 4,86902,HCPCS,300,RC,,both,405.61,365.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,283.93,,,,239.31,330.98
RBC ANTIGEN TIER 4,86902,HCPCS,300,RC,,both,405.61,365.05,Cigna,Default,Percent of Total Billed Charges,239.31,,,,239.31,330.98
RBC ANTIGEN TIER 4,86902,HCPCS,300,RC,,both,405.61,365.05,United Healthcare,Default,Fee Schedule,330.98,,,,239.31,330.98
BLD TYPE-SERUM,86904,HCPCS,300,RC,,both,117.78,106,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,82.45,,,,69.49,96.11
BLD TYPE-SERUM,86904,HCPCS,300,RC,,both,117.78,106,Cigna,Default,Percent of Total Billed Charges,69.49,,,,69.49,96.11
BLD TYPE-SERUM,86904,HCPCS,300,RC,,both,117.78,106,United Healthcare,Default,Fee Schedule,96.11,,,,69.49,96.11
RBC MOLECULAR TYPE,0001U,HCPCS,300,RC,,both,737.47,663.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,516.23,,,,435.11,601.78
RBC MOLECULAR TYPE,0001U,HCPCS,300,RC,,both,737.47,663.72,Cigna,Default,Percent of Total Billed Charges,435.11,,,,435.11,601.78
RBC MOLECULAR TYPE,0001U,HCPCS,300,RC,,both,737.47,663.72,United Healthcare,Default,Fee Schedule,601.78,,,,435.11,601.78
FACTOR IX ASSAY,85250,HCPCS,300,RC,,both,146.33,131.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.43,,,,86.33,119.41
FACTOR IX ASSAY,85250,HCPCS,300,RC,,both,146.33,131.7,Cigna,Default,Percent of Total Billed Charges,86.33,,,,86.33,119.41
FACTOR IX ASSAY,85250,HCPCS,300,RC,,both,146.33,131.7,United Healthcare,Default,Fee Schedule,119.41,,,,86.33,119.41
FACTOR XI ASSAY,85270,HCPCS,300,RC,,both,149.99,134.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.99,,,,88.49,122.39
FACTOR XI ASSAY,85270,HCPCS,300,RC,,both,149.99,134.99,Cigna,Default,Percent of Total Billed Charges,88.49,,,,88.49,122.39
FACTOR XI ASSAY,85270,HCPCS,300,RC,,both,149.99,134.99,United Healthcare,Default,Fee Schedule,122.39,,,,88.49,122.39
FACTOR XII ASSAY,85280,HCPCS,300,RC,,both,150.28,135.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.2,,,,88.67,122.63
FACTOR XII ASSAY,85280,HCPCS,300,RC,,both,150.28,135.25,Cigna,Default,Percent of Total Billed Charges,88.67,,,,88.67,122.63
FACTOR XII ASSAY,85280,HCPCS,300,RC,,both,150.28,135.25,United Healthcare,Default,Fee Schedule,122.63,,,,88.67,122.63
FACTOR X ASSAY,85260,HCPCS,300,RC,,both,150.56,135.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.39,,,,88.83,122.86
FACTOR X ASSAY,85260,HCPCS,300,RC,,both,150.56,135.5,Cigna,Default,Percent of Total Billed Charges,88.83,,,,88.83,122.86
FACTOR X ASSAY,85260,HCPCS,300,RC,,both,150.56,135.5,United Healthcare,Default,Fee Schedule,122.86,,,,88.83,122.86
FACTOR XIII,85290,HCPCS,300,RC,,both,59.46,53.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.62,,,,35.08,48.52
FACTOR XIII,85290,HCPCS,300,RC,,both,59.46,53.51,Cigna,Default,Percent of Total Billed Charges,35.08,,,,35.08,48.52
FACTOR XIII,85290,HCPCS,300,RC,,both,59.46,53.51,United Healthcare,Default,Fee Schedule,48.52,,,,35.08,48.52
TISSUE IHC ERA/PRA,88360,HCPCS,310,RC,,both,764.69,688.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,535.28,,,,451.17,623.99
TISSUE IHC ERA/PRA,88360,HCPCS,310,RC,,both,764.69,688.22,Cigna,Default,Percent of Total Billed Charges,451.17,,,,451.17,623.99
TISSUE IHC ERA/PRA,88360,HCPCS,310,RC,,both,764.69,688.22,United Healthcare,Default,Fee Schedule,623.99,,,,451.17,623.99
BREAST RECEPTOR,88361,HCPCS,310,RC,,both,255.6,230.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,178.92,,,,150.8,208.57
BREAST RECEPTOR,88361,HCPCS,310,RC,,both,255.6,230.04,Cigna,Default,Percent of Total Billed Charges,150.8,,,,150.8,208.57
BREAST RECEPTOR,88361,HCPCS,310,RC,,both,255.6,230.04,United Healthcare,Default,Fee Schedule,208.57,,,,150.8,208.57
TISSUE INSITU HYBRID,88365,HCPCS,310,RC,,both,373.18,335.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.23,,,,220.18,304.51
TISSUE INSITU HYBRID,88365,HCPCS,310,RC,,both,373.18,335.86,Cigna,Default,Percent of Total Billed Charges,220.18,,,,220.18,304.51
TISSUE INSITU HYBRID,88365,HCPCS,310,RC,,both,373.18,335.86,United Healthcare,Default,Fee Schedule,304.51,,,,220.18,304.51
TISSUE INSITU HYBRID MAYO,88365,HCPCS,310,RC,,both,1432.86,1289.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1003,,,,845.39,1169.21
TISSUE INSITU HYBRID MAYO,88365,HCPCS,310,RC,,both,1432.86,1289.57,Cigna,Default,Percent of Total Billed Charges,845.39,,,,845.39,1169.21
TISSUE INSITU HYBRID MAYO,88365,HCPCS,310,RC,,both,1432.86,1289.57,United Healthcare,Default,Fee Schedule,1169.21,,,,845.39,1169.21
FRZ SECTION,88331,HCPCS,310,RC,,both,373.18,335.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.23,,,,220.18,304.51
FRZ SECTION,88331,HCPCS,310,RC,,both,373.18,335.86,Cigna,Default,Percent of Total Billed Charges,220.18,,,,220.18,304.51
FRZ SECTION,88331,HCPCS,310,RC,,both,373.18,335.86,United Healthcare,Default,Fee Schedule,304.51,,,,220.18,304.51
FROZEN SECTION (EA ADDN),88332,HCPCS,310,RC,,both,117.03,105.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.92,,,,69.05,95.5
FROZEN SECTION (EA ADDN),88332,HCPCS,310,RC,,both,117.03,105.33,Cigna,Default,Percent of Total Billed Charges,69.05,,,,69.05,95.5
FROZEN SECTION (EA ADDN),88332,HCPCS,310,RC,,both,117.03,105.33,United Healthcare,Default,Fee Schedule,95.5,,,,69.05,95.5
GROSS EXAM,88300,HCPCS,310,RC,,both,111.4,100.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.98,,,,65.73,90.9
GROSS EXAM,88300,HCPCS,310,RC,,both,111.4,100.26,Cigna,Default,Percent of Total Billed Charges,65.73,,,,65.73,90.9
GROSS EXAM,88300,HCPCS,310,RC,,both,111.4,100.26,United Healthcare,Default,Fee Schedule,90.9,,,,65.73,90.9
CYTOLOGY FINE NEEDLE ASPIRATE,88173,HCPCS,311,RC,,both,249.49,224.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.64,,,,147.2,203.58
CYTOLOGY FINE NEEDLE ASPIRATE,88173,HCPCS,311,RC,,both,249.49,224.54,Cigna,Default,Percent of Total Billed Charges,147.2,,,,147.2,203.58
CYTOLOGY FINE NEEDLE ASPIRATE,88173,HCPCS,311,RC,,both,249.49,224.54,United Healthcare,Default,Fee Schedule,203.58,,,,147.2,203.58
CONSULTATION MAYO CLINIC,88321,HCPCS,310,RC,,both,598.23,538.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,418.76,,,,352.96,488.16
CONSULTATION MAYO CLINIC,88321,HCPCS,310,RC,,both,598.23,538.41,Cigna,Default,Percent of Total Billed Charges,352.96,,,,352.96,488.16
CONSULTATION MAYO CLINIC,88321,HCPCS,310,RC,,both,598.23,538.41,United Healthcare,Default,Fee Schedule,488.16,,,,352.96,488.16
PATH CONSULT,88329,HCPCS,310,RC,,both,347.05,312.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.94,,,,204.76,283.19
PATH CONSULT,88329,HCPCS,310,RC,,both,347.05,312.35,Cigna,Default,Percent of Total Billed Charges,204.76,,,,204.76,283.19
PATH CONSULT,88329,HCPCS,310,RC,,both,347.05,312.35,United Healthcare,Default,Fee Schedule,283.19,,,,204.76,283.19
MAYO CONSULT SLIDEPREP,88323,HCPCS,310,RC,,both,598.23,538.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,418.76,,,,352.96,488.16
MAYO CONSULT SLIDEPREP,88323,HCPCS,310,RC,,both,598.23,538.41,Cigna,Default,Percent of Total Billed Charges,352.96,,,,352.96,488.16
MAYO CONSULT SLIDEPREP,88323,HCPCS,310,RC,,both,598.23,538.41,United Healthcare,Default,Fee Schedule,488.16,,,,352.96,488.16
MAYO COMP CONSULT,88325,HCPCS,310,RC,,both,598.23,538.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,418.76,,,,352.96,488.16
MAYO COMP CONSULT,88325,HCPCS,310,RC,,both,598.23,538.41,Cigna,Default,Percent of Total Billed Charges,352.96,,,,352.96,488.16
MAYO COMP CONSULT,88325,HCPCS,310,RC,,both,598.23,538.41,United Healthcare,Default,Fee Schedule,488.16,,,,352.96,488.16
ELECTRON MICROSCOPY,88348TC,HCPCS,312,RC,,both,647.5,582.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,453.25,,,,382.02,528.36
ELECTRON MICROSCOPY,88348TC,HCPCS,312,RC,,both,647.5,582.75,Cigna,Default,Percent of Total Billed Charges,382.02,,,,382.02,528.36
ELECTRON MICROSCOPY,88348TC,HCPCS,312,RC,,both,647.5,582.75,United Healthcare,Default,Fee Schedule,528.36,,,,382.02,528.36
STONE ANALYSIS (CHEMICAL),82360,HCPCS,300,RC,,both,71,63.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.7,,,,41.89,57.94
STONE ANALYSIS (CHEMICAL),82360,HCPCS,300,RC,,both,71,63.9,Cigna,Default,Percent of Total Billed Charges,41.89,,,,41.89,57.94
STONE ANALYSIS (CHEMICAL),82360,HCPCS,300,RC,,both,71,63.9,United Healthcare,Default,Fee Schedule,57.94,,,,41.89,57.94
STONE ANALYSIS ( INFRARED SPEC ),82365,HCPCS,300,RC,,both,112,100.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.4,,,,66.08,91.39
STONE ANALYSIS ( INFRARED SPEC ),82365,HCPCS,300,RC,,both,112,100.8,Cigna,Default,Percent of Total Billed Charges,66.08,,,,66.08,91.39
STONE ANALYSIS ( INFRARED SPEC ),82365,HCPCS,300,RC,,both,112,100.8,United Healthcare,Default,Fee Schedule,91.39,,,,66.08,91.39
DECALCIFICATION,88311,HCPCS,310,RC,,both,72.47,65.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.73,,,,42.76,59.14
DECALCIFICATION,88311,HCPCS,310,RC,,both,72.47,65.22,Cigna,Default,Percent of Total Billed Charges,42.76,,,,42.76,59.14
DECALCIFICATION,88311,HCPCS,310,RC,,both,72.47,65.22,United Healthcare,Default,Fee Schedule,59.14,,,,42.76,59.14
SPECIAL STAINS GRP I,88312,HCPCS,312,RC,,both,181.98,163.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.39,,,,107.37,148.5
SPECIAL STAINS GRP I,88312,HCPCS,312,RC,,both,181.98,163.78,Cigna,Default,Percent of Total Billed Charges,107.37,,,,107.37,148.5
SPECIAL STAINS GRP I,88312,HCPCS,312,RC,,both,181.98,163.78,United Healthcare,Default,Fee Schedule,148.5,,,,107.37,148.5
SPECIAL STAIN GROUP II (OTHER),88313,HCPCS,312,RC,,both,176.68,159.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,123.68,,,,104.24,144.17
SPECIAL STAIN GROUP II (OTHER),88313,HCPCS,312,RC,,both,176.68,159.01,Cigna,Default,Percent of Total Billed Charges,104.24,,,,104.24,144.17
SPECIAL STAIN GROUP II (OTHER),88313,HCPCS,312,RC,,both,176.68,159.01,United Healthcare,Default,Fee Schedule,144.17,,,,104.24,144.17
MAYO SPEC STN II,88313,HCPCS,312,RC,,both,307.56,276.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.29,,,,181.46,250.97
MAYO SPEC STN II,88313,HCPCS,312,RC,,both,307.56,276.8,Cigna,Default,Percent of Total Billed Charges,181.46,,,,181.46,250.97
MAYO SPEC STN II,88313,HCPCS,312,RC,,both,307.56,276.8,United Healthcare,Default,Fee Schedule,250.97,,,,181.46,250.97
FUNGAL STAIN,88312,HCPCS,310,RC,,both,181.98,163.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.39,,,,107.37,148.5
FUNGAL STAIN,88312,HCPCS,310,RC,,both,181.98,163.78,Cigna,Default,Percent of Total Billed Charges,107.37,,,,107.37,148.5
FUNGAL STAIN,88312,HCPCS,310,RC,,both,181.98,163.78,United Healthcare,Default,Fee Schedule,148.5,,,,107.37,148.5
IMMUNOCYTOCHEM FIRST AB,88342,HCPCS,312,RC,,both,146.06,131.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.24,,,,86.18,119.18
IMMUNOCYTOCHEM FIRST AB,88342,HCPCS,312,RC,,both,146.06,131.45,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.18
IMMUNOCYTOCHEM FIRST AB,88342,HCPCS,312,RC,,both,146.06,131.45,United Healthcare,Default,Fee Schedule,119.18,,,,86.18,119.18
IMMUNOCYTOCHEM FIRST G,88342,HCPCS,310,RC,,both,83.34,75.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.34,,,,49.17,68.01
IMMUNOCYTOCHEM FIRST G,88342,HCPCS,310,RC,,both,83.34,75.01,Cigna,Default,Percent of Total Billed Charges,49.17,,,,49.17,68.01
IMMUNOCYTOCHEM FIRST G,88342,HCPCS,310,RC,,both,83.34,75.01,United Healthcare,Default,Fee Schedule,68.01,,,,49.17,68.01
IMMUNOCYTOCHEM EACH ADD AB G,88344,HCPCS,310,RC,,both,83.34,75.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.34,,,,49.17,68.01
IMMUNOCYTOCHEM EACH ADD AB G,88344,HCPCS,310,RC,,both,83.34,75.01,Cigna,Default,Percent of Total Billed Charges,49.17,,,,49.17,68.01
IMMUNOCYTOCHEM EACH ADD AB G,88344,HCPCS,310,RC,,both,83.34,75.01,United Healthcare,Default,Fee Schedule,68.01,,,,49.17,68.01
IMMUNOCYTOCHEM EACH ADDITIONAL AB,88341,HCPCS,310,RC,,both,93.64,84.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.55,,,,55.25,76.41
IMMUNOCYTOCHEM EACH ADDITIONAL AB,88341,HCPCS,310,RC,,both,93.64,84.28,Cigna,Default,Percent of Total Billed Charges,55.25,,,,55.25,76.41
IMMUNOCYTOCHEM EACH ADDITIONAL AB,88341,HCPCS,310,RC,,both,93.64,84.28,United Healthcare,Default,Fee Schedule,76.41,,,,55.25,76.41
IMMUNO PER SPEC;MULIPLEX AB,88344,HCPCS,312,RC,,both,146.06,131.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.24,,,,86.18,119.18
IMMUNO PER SPEC;MULIPLEX AB,88344,HCPCS,312,RC,,both,146.06,131.45,Cigna,Default,Percent of Total Billed Charges,86.18,,,,86.18,119.18
IMMUNO PER SPEC;MULIPLEX AB,88344,HCPCS,312,RC,,both,146.06,131.45,United Healthcare,Default,Fee Schedule,119.18,,,,86.18,119.18
CYTOLOGY NONGYN,88108,HCPCS,310,RC,,both,146.47,131.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.53,,,,86.42,119.52
CYTOLOGY NONGYN,88108,HCPCS,310,RC,,both,146.47,131.82,Cigna,Default,Percent of Total Billed Charges,86.42,,,,86.42,119.52
CYTOLOGY NONGYN,88108,HCPCS,310,RC,,both,146.47,131.82,United Healthcare,Default,Fee Schedule,119.52,,,,86.42,119.52
CYTO NGYN SPUTUM,88161,HCPCS,310,RC,,both,112.33,101.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.63,,,,66.27,91.66
CYTO NGYN SPUTUM,88161,HCPCS,310,RC,,both,112.33,101.1,Cigna,Default,Percent of Total Billed Charges,66.27,,,,66.27,91.66
CYTO NGYN SPUTUM,88161,HCPCS,310,RC,,both,112.33,101.1,United Healthcare,Default,Fee Schedule,91.66,,,,66.27,91.66
CELLULAR ENHANCEMENT,88112,HCPCS,310,RC,,both,202.51,182.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.76,,,,119.48,165.25
CELLULAR ENHANCEMENT,88112,HCPCS,310,RC,,both,202.51,182.26,Cigna,Default,Percent of Total Billed Charges,119.48,,,,119.48,165.25
CELLULAR ENHANCEMENT,88112,HCPCS,310,RC,,both,202.51,182.26,United Healthcare,Default,Fee Schedule,165.25,,,,119.48,165.25
PAP AUTO REVIEW,88175,HCPCS,311,RC,,both,120.22,108.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.15,,,,70.93,98.1
PAP AUTO REVIEW,88175,HCPCS,311,RC,,both,120.22,108.2,Cigna,Default,Percent of Total Billed Charges,70.93,,,,70.93,98.1
PAP AUTO REVIEW,88175,HCPCS,311,RC,,both,120.22,108.2,United Healthcare,Default,Fee Schedule,98.1,,,,70.93,98.1
PAP SMEAR MANUAL,88143,HCPCS,311,RC,,both,97.25,87.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.08,,,,57.38,79.36
PAP SMEAR MANUAL,88143,HCPCS,311,RC,,both,97.25,87.53,Cigna,Default,Percent of Total Billed Charges,57.38,,,,57.38,79.36
PAP SMEAR MANUAL,88143,HCPCS,311,RC,,both,97.25,87.53,United Healthcare,Default,Fee Schedule,79.36,,,,57.38,79.36
PAP SMEAR ROUTINE,88142,HCPCS,311,RC,,both,109.26,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.16
PAP SMEAR ROUTINE,88142,HCPCS,311,RC,,both,109.26,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.16
PAP SMEAR ROUTINE,88142,HCPCS,311,RC,,both,109.26,98.33,United Healthcare,Default,Fee Schedule,89.16,,,,64.46,89.16
PAP PATH REVIEW,88141,HCPCS,311,RC,,both,29.77,26.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.84,,,,17.56,24.29
PAP PATH REVIEW,88141,HCPCS,311,RC,,both,29.77,26.79,Cigna,Default,Percent of Total Billed Charges,17.56,,,,17.56,24.29
PAP PATH REVIEW,88141,HCPCS,311,RC,,both,29.77,26.79,United Healthcare,Default,Fee Schedule,24.29,,,,17.56,24.29
PAP SMEAR LOW/HI,G0145,HCPCS,311,RC,,both,106.18,95.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.33,,,,62.65,86.64
PAP SMEAR LOW/HI,G0145,HCPCS,311,RC,,both,106.18,95.56,Cigna,Default,Percent of Total Billed Charges,62.65,,,,62.65,86.64
PAP SMEAR LOW/HI,G0145,HCPCS,311,RC,,both,106.18,95.56,United Healthcare,Default,Fee Schedule,86.64,,,,62.65,86.64
PAP AUTO VERIFY,88174,HCPCS,311,RC,,both,254.11,228.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,177.88,,,,149.92,207.35
PAP AUTO VERIFY,88174,HCPCS,311,RC,,both,254.11,228.7,Cigna,Default,Percent of Total Billed Charges,149.92,,,,149.92,207.35
PAP AUTO VERIFY,88174,HCPCS,311,RC,,both,254.11,228.7,United Healthcare,Default,Fee Schedule,207.35,,,,149.92,207.35
PAP SMEAR MANUAL SCREEN & RESCREEN,G0143,HCPCS,311,RC,,both,109.26,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.16
PAP SMEAR MANUAL SCREEN & RESCREEN,G0143,HCPCS,311,RC,,both,109.26,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.16
PAP SMEAR MANUAL SCREEN & RESCREEN,G0143,HCPCS,311,RC,,both,109.26,98.33,United Healthcare,Default,Fee Schedule,89.16,,,,64.46,89.16
PAP SMEAR LOW RISK FP R AND V,G0144,HCPCS,311,RC,,both,109.26,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.16
PAP SMEAR LOW RISK FP R AND V,G0144,HCPCS,311,RC,,both,109.26,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.16
PAP SMEAR LOW RISK FP R AND V,G0144,HCPCS,311,RC,,both,109.26,98.33,United Healthcare,Default,Fee Schedule,89.16,,,,64.46,89.16
PAP SMEAR THIN LAYER PHYSICIAN ITRP,G0124,HCPCS,311,RC,,both,109.26,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.16
PAP SMEAR THIN LAYER PHYSICIAN ITRP,G0124,HCPCS,311,RC,,both,109.26,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.16
PAP SMEAR THIN LAYER PHYSICIAN ITRP,G0124,HCPCS,311,RC,,both,109.26,98.33,United Healthcare,Default,Fee Schedule,89.16,,,,64.46,89.16
PAP SMEAR DIAGNOSITIC,88148,HCPCS,311,RC,,both,122.14,109.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.5,,,,72.06,99.67
PAP SMEAR DIAGNOSITIC,88148,HCPCS,311,RC,,both,122.14,109.93,Cigna,Default,Percent of Total Billed Charges,72.06,,,,72.06,99.67
PAP SMEAR DIAGNOSITIC,88148,HCPCS,311,RC,,both,122.14,109.93,United Healthcare,Default,Fee Schedule,99.67,,,,72.06,99.67
CRYPTOCOCCAL TITER,86406,HCPCS,300,RC,,both,65,58.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.5,,,,38.35,53.04
CRYPTOCOCCAL TITER,86406,HCPCS,300,RC,,both,65,58.5,Cigna,Default,Percent of Total Billed Charges,38.35,,,,38.35,53.04
CRYPTOCOCCAL TITER,86406,HCPCS,300,RC,,both,65,58.5,United Healthcare,Default,Fee Schedule,53.04,,,,38.35,53.04
TB QUANTIFERON,86480,HCPCS,300,RC,,both,200.82,180.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.57,,,,118.48,163.87
TB QUANTIFERON,86480,HCPCS,300,RC,,both,200.82,180.74,Cigna,Default,Percent of Total Billed Charges,118.48,,,,118.48,163.87
TB QUANTIFERON,86480,HCPCS,300,RC,,both,200.82,180.74,United Healthcare,Default,Fee Schedule,163.87,,,,118.48,163.87
STREPTOCOCCUS TITER,86406,HCPCS,300,RC,,both,65,58.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.5,,,,38.35,53.04
STREPTOCOCCUS TITER,86406,HCPCS,300,RC,,both,65,58.5,Cigna,Default,Percent of Total Billed Charges,38.35,,,,38.35,53.04
STREPTOCOCCUS TITER,86406,HCPCS,300,RC,,both,65,58.5,United Healthcare,Default,Fee Schedule,53.04,,,,38.35,53.04
BRAIN NATRIURETIC PEPTIDE,83880,HCPCS,301,RC,,both,246.65,221.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,172.66,,,,145.52,201.27
BRAIN NATRIURETIC PEPTIDE,83880,HCPCS,301,RC,,both,246.65,221.99,Cigna,Default,Percent of Total Billed Charges,145.52,,,,145.52,201.27
BRAIN NATRIURETIC PEPTIDE,83880,HCPCS,301,RC,,both,246.65,221.99,United Healthcare,Default,Fee Schedule,201.27,,,,145.52,201.27
CRYPTOCOCCAL AG-CSF,86403,HCPCS,300,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
CRYPTOCOCCAL AG-CSF,86403,HCPCS,300,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
CRYPTOCOCCAL AG-CSF,86403,HCPCS,300,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
CRYPTOCOCCAL AG-SERUM,86403,HCPCS,300,RC,,both,76.97,69.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.88,,,,45.41,62.81
CRYPTOCOCCAL AG-SERUM,86403,HCPCS,300,RC,,both,76.97,69.27,Cigna,Default,Percent of Total Billed Charges,45.41,,,,45.41,62.81
CRYPTOCOCCAL AG-SERUM,86403,HCPCS,300,RC,,both,76.97,69.27,United Healthcare,Default,Fee Schedule,62.81,,,,45.41,62.81
STREPTOCOCCUS SCREEN SERUM,86403,HCPCS,300,RC,,both,68.5,61.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.95,,,,40.42,55.9
STREPTOCOCCUS SCREEN SERUM,86403,HCPCS,300,RC,,both,68.5,61.65,Cigna,Default,Percent of Total Billed Charges,40.42,,,,40.42,55.9
STREPTOCOCCUS SCREEN SERUM,86403,HCPCS,300,RC,,both,68.5,61.65,United Healthcare,Default,Fee Schedule,55.9,,,,40.42,55.9
LEVEL 2 GROSS MICRO,88302,HCPCS,310,RC,,both,154.87,139.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.41,,,,91.37,126.37
LEVEL 2 GROSS MICRO,88302,HCPCS,310,RC,,both,154.87,139.38,Cigna,Default,Percent of Total Billed Charges,91.37,,,,91.37,126.37
LEVEL 2 GROSS MICRO,88302,HCPCS,310,RC,,both,154.87,139.38,United Healthcare,Default,Fee Schedule,126.37,,,,91.37,126.37
LEVEL 3 GROSS MICRO,88304,HCPCS,310,RC,,both,196.14,176.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.3,,,,115.72,160.05
LEVEL 3 GROSS MICRO,88304,HCPCS,310,RC,,both,196.14,176.53,Cigna,Default,Percent of Total Billed Charges,115.72,,,,115.72,160.05
LEVEL 3 GROSS MICRO,88304,HCPCS,310,RC,,both,196.14,176.53,United Healthcare,Default,Fee Schedule,160.05,,,,115.72,160.05
LEVEL 4 GROSS MICRO,88305,HCPCS,310,RC,,both,266.11,239.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.28,,,,157,217.15
LEVEL 4 GROSS MICRO,88305,HCPCS,310,RC,,both,266.11,239.5,Cigna,Default,Percent of Total Billed Charges,157,,,,157,217.15
LEVEL 4 GROSS MICRO,88305,HCPCS,310,RC,,both,266.11,239.5,United Healthcare,Default,Fee Schedule,217.15,,,,157,217.15
LEVEL 5 GROSS MICRO,88307,HCPCS,310,RC,,both,511.5,460.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,358.05,,,,301.78,417.38
LEVEL 5 GROSS MICRO,88307,HCPCS,310,RC,,both,511.5,460.35,Cigna,Default,Percent of Total Billed Charges,301.78,,,,301.78,417.38
LEVEL 5 GROSS MICRO,88307,HCPCS,310,RC,,both,511.5,460.35,United Healthcare,Default,Fee Schedule,417.38,,,,301.78,417.38
LEVEL 6 GROSS MICRO,88309,HCPCS,310,RC,,both,727.17,654.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,509.02,,,,429.03,593.37
LEVEL 6 GROSS MICRO,88309,HCPCS,310,RC,,both,727.17,654.45,Cigna,Default,Percent of Total Billed Charges,429.03,,,,429.03,593.37
LEVEL 6 GROSS MICRO,88309,HCPCS,310,RC,,both,727.17,654.45,United Healthcare,Default,Fee Schedule,593.37,,,,429.03,593.37
PATH CONSULT SURG CYTO,88333,HCPCS,310,RC,,both,2211,1989.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1547.7,,,,1304.49,1804.18
PATH CONSULT SURG CYTO,88333,HCPCS,310,RC,,both,2211,1989.9,Cigna,Default,Percent of Total Billed Charges,1304.49,,,,1304.49,1804.18
PATH CONSULT SURG CYTO,88333,HCPCS,310,RC,,both,2211,1989.9,United Healthcare,Default,Fee Schedule,1804.18,,,,1304.49,1804.18
SP LV1 GROSS,88300,HCPCS,310,RC,,both,73.75,66.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.62,,,,43.51,60.18
SP LV1 GROSS,88300,HCPCS,310,RC,,both,73.75,66.38,Cigna,Default,Percent of Total Billed Charges,43.51,,,,43.51,60.18
SP LV1 GROSS,88300,HCPCS,310,RC,,both,73.75,66.38,United Healthcare,Default,Fee Schedule,60.18,,,,43.51,60.18
TISSUE CX NEOPLASTIC,88239,HCPCS,310,RC,,both,2926.69,2634.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2048.68,,,,1726.75,2388.18
TISSUE CX NEOPLASTIC,88239,HCPCS,310,RC,,both,2926.69,2634.02,Cigna,Default,Percent of Total Billed Charges,1726.75,,,,1726.75,2388.18
TISSUE CX NEOPLASTIC,88239,HCPCS,310,RC,,both,2926.69,2634.02,United Healthcare,Default,Fee Schedule,2388.18,,,,1726.75,2388.18
"BONE MARROW, TISSUE CULTURE",88237,HCPCS,310,RC,,both,495.8,446.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,347.06,,,,292.52,404.57
"BONE MARROW, TISSUE CULTURE",88237,HCPCS,310,RC,,both,495.8,446.22,Cigna,Default,Percent of Total Billed Charges,292.52,,,,292.52,404.57
"BONE MARROW, TISSUE CULTURE",88237,HCPCS,310,RC,,both,495.8,446.22,United Healthcare,Default,Fee Schedule,404.57,,,,292.52,404.57
CYTOLOGY NGYN BRUSHING,88104,HCPCS,310,RC,,both,161.41,145.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.99,,,,95.23,131.71
CYTOLOGY NGYN BRUSHING,88104,HCPCS,310,RC,,both,161.41,145.27,Cigna,Default,Percent of Total Billed Charges,95.23,,,,95.23,131.71
CYTOLOGY NGYN BRUSHING,88104,HCPCS,310,RC,,both,161.41,145.27,United Healthcare,Default,Fee Schedule,131.71,,,,95.23,131.71
CYTOPATHOLOGY OTHER THAN GYN,88160,HCPCS,311,RC,,both,130.25,117.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.18,,,,76.85,106.28
CYTOPATHOLOGY OTHER THAN GYN,88160,HCPCS,311,RC,,both,130.25,117.23,Cigna,Default,Percent of Total Billed Charges,76.85,,,,76.85,106.28
CYTOPATHOLOGY OTHER THAN GYN,88160,HCPCS,311,RC,,both,130.25,117.23,United Healthcare,Default,Fee Schedule,106.28,,,,76.85,106.28
"BONE MARROW, MSMART",88237,HCPCS,310,RC,,both,6731.28,6058.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4711.9,,,,3971.46,5492.72
"BONE MARROW, MSMART",88237,HCPCS,310,RC,,both,6731.28,6058.15,Cigna,Default,Percent of Total Billed Charges,3971.46,,,,3971.46,5492.72
"BONE MARROW, MSMART",88237,HCPCS,310,RC,,both,6731.28,6058.15,United Healthcare,Default,Fee Schedule,5492.72,,,,3971.46,5492.72
FNA-BX IMM EVAL,88172,HCPCS,311,RC,,both,74.25,66.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.98,,,,43.81,60.59
FNA-BX IMM EVAL,88172,HCPCS,311,RC,,both,74.25,66.83,Cigna,Default,Percent of Total Billed Charges,43.81,,,,43.81,60.59
FNA-BX IMM EVAL,88172,HCPCS,311,RC,,both,74.25,66.83,United Healthcare,Default,Fee Schedule,60.59,,,,43.81,60.59
BODY FLUID CRYSTALS,89060,HCPCS,300,RC,,both,80.71,72.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.5,,,,47.62,65.86
BODY FLUID CRYSTALS,89060,HCPCS,300,RC,,both,80.71,72.64,Cigna,Default,Percent of Total Billed Charges,47.62,,,,47.62,65.86
BODY FLUID CRYSTALS,89060,HCPCS,300,RC,,both,80.71,72.64,United Healthcare,Default,Fee Schedule,65.86,,,,47.62,65.86
PLATELET AB  (INDIRECT),86022,HCPCS,300,RC,,both,351.66,316.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,246.16,,,,207.48,286.95
PLATELET AB  (INDIRECT),86022,HCPCS,300,RC,,both,351.66,316.49,Cigna,Default,Percent of Total Billed Charges,207.48,,,,207.48,286.95
PLATELET AB  (INDIRECT),86022,HCPCS,300,RC,,both,351.66,316.49,United Healthcare,Default,Fee Schedule,286.95,,,,207.48,286.95
PLSMA CELL 1ST MARKER BM,88182,HCPCS,311,RC,,both,373.18,335.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.23,,,,220.18,304.51
PLSMA CELL 1ST MARKER BM,88182,HCPCS,311,RC,,both,373.18,335.86,Cigna,Default,Percent of Total Billed Charges,220.18,,,,220.18,304.51
PLSMA CELL 1ST MARKER BM,88182,HCPCS,311,RC,,both,373.18,335.86,United Healthcare,Default,Fee Schedule,304.51,,,,220.18,304.51
FLOW CYTOMETRY FIRST MARKER,88184,HCPCS,311,RC,,both,218.12,196.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.68,,,,128.69,177.99
FLOW CYTOMETRY FIRST MARKER,88184,HCPCS,311,RC,,both,218.12,196.31,Cigna,Default,Percent of Total Billed Charges,128.69,,,,128.69,177.99
FLOW CYTOMETRY FIRST MARKER,88184,HCPCS,311,RC,,both,218.12,196.31,United Healthcare,Default,Fee Schedule,177.99,,,,128.69,177.99
FLOW CYTOMETRY EACH ADD MARKER,88185,HCPCS,311,RC,,both,73.86,66.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.7,,,,43.58,60.27
FLOW CYTOMETRY EACH ADD MARKER,88185,HCPCS,311,RC,,both,73.86,66.47,Cigna,Default,Percent of Total Billed Charges,43.58,,,,43.58,60.27
FLOW CYTOMETRY EACH ADD MARKER,88185,HCPCS,311,RC,,both,73.86,66.47,United Healthcare,Default,Fee Schedule,60.27,,,,43.58,60.27
"CD4 AND CD8, ABSOLUTE COUNT",86360,HCPCS,300,RC,,both,80.52,72.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.36,,,,47.51,65.7
"CD4 AND CD8, ABSOLUTE COUNT",86360,HCPCS,300,RC,,both,80.52,72.47,Cigna,Default,Percent of Total Billed Charges,47.51,,,,47.51,65.7
"CD4 AND CD8, ABSOLUTE COUNT",86360,HCPCS,300,RC,,both,80.52,72.47,United Healthcare,Default,Fee Schedule,65.7,,,,47.51,65.7
CD4 COUNT,86361,HCPCS,300,RC,,both,77.52,69.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.26,,,,45.74,63.26
CD4 COUNT,86361,HCPCS,300,RC,,both,77.52,69.77,Cigna,Default,Percent of Total Billed Charges,45.74,,,,45.74,63.26
CD4 COUNT,86361,HCPCS,300,RC,,both,77.52,69.77,United Healthcare,Default,Fee Schedule,63.26,,,,45.74,63.26
MONONUCLEAR CELL AG QUANT,86356,HCPCS,302,RC,,both,88.25,79.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.78,,,,52.07,72.01
MONONUCLEAR CELL AG QUANT,86356,HCPCS,302,RC,,both,88.25,79.43,Cigna,Default,Percent of Total Billed Charges,52.07,,,,52.07,72.01
MONONUCLEAR CELL AG QUANT,86356,HCPCS,302,RC,,both,88.25,79.43,United Healthcare,Default,Fee Schedule,72.01,,,,52.07,72.01
B CELLS TOTAL,86355,HCPCS,300,RC,,both,99.16,89.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.41,,,,58.5,80.91
B CELLS TOTAL,86355,HCPCS,300,RC,,both,99.16,89.24,Cigna,Default,Percent of Total Billed Charges,58.5,,,,58.5,80.91
B CELLS TOTAL,86355,HCPCS,300,RC,,both,99.16,89.24,United Healthcare,Default,Fee Schedule,80.91,,,,58.5,80.91
NATURAL KILLER CELLS,86357,HCPCS,300,RC,,both,99.16,89.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.41,,,,58.5,80.91
NATURAL KILLER CELLS,86357,HCPCS,300,RC,,both,99.16,89.24,Cigna,Default,Percent of Total Billed Charges,58.5,,,,58.5,80.91
NATURAL KILLER CELLS,86357,HCPCS,300,RC,,both,99.16,89.24,United Healthcare,Default,Fee Schedule,80.91,,,,58.5,80.91
T CELLS TOTAL,86359,HCPCS,300,RC,,both,99.16,89.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.41,,,,58.5,80.91
T CELLS TOTAL,86359,HCPCS,300,RC,,both,99.16,89.24,Cigna,Default,Percent of Total Billed Charges,58.5,,,,58.5,80.91
T CELLS TOTAL,86359,HCPCS,300,RC,,both,99.16,89.24,United Healthcare,Default,Fee Schedule,80.91,,,,58.5,80.91
NEUTROPHIL OXIDATIVE BURST,86352,HCPCS,300,RC,,both,305.6,275.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,213.92,,,,180.3,249.37
NEUTROPHIL OXIDATIVE BURST,86352,HCPCS,300,RC,,both,305.6,275.04,Cigna,Default,Percent of Total Billed Charges,180.3,,,,180.3,249.37
NEUTROPHIL OXIDATIVE BURST,86352,HCPCS,300,RC,,both,305.6,275.04,United Healthcare,Default,Fee Schedule,249.37,,,,180.3,249.37
CHRONIC URTICARIA INDEX,86352,HCPCS,302,RC,,both,277.89,250.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,194.52,,,,163.96,226.76
CHRONIC URTICARIA INDEX,86352,HCPCS,302,RC,,both,277.89,250.1,Cigna,Default,Percent of Total Billed Charges,163.96,,,,163.96,226.76
CHRONIC URTICARIA INDEX,86352,HCPCS,302,RC,,both,277.89,250.1,United Healthcare,Default,Fee Schedule,226.76,,,,163.96,226.76
ADALIMUMAB ACTIVITY,80299,HCPCS,300,RC,,both,892.41,803.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,624.69,,,,526.52,728.21
ADALIMUMAB ACTIVITY,80299,HCPCS,300,RC,,both,892.41,803.17,Cigna,Default,Percent of Total Billed Charges,526.52,,,,526.52,728.21
ADALIMUMAB ACTIVITY,80299,HCPCS,300,RC,,both,892.41,803.17,United Healthcare,Default,Fee Schedule,728.21,,,,526.52,728.21
ADALIMUMAB ANTIBODY,82397,HCPCS,300,RC,,both,695.82,626.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,487.07,,,,410.53,567.79
ADALIMUMAB ANTIBODY,82397,HCPCS,300,RC,,both,695.82,626.24,Cigna,Default,Percent of Total Billed Charges,410.53,,,,410.53,567.79
ADALIMUMAB ANTIBODY,82397,HCPCS,300,RC,,both,695.82,626.24,United Healthcare,Default,Fee Schedule,567.79,,,,410.53,567.79
FLOWCYTO INT 2-8 MARK,88187,HCPCS,311,RC,,both,99.11,89.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.38,,,,58.47,80.87
FLOWCYTO INT 2-8 MARK,88187,HCPCS,311,RC,,both,99.11,89.2,Cigna,Default,Percent of Total Billed Charges,58.47,,,,58.47,80.87
FLOWCYTO INT 2-8 MARK,88187,HCPCS,311,RC,,both,99.11,89.2,United Healthcare,Default,Fee Schedule,80.87,,,,58.47,80.87
FLOWCYTO CELL CYCLE DNA,88182,HCPCS,311,RC,,both,131.68,118.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.18,,,,77.69,107.45
FLOWCYTO CELL CYCLE DNA,88182,HCPCS,311,RC,,both,131.68,118.51,Cigna,Default,Percent of Total Billed Charges,77.69,,,,77.69,107.45
FLOWCYTO CELL CYCLE DNA,88182,HCPCS,311,RC,,both,131.68,118.51,United Healthcare,Default,Fee Schedule,107.45,,,,77.69,107.45
PLSMA CELL 1ST SURF MARK BM,88184,HCPCS,311,RC,,both,764.69,688.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,535.28,,,,451.17,623.99
PLSMA CELL 1ST SURF MARK BM,88184,HCPCS,311,RC,,both,764.69,688.22,Cigna,Default,Percent of Total Billed Charges,451.17,,,,451.17,623.99
PLSMA CELL 1ST SURF MARK BM,88184,HCPCS,311,RC,,both,764.69,688.22,United Healthcare,Default,Fee Schedule,623.99,,,,451.17,623.99
LYMPHOCYTE TRANSFORMATION,86353,HCPCS,302,RC,,both,87,78.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.9,,,,51.33,70.99
LYMPHOCYTE TRANSFORMATION,86353,HCPCS,302,RC,,both,87,78.3,Cigna,Default,Percent of Total Billed Charges,51.33,,,,51.33,70.99
LYMPHOCYTE TRANSFORMATION,86353,HCPCS,302,RC,,both,87,78.3,United Healthcare,Default,Fee Schedule,70.99,,,,51.33,70.99
ISLET AG 2 AB,86341,HCPCS,302,RC,,both,793.11,713.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,555.18,,,,467.93,647.18
ISLET AG 2 AB,86341,HCPCS,302,RC,,both,793.11,713.8,Cigna,Default,Percent of Total Billed Charges,467.93,,,,467.93,647.18
ISLET AG 2 AB,86341,HCPCS,302,RC,,both,793.11,713.8,United Healthcare,Default,Fee Schedule,647.18,,,,467.93,647.18
GAD ANTIBODY,86341,HCPCS,302,RC,,both,93.37,84.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.36,,,,55.09,76.19
GAD ANTIBODY,86341,HCPCS,302,RC,,both,93.37,84.03,Cigna,Default,Percent of Total Billed Charges,55.09,,,,55.09,76.19
GAD ANTIBODY,86341,HCPCS,302,RC,,both,93.37,84.03,United Healthcare,Default,Fee Schedule,76.19,,,,55.09,76.19
CHROMOGRANIN A,86316,HCPCS,302,RC,,both,182.85,164.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128,,,,107.88,149.21
CHROMOGRANIN A,86316,HCPCS,302,RC,,both,182.85,164.57,Cigna,Default,Percent of Total Billed Charges,107.88,,,,107.88,149.21
CHROMOGRANIN A,86316,HCPCS,302,RC,,both,182.85,164.57,United Healthcare,Default,Fee Schedule,149.21,,,,107.88,149.21
DES GAMMA CARBOXY PROTHROMBIN,83951,HCPCS,301,RC,,both,254.43,228.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,178.1,,,,150.11,207.61
DES GAMMA CARBOXY PROTHROMBIN,83951,HCPCS,301,RC,,both,254.43,228.99,Cigna,Default,Percent of Total Billed Charges,150.11,,,,150.11,207.61
DES GAMMA CARBOXY PROTHROMBIN,83951,HCPCS,301,RC,,both,254.43,228.99,United Healthcare,Default,Fee Schedule,207.61,,,,150.11,207.61
ID MALDI-TOF MASS SPEC AFB,87118,HCPCS,300,RC,,both,322.13,289.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.49,,,,190.06,262.86
ID MALDI-TOF MASS SPEC AFB,87118,HCPCS,300,RC,,both,322.13,289.92,Cigna,Default,Percent of Total Billed Charges,190.06,,,,190.06,262.86
ID MALDI-TOF MASS SPEC AFB,87118,HCPCS,300,RC,,both,322.13,289.92,United Healthcare,Default,Fee Schedule,262.86,,,,190.06,262.86
PTH RELATED PEPTIDE,82397,HCPCS,301,RC,,both,105.52,94.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.86,,,,62.26,86.1
PTH RELATED PEPTIDE,82397,HCPCS,301,RC,,both,105.52,94.97,Cigna,Default,Percent of Total Billed Charges,62.26,,,,62.26,86.1
PTH RELATED PEPTIDE,82397,HCPCS,301,RC,,both,105.52,94.97,United Healthcare,Default,Fee Schedule,86.1,,,,62.26,86.1
FIBROTEST-ACTITEST,81596,HCPCS,300,RC,,both,503.87,453.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,352.71,,,,297.28,411.16
FIBROTEST-ACTITEST,81596,HCPCS,300,RC,,both,503.87,453.48,Cigna,Default,Percent of Total Billed Charges,297.28,,,,297.28,411.16
FIBROTEST-ACTITEST,81596,HCPCS,300,RC,,both,503.87,453.48,United Healthcare,Default,Fee Schedule,411.16,,,,297.28,411.16
"Carbamazepine-10,11-Epoxide",80161,HCPCS,300,RC,,both,59.53,53.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.67,,,,35.12,48.58
"Carbamazepine-10,11-Epoxide",80161,HCPCS,300,RC,,both,59.53,53.58,Cigna,Default,Percent of Total Billed Charges,35.12,,,,35.12,48.58
"Carbamazepine-10,11-Epoxide",80161,HCPCS,300,RC,,both,59.53,53.58,United Healthcare,Default,Fee Schedule,48.58,,,,35.12,48.58
"DIHYDROTESTOSTERONE, SERUM",82642,HCPCS,300,RC,,both,110.75,99.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.52,,,,65.34,90.37
"DIHYDROTESTOSTERONE, SERUM",82642,HCPCS,300,RC,,both,110.75,99.68,Cigna,Default,Percent of Total Billed Charges,65.34,,,,65.34,90.37
"DIHYDROTESTOSTERONE, SERUM",82642,HCPCS,300,RC,,both,110.75,99.68,United Healthcare,Default,Fee Schedule,90.37,,,,65.34,90.37
SARS-CoV-2 PCR,87635,HCPCS,300,RC,,both,184.66,166.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.26,,,,108.95,150.68
SARS-CoV-2 PCR,87635,HCPCS,300,RC,,both,184.66,166.19,Cigna,Default,Percent of Total Billed Charges,108.95,,,,108.95,150.68
SARS-CoV-2 PCR,87635,HCPCS,300,RC,,both,184.66,166.19,United Healthcare,Default,Fee Schedule,150.68,,,,108.95,150.68
ZINC TRANSPORTER 8 ANTIBODY,86341,HCPCS,300,RC,,both,524.13,471.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,366.89,,,,309.24,427.69
ZINC TRANSPORTER 8 ANTIBODY,86341,HCPCS,300,RC,,both,524.13,471.72,Cigna,Default,Percent of Total Billed Charges,309.24,,,,309.24,427.69
ZINC TRANSPORTER 8 ANTIBODY,86341,HCPCS,300,RC,,both,524.13,471.72,United Healthcare,Default,Fee Schedule,427.69,,,,309.24,427.69
SARS COV-2 IGG,86769,HCPCS,300,RC,,both,70.89,63.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.62,,,,41.83,57.85
SARS COV-2 IGG,86769,HCPCS,300,RC,,both,70.89,63.8,Cigna,Default,Percent of Total Billed Charges,41.83,,,,41.83,57.85
SARS COV-2 IGG,86769,HCPCS,300,RC,,both,70.89,63.8,United Healthcare,Default,Fee Schedule,57.85,,,,41.83,57.85
SARS-CoV-2 PCR (HMC),87635,HCPCS,300,RC,,both,233.66,210.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.56,,,,137.86,190.67
SARS-CoV-2 PCR (HMC),87635,HCPCS,300,RC,,both,233.66,210.29,Cigna,Default,Percent of Total Billed Charges,137.86,,,,137.86,190.67
SARS-CoV-2 PCR (HMC),87635,HCPCS,300,RC,,both,233.66,210.29,United Healthcare,Default,Fee Schedule,190.67,,,,137.86,190.67
MRSA SCREEN MOLECULAR,87641,HCPCS,300,RC,,both,163.59,147.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.51,,,,96.52,133.49
MRSA SCREEN MOLECULAR,87641,HCPCS,300,RC,,both,163.59,147.23,Cigna,Default,Percent of Total Billed Charges,96.52,,,,96.52,133.49
MRSA SCREEN MOLECULAR,87641,HCPCS,300,RC,,both,163.59,147.23,United Healthcare,Default,Fee Schedule,133.49,,,,96.52,133.49
SARS RAPID ANTIGEN,87426,HCPCS,300,RC,,both,138.56,124.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.99,,,,81.75,113.06
SARS RAPID ANTIGEN,87426,HCPCS,300,RC,,both,138.56,124.7,Cigna,Default,Percent of Total Billed Charges,81.75,,,,81.75,113.06
SARS RAPID ANTIGEN,87426,HCPCS,300,RC,,both,138.56,124.7,United Healthcare,Default,Fee Schedule,113.06,,,,81.75,113.06
RESP 4PLEX PANEL,0241U,HCPCS,300,RC,,both,293.24,263.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,205.27,,,,173.01,239.28
RESP 4PLEX PANEL,0241U,HCPCS,300,RC,,both,293.24,263.92,Cigna,Default,Percent of Total Billed Charges,173.01,,,,173.01,239.28
RESP 4PLEX PANEL,0241U,HCPCS,300,RC,,both,293.24,263.92,United Healthcare,Default,Fee Schedule,239.28,,,,173.01,239.28
CYTOGEN/MOLECULAR INTERP/REPORT,88291,HCPCS,319,RC,,both,105.99,95.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.19,,,,62.53,86.49
CYTOGEN/MOLECULAR INTERP/REPORT,88291,HCPCS,319,RC,,both,105.99,95.39,Cigna,Default,Percent of Total Billed Charges,62.53,,,,62.53,86.49
CYTOGEN/MOLECULAR INTERP/REPORT,88291,HCPCS,319,RC,,both,105.99,95.39,United Healthcare,Default,Fee Schedule,86.49,,,,62.53,86.49
PRE OP Staph PCR,87640,HCPCS,300,RC,,both,322.77,290.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.94,,,,190.43,263.38
PRE OP Staph PCR,87640,HCPCS,300,RC,,both,322.77,290.49,Cigna,Default,Percent of Total Billed Charges,190.43,,,,190.43,263.38
PRE OP Staph PCR,87640,HCPCS,300,RC,,both,322.77,290.49,United Healthcare,Default,Fee Schedule,263.38,,,,190.43,263.38
M PROTEIN MALDI,0077U,HCPCS,300,RC,,both,845.91,761.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,592.14,,,,499.09,690.26
M PROTEIN MALDI,0077U,HCPCS,300,RC,,both,845.91,761.32,Cigna,Default,Percent of Total Billed Charges,499.09,,,,499.09,690.26
M PROTEIN MALDI,0077U,HCPCS,300,RC,,both,845.91,761.32,United Healthcare,Default,Fee Schedule,690.26,,,,499.09,690.26
LAMBDA FREE LIGHT CHAINS,83520,HCPCS,300,RC,,both,672.83,605.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,470.98,,,,396.97,549.03
LAMBDA FREE LIGHT CHAINS,83520,HCPCS,300,RC,,both,672.83,605.55,Cigna,Default,Percent of Total Billed Charges,396.97,,,,396.97,549.03
LAMBDA FREE LIGHT CHAINS,83520,HCPCS,300,RC,,both,672.83,605.55,United Healthcare,Default,Fee Schedule,549.03,,,,396.97,549.03
KAPPA FREE LIGHT CHAINS,83520,HCPCS,300,RC,,both,672.83,605.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,470.98,,,,396.97,549.03
KAPPA FREE LIGHT CHAINS,83520,HCPCS,300,RC,,both,672.83,605.55,Cigna,Default,Percent of Total Billed Charges,396.97,,,,396.97,549.03
KAPPA FREE LIGHT CHAINS,83520,HCPCS,300,RC,,both,672.83,605.55,United Healthcare,Default,Fee Schedule,549.03,,,,396.97,549.03
BM ASP INTERP,85097,HCPCS,310,RC,,both,867.35,780.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,607.14,,,,511.74,707.76
BM ASP INTERP,85097,HCPCS,310,RC,,both,867.35,780.62,Cigna,Default,Percent of Total Billed Charges,511.74,,,,511.74,707.76
BM ASP INTERP,85097,HCPCS,310,RC,,both,867.35,780.62,United Healthcare,Default,Fee Schedule,707.76,,,,511.74,707.76
HOMOCYSTINE URINE,82131,HCPCS,300,RC,,both,161.23,145.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.86,,,,95.13,131.56
HOMOCYSTINE URINE,82131,HCPCS,300,RC,,both,161.23,145.11,Cigna,Default,Percent of Total Billed Charges,95.13,,,,95.13,131.56
HOMOCYSTINE URINE,82131,HCPCS,300,RC,,both,161.23,145.11,United Healthcare,Default,Fee Schedule,131.56,,,,95.13,131.56
PHOSPHOETHANOLAMINE URINE,82131,HCPCS,300,RC,,both,640.75,576.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,448.52,,,,378.04,522.85
PHOSPHOETHANOLAMINE URINE,82131,HCPCS,300,RC,,both,640.75,576.68,Cigna,Default,Percent of Total Billed Charges,378.04,,,,378.04,522.85
PHOSPHOETHANOLAMINE URINE,82131,HCPCS,300,RC,,both,640.75,576.68,United Healthcare,Default,Fee Schedule,522.85,,,,378.04,522.85
CYSTINE URINE,82136,HCPCS,301,RC,,both,244.57,220.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,171.2,,,,144.3,199.57
CYSTINE URINE,82136,HCPCS,301,RC,,both,244.57,220.11,Cigna,Default,Percent of Total Billed Charges,144.3,,,,144.3,199.57
CYSTINE URINE,82136,HCPCS,301,RC,,both,244.57,220.11,United Healthcare,Default,Fee Schedule,199.57,,,,144.3,199.57
NUCLEAR ANTIGEN ANTIBODY,86235,HCPCS,302,RC,,both,93.51,84.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.46,,,,55.17,76.3
NUCLEAR ANTIGEN ANTIBODY,86235,HCPCS,302,RC,,both,93.51,84.16,Cigna,Default,Percent of Total Billed Charges,55.17,,,,55.17,76.3
NUCLEAR ANTIGEN ANTIBODY,86235,HCPCS,302,RC,,both,93.51,84.16,United Healthcare,Default,Fee Schedule,76.3,,,,55.17,76.3
"IGF-1, LC/MS, S",84305,HCPCS,300,RC,,both,54.46,49.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.12,,,,32.13,44.44
"IGF-1, LC/MS, S",84305,HCPCS,300,RC,,both,54.46,49.01,Cigna,Default,Percent of Total Billed Charges,32.13,,,,32.13,44.44
"IGF-1, LC/MS, S",84305,HCPCS,300,RC,,both,54.46,49.01,United Healthcare,Default,Fee Schedule,44.44,,,,32.13,44.44
INTERPHASE INSITU HYBRIDIZATION,88274,HCPCS,311,RC,,both,109.54,98.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.68,,,,64.63,89.38
INTERPHASE INSITU HYBRIDIZATION,88274,HCPCS,311,RC,,both,109.54,98.59,Cigna,Default,Percent of Total Billed Charges,64.63,,,,64.63,89.38
INTERPHASE INSITU HYBRIDIZATION,88274,HCPCS,311,RC,,both,109.54,98.59,United Healthcare,Default,Fee Schedule,89.38,,,,64.63,89.38
IN SITU HYBRID 100 TO 300 CELLS,88275,HCPCS,311,RC,,both,185.09,166.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,129.56,,,,109.2,151.03
IN SITU HYBRID 100 TO 300 CELLS,88275,HCPCS,311,RC,,both,185.09,166.58,Cigna,Default,Percent of Total Billed Charges,109.2,,,,109.2,151.03
IN SITU HYBRID 100 TO 300 CELLS,88275,HCPCS,311,RC,,both,185.09,166.58,United Healthcare,Default,Fee Schedule,151.03,,,,109.2,151.03
ANTI-GBM PANEL (GBM IGA),86255,HCPCS,300,RC,,both,177.5,159.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.25,,,,104.72,144.84
ANTI-GBM PANEL (GBM IGA),86255,HCPCS,300,RC,,both,177.5,159.75,Cigna,Default,Percent of Total Billed Charges,104.72,,,,104.72,144.84
ANTI-GBM PANEL (GBM IGA),86255,HCPCS,300,RC,,both,177.5,159.75,United Healthcare,Default,Fee Schedule,144.84,,,,104.72,144.84
MYCOPLASMA PN IgM,86738,HCPCS,300,RC,,both,71.63,64.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.14,,,,42.26,58.45
MYCOPLASMA PN IgM,86738,HCPCS,300,RC,,both,71.63,64.47,Cigna,Default,Percent of Total Billed Charges,42.26,,,,42.26,58.45
MYCOPLASMA PN IgM,86738,HCPCS,300,RC,,both,71.63,64.47,United Healthcare,Default,Fee Schedule,58.45,,,,42.26,58.45
EBV ABS-EBNA,86664,HCPCS,300,RC,,both,58.99,53.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.29,,,,34.8,48.14
EBV ABS-EBNA,86664,HCPCS,300,RC,,both,58.99,53.09,Cigna,Default,Percent of Total Billed Charges,34.8,,,,34.8,48.14
EBV ABS-EBNA,86664,HCPCS,300,RC,,both,58.99,53.09,United Healthcare,Default,Fee Schedule,48.14,,,,34.8,48.14
HANTA VIRUS IgM,86790,HCPCS,300,RC,,both,92,82.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.4,,,,54.28,75.07
HANTA VIRUS IgM,86790,HCPCS,300,RC,,both,92,82.8,Cigna,Default,Percent of Total Billed Charges,54.28,,,,54.28,75.07
HANTA VIRUS IgM,86790,HCPCS,300,RC,,both,92,82.8,United Healthcare,Default,Fee Schedule,75.07,,,,54.28,75.07
WEST NILE VIRUS IGM,86788,HCPCS,300,RC,,both,194.09,174.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,135.86,,,,114.51,158.38
WEST NILE VIRUS IGM,86788,HCPCS,300,RC,,both,194.09,174.68,Cigna,Default,Percent of Total Billed Charges,114.51,,,,114.51,158.38
WEST NILE VIRUS IGM,86788,HCPCS,300,RC,,both,194.09,174.68,United Healthcare,Default,Fee Schedule,158.38,,,,114.51,158.38
ALK PHOS ISOS (TOTAL),84075,HCPCS,301,RC,,both,48.31,43.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.82,,,,28.5,39.42
ALK PHOS ISOS (TOTAL),84075,HCPCS,301,RC,,both,48.31,43.48,Cigna,Default,Percent of Total Billed Charges,28.5,,,,28.5,39.42
ALK PHOS ISOS (TOTAL),84075,HCPCS,301,RC,,both,48.31,43.48,United Healthcare,Default,Fee Schedule,39.42,,,,28.5,39.42
ARBOVIRUS PANEL Eastern Equine,86652,HCPCS,300,RC,,both,49.75,44.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.82,,,,29.35,40.6
ARBOVIRUS PANEL Eastern Equine,86652,HCPCS,300,RC,,both,49.75,44.78,Cigna,Default,Percent of Total Billed Charges,29.35,,,,29.35,40.6
ARBOVIRUS PANEL Eastern Equine,86652,HCPCS,300,RC,,both,49.75,44.78,United Healthcare,Default,Fee Schedule,40.6,,,,29.35,40.6
HERPES SIMPLX IGM TYPE II,86696,HCPCS,300,RC,,both,48.5,43.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.95,,,,28.62,39.58
HERPES SIMPLX IGM TYPE II,86696,HCPCS,300,RC,,both,48.5,43.65,Cigna,Default,Percent of Total Billed Charges,28.62,,,,28.62,39.58
HERPES SIMPLX IGM TYPE II,86696,HCPCS,300,RC,,both,48.5,43.65,United Healthcare,Default,Fee Schedule,39.58,,,,28.62,39.58
HERPES SIMPLEX IgG TYPE II,86696,HCPCS,300,RC,,both,68.81,61.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.17,,,,40.6,56.15
HERPES SIMPLEX IgG TYPE II,86696,HCPCS,300,RC,,both,68.81,61.93,Cigna,Default,Percent of Total Billed Charges,40.6,,,,40.6,56.15
HERPES SIMPLEX IgG TYPE II,86696,HCPCS,300,RC,,both,68.81,61.93,United Healthcare,Default,Fee Schedule,56.15,,,,40.6,56.15
FROZ EST RECEPTOR,84233,HCPCS,300,RC,,both,258.42,232.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,180.89,,,,152.47,210.87
FROZ EST RECEPTOR,84233,HCPCS,300,RC,,both,258.42,232.58,Cigna,Default,Percent of Total Billed Charges,152.47,,,,152.47,210.87
FROZ EST RECEPTOR,84233,HCPCS,300,RC,,both,258.42,232.58,United Healthcare,Default,Fee Schedule,210.87,,,,152.47,210.87
COXSACKIE A VIRUS AB A9,86658,HCPCS,300,RC,,both,45,40.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.5,,,,26.55,36.72
COXSACKIE A VIRUS AB A9,86658,HCPCS,300,RC,,both,45,40.5,Cigna,Default,Percent of Total Billed Charges,26.55,,,,26.55,36.72
COXSACKIE A VIRUS AB A9,86658,HCPCS,300,RC,,both,45,40.5,United Healthcare,Default,Fee Schedule,36.72,,,,26.55,36.72
COXSACKIE B VIRUS AB B2,86658,HCPCS,300,RC,,both,43.25,38.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.28,,,,25.52,35.29
COXSACKIE B VIRUS AB B2,86658,HCPCS,300,RC,,both,43.25,38.93,Cigna,Default,Percent of Total Billed Charges,25.52,,,,25.52,35.29
COXSACKIE B VIRUS AB B2,86658,HCPCS,300,RC,,both,43.25,38.93,United Healthcare,Default,Fee Schedule,35.29,,,,25.52,35.29
INFLUENZA A AB IgM,86710,HCPCS,300,RC,,both,121.06,108.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.74,,,,71.43,98.78
INFLUENZA A AB IgM,86710,HCPCS,300,RC,,both,121.06,108.95,Cigna,Default,Percent of Total Billed Charges,71.43,,,,71.43,98.78
INFLUENZA A AB IgM,86710,HCPCS,300,RC,,both,121.06,108.95,United Healthcare,Default,Fee Schedule,98.78,,,,71.43,98.78
FREE INSULIN,83527,HCPCS,301,RC,,both,54.49,49.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.14,,,,32.15,44.46
FREE INSULIN,83527,HCPCS,301,RC,,both,54.49,49.04,Cigna,Default,Percent of Total Billed Charges,32.15,,,,32.15,44.46
FREE INSULIN,83527,HCPCS,301,RC,,both,54.49,49.04,United Healthcare,Default,Fee Schedule,44.46,,,,32.15,44.46
TOXOPLASMOSIS ABS IgM,86778,HCPCS,300,RC,,both,74.46,67.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.12,,,,43.93,60.76
TOXOPLASMOSIS ABS IgM,86778,HCPCS,300,RC,,both,74.46,67.01,Cigna,Default,Percent of Total Billed Charges,43.93,,,,43.93,60.76
TOXOPLASMOSIS ABS IgM,86778,HCPCS,300,RC,,both,74.46,67.01,United Healthcare,Default,Fee Schedule,60.76,,,,43.93,60.76
B2 GLYCOPROTEIN 1 AB IGA,86146,HCPCS,302,RC,,both,25.45,22.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.82,,,,15.02,20.77
B2 GLYCOPROTEIN 1 AB IGA,86146,HCPCS,302,RC,,both,25.45,22.91,Cigna,Default,Percent of Total Billed Charges,15.02,,,,15.02,20.77
B2 GLYCOPROTEIN 1 AB IGA,86146,HCPCS,302,RC,,both,25.45,22.91,United Healthcare,Default,Fee Schedule,20.77,,,,15.02,20.77
CARDIOLIPIN AB-IgM,86147,HCPCS,300,RC,,both,109.54,98.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.68,,,,64.63,89.38
CARDIOLIPIN AB-IgM,86147,HCPCS,300,RC,,both,109.54,98.59,Cigna,Default,Percent of Total Billed Charges,64.63,,,,64.63,89.38
CARDIOLIPIN AB-IgM,86147,HCPCS,300,RC,,both,109.54,98.59,United Healthcare,Default,Fee Schedule,89.38,,,,64.63,89.38
PHOSPHATIDYLSERINE AB IGM,86148,HCPCS,300,RC,,both,81.75,73.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.22,,,,48.23,66.71
PHOSPHATIDYLSERINE AB IGM,86148,HCPCS,300,RC,,both,81.75,73.58,Cigna,Default,Percent of Total Billed Charges,48.23,,,,48.23,66.71
PHOSPHATIDYLSERINE AB IGM,86148,HCPCS,300,RC,,both,81.75,73.58,United Healthcare,Default,Fee Schedule,66.71,,,,48.23,66.71
FACT VIII (RISTCTN),85245,HCPCS,300,RC,,both,124.43,111.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.1,,,,73.41,101.53
FACT VIII (RISTCTN),85245,HCPCS,300,RC,,both,124.43,111.99,Cigna,Default,Percent of Total Billed Charges,73.41,,,,73.41,101.53
FACT VIII (RISTCTN),85245,HCPCS,300,RC,,both,124.43,111.99,United Healthcare,Default,Fee Schedule,101.53,,,,73.41,101.53
INFLVENZA B ANTIBODY IGM,86710,HCPCS,300,RC,,both,121.06,108.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.74,,,,71.43,98.78
INFLVENZA B ANTIBODY IGM,86710,HCPCS,300,RC,,both,121.06,108.95,Cigna,Default,Percent of Total Billed Charges,71.43,,,,71.43,98.78
INFLVENZA B ANTIBODY IGM,86710,HCPCS,300,RC,,both,121.06,108.95,United Healthcare,Default,Fee Schedule,98.78,,,,71.43,98.78
PSA - DIAGNOSTIC,84153,HCPCS,301,RC,,both,145.5,130.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.85,,,,85.84,118.73
PSA - DIAGNOSTIC,84153,HCPCS,301,RC,,both,145.5,130.95,Cigna,Default,Percent of Total Billed Charges,85.84,,,,85.84,118.73
PSA - DIAGNOSTIC,84153,HCPCS,301,RC,,both,145.5,130.95,United Healthcare,Default,Fee Schedule,118.73,,,,85.84,118.73
PSA - REFERRED,84153,HCPCS,301,RC,,both,145.5,130.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.85,,,,85.84,118.73
PSA - REFERRED,84153,HCPCS,301,RC,,both,145.5,130.95,Cigna,Default,Percent of Total Billed Charges,85.84,,,,85.84,118.73
PSA - REFERRED,84153,HCPCS,301,RC,,both,145.5,130.95,United Healthcare,Default,Fee Schedule,118.73,,,,85.84,118.73
UNSCHED DIALYSIS ESRD PT HOS,G0257,HCPCS,301,RC,,both,0.01,0.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
UNSCHED DIALYSIS ESRD PT HOS,G0257,HCPCS,301,RC,,both,0.01,0.01,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
UNSCHED DIALYSIS ESRD PT HOS,G0257,HCPCS,301,RC,,both,0.01,0.01,United Healthcare,Default,Fee Schedule,0.01,,,,0.01,0.01
CHLAMYDIA AB PANEL-IGM(C. PNEUMONIA),86632,HCPCS,300,RC,,both,51,45.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.7,,,,30.09,41.62
CHLAMYDIA AB PANEL-IGM(C. PNEUMONIA),86632,HCPCS,300,RC,,both,51,45.9,Cigna,Default,Percent of Total Billed Charges,30.09,,,,30.09,41.62
CHLAMYDIA AB PANEL-IGM(C. PNEUMONIA),86632,HCPCS,300,RC,,both,51,45.9,United Healthcare,Default,Fee Schedule,41.62,,,,30.09,41.62
TYPHUS AB IGM,86757,HCPCS,300,RC,,both,48.5,43.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.95,,,,28.62,39.58
TYPHUS AB IGM,86757,HCPCS,300,RC,,both,48.5,43.65,Cigna,Default,Percent of Total Billed Charges,28.62,,,,28.62,39.58
TYPHUS AB IGM,86757,HCPCS,300,RC,,both,48.5,43.65,United Healthcare,Default,Fee Schedule,39.58,,,,28.62,39.58
ROCKY MTN IgM,86757,HCPCS,300,RC,,both,91.85,82.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.3,,,,54.19,74.95
ROCKY MTN IgM,86757,HCPCS,300,RC,,both,91.85,82.67,Cigna,Default,Percent of Total Billed Charges,54.19,,,,54.19,74.95
ROCKY MTN IgM,86757,HCPCS,300,RC,,both,91.85,82.67,United Healthcare,Default,Fee Schedule,74.95,,,,54.19,74.95
CHROMOSOME AN/TISSUE CULTURE,88230,HCPCS,310,RC,,both,200.75,180.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.52,,,,118.44,163.81
CHROMOSOME AN/TISSUE CULTURE,88230,HCPCS,310,RC,,both,200.75,180.68,Cigna,Default,Percent of Total Billed Charges,118.44,,,,118.44,163.81
CHROMOSOME AN/TISSUE CULTURE,88230,HCPCS,310,RC,,both,200.75,180.68,United Healthcare,Default,Fee Schedule,163.81,,,,118.44,163.81
THYROGLOBULIN ANTIBODY,86800,HCPCS,300,RC,,both,64.61,58.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.23,,,,38.12,52.72
THYROGLOBULIN ANTIBODY,86800,HCPCS,300,RC,,both,64.61,58.15,Cigna,Default,Percent of Total Billed Charges,38.12,,,,38.12,52.72
THYROGLOBULIN ANTIBODY,86800,HCPCS,300,RC,,both,64.61,58.15,United Healthcare,Default,Fee Schedule,52.72,,,,38.12,52.72
PAP SMEAR DIAGNOSTIC,88142,HCPCS,311,RC,,both,94.5,85.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.15,,,,55.76,77.11
PAP SMEAR DIAGNOSTIC,88142,HCPCS,311,RC,,both,94.5,85.05,Cigna,Default,Percent of Total Billed Charges,55.76,,,,55.76,77.11
PAP SMEAR DIAGNOSTIC,88142,HCPCS,311,RC,,both,94.5,85.05,United Healthcare,Default,Fee Schedule,77.11,,,,55.76,77.11
ANTI-GBM PANEL (GBM IGG),86255,HCPCS,300,RC,,both,177.5,159.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.25,,,,104.72,144.84
ANTI-GBM PANEL (GBM IGG),86255,HCPCS,300,RC,,both,177.5,159.75,Cigna,Default,Percent of Total Billed Charges,104.72,,,,104.72,144.84
ANTI-GBM PANEL (GBM IGG),86255,HCPCS,300,RC,,both,177.5,159.75,United Healthcare,Default,Fee Schedule,144.84,,,,104.72,144.84
EBV ABS-VCA IgG,86665,HCPCS,300,RC,,both,68.81,61.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.17,,,,40.6,56.15
EBV ABS-VCA IgG,86665,HCPCS,300,RC,,both,68.81,61.93,Cigna,Default,Percent of Total Billed Charges,40.6,,,,40.6,56.15
EBV ABS-VCA IgG,86665,HCPCS,300,RC,,both,68.81,61.93,United Healthcare,Default,Fee Schedule,56.15,,,,40.6,56.15
ARBOVIRUS PANEL St. Louis,86653,HCPCS,300,RC,,both,49.75,44.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.82,,,,29.35,40.6
ARBOVIRUS PANEL St. Louis,86653,HCPCS,300,RC,,both,49.75,44.78,Cigna,Default,Percent of Total Billed Charges,29.35,,,,29.35,40.6
ARBOVIRUS PANEL St. Louis,86653,HCPCS,300,RC,,both,49.75,44.78,United Healthcare,Default,Fee Schedule,40.6,,,,29.35,40.6
COXSACKIE A VIRUS AB A10,86658,HCPCS,300,RC,,both,45,40.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.5,,,,26.55,36.72
COXSACKIE A VIRUS AB A10,86658,HCPCS,300,RC,,both,45,40.5,Cigna,Default,Percent of Total Billed Charges,26.55,,,,26.55,36.72
COXSACKIE A VIRUS AB A10,86658,HCPCS,300,RC,,both,45,40.5,United Healthcare,Default,Fee Schedule,36.72,,,,26.55,36.72
COXSACKIE B VIRUS AB B3,86658,HCPCS,300,RC,,both,43.25,38.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.28,,,,25.52,35.29
COXSACKIE B VIRUS AB B3,86658,HCPCS,300,RC,,both,43.25,38.93,Cigna,Default,Percent of Total Billed Charges,25.52,,,,25.52,35.29
COXSACKIE B VIRUS AB B3,86658,HCPCS,300,RC,,both,43.25,38.93,United Healthcare,Default,Fee Schedule,35.29,,,,25.52,35.29
B2 GLYCOPROTEIN 1 AB IGM,86146,HCPCS,302,RC,,both,25.45,22.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.82,,,,15.02,20.77
B2 GLYCOPROTEIN 1 AB IGM,86146,HCPCS,302,RC,,both,25.45,22.91,Cigna,Default,Percent of Total Billed Charges,15.02,,,,15.02,20.77
B2 GLYCOPROTEIN 1 AB IGM,86146,HCPCS,302,RC,,both,25.45,22.91,United Healthcare,Default,Fee Schedule,20.77,,,,15.02,20.77
CARDIOLIPIN AB - IGA,86147,HCPCS,300,RC,,both,109.54,98.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.68,,,,64.63,89.38
CARDIOLIPIN AB - IGA,86147,HCPCS,300,RC,,both,109.54,98.59,Cigna,Default,Percent of Total Billed Charges,64.63,,,,64.63,89.38
CARDIOLIPIN AB - IGA,86147,HCPCS,300,RC,,both,109.54,98.59,United Healthcare,Default,Fee Schedule,89.38,,,,64.63,89.38
PHOSPHATIDYLSERINE AB IGA,86148,HCPCS,300,RC,,both,81.75,73.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.22,,,,48.23,66.71
PHOSPHATIDYLSERINE AB IGA,86148,HCPCS,300,RC,,both,81.75,73.58,Cigna,Default,Percent of Total Billed Charges,48.23,,,,48.23,66.71
PHOSPHATIDYLSERINE AB IGA,86148,HCPCS,300,RC,,both,81.75,73.58,United Healthcare,Default,Fee Schedule,66.71,,,,48.23,66.71
FACT VIII vWF/Ag,85246,HCPCS,300,RC,,both,101.13,91.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.79,,,,59.67,82.52
FACT VIII vWF/Ag,85246,HCPCS,300,RC,,both,101.13,91.02,Cigna,Default,Percent of Total Billed Charges,59.67,,,,59.67,82.52
FACT VIII vWF/Ag,85246,HCPCS,300,RC,,both,101.13,91.02,United Healthcare,Default,Fee Schedule,82.52,,,,59.67,82.52
CHLAMYDIA AB PANEL-IGM(C. PSITTACI),86632,HCPCS,300,RC,,both,51,45.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.7,,,,30.09,41.62
CHLAMYDIA AB PANEL-IGM(C. PSITTACI),86632,HCPCS,300,RC,,both,51,45.9,Cigna,Default,Percent of Total Billed Charges,30.09,,,,30.09,41.62
CHLAMYDIA AB PANEL-IGM(C. PSITTACI),86632,HCPCS,300,RC,,both,51,45.9,United Healthcare,Default,Fee Schedule,41.62,,,,30.09,41.62
EBV ABS-VCA IgM,86665,HCPCS,300,RC,,both,68.81,61.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.17,,,,40.6,56.15
EBV ABS-VCA IgM,86665,HCPCS,300,RC,,both,68.81,61.93,Cigna,Default,Percent of Total Billed Charges,40.6,,,,40.6,56.15
EBV ABS-VCA IgM,86665,HCPCS,300,RC,,both,68.81,61.93,United Healthcare,Default,Fee Schedule,56.15,,,,40.6,56.15
HEPB SCREEN HIGH RISK INDIV MEDICARE,G0499,HCPCS,300,RC,,both,165.22,148.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.65,,,,97.48,134.82
HEPB SCREEN HIGH RISK INDIV MEDICARE,G0499,HCPCS,300,RC,,both,165.22,148.7,Cigna,Default,Percent of Total Billed Charges,97.48,,,,97.48,134.82
HEPB SCREEN HIGH RISK INDIV MEDICARE,G0499,HCPCS,300,RC,,both,165.22,148.7,United Healthcare,Default,Fee Schedule,134.82,,,,97.48,134.82
HUMAN EPIDIDYMIS PROTEIN 4,86305,HCPCS,300,RC,,both,374.3,336.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.01,,,,220.84,305.43
HUMAN EPIDIDYMIS PROTEIN 4,86305,HCPCS,300,RC,,both,374.3,336.87,Cigna,Default,Percent of Total Billed Charges,220.84,,,,220.84,305.43
HUMAN EPIDIDYMIS PROTEIN 4,86305,HCPCS,300,RC,,both,374.3,336.87,United Healthcare,Default,Fee Schedule,305.43,,,,220.84,305.43
HISTOCHEMICAL STAINS ADD-ON,88314,HCPCS,310,RC,,both,154.21,138.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.95,,,,90.98,125.84
HISTOCHEMICAL STAINS ADD-ON,88314,HCPCS,310,RC,,both,154.21,138.79,Cigna,Default,Percent of Total Billed Charges,90.98,,,,90.98,125.84
HISTOCHEMICAL STAINS ADD-ON,88314,HCPCS,310,RC,,both,154.21,138.79,United Healthcare,Default,Fee Schedule,125.84,,,,90.98,125.84
ENZYME HISTOCHEMISTRY,88319,HCPCS,310,RC,,both,209.3,188.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.51,,,,123.49,170.79
ENZYME HISTOCHEMISTRY,88319,HCPCS,310,RC,,both,209.3,188.37,Cigna,Default,Percent of Total Billed Charges,123.49,,,,123.49,170.79
ENZYME HISTOCHEMISTRY,88319,HCPCS,310,RC,,both,209.3,188.37,United Healthcare,Default,Fee Schedule,170.79,,,,123.49,170.79
FLOW CYTOMETRY INTERPRETATION 16/> MARKE,88189,HCPCS,310,RC,,both,308.15,277.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,215.7,,,,181.81,251.45
FLOW CYTOMETRY INTERPRETATION 16/> MARKE,88189,HCPCS,310,RC,,both,308.15,277.34,Cigna,Default,Percent of Total Billed Charges,181.81,,,,181.81,251.45
FLOW CYTOMETRY INTERPRETATION 16/> MARKE,88189,HCPCS,310,RC,,both,308.15,277.34,United Healthcare,Default,Fee Schedule,251.45,,,,181.81,251.45
FLOW CYTOMETRY INTERP 9-15 MARKERS,88188,HCPCS,310,RC,,both,235.11,211.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.58,,,,138.71,191.85
FLOW CYTOMETRY INTERP 9-15 MARKERS,88188,HCPCS,310,RC,,both,235.11,211.6,Cigna,Default,Percent of Total Billed Charges,138.71,,,,138.71,191.85
FLOW CYTOMETRY INTERP 9-15 MARKERS,88188,HCPCS,310,RC,,both,235.11,211.6,United Healthcare,Default,Fee Schedule,191.85,,,,138.71,191.85
AMINOLEVULINIC ACID DELTA,82135,HCPCS,301,RC,,both,213.67,192.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.57,,,,126.07,174.35
AMINOLEVULINIC ACID DELTA,82135,HCPCS,301,RC,,both,213.67,192.3,Cigna,Default,Percent of Total Billed Charges,126.07,,,,126.07,174.35
AMINOLEVULINIC ACID DELTA,82135,HCPCS,301,RC,,both,213.67,192.3,United Healthcare,Default,Fee Schedule,174.35,,,,126.07,174.35
PORPHOBILINOGEN URINE; QUAN,84110,HCPCS,301,RC,,both,96.89,87.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.82,,,,57.17,79.06
PORPHOBILINOGEN URINE; QUAN,84110,HCPCS,301,RC,,both,96.89,87.2,Cigna,Default,Percent of Total Billed Charges,57.17,,,,57.17,79.06
PORPHOBILINOGEN URINE; QUAN,84110,HCPCS,301,RC,,both,96.89,87.2,United Healthcare,Default,Fee Schedule,79.06,,,,57.17,79.06
ARBOVIRUS PANEL Western Equine,86654,HCPCS,300,RC,,both,49.75,44.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.82,,,,29.35,40.6
ARBOVIRUS PANEL Western Equine,86654,HCPCS,300,RC,,both,49.75,44.78,Cigna,Default,Percent of Total Billed Charges,29.35,,,,29.35,40.6
ARBOVIRUS PANEL Western Equine,86654,HCPCS,300,RC,,both,49.75,44.78,United Healthcare,Default,Fee Schedule,40.6,,,,29.35,40.6
COXSACKIE A VIRUS AB A16,86658,HCPCS,300,RC,,both,45,40.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.5,,,,26.55,36.72
COXSACKIE A VIRUS AB A16,86658,HCPCS,300,RC,,both,45,40.5,Cigna,Default,Percent of Total Billed Charges,26.55,,,,26.55,36.72
COXSACKIE A VIRUS AB A16,86658,HCPCS,300,RC,,both,45,40.5,United Healthcare,Default,Fee Schedule,36.72,,,,26.55,36.72
COXSACKIE B VIRUS AB B4,86658,HCPCS,300,RC,,both,43.25,38.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.28,,,,25.52,35.29
COXSACKIE B VIRUS AB B4,86658,HCPCS,300,RC,,both,43.25,38.93,Cigna,Default,Percent of Total Billed Charges,25.52,,,,25.52,35.29
COXSACKIE B VIRUS AB B4,86658,HCPCS,300,RC,,both,43.25,38.93,United Healthcare,Default,Fee Schedule,35.29,,,,25.52,35.29
FACTOR 8 VWF MULTIMERIC,85247,HCPCS,300,RC,,both,280.75,252.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.52,,,,165.64,229.09
FACTOR 8 VWF MULTIMERIC,85247,HCPCS,300,RC,,both,280.75,252.68,Cigna,Default,Percent of Total Billed Charges,165.64,,,,165.64,229.09
FACTOR 8 VWF MULTIMERIC,85247,HCPCS,300,RC,,both,280.75,252.68,United Healthcare,Default,Fee Schedule,229.09,,,,165.64,229.09
CRYOGLOBULIN QUANT,82595,HCPCS,301,RC,,both,44.67,40.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.27,,,,26.36,36.45
CRYOGLOBULIN QUANT,82595,HCPCS,301,RC,,both,44.67,40.2,Cigna,Default,Percent of Total Billed Charges,26.36,,,,26.36,36.45
CRYOGLOBULIN QUANT,82595,HCPCS,301,RC,,both,44.67,40.2,United Healthcare,Default,Fee Schedule,36.45,,,,26.36,36.45
GALOP CHG,83520,HCPCS,301,RC,,both,782.69,704.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,547.88,,,,461.79,638.68
GALOP CHG,83520,HCPCS,301,RC,,both,782.69,704.42,Cigna,Default,Percent of Total Billed Charges,461.79,,,,461.79,638.68
GALOP CHG,83520,HCPCS,301,RC,,both,782.69,704.42,United Healthcare,Default,Fee Schedule,638.68,,,,461.79,638.68
COXSACKIE B VIRUS AB B5,86658,HCPCS,300,RC,,both,43.25,38.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.28,,,,25.52,35.29
COXSACKIE B VIRUS AB B5,86658,HCPCS,300,RC,,both,43.25,38.93,Cigna,Default,Percent of Total Billed Charges,25.52,,,,25.52,35.29
COXSACKIE B VIRUS AB B5,86658,HCPCS,300,RC,,both,43.25,38.93,United Healthcare,Default,Fee Schedule,35.29,,,,25.52,35.29
COXSACKIE B VIRUS AB B6,86658,HCPCS,300,RC,,both,43.25,38.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.28,,,,25.52,35.29
COXSACKIE B VIRUS AB B6,86658,HCPCS,300,RC,,both,43.25,38.93,Cigna,Default,Percent of Total Billed Charges,25.52,,,,25.52,35.29
COXSACKIE B VIRUS AB B6,86658,HCPCS,300,RC,,both,43.25,38.93,United Healthcare,Default,Fee Schedule,35.29,,,,25.52,35.29
NM AORTOGRAM,78499,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM AORTOGRAM,78499,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM AORTOGRAM,78499,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM LABEL WHITE BLOOD CELL SCAN,78800,HCPCS,341,RC,,both,4047.57,3642.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2833.3,,,,2388.07,3302.82
NM LABEL WHITE BLOOD CELL SCAN,78800,HCPCS,341,RC,,both,4047.57,3642.81,Cigna,Default,Percent of Total Billed Charges,2388.07,,,,2388.07,3302.82
NM LABEL WHITE BLOOD CELL SCAN,78800,HCPCS,341,RC,,both,4047.57,3642.81,United Healthcare,Default,Fee Schedule,3302.82,,,,2388.07,3302.82
NM BONE MARROW,78104,HCPCS,341,RC,,both,1381.96,1243.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,967.37,,,,815.36,1127.68
NM BONE MARROW,78104,HCPCS,341,RC,,both,1381.96,1243.76,Cigna,Default,Percent of Total Billed Charges,815.36,,,,815.36,1127.68
NM BONE MARROW,78104,HCPCS,341,RC,,both,1381.96,1243.76,United Healthcare,Default,Fee Schedule,1127.68,,,,815.36,1127.68
NM BONE SCAN 3 PHASE,78315,HCPCS,341,RC,,both,1235.9,1112.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,865.13,,,,729.18,1008.49
NM BONE SCAN 3 PHASE,78315,HCPCS,341,RC,,both,1235.9,1112.31,Cigna,Default,Percent of Total Billed Charges,729.18,,,,729.18,1008.49
NM BONE SCAN 3 PHASE,78315,HCPCS,341,RC,,both,1235.9,1112.31,United Healthcare,Default,Fee Schedule,1008.49,,,,729.18,1008.49
NM BONE/JOINT SPECT,78803,HCPCS,341,RC,,both,2022.38,1820.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1415.67,,,,1193.2,1650.26
NM BONE/JOINT SPECT,78803,HCPCS,341,RC,,both,2022.38,1820.14,Cigna,Default,Percent of Total Billed Charges,1193.2,,,,1193.2,1650.26
NM BONE/JOINT SPECT,78803,HCPCS,341,RC,,both,2022.38,1820.14,United Healthcare,Default,Fee Schedule,1650.26,,,,1193.2,1650.26
NM BONE TOTAL,78306,HCPCS,341,RC,,both,1348.25,1213.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,943.78,,,,795.47,1100.17
NM BONE TOTAL,78306,HCPCS,341,RC,,both,1348.25,1213.43,Cigna,Default,Percent of Total Billed Charges,795.47,,,,795.47,1100.17
NM BONE TOTAL,78306,HCPCS,341,RC,,both,1348.25,1213.43,United Healthcare,Default,Fee Schedule,1100.17,,,,795.47,1100.17
"XR spine, thoracolum junc 2VW+",72080,HCPCS,320,RC,,both,392.43,353.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.7,,,,231.53,320.22
"XR spine, thoracolum junc 2VW+",72080,HCPCS,320,RC,,both,392.43,353.19,Cigna,Default,Percent of Total Billed Charges,231.53,,,,231.53,320.22
"XR spine, thoracolum junc 2VW+",72080,HCPCS,320,RC,,both,392.43,353.19,United Healthcare,Default,Fee Schedule,320.22,,,,231.53,320.22
XR Spine; 1 VW Scoliotic exam,72081,HCPCS,320,RC,,both,403.81,363.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.67,,,,238.25,329.51
XR Spine; 1 VW Scoliotic exam,72081,HCPCS,320,RC,,both,403.81,363.43,Cigna,Default,Percent of Total Billed Charges,238.25,,,,238.25,329.51
XR Spine; 1 VW Scoliotic exam,72081,HCPCS,320,RC,,both,403.81,363.43,United Healthcare,Default,Fee Schedule,329.51,,,,238.25,329.51
XR spine; 2 or 3 VW scoliotic exam,72082,HCPCS,320,RC,,both,466.4,419.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,326.48,,,,275.18,380.58
XR spine; 2 or 3 VW scoliotic exam,72082,HCPCS,320,RC,,both,466.4,419.76,Cigna,Default,Percent of Total Billed Charges,275.18,,,,275.18,380.58
XR spine; 2 or 3 VW scoliotic exam,72082,HCPCS,320,RC,,both,466.4,419.76,United Healthcare,Default,Fee Schedule,380.58,,,,275.18,380.58
XR spine; 4 or 5 VW scoliotic exxam,72083,HCPCS,320,RC,,both,718.51,646.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,502.96,,,,423.92,586.3
XR spine; 4 or 5 VW scoliotic exxam,72083,HCPCS,320,RC,,both,718.51,646.66,Cigna,Default,Percent of Total Billed Charges,423.92,,,,423.92,586.3
XR spine; 4 or 5 VW scoliotic exxam,72083,HCPCS,320,RC,,both,718.51,646.66,United Healthcare,Default,Fee Schedule,586.3,,,,423.92,586.3
XR spine; min 6VW scoliotic exam,72084,HCPCS,320,RC,,both,718.51,646.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,502.96,,,,423.92,586.3
XR spine; min 6VW scoliotic exam,72084,HCPCS,320,RC,,both,718.51,646.66,Cigna,Default,Percent of Total Billed Charges,423.92,,,,423.92,586.3
XR spine; min 6VW scoliotic exam,72084,HCPCS,320,RC,,both,718.51,646.66,United Healthcare,Default,Fee Schedule,586.3,,,,423.92,586.3
XR hip; unilat 1VW,73501,HCPCS,320,RC,,both,403.81,363.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.67,,,,238.25,329.51
XR hip; unilat 1VW,73501,HCPCS,320,RC,,both,403.81,363.43,Cigna,Default,Percent of Total Billed Charges,238.25,,,,238.25,329.51
XR hip; unilat 1VW,73501,HCPCS,320,RC,,both,403.81,363.43,United Healthcare,Default,Fee Schedule,329.51,,,,238.25,329.51
XR hip; unilat 2-3VWS,73502,HCPCS,320,RC,,both,403.81,363.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.67,,,,238.25,329.51
XR hip; unilat 2-3VWS,73502,HCPCS,320,RC,,both,403.81,363.43,Cigna,Default,Percent of Total Billed Charges,238.25,,,,238.25,329.51
XR hip; unilat 2-3VWS,73502,HCPCS,320,RC,,both,403.81,363.43,United Healthcare,Default,Fee Schedule,329.51,,,,238.25,329.51
"XR hip; unilat, min 4VW",73503,HCPCS,320,RC,,both,453.26,407.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,317.28,,,,267.42,369.86
"XR hip; unilat, min 4VW",73503,HCPCS,320,RC,,both,453.26,407.93,Cigna,Default,Percent of Total Billed Charges,267.42,,,,267.42,369.86
"XR hip; unilat, min 4VW",73503,HCPCS,320,RC,,both,453.26,407.93,United Healthcare,Default,Fee Schedule,369.86,,,,267.42,369.86
XR HIP BILATERAL 2V,73521,HCPCS,320,RC,,both,453.26,407.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,317.28,,,,267.42,369.86
XR HIP BILATERAL 2V,73521,HCPCS,320,RC,,both,453.26,407.93,Cigna,Default,Percent of Total Billed Charges,267.42,,,,267.42,369.86
XR HIP BILATERAL 2V,73521,HCPCS,320,RC,,both,453.26,407.93,United Healthcare,Default,Fee Schedule,369.86,,,,267.42,369.86
XR HIP BILATERAL 3-4V,73522,HCPCS,320,RC,,both,453.26,407.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,317.28,,,,267.42,369.86
XR HIP BILATERAL 3-4V,73522,HCPCS,320,RC,,both,453.26,407.93,Cigna,Default,Percent of Total Billed Charges,267.42,,,,267.42,369.86
XR HIP BILATERAL 3-4V,73522,HCPCS,320,RC,,both,453.26,407.93,United Healthcare,Default,Fee Schedule,369.86,,,,267.42,369.86
XR HIP BILATERAL 5V,73523,HCPCS,320,RC,,both,698.26,628.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,488.78,,,,411.97,569.78
XR HIP BILATERAL 5V,73523,HCPCS,320,RC,,both,698.26,628.43,Cigna,Default,Percent of Total Billed Charges,411.97,,,,411.97,569.78
XR HIP BILATERAL 5V,73523,HCPCS,320,RC,,both,698.26,628.43,United Healthcare,Default,Fee Schedule,569.78,,,,411.97,569.78
XR FEMUR 1V BILATERAL,73551,HCPCS,320,RC,50,both,403.81,363.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.67,,,,238.25,329.51
XR FEMUR 1V BILATERAL,73551,HCPCS,320,RC,50,both,403.81,363.43,Cigna,Default,Percent of Total Billed Charges,238.25,,,,238.25,329.51
XR FEMUR 1V BILATERAL,73551,HCPCS,320,RC,50,both,403.81,363.43,United Healthcare,Default,Fee Schedule,329.51,,,,238.25,329.51
XR FEMUR 2V BILATERAL,73552,HCPCS,320,RC,50,both,403.81,363.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.67,,,,238.25,329.51
XR FEMUR 2V BILATERAL,73552,HCPCS,320,RC,50,both,403.81,363.43,Cigna,Default,Percent of Total Billed Charges,238.25,,,,238.25,329.51
XR FEMUR 2V BILATERAL,73552,HCPCS,320,RC,50,both,403.81,363.43,United Healthcare,Default,Fee Schedule,329.51,,,,238.25,329.51
NM BOWEL (MECKELS) STUDY,78290,HCPCS,341,RC,,both,2072.94,1865.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1451.06,,,,1223.03,1691.52
NM BOWEL (MECKELS) STUDY,78290,HCPCS,341,RC,,both,2072.94,1865.65,Cigna,Default,Percent of Total Billed Charges,1223.03,,,,1223.03,1691.52
NM BOWEL (MECKELS) STUDY,78290,HCPCS,341,RC,,both,2072.94,1865.65,United Healthcare,Default,Fee Schedule,1691.52,,,,1223.03,1691.52
NM MIRALUMA,78800,HCPCS,340,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM MIRALUMA,78800,HCPCS,340,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM MIRALUMA,78800,HCPCS,340,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM BRAIN(STATIC),78605,HCPCS,341,RC,,both,1611.63,1450.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1128.14,,,,950.86,1315.09
NM BRAIN(STATIC),78605,HCPCS,341,RC,,both,1611.63,1450.47,Cigna,Default,Percent of Total Billed Charges,950.86,,,,950.86,1315.09
NM BRAIN(STATIC),78605,HCPCS,341,RC,,both,1611.63,1450.47,United Healthcare,Default,Fee Schedule,1315.09,,,,950.86,1315.09
NM DYNAMIC BRAIN,78699,HCPCS,341,RC,,both,1654.89,1489.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1158.42,,,,976.39,1350.39
NM DYNAMIC BRAIN,78699,HCPCS,341,RC,,both,1654.89,1489.4,Cigna,Default,Percent of Total Billed Charges,976.39,,,,976.39,1350.39
NM DYNAMIC BRAIN,78699,HCPCS,341,RC,,both,1654.89,1489.4,United Healthcare,Default,Fee Schedule,1350.39,,,,976.39,1350.39
NM CARDC BLD PL,78472,HCPCS,341,RC,,both,1516.78,1365.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1061.75,,,,894.9,1237.69
NM CARDC BLD PL,78472,HCPCS,341,RC,,both,1516.78,1365.1,Cigna,Default,Percent of Total Billed Charges,894.9,,,,894.9,1237.69
NM CARDC BLD PL,78472,HCPCS,341,RC,,both,1516.78,1365.1,United Healthcare,Default,Fee Schedule,1237.69,,,,894.9,1237.69
NM MYOCARDIAL SPECT  STRESS TEST,78452,HCPCS,341,RC,,both,4323.67,3891.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3026.57,,,,2550.97,3528.11
NM MYOCARDIAL SPECT  STRESS TEST,78452,HCPCS,341,RC,,both,4323.67,3891.3,Cigna,Default,Percent of Total Billed Charges,2550.97,,,,2550.97,3528.11
NM MYOCARDIAL SPECT  STRESS TEST,78452,HCPCS,341,RC,,both,4323.67,3891.3,United Healthcare,Default,Fee Schedule,3528.11,,,,2550.97,3528.11
NM MYOCARD SPECT 2 DAY PROTOCOL,78451,HCPCS,341,RC,,both,4323.39,3891.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3026.37,,,,2550.8,3527.89
NM MYOCARD SPECT 2 DAY PROTOCOL,78451,HCPCS,341,RC,,both,4323.39,3891.05,Cigna,Default,Percent of Total Billed Charges,2550.8,,,,2550.8,3527.89
NM MYOCARD SPECT 2 DAY PROTOCOL,78451,HCPCS,341,RC,,both,4323.39,3891.05,United Healthcare,Default,Fee Schedule,3527.89,,,,2550.8,3527.89
NM CRDC MYOCARD I,78466,HCPCS,341,RC,,both,1338.7,1204.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,937.09,,,,789.83,1092.38
NM CRDC MYOCARD I,78466,HCPCS,341,RC,,both,1338.7,1204.83,Cigna,Default,Percent of Total Billed Charges,789.83,,,,789.83,1092.38
NM CRDC MYOCARD I,78466,HCPCS,341,RC,,both,1338.7,1204.83,United Healthcare,Default,Fee Schedule,1092.38,,,,789.83,1092.38
NM CISTERNOGRAM,78630,HCPCS,341,RC,,both,1696.26,1526.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1187.38,,,,1000.79,1384.15
NM CISTERNOGRAM,78630,HCPCS,341,RC,,both,1696.26,1526.63,Cigna,Default,Percent of Total Billed Charges,1000.79,,,,1000.79,1384.15
NM CISTERNOGRAM,78630,HCPCS,341,RC,,both,1696.26,1526.63,United Healthcare,Default,Fee Schedule,1384.15,,,,1000.79,1384.15
NM JOINT LMTD AREA,78300,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM JOINT LMTD AREA,78300,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM JOINT LMTD AREA,78300,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM JOINT MLTP AREA,78305,HCPCS,341,RC,,both,1226.35,1103.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,858.44,,,,723.55,1000.7
NM JOINT MLTP AREA,78305,HCPCS,341,RC,,both,1226.35,1103.72,Cigna,Default,Percent of Total Billed Charges,723.55,,,,723.55,1000.7
NM JOINT MLTP AREA,78305,HCPCS,341,RC,,both,1226.35,1103.72,United Healthcare,Default,Fee Schedule,1000.7,,,,723.55,1000.7
NM LIVER,78201,HCPCS,341,RC,,both,1548.94,1394.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1084.26,,,,913.87,1263.94
NM LIVER,78201,HCPCS,341,RC,,both,1548.94,1394.05,Cigna,Default,Percent of Total Billed Charges,913.87,,,,913.87,1263.94
NM LIVER,78201,HCPCS,341,RC,,both,1548.94,1394.05,United Healthcare,Default,Fee Schedule,1263.94,,,,913.87,1263.94
NM LIVER & SPLEEN,78215,HCPCS,341,RC,,both,1894.44,1705,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1326.11,,,,1117.72,1545.86
NM LIVER & SPLEEN,78215,HCPCS,341,RC,,both,1894.44,1705,Cigna,Default,Percent of Total Billed Charges,1117.72,,,,1117.72,1545.86
NM LIVER & SPLEEN,78215,HCPCS,341,RC,,both,1894.44,1705,United Healthcare,Default,Fee Schedule,1545.86,,,,1117.72,1545.86
INTRO PROC-KDN BX,50200,HCPCS,360,RC,,both,908.25,817.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,635.78,,,,535.87,741.13
INTRO PROC-KDN BX,50200,HCPCS,360,RC,,both,908.25,817.43,Cigna,Default,Percent of Total Billed Charges,535.87,,,,535.87,741.13
INTRO PROC-KDN BX,50200,HCPCS,360,RC,,both,908.25,817.43,United Healthcare,Default,Fee Schedule,741.13,,,,535.87,741.13
NM HEPATOBILIARY HIDA SCAN WO CCK,78226,HCPCS,341,RC,,both,1635.88,1472.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1145.12,,,,965.17,1334.88
NM HEPATOBILIARY HIDA SCAN WO CCK,78226,HCPCS,341,RC,,both,1635.88,1472.29,Cigna,Default,Percent of Total Billed Charges,965.17,,,,965.17,1334.88
NM HEPATOBILIARY HIDA SCAN WO CCK,78226,HCPCS,341,RC,,both,1635.88,1472.29,United Healthcare,Default,Fee Schedule,1334.88,,,,965.17,1334.88
NM HEPATOBILIARY HIDA SCAN WITH CCK,78227,HCPCS,341,RC,,both,1685.31,1516.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1179.72,,,,994.33,1375.21
NM HEPATOBILIARY HIDA SCAN WITH CCK,78227,HCPCS,341,RC,,both,1685.31,1516.78,Cigna,Default,Percent of Total Billed Charges,994.33,,,,994.33,1375.21
NM HEPATOBILIARY HIDA SCAN WITH CCK,78227,HCPCS,341,RC,,both,1685.31,1516.78,United Healthcare,Default,Fee Schedule,1375.21,,,,994.33,1375.21
NM LUNG PRFSN STDY,78580,HCPCS,341,RC,,both,1348.25,1213.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,943.78,,,,795.47,1100.17
NM LUNG PRFSN STDY,78580,HCPCS,341,RC,,both,1348.25,1213.43,Cigna,Default,Percent of Total Billed Charges,795.47,,,,795.47,1100.17
NM LUNG PRFSN STDY,78580,HCPCS,341,RC,,both,1348.25,1213.43,United Healthcare,Default,Fee Schedule,1100.17,,,,795.47,1100.17
NM LUNG VENTILATION,78579,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM LUNG VENTILATION,78579,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM LUNG VENTILATION,78579,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM LUNG PERFUSION,78580,HCPCS,341,RC,,both,1200,1080,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,840,,,,708,979.2
NM LUNG PERFUSION,78580,HCPCS,341,RC,,both,1200,1080,Cigna,Default,Percent of Total Billed Charges,708,,,,708,979.2
NM LUNG PERFUSION,78580,HCPCS,341,RC,,both,1200,1080,United Healthcare,Default,Fee Schedule,979.2,,,,708,979.2
NM LUNG VENT & PERF. (VQ),78582,HCPCS,341,RC,,both,547.72,492.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,383.4,,,,323.15,446.94
NM LUNG VENT & PERF. (VQ),78582,HCPCS,341,RC,,both,547.72,492.95,Cigna,Default,Percent of Total Billed Charges,323.15,,,,323.15,446.94
NM LUNG VENT & PERF. (VQ),78582,HCPCS,341,RC,,both,547.72,492.95,United Healthcare,Default,Fee Schedule,446.94,,,,323.15,446.94
NM LUNG QUANTITATIVE,78598,HCPCS,341,RC,,both,1611.63,1450.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1128.14,,,,950.86,1315.09
NM LUNG QUANTITATIVE,78598,HCPCS,341,RC,,both,1611.63,1450.47,Cigna,Default,Percent of Total Billed Charges,950.86,,,,950.86,1315.09
NM LUNG QUANTITATIVE,78598,HCPCS,341,RC,,both,1611.63,1450.47,United Healthcare,Default,Fee Schedule,1315.09,,,,950.86,1315.09
NM UREA BREATH TEST C-14; ACQUISITION,78267,HCPCS,341,RC,,both,775.24,697.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,542.67,,,,457.39,632.6
NM UREA BREATH TEST C-14; ACQUISITION,78267,HCPCS,341,RC,,both,775.24,697.72,Cigna,Default,Percent of Total Billed Charges,457.39,,,,457.39,632.6
NM UREA BREATH TEST C-14; ACQUISITION,78267,HCPCS,341,RC,,both,775.24,697.72,United Healthcare,Default,Fee Schedule,632.6,,,,457.39,632.6
NM UREA BREATH TEST C-14; ANALYSIS,78268,HCPCS,341,RC,,both,387.63,348.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,271.34,,,,228.7,316.31
NM UREA BREATH TEST C-14; ANALYSIS,78268,HCPCS,341,RC,,both,387.63,348.87,Cigna,Default,Percent of Total Billed Charges,228.7,,,,228.7,316.31
NM UREA BREATH TEST C-14; ANALYSIS,78268,HCPCS,341,RC,,both,387.63,348.87,United Healthcare,Default,Fee Schedule,316.31,,,,228.7,316.31
NM MUGA SCAN,78473,HCPCS,341,RC,,both,1672.97,1505.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1171.08,,,,987.05,1365.14
NM MUGA SCAN,78473,HCPCS,341,RC,,both,1672.97,1505.67,Cigna,Default,Percent of Total Billed Charges,987.05,,,,987.05,1365.14
NM MUGA SCAN,78473,HCPCS,341,RC,,both,1672.97,1505.67,United Healthcare,Default,Fee Schedule,1365.14,,,,987.05,1365.14
NM RENAL,78700,HCPCS,341,RC,,both,1483.08,1334.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1038.16,,,,875.02,1210.19
NM RENAL,78700,HCPCS,341,RC,,both,1483.08,1334.77,Cigna,Default,Percent of Total Billed Charges,875.02,,,,875.02,1210.19
NM RENAL,78700,HCPCS,341,RC,,both,1483.08,1334.77,United Healthcare,Default,Fee Schedule,1210.19,,,,875.02,1210.19
NM RENL W/ARTFLW,78701,HCPCS,341,RC,,both,1645.99,1481.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1152.19,,,,971.13,1343.13
NM RENL W/ARTFLW,78701,HCPCS,341,RC,,both,1645.99,1481.39,Cigna,Default,Percent of Total Billed Charges,971.13,,,,971.13,1343.13
NM RENL W/ARTFLW,78701,HCPCS,341,RC,,both,1645.99,1481.39,United Healthcare,Default,Fee Schedule,1343.13,,,,971.13,1343.13
SITZ MARK NON-RAD CONTRAST MATERIALNOC,A9698,HCPCS,250,RC,,both,93.19,83.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.23,,,,54.98,76.04
SITZ MARK NON-RAD CONTRAST MATERIALNOC,A9698,HCPCS,250,RC,,both,93.19,83.87,Cigna,Default,Percent of Total Billed Charges,54.98,,,,54.98,76.04
SITZ MARK NON-RAD CONTRAST MATERIALNOC,A9698,HCPCS,250,RC,,both,93.19,83.87,United Healthcare,Default,Fee Schedule,76.04,,,,54.98,76.04
NM TECHNETIUM PERTECHNETATE,A9512,HCPCS,343,RC,,both,115.89,104.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.12,,,,68.38,94.57
NM TECHNETIUM PERTECHNETATE,A9512,HCPCS,343,RC,,both,115.89,104.3,Cigna,Default,Percent of Total Billed Charges,68.38,,,,68.38,94.57
NM TECHNETIUM PERTECHNETATE,A9512,HCPCS,343,RC,,both,115.89,104.3,United Healthcare,Default,Fee Schedule,94.57,,,,68.38,94.57
NM RENAL DOSE (TC MAG3),A9562,HCPCS,343,RC,,both,446.56,401.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,312.59,,,,263.47,364.39
NM RENAL DOSE (TC MAG3),A9562,HCPCS,343,RC,,both,446.56,401.9,Cigna,Default,Percent of Total Billed Charges,263.47,,,,263.47,364.39
NM RENAL DOSE (TC MAG3),A9562,HCPCS,343,RC,,both,446.56,401.9,United Healthcare,Default,Fee Schedule,364.39,,,,263.47,364.39
NM HEPATOBILIARY DOSE-CHO,A9537,HCPCS,343,RC,,both,189.03,170.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.32,,,,111.53,154.25
NM HEPATOBILIARY DOSE-CHO,A9537,HCPCS,343,RC,,both,189.03,170.13,Cigna,Default,Percent of Total Billed Charges,111.53,,,,111.53,154.25
NM HEPATOBILIARY DOSE-CHO,A9537,HCPCS,343,RC,,both,189.03,170.13,United Healthcare,Default,Fee Schedule,154.25,,,,111.53,154.25
NM LUNG VENTIL DOSE(DTPA) <=25.00 mci,A9539,HCPCS,343,RC,,both,493.15,443.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,345.2,,,,290.96,402.41
NM LUNG VENTIL DOSE(DTPA) <=25.00 mci,A9539,HCPCS,343,RC,,both,493.15,443.84,Cigna,Default,Percent of Total Billed Charges,290.96,,,,290.96,402.41
NM LUNG VENTIL DOSE(DTPA) <=25.00 mci,A9539,HCPCS,343,RC,,both,493.15,443.84,United Healthcare,Default,Fee Schedule,402.41,,,,290.96,402.41
NM MUGA DOSE (PYP),A9560,HCPCS,343,RC,,both,159.51,143.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.66,,,,94.11,130.16
NM MUGA DOSE (PYP),A9560,HCPCS,343,RC,,both,159.51,143.56,Cigna,Default,Percent of Total Billed Charges,94.11,,,,94.11,130.16
NM MUGA DOSE (PYP),A9560,HCPCS,343,RC,,both,159.51,143.56,United Healthcare,Default,Fee Schedule,130.16,,,,94.11,130.16
NM CARDIOLITE DOSE (TC),A9500,HCPCS,343,RC,,both,638.39,574.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,446.87,,,,376.65,520.93
NM CARDIOLITE DOSE (TC),A9500,HCPCS,343,RC,,both,638.39,574.55,Cigna,Default,Percent of Total Billed Charges,376.65,,,,376.65,520.93
NM CARDIOLITE DOSE (TC),A9500,HCPCS,343,RC,,both,638.39,574.55,United Healthcare,Default,Fee Schedule,520.93,,,,376.65,520.93
NM BONE DOSE (TCMDP),A9503,HCPCS,343,RC,,both,118.8,106.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.16,,,,70.09,96.94
NM BONE DOSE (TCMDP),A9503,HCPCS,343,RC,,both,118.8,106.92,Cigna,Default,Percent of Total Billed Charges,70.09,,,,70.09,96.94
NM BONE DOSE (TCMDP),A9503,HCPCS,343,RC,,both,118.8,106.92,United Healthcare,Default,Fee Schedule,96.94,,,,70.09,96.94
NM TCMAA-1 LUNG PERFUSION <=10.00 mci,A9540,HCPCS,343,RC,,both,491.24,442.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,343.87,,,,289.83,400.85
NM TCMAA-1 LUNG PERFUSION <=10.00 mci,A9540,HCPCS,343,RC,,both,491.24,442.12,Cigna,Default,Percent of Total Billed Charges,289.83,,,,289.83,400.85
NM TCMAA-1 LUNG PERFUSION <=10.00 mci,A9540,HCPCS,343,RC,,both,491.24,442.12,United Healthcare,Default,Fee Schedule,400.85,,,,289.83,400.85
NM MYOCARDIO-WALL MOTION,78453,HCPCS,341,RC,,both,1611.63,1450.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1128.14,,,,950.86,1315.09
NM MYOCARDIO-WALL MOTION,78453,HCPCS,341,RC,,both,1611.63,1450.47,Cigna,Default,Percent of Total Billed Charges,950.86,,,,950.86,1315.09
NM MYOCARDIO-WALL MOTION,78453,HCPCS,341,RC,,both,1611.63,1450.47,United Healthcare,Default,Fee Schedule,1315.09,,,,950.86,1315.09
NM RENAL W/PHARMACY,78708,HCPCS,340,RC,,both,1611.63,1450.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1128.14,,,,950.86,1315.09
NM RENAL W/PHARMACY,78708,HCPCS,340,RC,,both,1611.63,1450.47,Cigna,Default,Percent of Total Billed Charges,950.86,,,,950.86,1315.09
NM RENAL W/PHARMACY,78708,HCPCS,340,RC,,both,1611.63,1450.47,United Healthcare,Default,Fee Schedule,1315.09,,,,950.86,1315.09
NM Tc99m Sulfur Colloid,A9541,HCPCS,343,RC,,both,578.64,520.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,405.05,,,,341.4,472.17
NM Tc99m Sulfur Colloid,A9541,HCPCS,343,RC,,both,578.64,520.78,Cigna,Default,Percent of Total Billed Charges,341.4,,,,341.4,472.17
NM Tc99m Sulfur Colloid,A9541,HCPCS,343,RC,,both,578.64,520.78,United Healthcare,Default,Fee Schedule,472.17,,,,341.4,472.17
NM SPLEEN W/FLOW,78185,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM SPLEEN W/FLOW,78185,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM SPLEEN W/FLOW,78185,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM THYROID,78013,HCPCS,340,RC,,both,1335.89,1202.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,935.12,,,,788.18,1090.09
NM THYROID,78013,HCPCS,340,RC,,both,1335.89,1202.3,Cigna,Default,Percent of Total Billed Charges,788.18,,,,788.18,1090.09
NM THYROID,78013,HCPCS,340,RC,,both,1335.89,1202.3,United Healthcare,Default,Fee Schedule,1090.09,,,,788.18,1090.09
NM PARATHYROID IMAGING,78070,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM PARATHYROID IMAGING,78070,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM PARATHYROID IMAGING,78070,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM THYROID UPTAKE,78012,HCPCS,340,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM THYROID UPTAKE,78012,HCPCS,340,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM THYROID UPTAKE,78012,HCPCS,340,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM THYROID MET SCAN-WHOLE BODY,78018,HCPCS,341,RC,,both,1560.6,1404.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1092.42,,,,920.75,1273.45
NM THYROID MET SCAN-WHOLE BODY,78018,HCPCS,341,RC,,both,1560.6,1404.54,Cigna,Default,Percent of Total Billed Charges,920.75,,,,920.75,1273.45
NM THYROID MET SCAN-WHOLE BODY,78018,HCPCS,341,RC,,both,1560.6,1404.54,United Healthcare,Default,Fee Schedule,1273.45,,,,920.75,1273.45
NM THYROID UPTAKE&SCN,78014,HCPCS,340,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM THYROID UPTAKE&SCN,78014,HCPCS,340,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM THYROID UPTAKE&SCN,78014,HCPCS,340,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM SHUNT EVALUATION,78645,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM SHUNT EVALUATION,78645,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM SHUNT EVALUATION,78645,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM TESTICULAR IMAGING W/VASCULAR FLOW,78761,HCPCS,341,RC,,both,1253.27,1127.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,877.29,,,,739.43,1022.67
NM TESTICULAR IMAGING W/VASCULAR FLOW,78761,HCPCS,341,RC,,both,1253.27,1127.94,Cigna,Default,Percent of Total Billed Charges,739.43,,,,739.43,1022.67
NM TESTICULAR IMAGING W/VASCULAR FLOW,78761,HCPCS,341,RC,,both,1253.27,1127.94,United Healthcare,Default,Fee Schedule,1022.67,,,,739.43,1022.67
NM VENOGRAM,78458,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM VENOGRAM,78458,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM VENOGRAM,78458,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM VENOGRAM/LUNG,78445,HCPCS,341,RC,,both,1342.07,1207.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,939.45,,,,791.82,1095.13
NM VENOGRAM/LUNG,78445,HCPCS,341,RC,,both,1342.07,1207.86,Cigna,Default,Percent of Total Billed Charges,791.82,,,,791.82,1095.13
NM VENOGRAM/LUNG,78445,HCPCS,341,RC,,both,1342.07,1207.86,United Healthcare,Default,Fee Schedule,1095.13,,,,791.82,1095.13
NM VOIDING CYSTO,78740,HCPCS,341,RC,,both,1214.68,1093.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,850.28,,,,716.66,991.18
NM VOIDING CYSTO,78740,HCPCS,341,RC,,both,1214.68,1093.21,Cigna,Default,Percent of Total Billed Charges,716.66,,,,716.66,991.18
NM VOIDING CYSTO,78740,HCPCS,341,RC,,both,1214.68,1093.21,United Healthcare,Default,Fee Schedule,991.18,,,,716.66,991.18
NM ANY ADD FLOW STDY,341,RC,,,,both,403.75,363.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.62,,,,238.21,329.46
NM ANY ADD FLOW STDY,341,RC,,,,both,403.75,363.38,Cigna,Default,Percent of Total Billed Charges,238.21,,,,238.21,329.46
NM ANY ADD FLOW STDY,341,RC,,,,both,403.75,363.38,United Healthcare,Default,Fee Schedule,329.46,,,,238.21,329.46
NM LYMPHOSCINTIGRAPY,78195,HCPCS,341,RC,,both,2324.34,2091.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1627.04,,,,1371.36,1896.66
NM LYMPHOSCINTIGRAPY,78195,HCPCS,341,RC,,both,2324.34,2091.91,Cigna,Default,Percent of Total Billed Charges,1371.36,,,,1371.36,1896.66
NM LYMPHOSCINTIGRAPY,78195,HCPCS,341,RC,,both,2324.34,2091.91,United Healthcare,Default,Fee Schedule,1896.66,,,,1371.36,1896.66
NM CHRG ON CALL,341,RC,,,,both,377.75,339.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.42,,,,222.87,308.24
NM CHRG ON CALL,341,RC,,,,both,377.75,339.98,Cigna,Default,Percent of Total Billed Charges,222.87,,,,222.87,308.24
NM CHRG ON CALL,341,RC,,,,both,377.75,339.98,United Healthcare,Default,Fee Schedule,308.24,,,,222.87,308.24
NM CHRG CONCUR ON CAL,341,RC,,,,both,213,191.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.1,,,,125.67,173.81
NM CHRG CONCUR ON CAL,341,RC,,,,both,213,191.7,Cigna,Default,Percent of Total Billed Charges,125.67,,,,125.67,173.81
NM CHRG CONCUR ON CAL,341,RC,,,,both,213,191.7,United Healthcare,Default,Fee Schedule,173.81,,,,125.67,173.81
NM PAROTID,78230,HCPCS,341,RC,,both,1245.04,1120.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,871.53,,,,734.57,1015.95
NM PAROTID,78230,HCPCS,341,RC,,both,1245.04,1120.54,Cigna,Default,Percent of Total Billed Charges,734.57,,,,734.57,1015.95
NM PAROTID,78230,HCPCS,341,RC,,both,1245.04,1120.54,United Healthcare,Default,Fee Schedule,1015.95,,,,734.57,1015.95
NM GASTRIC REFLUX STUDY,78262,HCPCS,340,RC,,both,1245.04,1120.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,871.53,,,,734.57,1015.95
NM GASTRIC REFLUX STUDY,78262,HCPCS,340,RC,,both,1245.04,1120.54,Cigna,Default,Percent of Total Billed Charges,734.57,,,,734.57,1015.95
NM GASTRIC REFLUX STUDY,78262,HCPCS,340,RC,,both,1245.04,1120.54,United Healthcare,Default,Fee Schedule,1015.95,,,,734.57,1015.95
NM GI BLEED LOC,78278,HCPCS,341,RC,,both,1245.04,1120.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,871.53,,,,734.57,1015.95
NM GI BLEED LOC,78278,HCPCS,341,RC,,both,1245.04,1120.54,Cigna,Default,Percent of Total Billed Charges,734.57,,,,734.57,1015.95
NM GI BLEED LOC,78278,HCPCS,341,RC,,both,1245.04,1120.54,United Healthcare,Default,Fee Schedule,1015.95,,,,734.57,1015.95
NM GASTRIC EMPTYING STUDY,78264,HCPCS,341,RC,,both,1219.06,1097.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,853.34,,,,719.25,994.75
NM GASTRIC EMPTYING STUDY,78264,HCPCS,341,RC,,both,1219.06,1097.15,Cigna,Default,Percent of Total Billed Charges,719.25,,,,719.25,994.75
NM GASTRIC EMPTYING STUDY,78264,HCPCS,341,RC,,both,1219.06,1097.15,United Healthcare,Default,Fee Schedule,994.75,,,,719.25,994.75
NM Absesses/Infec whole body,78802,HCPCS,341,RC,,both,4047.57,3642.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2833.3,,,,2388.07,3302.82
NM Absesses/Infec whole body,78802,HCPCS,341,RC,,both,4047.57,3642.81,Cigna,Default,Percent of Total Billed Charges,2388.07,,,,2388.07,3302.82
NM Absesses/Infec whole body,78802,HCPCS,341,RC,,both,4047.57,3642.81,United Healthcare,Default,Fee Schedule,3302.82,,,,2388.07,3302.82
US GUIDE INTRAOP,76998,HCPCS,402,RC,,both,790.89,711.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.62,,,,466.63,645.37
US GUIDE INTRAOP,76998,HCPCS,402,RC,,both,790.89,711.8,Cigna,Default,Percent of Total Billed Charges,466.63,,,,466.63,645.37
US GUIDE INTRAOP,76998,HCPCS,402,RC,,both,790.89,711.8,United Healthcare,Default,Fee Schedule,645.37,,,,466.63,645.37
SONO SCROTUM,76870,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO SCROTUM,76870,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO SCROTUM,76870,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO KNEE RIGHT,76880,HCPCS,402,RC,RT,both,263.25,236.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.28,,,,155.32,214.81
SONO KNEE RIGHT,76880,HCPCS,402,RC,RT,both,263.25,236.93,Cigna,Default,Percent of Total Billed Charges,155.32,,,,155.32,214.81
SONO KNEE RIGHT,76880,HCPCS,402,RC,RT,both,263.25,236.93,United Healthcare,Default,Fee Schedule,214.81,,,,155.32,214.81
SONO KNEE LEFT,76880,HCPCS,402,RC,LT,both,263.25,236.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.28,,,,155.32,214.81
SONO KNEE LEFT,76880,HCPCS,402,RC,LT,both,263.25,236.93,Cigna,Default,Percent of Total Billed Charges,155.32,,,,155.32,214.81
SONO KNEE LEFT,76880,HCPCS,402,RC,LT,both,263.25,236.93,United Healthcare,Default,Fee Schedule,214.81,,,,155.32,214.81
SONO GUIDED NEEDLE PLACEMENT,76942,HCPCS,402,RC,,both,560.79,504.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,392.55,,,,330.87,457.6
SONO GUIDED NEEDLE PLACEMENT,76942,HCPCS,402,RC,,both,560.79,504.71,Cigna,Default,Percent of Total Billed Charges,330.87,,,,330.87,457.6
SONO GUIDED NEEDLE PLACEMENT,76942,HCPCS,402,RC,,both,560.79,504.71,United Healthcare,Default,Fee Schedule,457.6,,,,330.87,457.6
SONO LLQ RLQ,76705,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO LLQ RLQ,76705,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO LLQ RLQ,76705,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO PELVIC,76856,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO PELVIC,76856,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO PELVIC,76856,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO PREGNCY FTL AGE LIMITED,76815,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO PREGNCY FTL AGE LIMITED,76815,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO PREGNCY FTL AGE LIMITED,76815,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO POST VOID RESIDUAL,76857,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO POST VOID RESIDUAL,76857,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO POST VOID RESIDUAL,76857,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO RETROPEROTINEAL,76770,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO RETROPEROTINEAL,76770,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO RETROPEROTINEAL,76770,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO ABDOMINAL AORTA,76775,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO ABDOMINAL AORTA,76775,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO ABDOMINAL AORTA,76775,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO SPLEEN,76705,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO SPLEEN,76705,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO SPLEEN,76705,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO PANCREAS,76705,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO PANCREAS,76705,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO PANCREAS,76705,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO KIDNEYS BILATERAL,76775,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO KIDNEYS BILATERAL,76775,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO KIDNEYS BILATERAL,76775,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO KIDNEY RIGHT,76775,HCPCS,402,RC,RT,both,558.63,502.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.04,,,,329.59,455.84
SONO KIDNEY RIGHT,76775,HCPCS,402,RC,RT,both,558.63,502.77,Cigna,Default,Percent of Total Billed Charges,329.59,,,,329.59,455.84
SONO KIDNEY RIGHT,76775,HCPCS,402,RC,RT,both,558.63,502.77,United Healthcare,Default,Fee Schedule,455.84,,,,329.59,455.84
SONO KIDNEY LEFT,76775,HCPCS,402,RC,LT,both,558.63,502.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.04,,,,329.59,455.84
SONO KIDNEY LEFT,76775,HCPCS,402,RC,LT,both,558.63,502.77,Cigna,Default,Percent of Total Billed Charges,329.59,,,,329.59,455.84
SONO KIDNEY LEFT,76775,HCPCS,402,RC,LT,both,558.63,502.77,United Healthcare,Default,Fee Schedule,455.84,,,,329.59,455.84
SONO GALL BLADDR,76705,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO GALL BLADDR,76705,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO GALL BLADDR,76705,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO LIVER,76705,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO LIVER,76705,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO LIVER,76705,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO ABDOMEN COMPLETE,76700,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO ABDOMEN COMPLETE,76700,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO ABDOMEN COMPLETE,76700,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO ABDMEN LMTD,76705,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO ABDMEN LMTD,76705,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO ABDMEN LMTD,76705,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO THYROID,76536,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO THYROID,76536,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO THYROID,76536,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO PAROTID,76536,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO PAROTID,76536,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO PAROTID,76536,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO TRANSVAGINAL,76830,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO TRANSVAGINAL,76830,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO TRANSVAGINAL,76830,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO EXTREMITY BILATERAL (NON VASC),76882,HCPCS,402,RC,,both,275,247.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,192.5,,,,162.25,224.4
SONO EXTREMITY BILATERAL (NON VASC),76882,HCPCS,402,RC,,both,275,247.5,Cigna,Default,Percent of Total Billed Charges,162.25,,,,162.25,224.4
SONO EXTREMITY BILATERAL (NON VASC),76882,HCPCS,402,RC,,both,275,247.5,United Healthcare,Default,Fee Schedule,224.4,,,,162.25,224.4
SONO EXTREMITY (NON VASCULAR),76882,HCPCS,402,RC,,both,560.79,504.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,392.55,,,,330.87,457.6
SONO EXTREMITY (NON VASCULAR),76882,HCPCS,402,RC,,both,560.79,504.71,Cigna,Default,Percent of Total Billed Charges,330.87,,,,330.87,457.6
SONO EXTREMITY (NON VASCULAR),76882,HCPCS,402,RC,,both,560.79,504.71,United Healthcare,Default,Fee Schedule,457.6,,,,330.87,457.6
SONO EXTREMITY LEFT (NON-VASC),76882,HCPCS,402,RC,,both,275,247.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,192.5,,,,162.25,224.4
SONO EXTREMITY LEFT (NON-VASC),76882,HCPCS,402,RC,,both,275,247.5,Cigna,Default,Percent of Total Billed Charges,162.25,,,,162.25,224.4
SONO EXTREMITY LEFT (NON-VASC),76882,HCPCS,402,RC,,both,275,247.5,United Healthcare,Default,Fee Schedule,224.4,,,,162.25,224.4
SONO NECK BILATERAL,76536,HCPCS,402,RC,50,both,558.63,502.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.04,,,,329.59,455.84
SONO NECK BILATERAL,76536,HCPCS,402,RC,50,both,558.63,502.77,Cigna,Default,Percent of Total Billed Charges,329.59,,,,329.59,455.84
SONO NECK BILATERAL,76536,HCPCS,402,RC,50,both,558.63,502.77,United Healthcare,Default,Fee Schedule,455.84,,,,329.59,455.84
SONO NECK RIGHT,76536,HCPCS,402,RC,RT,both,558.63,502.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.04,,,,329.59,455.84
SONO NECK RIGHT,76536,HCPCS,402,RC,RT,both,558.63,502.77,Cigna,Default,Percent of Total Billed Charges,329.59,,,,329.59,455.84
SONO NECK RIGHT,76536,HCPCS,402,RC,RT,both,558.63,502.77,United Healthcare,Default,Fee Schedule,455.84,,,,329.59,455.84
SONO NECK LEFT,76536,HCPCS,402,RC,LT,both,558.63,502.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.04,,,,329.59,455.84
SONO NECK LEFT,76536,HCPCS,402,RC,LT,both,558.63,502.77,Cigna,Default,Percent of Total Billed Charges,329.59,,,,329.59,455.84
SONO NECK LEFT,76536,HCPCS,402,RC,LT,both,558.63,502.77,United Healthcare,Default,Fee Schedule,455.84,,,,329.59,455.84
SONO SOFT TISSUE H+N,76536,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO SOFT TISSUE H+N,76536,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO SOFT TISSUE H+N,76536,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO CHEST,76604,HCPCS,402,RC,,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO CHEST,76604,HCPCS,402,RC,,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO CHEST,76604,HCPCS,402,RC,,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO BREAST RIGHT COMPLETE,76641,HCPCS,402,RC,RT,both,790.89,711.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.62,,,,466.63,645.37
SONO BREAST RIGHT COMPLETE,76641,HCPCS,402,RC,RT,both,790.89,711.8,Cigna,Default,Percent of Total Billed Charges,466.63,,,,466.63,645.37
SONO BREAST RIGHT COMPLETE,76641,HCPCS,402,RC,RT,both,790.89,711.8,United Healthcare,Default,Fee Schedule,645.37,,,,466.63,645.37
SONO BREAST LEFT COMPLETE,76641,HCPCS,402,RC,LT,both,790.89,711.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.62,,,,466.63,645.37
SONO BREAST LEFT COMPLETE,76641,HCPCS,402,RC,LT,both,790.89,711.8,Cigna,Default,Percent of Total Billed Charges,466.63,,,,466.63,645.37
SONO BREAST LEFT COMPLETE,76641,HCPCS,402,RC,LT,both,790.89,711.8,United Healthcare,Default,Fee Schedule,645.37,,,,466.63,645.37
SONO BREAST RIGHT,76642,HCPCS,402,RC,RT,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO BREAST RIGHT,76642,HCPCS,402,RC,RT,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO BREAST RIGHT,76642,HCPCS,402,RC,RT,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
SONO BREAST LEFT LIMITED,76642,HCPCS,402,RC,LT,both,574.83,517.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.38,,,,339.15,469.06
SONO BREAST LEFT LIMITED,76642,HCPCS,402,RC,LT,both,574.83,517.35,Cigna,Default,Percent of Total Billed Charges,339.15,,,,339.15,469.06
SONO BREAST LEFT LIMITED,76642,HCPCS,402,RC,LT,both,574.83,517.35,United Healthcare,Default,Fee Schedule,469.06,,,,339.15,469.06
XR FOOT LEFT,73630,HCPCS,320,RC,LT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR FOOT LEFT,73630,HCPCS,320,RC,LT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR FOOT LEFT,73630,HCPCS,320,RC,LT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR FOOT RIGHT,73630,HCPCS,320,RC,RT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR FOOT RIGHT,73630,HCPCS,320,RC,RT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR FOOT RIGHT,73630,HCPCS,320,RC,RT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR FOOT 2 VIEW,73620,HCPCS,320,RC,,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR FOOT 2 VIEW,73620,HCPCS,320,RC,,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR FOOT 2 VIEW,73620,HCPCS,320,RC,,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR C SPINE AP LAT,72040,HCPCS,320,RC,,both,327.24,294.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,229.07,,,,193.07,267.03
XR C SPINE AP LAT,72040,HCPCS,320,RC,,both,327.24,294.52,Cigna,Default,Percent of Total Billed Charges,193.07,,,,193.07,267.03
XR C SPINE AP LAT,72040,HCPCS,320,RC,,both,327.24,294.52,United Healthcare,Default,Fee Schedule,267.03,,,,193.07,267.03
XR ANKLE RT 3V,73610,HCPCS,320,RC,RT,both,368.51,331.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.96,,,,217.42,300.7
XR ANKLE RT 3V,73610,HCPCS,320,RC,RT,both,368.51,331.66,Cigna,Default,Percent of Total Billed Charges,217.42,,,,217.42,300.7
XR ANKLE RT 3V,73610,HCPCS,320,RC,RT,both,368.51,331.66,United Healthcare,Default,Fee Schedule,300.7,,,,217.42,300.7
XR ANKLE LT 3V,73610,HCPCS,320,RC,LT,both,367.93,331.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,257.55,,,,217.08,300.23
XR ANKLE LT 3V,73610,HCPCS,320,RC,LT,both,367.93,331.14,Cigna,Default,Percent of Total Billed Charges,217.08,,,,217.08,300.23
XR ANKLE LT 3V,73610,HCPCS,320,RC,LT,both,367.93,331.14,United Healthcare,Default,Fee Schedule,300.23,,,,217.08,300.23
XR LOWER LEG RIGHT,73590,HCPCS,320,RC,RT,both,395.58,356.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.91,,,,233.39,322.79
XR LOWER LEG RIGHT,73590,HCPCS,320,RC,RT,both,395.58,356.02,Cigna,Default,Percent of Total Billed Charges,233.39,,,,233.39,322.79
XR LOWER LEG RIGHT,73590,HCPCS,320,RC,RT,both,395.58,356.02,United Healthcare,Default,Fee Schedule,322.79,,,,233.39,322.79
XR LOWER LEG LEFT,73590,HCPCS,320,RC,LT,both,395.58,356.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.91,,,,233.39,322.79
XR LOWER LEG LEFT,73590,HCPCS,320,RC,LT,both,395.58,356.02,Cigna,Default,Percent of Total Billed Charges,233.39,,,,233.39,322.79
XR LOWER LEG LEFT,73590,HCPCS,320,RC,LT,both,395.58,356.02,United Healthcare,Default,Fee Schedule,322.79,,,,233.39,322.79
XR KNEE COMPLETE,73564,HCPCS,320,RC,RT,both,336,302.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,235.2,,,,198.24,274.18
XR KNEE COMPLETE,73564,HCPCS,320,RC,RT,both,336,302.4,Cigna,Default,Percent of Total Billed Charges,198.24,,,,198.24,274.18
XR KNEE COMPLETE,73564,HCPCS,320,RC,RT,both,336,302.4,United Healthcare,Default,Fee Schedule,274.18,,,,198.24,274.18
XR KNEE COMPLETE,73564,HCPCS,320,RC,LT,both,336,302.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,235.2,,,,198.24,274.18
XR KNEE COMPLETE,73564,HCPCS,320,RC,LT,both,336,302.4,Cigna,Default,Percent of Total Billed Charges,198.24,,,,198.24,274.18
XR KNEE COMPLETE,73564,HCPCS,320,RC,LT,both,336,302.4,United Healthcare,Default,Fee Schedule,274.18,,,,198.24,274.18
XR KNEE STDG AP BILT,73565,HCPCS,320,RC,,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR KNEE STDG AP BILT,73565,HCPCS,320,RC,,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR KNEE STDG AP BILT,73565,HCPCS,320,RC,,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR KNEE 4V+ LEFT,73564,HCPCS,320,RC,LT,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR KNEE 4V+ LEFT,73564,HCPCS,320,RC,LT,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR KNEE 4V+ LEFT,73564,HCPCS,320,RC,LT,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR KNEE 4V+ RIGHT,73564,HCPCS,320,RC,RT,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR KNEE 4V+ RIGHT,73564,HCPCS,320,RC,RT,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR KNEE 4V+ RIGHT,73564,HCPCS,320,RC,RT,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR KNEE 1/2 VIEWS LEFT,73560,HCPCS,320,RC,LT,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR KNEE 1/2 VIEWS LEFT,73560,HCPCS,320,RC,LT,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR KNEE 1/2 VIEWS LEFT,73560,HCPCS,320,RC,LT,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR KNEE 1/2 VIEWS RIGHT,73560,HCPCS,320,RC,RT,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR KNEE 1/2 VIEWS RIGHT,73560,HCPCS,320,RC,RT,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR KNEE 1/2 VIEWS RIGHT,73560,HCPCS,320,RC,RT,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR KNEE 3V LT,73562,HCPCS,320,RC,LT,both,383,344.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.1,,,,225.97,312.53
XR KNEE 3V LT,73562,HCPCS,320,RC,LT,both,383,344.7,Cigna,Default,Percent of Total Billed Charges,225.97,,,,225.97,312.53
XR KNEE 3V LT,73562,HCPCS,320,RC,LT,both,383,344.7,United Healthcare,Default,Fee Schedule,312.53,,,,225.97,312.53
XR KNEE 3V RT,73562,HCPCS,320,RC,RT,both,383,344.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.1,,,,225.97,312.53
XR KNEE 3V RT,73562,HCPCS,320,RC,RT,both,383,344.7,Cigna,Default,Percent of Total Billed Charges,225.97,,,,225.97,312.53
XR KNEE 3V RT,73562,HCPCS,320,RC,RT,both,383,344.7,United Healthcare,Default,Fee Schedule,312.53,,,,225.97,312.53
XR KNEE BILATERAL,73560,HCPCS,320,RC,50,both,445.64,401.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.95,,,,262.93,363.64
XR KNEE BILATERAL,73560,HCPCS,320,RC,50,both,445.64,401.08,Cigna,Default,Percent of Total Billed Charges,262.93,,,,262.93,363.64
XR KNEE BILATERAL,73560,HCPCS,320,RC,50,both,445.64,401.08,United Healthcare,Default,Fee Schedule,363.64,,,,262.93,363.64
XR FEMUR 2 VWS LEFT,73550,HCPCS,320,RC,LT,both,231.75,208.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.22,,,,136.73,189.11
XR FEMUR 2 VWS LEFT,73550,HCPCS,320,RC,LT,both,231.75,208.58,Cigna,Default,Percent of Total Billed Charges,136.73,,,,136.73,189.11
XR FEMUR 2 VWS LEFT,73550,HCPCS,320,RC,LT,both,231.75,208.58,United Healthcare,Default,Fee Schedule,189.11,,,,136.73,189.11
XR FEMUR 2VWS RIGHT,73550,HCPCS,320,RC,RT,both,231.75,208.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.22,,,,136.73,189.11
XR FEMUR 2VWS RIGHT,73550,HCPCS,320,RC,RT,both,231.75,208.58,Cigna,Default,Percent of Total Billed Charges,136.73,,,,136.73,189.11
XR FEMUR 2VWS RIGHT,73550,HCPCS,320,RC,RT,both,231.75,208.58,United Healthcare,Default,Fee Schedule,189.11,,,,136.73,189.11
XR TOE LEFT GREAT TOE,73660,HCPCS,320,RC,"TA,LT",both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE LEFT GREAT TOE,73660,HCPCS,320,RC,"TA,LT",both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE LEFT GREAT TOE,73660,HCPCS,320,RC,"TA,LT",both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR TOE RIGHT 5TH,73660,HCPCS,320,RC,T9,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE RIGHT 5TH,73660,HCPCS,320,RC,T9,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE RIGHT 5TH,73660,HCPCS,320,RC,T9,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR HIP COMPLETE RIGHT,73510,HCPCS,320,RC,RT,both,333.25,299.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.28,,,,196.62,271.93
XR HIP COMPLETE RIGHT,73510,HCPCS,320,RC,RT,both,333.25,299.93,Cigna,Default,Percent of Total Billed Charges,196.62,,,,196.62,271.93
XR HIP COMPLETE RIGHT,73510,HCPCS,320,RC,RT,both,333.25,299.93,United Healthcare,Default,Fee Schedule,271.93,,,,196.62,271.93
XR HIP COMPLETE LEFT,73510,HCPCS,320,RC,LT,both,333.25,299.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,233.28,,,,196.62,271.93
XR HIP COMPLETE LEFT,73510,HCPCS,320,RC,LT,both,333.25,299.93,Cigna,Default,Percent of Total Billed Charges,196.62,,,,196.62,271.93
XR HIP COMPLETE LEFT,73510,HCPCS,320,RC,LT,both,333.25,299.93,United Healthcare,Default,Fee Schedule,271.93,,,,196.62,271.93
XR PELVIS 1/2 VWS,72170,HCPCS,320,RC,,both,417.22,375.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.05,,,,246.16,340.45
XR PELVIS 1/2 VWS,72170,HCPCS,320,RC,,both,417.22,375.5,Cigna,Default,Percent of Total Billed Charges,246.16,,,,246.16,340.45
XR PELVIS 1/2 VWS,72170,HCPCS,320,RC,,both,417.22,375.5,United Healthcare,Default,Fee Schedule,340.45,,,,246.16,340.45
XR PEL HIP INFANT,73540,HCPCS,320,RC,,both,209.5,188.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.65,,,,123.6,170.95
XR PEL HIP INFANT,73540,HCPCS,320,RC,,both,209.5,188.55,Cigna,Default,Percent of Total Billed Charges,123.6,,,,123.6,170.95
XR PEL HIP INFANT,73540,HCPCS,320,RC,,both,209.5,188.55,United Healthcare,Default,Fee Schedule,170.95,,,,123.6,170.95
XR SKELETAL SURVEY,77075,HCPCS,320,RC,,both,1000.66,900.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,700.46,,,,590.39,816.54
XR SKELETAL SURVEY,77075,HCPCS,320,RC,,both,1000.66,900.59,Cigna,Default,Percent of Total Billed Charges,590.39,,,,590.39,816.54
XR SKELETAL SURVEY,77075,HCPCS,320,RC,,both,1000.66,900.59,United Healthcare,Default,Fee Schedule,816.54,,,,590.39,816.54
XR BONE AGE,77072,HCPCS,320,RC,,both,376.86,339.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.8,,,,222.35,307.52
XR BONE AGE,77072,HCPCS,320,RC,,both,376.86,339.17,Cigna,Default,Percent of Total Billed Charges,222.35,,,,222.35,307.52
XR BONE AGE,77072,HCPCS,320,RC,,both,376.86,339.17,United Healthcare,Default,Fee Schedule,307.52,,,,222.35,307.52
XR STRNO CLVCLR JN,71130,HCPCS,320,RC,,both,315.45,283.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.82,,,,186.12,257.41
XR STRNO CLVCLR JN,71130,HCPCS,320,RC,,both,315.45,283.91,Cigna,Default,Percent of Total Billed Charges,186.12,,,,186.12,257.41
XR STRNO CLVCLR JN,71130,HCPCS,320,RC,,both,315.45,283.91,United Healthcare,Default,Fee Schedule,257.41,,,,186.12,257.41
XR TOE LEFT 2ND,73660,HCPCS,320,RC,T1,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE LEFT 2ND,73660,HCPCS,320,RC,T1,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE LEFT 2ND,73660,HCPCS,320,RC,T1,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR HAND MIN 3 VWS,73130,HCPCS,320,RC,,both,236.66,212.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.66,,,,139.63,193.11
XR HAND MIN 3 VWS,73130,HCPCS,320,RC,,both,236.66,212.99,Cigna,Default,Percent of Total Billed Charges,139.63,,,,139.63,193.11
XR HAND MIN 3 VWS,73130,HCPCS,320,RC,,both,236.66,212.99,United Healthcare,Default,Fee Schedule,193.11,,,,139.63,193.11
XR HAND MIN 3 VWS LT,73130,HCPCS,320,RC,LT,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR HAND MIN 3 VWS LT,73130,HCPCS,320,RC,LT,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR HAND MIN 3 VWS LT,73130,HCPCS,320,RC,LT,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR HAND 2 VIEW LEFT,73120,HCPCS,320,RC,LT,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR HAND 2 VIEW LEFT,73120,HCPCS,320,RC,LT,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR HAND 2 VIEW LEFT,73120,HCPCS,320,RC,LT,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR HAND 3 VWS RT,73130,HCPCS,320,RC,RT,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR HAND 3 VWS RT,73130,HCPCS,320,RC,RT,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR HAND 3 VWS RT,73130,HCPCS,320,RC,RT,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER LEFT THUMB,73140,HCPCS,320,RC,FA,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER LEFT THUMB,73140,HCPCS,320,RC,FA,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER LEFT THUMB,73140,HCPCS,320,RC,FA,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR HAND 2 VIEW RIGHT,73120,HCPCS,320,RC,RT,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR HAND 2 VIEW RIGHT,73120,HCPCS,320,RC,RT,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR HAND 2 VIEW RIGHT,73120,HCPCS,320,RC,RT,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR FINGER-2ND DIGIT LEFT,73140,HCPCS,320,RC,F1,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-2ND DIGIT LEFT,73140,HCPCS,320,RC,F1,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-2ND DIGIT LEFT,73140,HCPCS,320,RC,F1,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-3RD DIGIT LEFT,73140,HCPCS,320,RC,F2,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-3RD DIGIT LEFT,73140,HCPCS,320,RC,F2,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-3RD DIGIT LEFT,73140,HCPCS,320,RC,F2,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-4TH DIGIT LEFT,73140,HCPCS,320,RC,F4,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-4TH DIGIT LEFT,73140,HCPCS,320,RC,F4,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-4TH DIGIT LEFT,73140,HCPCS,320,RC,F4,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-5TH DIGIT LEFT,73140,HCPCS,320,RC,F4,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-5TH DIGIT LEFT,73140,HCPCS,320,RC,F4,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-5TH DIGIT LEFT,73140,HCPCS,320,RC,F4,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER RIGHT THUMB,73140,HCPCS,320,RC,F5,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER RIGHT THUMB,73140,HCPCS,320,RC,F5,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER RIGHT THUMB,73140,HCPCS,320,RC,F5,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-2ND DIGIT RIGHT,73140,HCPCS,320,RC,F6,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-2ND DIGIT RIGHT,73140,HCPCS,320,RC,F6,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-2ND DIGIT RIGHT,73140,HCPCS,320,RC,F6,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-3RD DIGIT RIGHT,73140,HCPCS,320,RC,F7,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-3RD DIGIT RIGHT,73140,HCPCS,320,RC,F7,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-3RD DIGIT RIGHT,73140,HCPCS,320,RC,F7,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-4TH DIGIT RIGHT,73140,HCPCS,320,RC,F8,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-4TH DIGIT RIGHT,73140,HCPCS,320,RC,F8,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-4TH DIGIT RIGHT,73140,HCPCS,320,RC,F8,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR FINGER-5TH DIGIT RIGHT,73140,HCPCS,320,RC,F9,both,297.09,267.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.43
XR FINGER-5TH DIGIT RIGHT,73140,HCPCS,320,RC,F9,both,297.09,267.38,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.43
XR FINGER-5TH DIGIT RIGHT,73140,HCPCS,320,RC,F9,both,297.09,267.38,United Healthcare,Default,Fee Schedule,242.43,,,,175.28,242.43
XR WRIST LEFT,73110,HCPCS,320,RC,LT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR WRIST LEFT,73110,HCPCS,320,RC,LT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR WRIST LEFT,73110,HCPCS,320,RC,LT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR WRIST RIGHT,73110,HCPCS,320,RC,RT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR WRIST RIGHT,73110,HCPCS,320,RC,RT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR WRIST RIGHT,73110,HCPCS,320,RC,RT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR FEMUR 1V RT,73551,HCPCS,320,RC,RT,both,392.43,353.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.7,,,,231.53,320.22
XR FEMUR 1V RT,73551,HCPCS,320,RC,RT,both,392.43,353.19,Cigna,Default,Percent of Total Billed Charges,231.53,,,,231.53,320.22
XR FEMUR 1V RT,73551,HCPCS,320,RC,RT,both,392.43,353.19,United Healthcare,Default,Fee Schedule,320.22,,,,231.53,320.22
XR FEMUR 2V RT,73552,HCPCS,320,RC,RT,both,392.43,353.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.7,,,,231.53,320.22
XR FEMUR 2V RT,73552,HCPCS,320,RC,RT,both,392.43,353.19,Cigna,Default,Percent of Total Billed Charges,231.53,,,,231.53,320.22
XR FEMUR 2V RT,73552,HCPCS,320,RC,RT,both,392.43,353.19,United Healthcare,Default,Fee Schedule,320.22,,,,231.53,320.22
XR FEMUR 1V LT,73551,HCPCS,320,RC,LT,both,392.43,353.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.7,,,,231.53,320.22
XR FEMUR 1V LT,73551,HCPCS,320,RC,LT,both,392.43,353.19,Cigna,Default,Percent of Total Billed Charges,231.53,,,,231.53,320.22
XR FEMUR 1V LT,73551,HCPCS,320,RC,LT,both,392.43,353.19,United Healthcare,Default,Fee Schedule,320.22,,,,231.53,320.22
XR FEMUR 2V LT,73552,HCPCS,320,RC,LT,both,392.43,353.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.7,,,,231.53,320.22
XR FEMUR 2V LT,73552,HCPCS,320,RC,LT,both,392.43,353.19,Cigna,Default,Percent of Total Billed Charges,231.53,,,,231.53,320.22
XR FEMUR 2V LT,73552,HCPCS,320,RC,LT,both,392.43,353.19,United Healthcare,Default,Fee Schedule,320.22,,,,231.53,320.22
CT UPPER EXT W/O LT,73200,HCPCS,350,RC,LT,both,2704.2,2433.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1892.94,,,,520,2206.63
CT UPPER EXT W/O LT,73200,HCPCS,350,RC,LT,both,2704.2,2433.78,Cigna,Default,Case Rate,520,,,,520,2206.63
CT UPPER EXT W/O LT,73200,HCPCS,350,RC,LT,both,2704.2,2433.78,United Healthcare,Default,Fee Schedule,2206.63,,,,520,2206.63
CT UPPER EXT W/ LT,73201,HCPCS,350,RC,LT,both,2704.2,2433.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1892.94,,,,520,2206.63
CT UPPER EXT W/ LT,73201,HCPCS,350,RC,LT,both,2704.2,2433.78,Cigna,Default,Case Rate,520,,,,520,2206.63
CT UPPER EXT W/ LT,73201,HCPCS,350,RC,LT,both,2704.2,2433.78,United Healthcare,Default,Fee Schedule,2206.63,,,,520,2206.63
CT UPPER EXT W/ & W/O LT,73202,HCPCS,350,RC,LT,both,2704.2,2433.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1892.94,,,,520,2206.63
CT UPPER EXT W/ & W/O LT,73202,HCPCS,350,RC,LT,both,2704.2,2433.78,Cigna,Default,Case Rate,520,,,,520,2206.63
CT UPPER EXT W/ & W/O LT,73202,HCPCS,350,RC,LT,both,2704.2,2433.78,United Healthcare,Default,Fee Schedule,2206.63,,,,520,2206.63
XR FOREARM RIGHT,73090,HCPCS,320,RC,RT,both,323.03,290.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,226.12,,,,190.59,263.59
XR FOREARM RIGHT,73090,HCPCS,320,RC,RT,both,323.03,290.73,Cigna,Default,Percent of Total Billed Charges,190.59,,,,190.59,263.59
XR FOREARM RIGHT,73090,HCPCS,320,RC,RT,both,323.03,290.73,United Healthcare,Default,Fee Schedule,263.59,,,,190.59,263.59
XR FOREARM LEFT,73090,HCPCS,320,RC,LT,both,323.03,290.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,226.12,,,,190.59,263.59
XR FOREARM LEFT,73090,HCPCS,320,RC,LT,both,323.03,290.73,Cigna,Default,Percent of Total Billed Charges,190.59,,,,190.59,263.59
XR FOREARM LEFT,73090,HCPCS,320,RC,LT,both,323.03,290.73,United Healthcare,Default,Fee Schedule,263.59,,,,190.59,263.59
XR HUMERUS RIGHT,73060,HCPCS,320,RC,RT,both,395.58,356.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.91,,,,233.39,322.79
XR HUMERUS RIGHT,73060,HCPCS,320,RC,RT,both,395.58,356.02,Cigna,Default,Percent of Total Billed Charges,233.39,,,,233.39,322.79
XR HUMERUS RIGHT,73060,HCPCS,320,RC,RT,both,395.58,356.02,United Healthcare,Default,Fee Schedule,322.79,,,,233.39,322.79
XR HUMERUS LEFT,73060,HCPCS,320,RC,LT,both,395.58,356.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.91,,,,233.39,322.79
XR HUMERUS LEFT,73060,HCPCS,320,RC,LT,both,395.58,356.02,Cigna,Default,Percent of Total Billed Charges,233.39,,,,233.39,322.79
XR HUMERUS LEFT,73060,HCPCS,320,RC,LT,both,395.58,356.02,United Healthcare,Default,Fee Schedule,322.79,,,,233.39,322.79
XR SCAPULA COMPLETE RT,73010,HCPCS,320,RC,RT,both,417.22,375.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.05,,,,246.16,340.45
XR SCAPULA COMPLETE RT,73010,HCPCS,320,RC,RT,both,417.22,375.5,Cigna,Default,Percent of Total Billed Charges,246.16,,,,246.16,340.45
XR SCAPULA COMPLETE RT,73010,HCPCS,320,RC,RT,both,417.22,375.5,United Healthcare,Default,Fee Schedule,340.45,,,,246.16,340.45
XR SCAPULA COMPLETE LT,73010,HCPCS,320,RC,LT,both,417.22,375.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.05,,,,246.16,340.45
XR SCAPULA COMPLETE LT,73010,HCPCS,320,RC,LT,both,417.22,375.5,Cigna,Default,Percent of Total Billed Charges,246.16,,,,246.16,340.45
XR SCAPULA COMPLETE LT,73010,HCPCS,320,RC,LT,both,417.22,375.5,United Healthcare,Default,Fee Schedule,340.45,,,,246.16,340.45
XR SCAPULA COMPLETE BIL,73010,HCPCS,320,RC,50,both,471.6,424.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,330.12,,,,278.24,384.83
XR SCAPULA COMPLETE BIL,73010,HCPCS,320,RC,50,both,471.6,424.44,Cigna,Default,Percent of Total Billed Charges,278.24,,,,278.24,384.83
XR SCAPULA COMPLETE BIL,73010,HCPCS,320,RC,50,both,471.6,424.44,United Healthcare,Default,Fee Schedule,384.83,,,,278.24,384.83
XR CLAVICLE COMPLETE LT,73000,HCPCS,320,RC,LT,both,321.77,289.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.24,,,,189.84,262.56
XR CLAVICLE COMPLETE LT,73000,HCPCS,320,RC,LT,both,321.77,289.59,Cigna,Default,Percent of Total Billed Charges,189.84,,,,189.84,262.56
XR CLAVICLE COMPLETE LT,73000,HCPCS,320,RC,LT,both,321.77,289.59,United Healthcare,Default,Fee Schedule,262.56,,,,189.84,262.56
XR CLAVICLE COMPLETE RT,73000,HCPCS,320,RC,RT,both,321.77,289.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.24,,,,189.84,262.56
XR CLAVICLE COMPLETE RT,73000,HCPCS,320,RC,RT,both,321.77,289.59,Cigna,Default,Percent of Total Billed Charges,189.84,,,,189.84,262.56
XR CLAVICLE COMPLETE RT,73000,HCPCS,320,RC,RT,both,321.77,289.59,United Healthcare,Default,Fee Schedule,262.56,,,,189.84,262.56
XR SHOULDER LEFT 1 VIEW,73020,HCPCS,320,RC,LT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR SHOULDER LEFT 1 VIEW,73020,HCPCS,320,RC,LT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR SHOULDER LEFT 1 VIEW,73020,HCPCS,320,RC,LT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR SHOULDER RIGHT 1 VIEW,73020,HCPCS,320,RC,RT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR SHOULDER RIGHT 1 VIEW,73020,HCPCS,320,RC,RT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR SHOULDER RIGHT 1 VIEW,73020,HCPCS,320,RC,RT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR SHOULDER COMPLETE LT,73030,HCPCS,320,RC,LT,both,309.22,278.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.45,,,,182.44,252.32
XR SHOULDER COMPLETE LT,73030,HCPCS,320,RC,LT,both,309.22,278.3,Cigna,Default,Percent of Total Billed Charges,182.44,,,,182.44,252.32
XR SHOULDER COMPLETE LT,73030,HCPCS,320,RC,LT,both,309.22,278.3,United Healthcare,Default,Fee Schedule,252.32,,,,182.44,252.32
XR SHOULDER COMPLETE BILATERAL,73030,HCPCS,320,RC,50,both,471.6,424.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,330.12,,,,278.24,384.83
XR SHOULDER COMPLETE BILATERAL,73030,HCPCS,320,RC,50,both,471.6,424.44,Cigna,Default,Percent of Total Billed Charges,278.24,,,,278.24,384.83
XR SHOULDER COMPLETE BILATERAL,73030,HCPCS,320,RC,50,both,471.6,424.44,United Healthcare,Default,Fee Schedule,384.83,,,,278.24,384.83
XR SHOULDER COMPLETE RT,73030,HCPCS,320,RC,RT,both,310.36,279.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,217.25,,,,183.11,253.25
XR SHOULDER COMPLETE RT,73030,HCPCS,320,RC,RT,both,310.36,279.32,Cigna,Default,Percent of Total Billed Charges,183.11,,,,183.11,253.25
XR SHOULDER COMPLETE RT,73030,HCPCS,320,RC,RT,both,310.36,279.32,United Healthcare,Default,Fee Schedule,253.25,,,,183.11,253.25
XR CLAVICLE BILATERAL,73000,HCPCS,320,RC,50,both,482.64,434.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,337.85,,,,284.76,393.83
XR CLAVICLE BILATERAL,73000,HCPCS,320,RC,50,both,482.64,434.38,Cigna,Default,Percent of Total Billed Charges,284.76,,,,284.76,393.83
XR CLAVICLE BILATERAL,73000,HCPCS,320,RC,50,both,482.64,434.38,United Healthcare,Default,Fee Schedule,393.83,,,,284.76,393.83
X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,HCPCS,320,RC,,both,576.1,518.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,403.27,,,,339.9,470.1
X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,HCPCS,320,RC,,both,576.1,518.49,Cigna,Default,Percent of Total Billed Charges,339.9,,,,339.9,470.1
X-RAY EXAM OF HUMERUS 2+ VIEWS,73060,HCPCS,320,RC,,both,576.1,518.49,United Healthcare,Default,Fee Schedule,470.1,,,,339.9,470.1
XR ELBOW 2v BILATERAL,73070,HCPCS,320,RC,50,both,447.85,403.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,313.5,,,,264.23,365.45
XR ELBOW 2v BILATERAL,73070,HCPCS,320,RC,50,both,447.85,403.07,Cigna,Default,Percent of Total Billed Charges,264.23,,,,264.23,365.45
XR ELBOW 2v BILATERAL,73070,HCPCS,320,RC,50,both,447.85,403.07,United Healthcare,Default,Fee Schedule,365.45,,,,264.23,365.45
XR ELBOW 3v BILATERAL,73080,HCPCS,320,RC,50,both,604.61,544.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,423.23,,,,356.72,493.36
XR ELBOW 3v BILATERAL,73080,HCPCS,320,RC,50,both,604.61,544.15,Cigna,Default,Percent of Total Billed Charges,356.72,,,,356.72,493.36
XR ELBOW 3v BILATERAL,73080,HCPCS,320,RC,50,both,604.61,544.15,United Healthcare,Default,Fee Schedule,493.36,,,,356.72,493.36
XR FOREARM BILATERAL,73090,HCPCS,320,RC,50,both,484.55,436.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,339.18,,,,285.88,395.39
XR FOREARM BILATERAL,73090,HCPCS,320,RC,50,both,484.55,436.1,Cigna,Default,Percent of Total Billed Charges,285.88,,,,285.88,395.39
XR FOREARM BILATERAL,73090,HCPCS,320,RC,50,both,484.55,436.1,United Healthcare,Default,Fee Schedule,395.39,,,,285.88,395.39
XR WRIST BILATERAL,73110,HCPCS,320,RC,50,both,354.99,319.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,248.49,,,,209.44,289.67
XR WRIST BILATERAL,73110,HCPCS,320,RC,50,both,354.99,319.49,Cigna,Default,Percent of Total Billed Charges,209.44,,,,209.44,289.67
XR WRIST BILATERAL,73110,HCPCS,320,RC,50,both,354.99,319.49,United Healthcare,Default,Fee Schedule,289.67,,,,209.44,289.67
XR HAND BILATERAL,73120,HCPCS,320,RC,50,both,376.86,339.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.8,,,,222.35,307.52
XR HAND BILATERAL,73120,HCPCS,320,RC,50,both,376.86,339.17,Cigna,Default,Percent of Total Billed Charges,222.35,,,,222.35,307.52
XR HAND BILATERAL,73120,HCPCS,320,RC,50,both,376.86,339.17,United Healthcare,Default,Fee Schedule,307.52,,,,222.35,307.52
XR HIP BILATERAL,73510,HCPCS,320,RC,50,both,499.88,449.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,349.92,,,,294.93,407.9
XR HIP BILATERAL,73510,HCPCS,320,RC,50,both,499.88,449.89,Cigna,Default,Percent of Total Billed Charges,294.93,,,,294.93,407.9
XR HIP BILATERAL,73510,HCPCS,320,RC,50,both,499.88,449.89,United Healthcare,Default,Fee Schedule,407.9,,,,294.93,407.9
XR FEMUR BILATERAL,73550,HCPCS,320,RC,50,both,347.62,312.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,243.33,,,,205.1,283.66
XR FEMUR BILATERAL,73550,HCPCS,320,RC,50,both,347.62,312.86,Cigna,Default,Percent of Total Billed Charges,205.1,,,,205.1,283.66
XR FEMUR BILATERAL,73550,HCPCS,320,RC,50,both,347.62,312.86,United Healthcare,Default,Fee Schedule,283.66,,,,205.1,283.66
XR LOWER LEG BILATERAL,73590,HCPCS,320,RC,50,both,593.38,534.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,415.37,,,,350.09,484.2
XR LOWER LEG BILATERAL,73590,HCPCS,320,RC,50,both,593.38,534.04,Cigna,Default,Percent of Total Billed Charges,350.09,,,,350.09,484.2
XR LOWER LEG BILATERAL,73590,HCPCS,320,RC,50,both,593.38,534.04,United Healthcare,Default,Fee Schedule,484.2,,,,350.09,484.2
XR ANKLE BILATERAL,73610,HCPCS,320,RC,50,both,536.78,483.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,375.75,,,,316.7,438.01
XR ANKLE BILATERAL,73610,HCPCS,320,RC,50,both,536.78,483.1,Cigna,Default,Percent of Total Billed Charges,316.7,,,,316.7,438.01
XR ANKLE BILATERAL,73610,HCPCS,320,RC,50,both,536.78,483.1,United Healthcare,Default,Fee Schedule,438.01,,,,316.7,438.01
XR FOOT BILATERAL,73630,HCPCS,320,RC,50,both,417.95,376.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.56,,,,246.59,341.05
XR FOOT BILATERAL,73630,HCPCS,320,RC,50,both,417.95,376.16,Cigna,Default,Percent of Total Billed Charges,246.59,,,,246.59,341.05
XR FOOT BILATERAL,73630,HCPCS,320,RC,50,both,417.95,376.16,United Healthcare,Default,Fee Schedule,341.05,,,,246.59,341.05
XR AC JOINTS BILATERAL,73050,HCPCS,320,RC,,both,424.95,382.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,297.46,,,,250.72,346.76
XR AC JOINTS BILATERAL,73050,HCPCS,320,RC,,both,424.95,382.46,Cigna,Default,Percent of Total Billed Charges,250.72,,,,250.72,346.76
XR AC JOINTS BILATERAL,73050,HCPCS,320,RC,,both,424.95,382.46,United Healthcare,Default,Fee Schedule,346.76,,,,250.72,346.76
XR TOE LEFT 3RD,73660,HCPCS,320,RC,T2,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE LEFT 3RD,73660,HCPCS,320,RC,T2,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE LEFT 3RD,73660,HCPCS,320,RC,T2,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR NECK SOFT TISSE,70360,HCPCS,320,RC,,both,298.85,268.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209.2,,,,176.32,243.86
XR NECK SOFT TISSE,70360,HCPCS,320,RC,,both,298.85,268.97,Cigna,Default,Percent of Total Billed Charges,176.32,,,,176.32,243.86
XR NECK SOFT TISSE,70360,HCPCS,320,RC,,both,298.85,268.97,United Healthcare,Default,Fee Schedule,243.86,,,,176.32,243.86
XR SPINE ENTIRE,72010,HCPCS,320,RC,,both,879,791.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,615.3,,,,518.61,717.26
XR SPINE ENTIRE,72010,HCPCS,320,RC,,both,879,791.1,Cigna,Default,Percent of Total Billed Charges,518.61,,,,518.61,717.26
XR SPINE ENTIRE,72010,HCPCS,320,RC,,both,879,791.1,United Healthcare,Default,Fee Schedule,717.26,,,,518.61,717.26
XR TSPINE 2VWS,72070,HCPCS,320,RC,,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR TSPINE 2VWS,72070,HCPCS,320,RC,,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR TSPINE 2VWS,72070,HCPCS,320,RC,,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR SACRO ILIAC JNT,72200,HCPCS,320,RC,,both,417.22,375.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.05,,,,246.16,340.45
XR SACRO ILIAC JNT,72200,HCPCS,320,RC,,both,417.22,375.5,Cigna,Default,Percent of Total Billed Charges,246.16,,,,246.16,340.45
XR SACRO ILIAC JNT,72200,HCPCS,320,RC,,both,417.22,375.5,United Healthcare,Default,Fee Schedule,340.45,,,,246.16,340.45
XR COCCYX & SACRUM,72220,HCPCS,320,RC,,both,323.33,291,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,226.33,,,,190.76,263.84
XR COCCYX & SACRUM,72220,HCPCS,320,RC,,both,323.33,291,Cigna,Default,Percent of Total Billed Charges,190.76,,,,190.76,263.84
XR COCCYX & SACRUM,72220,HCPCS,320,RC,,both,323.33,291,United Healthcare,Default,Fee Schedule,263.84,,,,190.76,263.84
XR SACRUM COCCYX,72220,HCPCS,320,RC,,both,782.44,704.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,547.71,,,,461.64,638.47
XR SACRUM COCCYX,72220,HCPCS,320,RC,,both,782.44,704.2,Cigna,Default,Percent of Total Billed Charges,461.64,,,,461.64,638.47
XR SACRUM COCCYX,72220,HCPCS,320,RC,,both,782.44,704.2,United Healthcare,Default,Fee Schedule,638.47,,,,461.64,638.47
XR LMBR SPNE MN 4VWS,72110,HCPCS,320,RC,,both,533.79,480.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,373.65,,,,314.94,435.57
XR LMBR SPNE MN 4VWS,72110,HCPCS,320,RC,,both,533.79,480.41,Cigna,Default,Percent of Total Billed Charges,314.94,,,,314.94,435.57
XR LMBR SPNE MN 4VWS,72110,HCPCS,320,RC,,both,533.79,480.41,United Healthcare,Default,Fee Schedule,435.57,,,,314.94,435.57
LUMBAR MYELOGRAM,72265,HCPCS,320,RC,,both,2472.55,2225.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1730.78,,,,1458.8,2017.6
LUMBAR MYELOGRAM,72265,HCPCS,320,RC,,both,2472.55,2225.3,Cigna,Default,Percent of Total Billed Charges,1458.8,,,,1458.8,2017.6
LUMBAR MYELOGRAM,72265,HCPCS,320,RC,,both,2472.55,2225.3,United Healthcare,Default,Fee Schedule,2017.6,,,,1458.8,2017.6
XR SPINE 1 VIEW,72020,HCPCS,320,RC,,both,240.69,216.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.48,,,,142.01,196.4
XR SPINE 1 VIEW,72020,HCPCS,320,RC,,both,240.69,216.62,Cigna,Default,Percent of Total Billed Charges,142.01,,,,142.01,196.4
XR SPINE 1 VIEW,72020,HCPCS,320,RC,,both,240.69,216.62,United Healthcare,Default,Fee Schedule,196.4,,,,142.01,196.4
XR LSPINE COMPLETE,72114,HCPCS,320,RC,,both,576.4,518.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,403.48,,,,340.08,470.34
XR LSPINE COMPLETE,72114,HCPCS,320,RC,,both,576.4,518.76,Cigna,Default,Percent of Total Billed Charges,340.08,,,,340.08,470.34
XR LSPINE COMPLETE,72114,HCPCS,320,RC,,both,576.4,518.76,United Healthcare,Default,Fee Schedule,470.34,,,,340.08,470.34
XR LUMBAR FLEXION EXTENSION 2V,72120,HCPCS,320,RC,,both,407.05,366.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,284.94,,,,240.16,332.15
XR LUMBAR FLEXION EXTENSION 2V,72120,HCPCS,320,RC,,both,407.05,366.35,Cigna,Default,Percent of Total Billed Charges,240.16,,,,240.16,332.15
XR LUMBAR FLEXION EXTENSION 2V,72120,HCPCS,320,RC,,both,407.05,366.35,United Healthcare,Default,Fee Schedule,332.15,,,,240.16,332.15
XR LUMBAR SPN 2/3 VIEW,72100,HCPCS,320,RC,,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR LUMBAR SPN 2/3 VIEW,72100,HCPCS,320,RC,,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR LUMBAR SPN 2/3 VIEW,72100,HCPCS,320,RC,,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR TSPINE 3 VWS,72072,HCPCS,320,RC,,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR TSPINE 3 VWS,72072,HCPCS,320,RC,,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR TSPINE 3 VWS,72072,HCPCS,320,RC,,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR TOE LEFT 4TH,73660,HCPCS,320,RC,T3,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE LEFT 4TH,73660,HCPCS,320,RC,T3,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE LEFT 4TH,73660,HCPCS,320,RC,T3,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR C SPINE 4/5 VWS,72050,HCPCS,320,RC,,both,448.86,403.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.2,,,,264.83,366.27
XR C SPINE 4/5 VWS,72050,HCPCS,320,RC,,both,448.86,403.97,Cigna,Default,Percent of Total Billed Charges,264.83,,,,264.83,366.27
XR C SPINE 4/5 VWS,72050,HCPCS,320,RC,,both,448.86,403.97,United Healthcare,Default,Fee Schedule,366.27,,,,264.83,366.27
XR C SPINE COMPLETE,72052,HCPCS,320,RC,,both,387.37,348.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,271.16,,,,228.55,316.09
XR C SPINE COMPLETE,72052,HCPCS,320,RC,,both,387.37,348.63,Cigna,Default,Percent of Total Billed Charges,228.55,,,,228.55,316.09
XR C SPINE COMPLETE,72052,HCPCS,320,RC,,both,387.37,348.63,United Healthcare,Default,Fee Schedule,316.09,,,,228.55,316.09
XR C SPINE 2/3 VWS,72040,HCPCS,320,RC,,both,376.86,339.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.8,,,,222.35,307.52
XR C SPINE 2/3 VWS,72040,HCPCS,320,RC,,both,376.86,339.17,Cigna,Default,Percent of Total Billed Charges,222.35,,,,222.35,307.52
XR C SPINE 2/3 VWS,72040,HCPCS,320,RC,,both,376.86,339.17,United Healthcare,Default,Fee Schedule,307.52,,,,222.35,307.52
XR CERVICAL MYELOGRAM,72240,HCPCS,320,RC,,both,2400.53,2160.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1680.37,,,,1416.31,1958.83
XR CERVICAL MYELOGRAM,72240,HCPCS,320,RC,,both,2400.53,2160.48,Cigna,Default,Percent of Total Billed Charges,1416.31,,,,1416.31,1958.83
XR CERVICAL MYELOGRAM,72240,HCPCS,320,RC,,both,2400.53,2160.48,United Healthcare,Default,Fee Schedule,1958.83,,,,1416.31,1958.83
XR ELBOW LT 2 VIEWS,73070,HCPCS,320,RC,,both,298.57,268.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209,,,,176.16,243.63
XR ELBOW LT 2 VIEWS,73070,HCPCS,320,RC,,both,298.57,268.71,Cigna,Default,Percent of Total Billed Charges,176.16,,,,176.16,243.63
XR ELBOW LT 2 VIEWS,73070,HCPCS,320,RC,,both,298.57,268.71,United Healthcare,Default,Fee Schedule,243.63,,,,176.16,243.63
XR ELBOW RT 2 VIEW,73070,HCPCS,320,RC,,both,298.57,268.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209,,,,176.16,243.63
XR ELBOW RT 2 VIEW,73070,HCPCS,320,RC,,both,298.57,268.71,Cigna,Default,Percent of Total Billed Charges,176.16,,,,176.16,243.63
XR ELBOW RT 2 VIEW,73070,HCPCS,320,RC,,both,298.57,268.71,United Healthcare,Default,Fee Schedule,243.63,,,,176.16,243.63
XR ELBOW RIGHT 3 VIEW,73080,HCPCS,320,RC,RT,both,403.07,362.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.15,,,,237.81,328.91
XR ELBOW RIGHT 3 VIEW,73080,HCPCS,320,RC,RT,both,403.07,362.76,Cigna,Default,Percent of Total Billed Charges,237.81,,,,237.81,328.91
XR ELBOW RIGHT 3 VIEW,73080,HCPCS,320,RC,RT,both,403.07,362.76,United Healthcare,Default,Fee Schedule,328.91,,,,237.81,328.91
XR ELBOW LEFT 3 VIEW,73080,HCPCS,320,RC,LT,both,403.07,362.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,282.15,,,,237.81,328.91
XR ELBOW LEFT 3 VIEW,73080,HCPCS,320,RC,LT,both,403.07,362.76,Cigna,Default,Percent of Total Billed Charges,237.81,,,,237.81,328.91
XR ELBOW LEFT 3 VIEW,73080,HCPCS,320,RC,LT,both,403.07,362.76,United Healthcare,Default,Fee Schedule,328.91,,,,237.81,328.91
XR CALCANEUS RIGHT (HEEL),73650,HCPCS,320,RC,RT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR CALCANEUS RIGHT (HEEL),73650,HCPCS,320,RC,RT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR CALCANEUS RIGHT (HEEL),73650,HCPCS,320,RC,RT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR CALCANEUS LEFT (HEEL),73650,HCPCS,320,RC,LT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR CALCANEUS LEFT (HEEL),73650,HCPCS,320,RC,LT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR CALCANEUS LEFT (HEEL),73650,HCPCS,320,RC,LT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR LOWER EXT. INFANT LEFT,73592,HCPCS,320,RC,LT,both,298.57,268.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209,,,,176.16,243.63
XR LOWER EXT. INFANT LEFT,73592,HCPCS,320,RC,LT,both,298.57,268.71,Cigna,Default,Percent of Total Billed Charges,176.16,,,,176.16,243.63
XR LOWER EXT. INFANT LEFT,73592,HCPCS,320,RC,LT,both,298.57,268.71,United Healthcare,Default,Fee Schedule,243.63,,,,176.16,243.63
XR LOWER EXT. INFANT RIGHT,73592,HCPCS,320,RC,RT,both,298.57,268.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209,,,,176.16,243.63
XR LOWER EXT. INFANT RIGHT,73592,HCPCS,320,RC,RT,both,298.57,268.71,Cigna,Default,Percent of Total Billed Charges,176.16,,,,176.16,243.63
XR LOWER EXT. INFANT RIGHT,73592,HCPCS,320,RC,RT,both,298.57,268.71,United Healthcare,Default,Fee Schedule,243.63,,,,176.16,243.63
XR BABYGRAM,76010,HCPCS,320,RC,,both,199.5,179.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.65,,,,117.7,162.79
XR BABYGRAM,76010,HCPCS,320,RC,,both,199.5,179.55,Cigna,Default,Percent of Total Billed Charges,117.7,,,,117.7,162.79
XR BABYGRAM,76010,HCPCS,320,RC,,both,199.5,179.55,United Healthcare,Default,Fee Schedule,162.79,,,,117.7,162.79
XR STERNUM,71120,HCPCS,320,RC,,both,321.31,289.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,224.92,,,,189.57,262.19
XR STERNUM,71120,HCPCS,320,RC,,both,321.31,289.18,Cigna,Default,Percent of Total Billed Charges,189.57,,,,189.57,262.19
XR STERNUM,71120,HCPCS,320,RC,,both,321.31,289.18,United Healthcare,Default,Fee Schedule,262.19,,,,189.57,262.19
XR RIBS BILATERAL MIN 4 VWS,71111,HCPCS,320,RC,,both,437.04,393.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,305.93,,,,257.85,356.62
XR RIBS BILATERAL MIN 4 VWS,71111,HCPCS,320,RC,,both,437.04,393.34,Cigna,Default,Percent of Total Billed Charges,257.85,,,,257.85,356.62
XR RIBS BILATERAL MIN 4 VWS,71111,HCPCS,320,RC,,both,437.04,393.34,United Healthcare,Default,Fee Schedule,356.62,,,,257.85,356.62
XR TOE LEFT 5TH,73660,HCPCS,320,RC,T4,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE LEFT 5TH,73660,HCPCS,320,RC,T4,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE LEFT 5TH,73660,HCPCS,320,RC,T4,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR RIBS/CHEST RIGHT MIN 3VWS,71101,HCPCS,320,RC,RT,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR RIBS/CHEST RIGHT MIN 3VWS,71101,HCPCS,320,RC,RT,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR RIBS/CHEST RIGHT MIN 3VWS,71101,HCPCS,320,RC,RT,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR RIBS/CHEST LEFT MIN 3 VWS,71101,HCPCS,320,RC,LT,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR RIBS/CHEST LEFT MIN 3 VWS,71101,HCPCS,320,RC,LT,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR RIBS/CHEST LEFT MIN 3 VWS,71101,HCPCS,320,RC,LT,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR CHEST 2 PA LAT,71046,HCPCS,324,RC,,both,223.42,201.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,156.39,,,,131.82,182.31
XR CHEST 2 PA LAT,71046,HCPCS,324,RC,,both,223.42,201.08,Cigna,Default,Percent of Total Billed Charges,131.82,,,,131.82,182.31
XR CHEST 2 PA LAT,71046,HCPCS,324,RC,,both,223.42,201.08,United Healthcare,Default,Fee Schedule,182.31,,,,131.82,182.31
XR CHEST 1 VIEW,71045,HCPCS,324,RC,,both,259.12,233.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,181.38,,,,152.88,211.44
XR CHEST 1 VIEW,71045,HCPCS,324,RC,,both,259.12,233.21,Cigna,Default,Percent of Total Billed Charges,152.88,,,,152.88,211.44
XR CHEST 1 VIEW,71045,HCPCS,324,RC,,both,259.12,233.21,United Healthcare,Default,Fee Schedule,211.44,,,,152.88,211.44
XR CHEST PORTABLE 1 VIEW AP,71045,HCPCS,324,RC,,both,252.8,227.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,176.96,,,,149.15,206.28
XR CHEST PORTABLE 1 VIEW AP,71045,HCPCS,324,RC,,both,252.8,227.52,Cigna,Default,Percent of Total Billed Charges,149.15,,,,149.15,206.28
XR CHEST PORTABLE 1 VIEW AP,71045,HCPCS,324,RC,,both,252.8,227.52,United Healthcare,Default,Fee Schedule,206.28,,,,149.15,206.28
XR CHEST 3VIEWS,71047,HCPCS,324,RC,,both,406.42,365.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,284.49,,,,239.79,331.64
XR CHEST 3VIEWS,71047,HCPCS,324,RC,,both,406.42,365.78,Cigna,Default,Percent of Total Billed Charges,239.79,,,,239.79,331.64
XR CHEST 3VIEWS,71047,HCPCS,324,RC,,both,406.42,365.78,United Healthcare,Default,Fee Schedule,331.64,,,,239.79,331.64
XR CHEST 4+ VWS,71048,HCPCS,324,RC,,both,406.42,365.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,284.49,,,,239.79,331.64
XR CHEST 4+ VWS,71048,HCPCS,324,RC,,both,406.42,365.78,Cigna,Default,Percent of Total Billed Charges,239.79,,,,239.79,331.64
XR CHEST 4+ VWS,71048,HCPCS,324,RC,,both,406.42,365.78,United Healthcare,Default,Fee Schedule,331.64,,,,239.79,331.64
XR FACIAL BONES COMPLETE,70150,HCPCS,320,RC,,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR FACIAL BONES COMPLETE,70150,HCPCS,320,RC,,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR FACIAL BONES COMPLETE,70150,HCPCS,320,RC,,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
XR TOE RIGHT GREAT TOE,73660T5,HCPCS,320,RC,RT,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE RIGHT GREAT TOE,73660T5,HCPCS,320,RC,RT,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE RIGHT GREAT TOE,73660T5,HCPCS,320,RC,RT,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR NASAL BONES COMPLETE,70160,HCPCS,320,RC,,both,298.85,268.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,209.2,,,,176.32,243.86
XR NASAL BONES COMPLETE,70160,HCPCS,320,RC,,both,298.85,268.97,Cigna,Default,Percent of Total Billed Charges,176.32,,,,176.32,243.86
XR NASAL BONES COMPLETE,70160,HCPCS,320,RC,,both,298.85,268.97,United Healthcare,Default,Fee Schedule,243.86,,,,176.32,243.86
XR ORBITS,70200,HCPCS,320,RC,,both,376.86,339.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.8,,,,222.35,307.52
XR ORBITS,70200,HCPCS,320,RC,,both,376.86,339.17,Cigna,Default,Percent of Total Billed Charges,222.35,,,,222.35,307.52
XR ORBITS,70200,HCPCS,320,RC,,both,376.86,339.17,United Healthcare,Default,Fee Schedule,307.52,,,,222.35,307.52
XR SINUSES COMPLETE,70220,HCPCS,320,RC,,both,379.75,341.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,265.82,,,,224.05,309.88
XR SINUSES COMPLETE,70220,HCPCS,320,RC,,both,379.75,341.78,Cigna,Default,Percent of Total Billed Charges,224.05,,,,224.05,309.88
XR SINUSES COMPLETE,70220,HCPCS,320,RC,,both,379.75,341.78,United Healthcare,Default,Fee Schedule,309.88,,,,224.05,309.88
XR TMJ BIL,70330,HCPCS,320,RC,,both,231.75,208.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.22,,,,136.73,189.11
XR TMJ BIL,70330,HCPCS,320,RC,,both,231.75,208.58,Cigna,Default,Percent of Total Billed Charges,136.73,,,,136.73,189.11
XR TMJ BIL,70330,HCPCS,320,RC,,both,231.75,208.58,United Healthcare,Default,Fee Schedule,189.11,,,,136.73,189.11
XR TMJ UNI,70328,HCPCS,320,RC,,both,201.75,181.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,141.22,,,,119.03,164.63
XR TMJ UNI,70328,HCPCS,320,RC,,both,201.75,181.58,Cigna,Default,Percent of Total Billed Charges,119.03,,,,119.03,164.63
XR TMJ UNI,70328,HCPCS,320,RC,,both,201.75,181.58,United Healthcare,Default,Fee Schedule,164.63,,,,119.03,164.63
XR TOE RIGHT 2ND,73660,HCPCS,320,RC,T6,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE RIGHT 2ND,73660,HCPCS,320,RC,T6,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE RIGHT 2ND,73660,HCPCS,320,RC,T6,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR MANDIBLE COMPLETE,70110,HCPCS,320,RC,,both,376.86,339.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.8,,,,222.35,307.52
XR MANDIBLE COMPLETE,70110,HCPCS,320,RC,,both,376.86,339.17,Cigna,Default,Percent of Total Billed Charges,222.35,,,,222.35,307.52
XR MANDIBLE COMPLETE,70110,HCPCS,320,RC,,both,376.86,339.17,United Healthcare,Default,Fee Schedule,307.52,,,,222.35,307.52
XR ZYGOMATIC ARCH <3VWS,70140,HCPCS,320,RC,,both,259.5,233.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,181.65,,,,153.1,211.75
XR ZYGOMATIC ARCH <3VWS,70140,HCPCS,320,RC,,both,259.5,233.55,Cigna,Default,Percent of Total Billed Charges,153.1,,,,153.1,211.75
XR ZYGOMATIC ARCH <3VWS,70140,HCPCS,320,RC,,both,259.5,233.55,United Healthcare,Default,Fee Schedule,211.75,,,,153.1,211.75
XR OPTC FRMNA RHSE,70190,HCPCS,320,RC,,both,316,284.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.2,,,,186.44,257.86
XR OPTC FRMNA RHSE,70190,HCPCS,320,RC,,both,316,284.4,Cigna,Default,Percent of Total Billed Charges,186.44,,,,186.44,257.86
XR OPTC FRMNA RHSE,70190,HCPCS,320,RC,,both,316,284.4,United Healthcare,Default,Fee Schedule,257.86,,,,186.44,257.86
XR SKULL LESS THAN 4 VIEWS,70250,HCPCS,320,RC,,both,387.37,348.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,271.16,,,,228.55,316.09
XR SKULL LESS THAN 4 VIEWS,70250,HCPCS,320,RC,,both,387.37,348.63,Cigna,Default,Percent of Total Billed Charges,228.55,,,,228.55,316.09
XR SKULL LESS THAN 4 VIEWS,70250,HCPCS,320,RC,,both,387.37,348.63,United Healthcare,Default,Fee Schedule,316.09,,,,228.55,316.09
XR SKULL COMPLETE,70260,HCPCS,320,RC,,both,421.93,379.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.35,,,,248.94,344.29
XR SKULL COMPLETE,70260,HCPCS,320,RC,,both,421.93,379.74,Cigna,Default,Percent of Total Billed Charges,248.94,,,,248.94,344.29
XR SKULL COMPLETE,70260,HCPCS,320,RC,,both,421.93,379.74,United Healthcare,Default,Fee Schedule,344.29,,,,248.94,344.29
X-RAY XM COLON 1CNTRST STD,74270,HCPCS,320,RC,,both,815.65,734.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,570.96,,,,481.23,665.57
X-RAY XM COLON 1CNTRST STD,74270,HCPCS,320,RC,,both,815.65,734.09,Cigna,Default,Percent of Total Billed Charges,481.23,,,,481.23,665.57
X-RAY XM COLON 1CNTRST STD,74270,HCPCS,320,RC,,both,815.65,734.09,United Healthcare,Default,Fee Schedule,665.57,,,,481.23,665.57
XR TOE RIGHT 3RD,73660,HCPCS,320,RC,T7,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE RIGHT 3RD,73660,HCPCS,320,RC,T7,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE RIGHT 3RD,73660,HCPCS,320,RC,T7,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR UGI/SM BOWEL,74240,HCPCS,320,RC,,both,697.58,627.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,488.31,,,,411.57,569.23
XR UGI/SM BOWEL,74240,HCPCS,320,RC,,both,697.58,627.82,Cigna,Default,Percent of Total Billed Charges,411.57,,,,411.57,569.23
XR UGI/SM BOWEL,74240,HCPCS,320,RC,,both,697.58,627.82,United Healthcare,Default,Fee Schedule,569.23,,,,411.57,569.23
ANG ABSCESS DRAINAGE /FLURO US CT GUIDED,75989,HCPCS,320,RC,,both,477.08,429.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,333.96,,,,281.48,389.3
ANG ABSCESS DRAINAGE /FLURO US CT GUIDED,75989,HCPCS,320,RC,,both,477.08,429.37,Cigna,Default,Percent of Total Billed Charges,281.48,,,,281.48,389.3
ANG ABSCESS DRAINAGE /FLURO US CT GUIDED,75989,HCPCS,320,RC,,both,477.08,429.37,United Healthcare,Default,Fee Schedule,389.3,,,,281.48,389.3
FL FLUORO TIME 60 MINUTES,76000,HCPCS,320,RC,,both,848.28,763.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,593.8,,,,500.49,692.2
FL FLUORO TIME 60 MINUTES,76000,HCPCS,320,RC,,both,848.28,763.45,Cigna,Default,Percent of Total Billed Charges,500.49,,,,500.49,692.2
FL FLUORO TIME 60 MINUTES,76000,HCPCS,320,RC,,both,848.28,763.45,United Healthcare,Default,Fee Schedule,692.2,,,,500.49,692.2
FL BRONCOSCOPY/ERCP,76000,HCPCS,320,RC,,both,734.2,660.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,513.94,,,,433.18,599.11
FL BRONCOSCOPY/ERCP,76000,HCPCS,320,RC,,both,734.2,660.78,Cigna,Default,Percent of Total Billed Charges,433.18,,,,433.18,599.11
FL BRONCOSCOPY/ERCP,76000,HCPCS,320,RC,,both,734.2,660.78,United Healthcare,Default,Fee Schedule,599.11,,,,433.18,599.11
FLUOROGUIDE FOR VEIN DEVICE,77001,HCPCS,320,RC,,both,567.39,510.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,397.17,,,,334.76,462.99
FLUOROGUIDE FOR VEIN DEVICE,77001,HCPCS,320,RC,,both,567.39,510.65,Cigna,Default,Percent of Total Billed Charges,334.76,,,,334.76,462.99
FLUOROGUIDE FOR VEIN DEVICE,77001,HCPCS,320,RC,,both,567.39,510.65,United Healthcare,Default,Fee Schedule,462.99,,,,334.76,462.99
FLURO GUIDANCE NEEDLE LOCALIZATION,77003,HCPCS,320,RC,,both,309,278.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.3,,,,182.31,252.14
FLURO GUIDANCE NEEDLE LOCALIZATION,77003,HCPCS,320,RC,,both,309,278.1,Cigna,Default,Percent of Total Billed Charges,182.31,,,,182.31,252.14
FLURO GUIDANCE NEEDLE LOCALIZATION,77003,HCPCS,320,RC,,both,309,278.1,United Healthcare,Default,Fee Schedule,252.14,,,,182.31,252.14
XR UGI,74240,HCPCS,320,RC,,both,649.33,584.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,454.53,,,,383.1,529.85
XR UGI,74240,HCPCS,320,RC,,both,649.33,584.4,Cigna,Default,Percent of Total Billed Charges,383.1,,,,383.1,529.85
XR UGI,74240,HCPCS,320,RC,,both,649.33,584.4,United Healthcare,Default,Fee Schedule,529.85,,,,383.1,529.85
NEEDLE LOCALIZATION BY XRAY,77002,HCPCS,320,RC,,both,809.58,728.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,566.71,,,,477.65,660.62
NEEDLE LOCALIZATION BY XRAY,77002,HCPCS,320,RC,,both,809.58,728.62,Cigna,Default,Percent of Total Billed Charges,477.65,,,,477.65,660.62
NEEDLE LOCALIZATION BY XRAY,77002,HCPCS,320,RC,,both,809.58,728.62,United Healthcare,Default,Fee Schedule,660.62,,,,477.65,660.62
FLVORO GUIDED MEDIPORT/VENOUS ACCES,77001,HCPCS,320,RC,,both,359,323.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,251.3,,,,211.81,292.94
FLVORO GUIDED MEDIPORT/VENOUS ACCES,77001,HCPCS,320,RC,,both,359,323.1,Cigna,Default,Percent of Total Billed Charges,211.81,,,,211.81,292.94
FLVORO GUIDED MEDIPORT/VENOUS ACCES,77001,HCPCS,320,RC,,both,359,323.1,United Healthcare,Default,Fee Schedule,292.94,,,,211.81,292.94
FLUOROGUIDE FOR SPINE INJECT,77003,HCPCS,320,RC,,both,625.04,562.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,437.53,,,,368.77,510.03
FLUOROGUIDE FOR SPINE INJECT,77003,HCPCS,320,RC,,both,625.04,562.54,Cigna,Default,Percent of Total Billed Charges,368.77,,,,368.77,510.03
FLUOROGUIDE FOR SPINE INJECT,77003,HCPCS,320,RC,,both,625.04,562.54,United Healthcare,Default,Fee Schedule,510.03,,,,368.77,510.03
XR BARIUM SWALLOW,74220,HCPCS,320,RC,,both,678.32,610.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,474.82,,,,400.21,553.51
XR BARIUM SWALLOW,74220,HCPCS,320,RC,,both,678.32,610.49,Cigna,Default,Percent of Total Billed Charges,400.21,,,,400.21,553.51
XR BARIUM SWALLOW,74220,HCPCS,320,RC,,both,678.32,610.49,United Healthcare,Default,Fee Schedule,553.51,,,,400.21,553.51
XR CYSTOGRAM VDNG,74455,HCPCS,320,RC,,both,1380.04,1242.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,966.03,,,,814.22,1126.11
XR CYSTOGRAM VDNG,74455,HCPCS,320,RC,,both,1380.04,1242.04,Cigna,Default,Percent of Total Billed Charges,814.22,,,,814.22,1126.11
XR CYSTOGRAM VDNG,74455,HCPCS,320,RC,,both,1380.04,1242.04,United Healthcare,Default,Fee Schedule,1126.11,,,,814.22,1126.11
X-RAY XM SM INT 2CNTRST STD,74251,HCPCS,320,RC,,both,886.08,797.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,620.26,,,,522.79,723.04
X-RAY XM SM INT 2CNTRST STD,74251,HCPCS,320,RC,,both,886.08,797.47,Cigna,Default,Percent of Total Billed Charges,522.79,,,,522.79,723.04
X-RAY XM SM INT 2CNTRST STD,74251,HCPCS,320,RC,,both,886.08,797.47,United Healthcare,Default,Fee Schedule,723.04,,,,522.79,723.04
XR CYSTOGRAM,74430,HCPCS,320,RC,,both,1386.77,1248.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,970.74,,,,818.19,1131.6
XR CYSTOGRAM,74430,HCPCS,320,RC,,both,1386.77,1248.09,Cigna,Default,Percent of Total Billed Charges,818.19,,,,818.19,1131.6
XR CYSTOGRAM,74430,HCPCS,320,RC,,both,1386.77,1248.09,United Healthcare,Default,Fee Schedule,1131.6,,,,818.19,1131.6
INJECTION CYSTOGRAM,51600,HCPCS,360,RC,,both,235.34,211.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.74,,,,138.85,192.04
INJECTION CYSTOGRAM,51600,HCPCS,360,RC,,both,235.34,211.81,Cigna,Default,Percent of Total Billed Charges,138.85,,,,138.85,192.04
INJECTION CYSTOGRAM,51600,HCPCS,360,RC,,both,235.34,211.81,United Healthcare,Default,Fee Schedule,192.04,,,,138.85,192.04
XR URETHROGRAM RETROGRADE,74450,HCPCS,320,RC,,both,697.58,627.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,488.31,,,,411.57,569.23
XR URETHROGRAM RETROGRADE,74450,HCPCS,320,RC,,both,697.58,627.82,Cigna,Default,Percent of Total Billed Charges,411.57,,,,411.57,569.23
XR URETHROGRAM RETROGRADE,74450,HCPCS,320,RC,,both,697.58,627.82,United Healthcare,Default,Fee Schedule,569.23,,,,411.57,569.23
UROGRAPHY RETOGRADE,74420,HCPCS,320,RC,,both,1421.44,1279.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,995.01,,,,838.65,1159.9
UROGRAPHY RETOGRADE,74420,HCPCS,320,RC,,both,1421.44,1279.3,Cigna,Default,Percent of Total Billed Charges,838.65,,,,838.65,1159.9
UROGRAPHY RETOGRADE,74420,HCPCS,320,RC,,both,1421.44,1279.3,United Healthcare,Default,Fee Schedule,1159.9,,,,838.65,1159.9
XR RETROGRADE OR,74450,HCPCS,320,RC,,both,774.25,696.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,541.98,,,,456.81,631.79
XR RETROGRADE OR,74450,HCPCS,320,RC,,both,774.25,696.83,Cigna,Default,Percent of Total Billed Charges,456.81,,,,456.81,631.79
XR RETROGRADE OR,74450,HCPCS,320,RC,,both,774.25,696.83,United Healthcare,Default,Fee Schedule,631.79,,,,456.81,631.79
INJECTION RETRO URETHVCYSTGRAM,51610,HCPCS,360,RC,,both,241.23,217.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.86,,,,142.33,196.84
INJECTION RETRO URETHVCYSTGRAM,51610,HCPCS,360,RC,,both,241.23,217.11,Cigna,Default,Percent of Total Billed Charges,142.33,,,,142.33,196.84
INJECTION RETRO URETHVCYSTGRAM,51610,HCPCS,360,RC,,both,241.23,217.11,United Healthcare,Default,Fee Schedule,196.84,,,,142.33,196.84
DILATION URETHRA - URETERS NEPHROSTOM,74485,HCPCS,320,RC,,both,6433.77,5790.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4503.64,,,,3795.92,5249.96
DILATION URETHRA - URETERS NEPHROSTOM,74485,HCPCS,320,RC,,both,6433.77,5790.39,Cigna,Default,Percent of Total Billed Charges,3795.92,,,,3795.92,5249.96
DILATION URETHRA - URETERS NEPHROSTOM,74485,HCPCS,320,RC,,both,6433.77,5790.39,United Healthcare,Default,Fee Schedule,5249.96,,,,3795.92,5249.96
XR IVP,74400,HCPCS,320,RC,,both,720.89,648.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,504.62,,,,425.33,588.25
XR IVP,74400,HCPCS,320,RC,,both,720.89,648.8,Cigna,Default,Percent of Total Billed Charges,425.33,,,,425.33,588.25
XR IVP,74400,HCPCS,320,RC,,both,720.89,648.8,United Healthcare,Default,Fee Schedule,588.25,,,,425.33,588.25
XR TOE RIGHT 4TH,73660,HCPCS,320,RC,T8,both,297.08,267.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.96,,,,175.28,242.42
XR TOE RIGHT 4TH,73660,HCPCS,320,RC,T8,both,297.08,267.37,Cigna,Default,Percent of Total Billed Charges,175.28,,,,175.28,242.42
XR TOE RIGHT 4TH,73660,HCPCS,320,RC,T8,both,297.08,267.37,United Healthcare,Default,Fee Schedule,242.42,,,,175.28,242.42
XR CHOLANGIOGRAM ADDITIONAL INTRAOP,74301,HCPCS,320,RC,,both,659.23,593.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,461.46,,,,388.95,537.93
XR CHOLANGIOGRAM ADDITIONAL INTRAOP,74301,HCPCS,320,RC,,both,659.23,593.31,Cigna,Default,Percent of Total Billed Charges,388.95,,,,388.95,537.93
XR CHOLANGIOGRAM ADDITIONAL INTRAOP,74301,HCPCS,320,RC,,both,659.23,593.31,United Healthcare,Default,Fee Schedule,537.93,,,,388.95,537.93
XR CHOLANGIOGRAM INTRAOP,74300,HCPCS,320,RC,,both,1270.38,1143.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,889.27,,,,749.52,1036.63
XR CHOLANGIOGRAM INTRAOP,74300,HCPCS,320,RC,,both,1270.38,1143.34,Cigna,Default,Percent of Total Billed Charges,749.52,,,,749.52,1036.63
XR CHOLANGIOGRAM INTRAOP,74300,HCPCS,320,RC,,both,1270.38,1143.34,United Healthcare,Default,Fee Schedule,1036.63,,,,749.52,1036.63
ANG ADDITIONAL SET CHOLANGIOGRAPHY,74301,HCPCS,320,RC,,both,327.75,294.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,229.42,,,,193.37,267.44
ANG ADDITIONAL SET CHOLANGIOGRAPHY,74301,HCPCS,320,RC,,both,327.75,294.98,Cigna,Default,Percent of Total Billed Charges,193.37,,,,193.37,267.44
ANG ADDITIONAL SET CHOLANGIOGRAPHY,74301,HCPCS,320,RC,,both,327.75,294.98,United Healthcare,Default,Fee Schedule,267.44,,,,193.37,267.44
INTRALUMINAL DILATION ESOPHOGUS,74360,HCPCS,320,RC,,both,574.98,517.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,402.49,,,,339.24,469.18
INTRALUMINAL DILATION ESOPHOGUS,74360,HCPCS,320,RC,,both,574.98,517.48,Cigna,Default,Percent of Total Billed Charges,339.24,,,,339.24,469.18
INTRALUMINAL DILATION ESOPHOGUS,74360,HCPCS,320,RC,,both,574.98,517.48,United Healthcare,Default,Fee Schedule,469.18,,,,339.24,469.18
INTRO GI TUBE WITH FLUORO OR FILM,74340,HCPCS,320,RC,,both,319.37,287.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,223.56,,,,188.43,260.61
INTRO GI TUBE WITH FLUORO OR FILM,74340,HCPCS,320,RC,,both,319.37,287.43,Cigna,Default,Percent of Total Billed Charges,188.43,,,,188.43,260.61
INTRO GI TUBE WITH FLUORO OR FILM,74340,HCPCS,320,RC,,both,319.37,287.43,United Healthcare,Default,Fee Schedule,260.61,,,,188.43,260.61
ANG PERCUTANEOUS PLACEMENT GASTRO TUBE,49440,HCPCS,320,RC,,both,4072.17,3664.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2850.52,,,,2402.58,3322.89
ANG PERCUTANEOUS PLACEMENT GASTRO TUBE,49440,HCPCS,320,RC,,both,4072.17,3664.95,Cigna,Default,Percent of Total Billed Charges,2402.58,,,,2402.58,3322.89
ANG PERCUTANEOUS PLACEMENT GASTRO TUBE,49440,HCPCS,320,RC,,both,4072.17,3664.95,United Healthcare,Default,Fee Schedule,3322.89,,,,2402.58,3322.89
ANG PERCUT PLACEMENT ENTERCLYSIS TUBE,74355,HCPCS,320,RC,,both,452.51,407.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.76,,,,266.98,369.25
ANG PERCUT PLACEMENT ENTERCLYSIS TUBE,74355,HCPCS,320,RC,,both,452.51,407.26,Cigna,Default,Percent of Total Billed Charges,266.98,,,,266.98,369.25
ANG PERCUT PLACEMENT ENTERCLYSIS TUBE,74355,HCPCS,320,RC,,both,452.51,407.26,United Healthcare,Default,Fee Schedule,369.25,,,,266.98,369.25
XR ACUTE ABD SERIES,74022,HCPCS,320,RC,,both,459.5,413.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,321.65,,,,271.1,374.95
XR ACUTE ABD SERIES,74022,HCPCS,320,RC,,both,459.5,413.55,Cigna,Default,Percent of Total Billed Charges,271.1,,,,271.1,374.95
XR ACUTE ABD SERIES,74022,HCPCS,320,RC,,both,459.5,413.55,United Healthcare,Default,Fee Schedule,374.95,,,,271.1,374.95
XR ABDOMEN 2 VIEWS,74019,HCPCS,320,RC,,both,417.22,375.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.05,,,,246.16,340.45
XR ABDOMEN 2 VIEWS,74019,HCPCS,320,RC,,both,417.22,375.5,Cigna,Default,Percent of Total Billed Charges,246.16,,,,246.16,340.45
XR ABDOMEN 2 VIEWS,74019,HCPCS,320,RC,,both,417.22,375.5,United Healthcare,Default,Fee Schedule,340.45,,,,246.16,340.45
XR ABDOMEN 3+ VIEWS,74021,HCPCS,320,RC,,both,436.47,392.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,305.53,,,,257.52,356.16
XR ABDOMEN 3+ VIEWS,74021,HCPCS,320,RC,,both,436.47,392.82,Cigna,Default,Percent of Total Billed Charges,257.52,,,,257.52,356.16
XR ABDOMEN 3+ VIEWS,74021,HCPCS,320,RC,,both,436.47,392.82,United Healthcare,Default,Fee Schedule,356.16,,,,257.52,356.16
XR BILATERAL KNEE,73560,HCPCS,320,RC,50,both,420.47,378.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,294.33,,,,248.08,343.1
XR BILATERAL KNEE,73560,HCPCS,320,RC,50,both,420.47,378.42,Cigna,Default,Percent of Total Billed Charges,248.08,,,,248.08,343.1
XR BILATERAL KNEE,73560,HCPCS,320,RC,50,both,420.47,378.42,United Healthcare,Default,Fee Schedule,343.1,,,,248.08,343.1
XR ABDOMEN 1 VIEW KUB,74018,HCPCS,320,RC,,both,345.49,310.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,241.84,,,,203.84,281.92
XR ABDOMEN 1 VIEW KUB,74018,HCPCS,320,RC,,both,345.49,310.94,Cigna,Default,Percent of Total Billed Charges,203.84,,,,203.84,281.92
XR ABDOMEN 1 VIEW KUB,74018,HCPCS,320,RC,,both,345.49,310.94,United Healthcare,Default,Fee Schedule,281.92,,,,203.84,281.92
MAMMO DIGITAL DIAGNOSTICE LEFT WITH CAD,77065,HCPCS,401,RC,LT,both,314.46,283.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.12,,,,185.53,256.6
MAMMO DIGITAL DIAGNOSTICE LEFT WITH CAD,77065,HCPCS,401,RC,LT,both,314.46,283.01,Cigna,Default,Percent of Total Billed Charges,185.53,,,,185.53,256.6
MAMMO DIGITAL DIAGNOSTICE LEFT WITH CAD,77065,HCPCS,401,RC,LT,both,314.46,283.01,United Healthcare,Default,Fee Schedule,256.6,,,,185.53,256.6
MAMMO DIGITAL DIAGNOSTIC LEFT,77065,HCPCS,401,RC,LT,both,509.85,458.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,356.9,,,,300.81,416.04
MAMMO DIGITAL DIAGNOSTIC LEFT,77065,HCPCS,401,RC,LT,both,509.85,458.87,Cigna,Default,Percent of Total Billed Charges,300.81,,,,300.81,416.04
MAMMO DIGITAL DIAGNOSTIC LEFT,77065,HCPCS,401,RC,LT,both,509.85,458.87,United Healthcare,Default,Fee Schedule,416.04,,,,300.81,416.04
MAMMO DIGITAL DIAGNOSTIC RIGHTWITH CAD,77065,HCPCS,401,RC,RT,both,281.25,253.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.88,,,,165.94,229.5
MAMMO DIGITAL DIAGNOSTIC RIGHTWITH CAD,77065,HCPCS,401,RC,RT,both,281.25,253.13,Cigna,Default,Percent of Total Billed Charges,165.94,,,,165.94,229.5
MAMMO DIGITAL DIAGNOSTIC RIGHTWITH CAD,77065,HCPCS,401,RC,RT,both,281.25,253.13,United Healthcare,Default,Fee Schedule,229.5,,,,165.94,229.5
MAMMO DIGITAL DIAGNOSTIC BILATERAL,77066,HCPCS,401,RC,,both,655.08,589.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,458.56,,,,386.5,534.55
MAMMO DIGITAL DIAGNOSTIC BILATERAL,77066,HCPCS,401,RC,,both,655.08,589.57,Cigna,Default,Percent of Total Billed Charges,386.5,,,,386.5,534.55
MAMMO DIGITAL DIAGNOSTIC BILATERAL,77066,HCPCS,401,RC,,both,655.08,589.57,United Healthcare,Default,Fee Schedule,534.55,,,,386.5,534.55
MAMMMO BILATERAL,401,RC,,,,both,151.25,136.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.88,,,,89.24,123.42
MAMMMO BILATERAL,401,RC,,,,both,151.25,136.13,Cigna,Default,Percent of Total Billed Charges,89.24,,,,89.24,123.42
MAMMMO BILATERAL,401,RC,,,,both,151.25,136.13,United Healthcare,Default,Fee Schedule,123.42,,,,89.24,123.42
MAMMO DIGITAL DIAGNOSTIC RIGHT,77065,HCPCS,401,RC,RT,both,509.85,458.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,356.9,,,,300.81,416.04
MAMMO DIGITAL DIAGNOSTIC RIGHT,77065,HCPCS,401,RC,RT,both,509.85,458.87,Cigna,Default,Percent of Total Billed Charges,300.81,,,,300.81,416.04
MAMMO DIGITAL DIAGNOSTIC RIGHT,77065,HCPCS,401,RC,RT,both,509.85,458.87,United Healthcare,Default,Fee Schedule,416.04,,,,300.81,416.04
MAMMO DIAG TOMOSYNTHESIS,G0279,HCPCS,401,RC,,both,157.59,141.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.31,,,,92.98,128.59
MAMMO DIAG TOMOSYNTHESIS,G0279,HCPCS,401,RC,,both,157.59,141.83,Cigna,Default,Percent of Total Billed Charges,92.98,,,,92.98,128.59
MAMMO DIAG TOMOSYNTHESIS,G0279,HCPCS,401,RC,,both,157.59,141.83,United Healthcare,Default,Fee Schedule,128.59,,,,92.98,128.59
MAMMO TOMO BILATERAL,77063,HCPCS,403,RC,,both,164.8,148.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.36,,,,97.23,134.48
MAMMO TOMO BILATERAL,77063,HCPCS,403,RC,,both,164.8,148.32,Cigna,Default,Percent of Total Billed Charges,97.23,,,,97.23,134.48
MAMMO TOMO BILATERAL,77063,HCPCS,403,RC,,both,164.8,148.32,United Healthcare,Default,Fee Schedule,134.48,,,,97.23,134.48
MAMMO DIG SCR BILAT INCLUD CAD,77067,HCPCS,403,RC,,both,528.39,475.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,369.87,,,,311.75,431.17
MAMMO DIG SCR BILAT INCLUD CAD,77067,HCPCS,403,RC,,both,528.39,475.55,Cigna,Default,Percent of Total Billed Charges,311.75,,,,311.75,431.17
MAMMO DIG SCR BILAT INCLUD CAD,77067,HCPCS,403,RC,,both,528.39,475.55,United Healthcare,Default,Fee Schedule,431.17,,,,311.75,431.17
XR PED UPPER EXT BIL,73092,HCPCS,320,RC,,both,417.22,375.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.05,,,,246.16,340.45
XR PED UPPER EXT BIL,73092,HCPCS,320,RC,,both,417.22,375.5,Cigna,Default,Percent of Total Billed Charges,246.16,,,,246.16,340.45
XR PED UPPER EXT BIL,73092,HCPCS,320,RC,,both,417.22,375.5,United Healthcare,Default,Fee Schedule,340.45,,,,246.16,340.45
XR CHOLECYSTOGRAPHY ORAL,74290,HCPCS,320,RC,,both,697.58,627.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,488.31,,,,411.57,569.23
XR CHOLECYSTOGRAPHY ORAL,74290,HCPCS,320,RC,,both,697.58,627.82,Cigna,Default,Percent of Total Billed Charges,411.57,,,,411.57,569.23
XR CHOLECYSTOGRAPHY ORAL,74290,HCPCS,320,RC,,both,697.58,627.82,United Healthcare,Default,Fee Schedule,569.23,,,,411.57,569.23
XR SMALL X-RAY XM SM INT 1CNTRST STD,74250,HCPCS,320,RC,,both,678.21,610.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,474.75,,,,400.14,553.42
XR SMALL X-RAY XM SM INT 1CNTRST STD,74250,HCPCS,320,RC,,both,678.21,610.39,Cigna,Default,Percent of Total Billed Charges,400.14,,,,400.14,553.42
XR SMALL X-RAY XM SM INT 1CNTRST STD,74250,HCPCS,320,RC,,both,678.21,610.39,United Healthcare,Default,Fee Schedule,553.42,,,,400.14,553.42
XR FISTULOGRAM,76080,HCPCS,320,RC,,both,1698.02,1528.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1188.61,,,,1001.83,1385.58
XR FISTULOGRAM,76080,HCPCS,320,RC,,both,1698.02,1528.22,Cigna,Default,Percent of Total Billed Charges,1001.83,,,,1001.83,1385.58
XR FISTULOGRAM,76080,HCPCS,320,RC,,both,1698.02,1528.22,United Healthcare,Default,Fee Schedule,1385.58,,,,1001.83,1385.58
XR FLURO BARIUM ENEMA AIR X-RAY XM COLON,74280,HCPCS,320,RC,,both,1397.89,1258.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,978.52,,,,824.76,1140.68
XR FLURO BARIUM ENEMA AIR X-RAY XM COLON,74280,HCPCS,320,RC,,both,1397.89,1258.1,Cigna,Default,Percent of Total Billed Charges,824.76,,,,824.76,1140.68
XR FLURO BARIUM ENEMA AIR X-RAY XM COLON,74280,HCPCS,320,RC,,both,1397.89,1258.1,United Healthcare,Default,Fee Schedule,1140.68,,,,824.76,1140.68
MAMMO NEEDLE LOCALIZATION RIGHT BREAST,19281,HCPCS,401,RC,,both,442.25,398.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,309.58,,,,260.93,360.88
MAMMO NEEDLE LOCALIZATION RIGHT BREAST,19281,HCPCS,401,RC,,both,442.25,398.03,Cigna,Default,Percent of Total Billed Charges,260.93,,,,260.93,360.88
MAMMO NEEDLE LOCALIZATION RIGHT BREAST,19281,HCPCS,401,RC,,both,442.25,398.03,United Healthcare,Default,Fee Schedule,360.88,,,,260.93,360.88
MAMMO STEREOTACTIC NEEDLE LOC RIGHT BRST,19283,HCPCS,360,RC,,both,1562.08,1405.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1093.46,,,,921.63,1274.66
MAMMO STEREOTACTIC NEEDLE LOC RIGHT BRST,19283,HCPCS,360,RC,,both,1562.08,1405.87,Cigna,Default,Percent of Total Billed Charges,921.63,,,,921.63,1274.66
MAMMO STEREOTACTIC NEEDLE LOC RIGHT BRST,19283,HCPCS,360,RC,,both,1562.08,1405.87,United Healthcare,Default,Fee Schedule,1274.66,,,,921.63,1274.66
MAMMO STEREOTACTIC NEEDLE LOC LEFT BRST,19284,HCPCS,360,RC,,both,1026,923.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,718.2,,,,605.34,837.22
MAMMO STEREOTACTIC NEEDLE LOC LEFT BRST,19284,HCPCS,360,RC,,both,1026,923.4,Cigna,Default,Percent of Total Billed Charges,605.34,,,,605.34,837.22
MAMMO STEREOTACTIC NEEDLE LOC LEFT BRST,19284,HCPCS,360,RC,,both,1026,923.4,United Healthcare,Default,Fee Schedule,837.22,,,,605.34,837.22
MAMMO BREAST STEREO UNILAT + WIRE,19081,HCPCS,360,RC,,both,3061.44,2755.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2143.01,,,,1806.25,2498.14
MAMMO BREAST STEREO UNILAT + WIRE,19081,HCPCS,360,RC,,both,3061.44,2755.3,Cigna,Default,Percent of Total Billed Charges,1806.25,,,,1806.25,2498.14
MAMMO BREAST STEREO UNILAT + WIRE,19081,HCPCS,360,RC,,both,3061.44,2755.3,United Healthcare,Default,Fee Schedule,2498.14,,,,1806.25,2498.14
MAMMO BREAST STERO UNILAT AD LESIONS,19082,HCPCS,360,RC,,both,1026,923.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,718.2,,,,605.34,837.22
MAMMO BREAST STERO UNILAT AD LESIONS,19082,HCPCS,360,RC,,both,1026,923.4,Cigna,Default,Percent of Total Billed Charges,605.34,,,,605.34,837.22
MAMMO BREAST STERO UNILAT AD LESIONS,19082,HCPCS,360,RC,,both,1026,923.4,United Healthcare,Default,Fee Schedule,837.22,,,,605.34,837.22
MAMMO BREAST NEEDLE LOC EACH ADD'L,19282,HCPCS,360,RC,,both,442.25,398.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,309.58,,,,260.93,360.88
MAMMO BREAST NEEDLE LOC EACH ADD'L,19282,HCPCS,360,RC,,both,442.25,398.03,Cigna,Default,Percent of Total Billed Charges,260.93,,,,260.93,360.88
MAMMO BREAST NEEDLE LOC EACH ADD'L,19282,HCPCS,360,RC,,both,442.25,398.03,United Healthcare,Default,Fee Schedule,360.88,,,,260.93,360.88
MAMMO SURGICAL SPECIMEN,76098,HCPCS,320,RC,,both,1792.68,1613.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1254.88,,,,1057.68,1462.83
MAMMO SURGICAL SPECIMEN,76098,HCPCS,320,RC,,both,1792.68,1613.41,Cigna,Default,Percent of Total Billed Charges,1057.68,,,,1057.68,1462.83
MAMMO SURGICAL SPECIMEN,76098,HCPCS,320,RC,,both,1792.68,1613.41,United Healthcare,Default,Fee Schedule,1462.83,,,,1057.68,1462.83
XR INJ PROC 9 SISTUL,20501,HCPCS,320,RC,,both,238,214.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.6,,,,140.42,194.21
XR INJ PROC 9 SISTUL,20501,HCPCS,320,RC,,both,238,214.2,Cigna,Default,Percent of Total Billed Charges,140.42,,,,140.42,194.21
XR INJ PROC 9 SISTUL,20501,HCPCS,320,RC,,both,238,214.2,United Healthcare,Default,Fee Schedule,194.21,,,,140.42,194.21
LUNG CYST ASPRI,32555,HCPCS,360,RC,,both,1763.06,1586.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1234.14,,,,1040.21,1438.66
LUNG CYST ASPRI,32555,HCPCS,360,RC,,both,1763.06,1586.75,Cigna,Default,Percent of Total Billed Charges,1040.21,,,,1040.21,1438.66
LUNG CYST ASPRI,32555,HCPCS,360,RC,,both,1763.06,1586.75,United Healthcare,Default,Fee Schedule,1438.66,,,,1040.21,1438.66
ANG RETRO PERI CYST ASP,49406,HCPCS,360,RC,,both,5293.37,4764.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3705.36,,,,3123.09,4319.39
ANG RETRO PERI CYST ASP,49406,HCPCS,360,RC,,both,5293.37,4764.03,Cigna,Default,Percent of Total Billed Charges,3123.09,,,,3123.09,4319.39
ANG RETRO PERI CYST ASP,49406,HCPCS,360,RC,,both,5293.37,4764.03,United Healthcare,Default,Fee Schedule,4319.39,,,,3123.09,4319.39
INTRO CYST ASP-BRST,19001,HCPCS,360,RC,,both,342,307.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,239.4,,,,201.78,279.07
INTRO CYST ASP-BRST,19001,HCPCS,360,RC,,both,342,307.8,Cigna,Default,Percent of Total Billed Charges,201.78,,,,201.78,279.07
INTRO CYST ASP-BRST,19001,HCPCS,360,RC,,both,342,307.8,United Healthcare,Default,Fee Schedule,279.07,,,,201.78,279.07
INTRO CYST ASP-BRST,19000,HCPCS,360,RC,,both,342,307.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,239.4,,,,201.78,279.07
INTRO CYST ASP-BRST,19000,HCPCS,360,RC,,both,342,307.8,Cigna,Default,Percent of Total Billed Charges,201.78,,,,201.78,279.07
INTRO CYST ASP-BRST,19000,HCPCS,360,RC,,both,342,307.8,United Healthcare,Default,Fee Schedule,279.07,,,,201.78,279.07
DXA BONE DENSITY VERT FX ASS,77086,HCPCS,320,RC,,both,178.02,160.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.61,,,,105.03,145.26
DXA BONE DENSITY VERT FX ASS,77086,HCPCS,320,RC,,both,178.02,160.22,Cigna,Default,Percent of Total Billed Charges,105.03,,,,105.03,145.26
DXA BONE DENSITY VERT FX ASS,77086,HCPCS,320,RC,,both,178.02,160.22,United Healthcare,Default,Fee Schedule,145.26,,,,105.03,145.26
ARTHROCENTESIS/ASPRI/INJ; SML JT US,20604,HCPCS,450,RC,,both,633.39,570.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.37,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; SML JT US,20604,HCPCS,450,RC,,both,633.39,570.05,Cigna,Default,Percent of Total Billed Charges,373.7,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; SML JT US,20604,HCPCS,450,RC,,both,633.39,570.05,United Healthcare,Default,Fee Schedule,516.85,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; INTJT US,20606,HCPCS,450,RC,,both,633.39,570.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.37,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; INTJT US,20606,HCPCS,450,RC,,both,633.39,570.05,Cigna,Default,Percent of Total Billed Charges,373.7,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; INTJT US,20606,HCPCS,450,RC,,both,633.39,570.05,United Healthcare,Default,Fee Schedule,516.85,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; MAJ JT US,20611,HCPCS,450,RC,,both,633.39,570.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,443.37,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; MAJ JT US,20611,HCPCS,450,RC,,both,633.39,570.05,Cigna,Default,Percent of Total Billed Charges,373.7,,,,373.7,516.85
ARTHROCENTESIS/ASPRI/INJ; MAJ JT US,20611,HCPCS,450,RC,,both,633.39,570.05,United Healthcare,Default,Fee Schedule,516.85,,,,373.7,516.85
Myelography Lumbar Injection Cervical,62302,HCPCS,450,RC,,both,1842.12,1657.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1289.48,,,,1086.85,1503.17
Myelography Lumbar Injection Cervical,62302,HCPCS,450,RC,,both,1842.12,1657.91,Cigna,Default,Percent of Total Billed Charges,1086.85,,,,1086.85,1503.17
Myelography Lumbar Injection Cervical,62302,HCPCS,450,RC,,both,1842.12,1657.91,United Healthcare,Default,Fee Schedule,1503.17,,,,1086.85,1503.17
Myelography Lumbar Injection Thoracic,62303,HCPCS,450,RC,,both,1842.12,1657.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1289.48,,,,1086.85,1503.17
Myelography Lumbar Injection Thoracic,62303,HCPCS,450,RC,,both,1842.12,1657.91,Cigna,Default,Percent of Total Billed Charges,1086.85,,,,1086.85,1503.17
Myelography Lumbar Injection Thoracic,62303,HCPCS,450,RC,,both,1842.12,1657.91,United Healthcare,Default,Fee Schedule,1503.17,,,,1086.85,1503.17
Myelography Lumbar Injection Lumbrosacr,62304,HCPCS,450,RC,,both,1842.12,1657.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1289.48,,,,1086.85,1503.17
Myelography Lumbar Injection Lumbrosacr,62304,HCPCS,450,RC,,both,1842.12,1657.91,Cigna,Default,Percent of Total Billed Charges,1086.85,,,,1086.85,1503.17
Myelography Lumbar Injection Lumbrosacr,62304,HCPCS,450,RC,,both,1842.12,1657.91,United Healthcare,Default,Fee Schedule,1503.17,,,,1086.85,1503.17
Myelography Lumbar Injection- 2 or more,62305,HCPCS,450,RC,,both,1842.12,1657.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1289.48,,,,1086.85,1503.17
Myelography Lumbar Injection- 2 or more,62305,HCPCS,450,RC,,both,1842.12,1657.91,Cigna,Default,Percent of Total Billed Charges,1086.85,,,,1086.85,1503.17
Myelography Lumbar Injection- 2 or more,62305,HCPCS,450,RC,,both,1842.12,1657.91,United Healthcare,Default,Fee Schedule,1503.17,,,,1086.85,1503.17
DNU DXA BONE DENSITY AXIAL,77080,HCPCS,320,RC,,both,365.88,329.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,256.12,,,,215.87,298.56
DNU DXA BONE DENSITY AXIAL,77080,HCPCS,320,RC,,both,365.88,329.29,Cigna,Default,Percent of Total Billed Charges,215.87,,,,215.87,298.56
DNU DXA BONE DENSITY AXIAL,77080,HCPCS,320,RC,,both,365.88,329.29,United Healthcare,Default,Fee Schedule,298.56,,,,215.87,298.56
DXA BONE DENSITY / PERIPHERAL,77081,HCPCS,320,RC,,both,220.94,198.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.66,,,,130.35,180.29
DXA BONE DENSITY / PERIPHERAL,77081,HCPCS,320,RC,,both,220.94,198.85,Cigna,Default,Percent of Total Billed Charges,130.35,,,,130.35,180.29
DXA BONE DENSITY / PERIPHERAL,77081,HCPCS,320,RC,,both,220.94,198.85,United Healthcare,Default,Fee Schedule,180.29,,,,130.35,180.29
DXA BONE DENSITY AXIAL,77080,HCPCS,320,RC,,both,376.86,339.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.8,,,,222.35,307.52
DXA BONE DENSITY AXIAL,77080,HCPCS,320,RC,,both,376.86,339.17,Cigna,Default,Percent of Total Billed Charges,222.35,,,,222.35,307.52
DXA BONE DENSITY AXIAL,77080,HCPCS,320,RC,,both,376.86,339.17,United Healthcare,Default,Fee Schedule,307.52,,,,222.35,307.52
ANG UNLISTED FLURO PROCEDURE,76496,HCPCS,320,RC,,both,327.35,294.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,229.14,,,,193.14,267.12
ANG UNLISTED FLURO PROCEDURE,76496,HCPCS,320,RC,,both,327.35,294.62,Cigna,Default,Percent of Total Billed Charges,193.14,,,,193.14,267.12
ANG UNLISTED FLURO PROCEDURE,76496,HCPCS,320,RC,,both,327.35,294.62,United Healthcare,Default,Fee Schedule,267.12,,,,193.14,267.12
INTRO PROC-LIV BX,47000,HCPCS,360,RC,,both,530.25,477.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,371.18,,,,312.85,432.68
INTRO PROC-LIV BX,47000,HCPCS,360,RC,,both,530.25,477.23,Cigna,Default,Percent of Total Billed Charges,312.85,,,,312.85,432.68
INTRO PROC-LIV BX,47000,HCPCS,360,RC,,both,530.25,477.23,United Healthcare,Default,Fee Schedule,432.68,,,,312.85,432.68
MMRI CONTRAST GADOL WASTE,A9579,HCPCS,636,RC,JW,both,12.38,11.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.67,,,,7.3,10.1
MMRI CONTRAST GADOL WASTE,A9579,HCPCS,636,RC,JW,both,12.38,11.14,Cigna,Default,Percent of Total Billed Charges,7.3,,,,7.3,10.1
MMRI CONTRAST GADOL WASTE,A9579,HCPCS,636,RC,JW,both,12.38,11.14,United Healthcare,Default,Fee Schedule,10.1,,,,7.3,10.1
OUTSIDE PET SCAN EXAM,404,RC,,,,both,8825,7942.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6177.5,,,,5206.75,7201.2
OUTSIDE PET SCAN EXAM,404,RC,,,,both,8825,7942.5,Cigna,Default,Percent of Total Billed Charges,5206.75,,,,5206.75,7201.2
OUTSIDE PET SCAN EXAM,404,RC,,,,both,8825,7942.5,United Healthcare,Default,Fee Schedule,7201.2,,,,5206.75,7201.2
X-RAY XM SWLNG FUNCJ C+,74230,HCPCS,320,RC,,both,642.5,578.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,449.75,,,,379.08,524.28
X-RAY XM SWLNG FUNCJ C+,74230,HCPCS,320,RC,,both,642.5,578.25,Cigna,Default,Percent of Total Billed Charges,379.08,,,,379.08,524.28
X-RAY XM SWLNG FUNCJ C+,74230,HCPCS,320,RC,,both,642.5,578.25,United Healthcare,Default,Fee Schedule,524.28,,,,379.08,524.28
INTRO PROC RETROP BX,49010,HCPCS,360,RC,,both,3174.5,2857.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2222.15,,,,1872.96,2590.39
INTRO PROC RETROP BX,49010,HCPCS,360,RC,,both,3174.5,2857.05,Cigna,Default,Percent of Total Billed Charges,1872.96,,,,1872.96,2590.39
INTRO PROC RETROP BX,49010,HCPCS,360,RC,,both,3174.5,2857.05,United Healthcare,Default,Fee Schedule,2590.39,,,,1872.96,2590.39
INTRO PROC-BRST BX,19100,HCPCS,360,RC,,both,3525.66,3173.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2467.96,,,,2080.14,2876.94
INTRO PROC-BRST BX,19100,HCPCS,360,RC,,both,3525.66,3173.09,Cigna,Default,Percent of Total Billed Charges,2080.14,,,,2080.14,2876.94
INTRO PROC-BRST BX,19100,HCPCS,360,RC,,both,3525.66,3173.09,United Healthcare,Default,Fee Schedule,2876.94,,,,2080.14,2876.94
BX BREAST 1st LES US GUID,19083,HCPCS,360,RC,,both,4515.53,4063.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3160.87,,,,2664.16,3684.67
BX BREAST 1st LES US GUID,19083,HCPCS,360,RC,,both,4515.53,4063.98,Cigna,Default,Percent of Total Billed Charges,2664.16,,,,2664.16,3684.67
BX BREAST 1st LES US GUID,19083,HCPCS,360,RC,,both,4515.53,4063.98,United Healthcare,Default,Fee Schedule,3684.67,,,,2664.16,3684.67
IODINE I-123 SOD IODIDE PER 100 UCI TO 9,A9516,HCPCS,341,RC,,both,376.78,339.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.75,,,,222.3,307.45
IODINE I-123 SOD IODIDE PER 100 UCI TO 9,A9516,HCPCS,341,RC,,both,376.78,339.1,Cigna,Default,Percent of Total Billed Charges,222.3,,,,222.3,307.45
IODINE I-123 SOD IODIDE PER 100 UCI TO 9,A9516,HCPCS,341,RC,,both,376.78,339.1,United Healthcare,Default,Fee Schedule,307.45,,,,222.3,307.45
XR JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,HCPCS,320,RC,,both,412.84,371.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,288.99,,,,243.58,336.88
XR JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,HCPCS,320,RC,,both,412.84,371.56,Cigna,Default,Percent of Total Billed Charges,243.58,,,,243.58,336.88
XR JOINT SURVEY SINGLE VIEW 2+ JOINTS,77077,HCPCS,320,RC,,both,412.84,371.56,United Healthcare,Default,Fee Schedule,336.88,,,,243.58,336.88
X-RAY XM ESOPHAGUS 2CNTRST,74221,HCPCS,320,RC,,both,658.56,592.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,460.99,,,,388.55,537.38
X-RAY XM ESOPHAGUS 2CNTRST,74221,HCPCS,320,RC,,both,658.56,592.7,Cigna,Default,Percent of Total Billed Charges,388.55,,,,388.55,537.38
X-RAY XM ESOPHAGUS 2CNTRST,74221,HCPCS,320,RC,,both,658.56,592.7,United Healthcare,Default,Fee Schedule,537.38,,,,388.55,537.38
X-RAY SM INT F-THRU STD,74248,HCPCS,320,RC,,both,397.07,357.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,277.95,,,,234.27,324.01
X-RAY SM INT F-THRU STD,74248,HCPCS,320,RC,,both,397.07,357.36,Cigna,Default,Percent of Total Billed Charges,234.27,,,,234.27,324.01
X-RAY SM INT F-THRU STD,74248,HCPCS,320,RC,,both,397.07,357.36,United Healthcare,Default,Fee Schedule,324.01,,,,234.27,324.01
SONO BREAST BILATERAL,76641,HCPCS,402,RC,50,both,790.89,711.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,553.62,,,,466.63,645.37
SONO BREAST BILATERAL,76641,HCPCS,402,RC,50,both,790.89,711.8,Cigna,Default,Percent of Total Billed Charges,466.63,,,,466.63,645.37
SONO BREAST BILATERAL,76641,HCPCS,402,RC,50,both,790.89,711.8,United Healthcare,Default,Fee Schedule,645.37,,,,466.63,645.37
XR NJX CHOLANGIO PRQ W/IMG GID RS&I EXIS,47531,HCPCS,320,RC,,both,11144.95,10030.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7801.46,,,,6575.52,9094.28
XR NJX CHOLANGIO PRQ W/IMG GID RS&I EXIS,47531,HCPCS,320,RC,,both,11144.95,10030.46,Cigna,Default,Percent of Total Billed Charges,6575.52,,,,6575.52,9094.28
XR NJX CHOLANGIO PRQ W/IMG GID RS&I EXIS,47531,HCPCS,320,RC,,both,11144.95,10030.46,United Healthcare,Default,Fee Schedule,9094.28,,,,6575.52,9094.28
XR NJX CHOLANGIO PRQ W/IMG GID RS&I NEW,47532,HCPCS,320,RC,,both,11144.95,10030.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7801.46,,,,6575.52,9094.28
XR NJX CHOLANGIO PRQ W/IMG GID RS&I NEW,47532,HCPCS,320,RC,,both,11144.95,10030.46,Cigna,Default,Percent of Total Billed Charges,6575.52,,,,6575.52,9094.28
XR NJX CHOLANGIO PRQ W/IMG GID RS&I NEW,47532,HCPCS,320,RC,,both,11144.95,10030.46,United Healthcare,Default,Fee Schedule,9094.28,,,,6575.52,9094.28
SONO BREAST  LIMITED BILATERAL,76642,HCPCS,402,RC,50,both,862.25,776.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,603.58,,,,508.73,703.6
SONO BREAST  LIMITED BILATERAL,76642,HCPCS,402,RC,50,both,862.25,776.03,Cigna,Default,Percent of Total Billed Charges,508.73,,,,508.73,703.6
SONO BREAST  LIMITED BILATERAL,76642,HCPCS,402,RC,50,both,862.25,776.03,United Healthcare,Default,Fee Schedule,703.6,,,,508.73,703.6
XR CHEST 2V INSP/ESP,71046,HCPCS,324,RC,,both,210.8,189.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.56,,,,124.37,172.01
XR CHEST 2V INSP/ESP,71046,HCPCS,324,RC,,both,210.8,189.72,Cigna,Default,Percent of Total Billed Charges,124.37,,,,124.37,172.01
XR CHEST 2V INSP/ESP,71046,HCPCS,324,RC,,both,210.8,189.72,United Healthcare,Default,Fee Schedule,172.01,,,,124.37,172.01
XR CALCANEUS BILATERAL (HEEL),73650,HCPCS,320,RC,50,both,445.63,401.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.94,,,,262.92,363.63
XR CALCANEUS BILATERAL (HEEL),73650,HCPCS,320,RC,50,both,445.63,401.07,Cigna,Default,Percent of Total Billed Charges,262.92,,,,262.92,363.63
XR CALCANEUS BILATERAL (HEEL),73650,HCPCS,320,RC,50,both,445.63,401.07,United Healthcare,Default,Fee Schedule,363.63,,,,262.92,363.63
XR HUMERUS BILATERAL,73060,HCPCS,320,RC,50,both,576.66,518.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,403.66,,,,340.23,470.55
XR HUMERUS BILATERAL,73060,HCPCS,320,RC,50,both,576.66,518.99,Cigna,Default,Percent of Total Billed Charges,340.23,,,,340.23,470.55
XR HUMERUS BILATERAL,73060,HCPCS,320,RC,50,both,576.66,518.99,United Healthcare,Default,Fee Schedule,470.55,,,,340.23,470.55
FLUOROGUIDE FOR SPINE INJECT,77003,HCPCS,320,RC,,both,1571,1413.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1099.7,,,,926.89,1281.94
FLUOROGUIDE FOR SPINE INJECT,77003,HCPCS,320,RC,,both,1571,1413.9,Cigna,Default,Percent of Total Billed Charges,926.89,,,,926.89,1281.94
FLUOROGUIDE FOR SPINE INJECT,77003,HCPCS,320,RC,,both,1571,1413.9,United Healthcare,Default,Fee Schedule,1281.94,,,,926.89,1281.94
CONTRAST ISOVUE 300,Q9967,HCPCS,636,RC,,both,0.84,0.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.59,,,,0.5,0.69
CONTRAST ISOVUE 300,Q9967,HCPCS,636,RC,,both,0.84,0.76,Cigna,Default,Percent of Total Billed Charges,0.5,,,,0.5,0.69
CONTRAST ISOVUE 300,Q9967,HCPCS,636,RC,,both,0.84,0.76,United Healthcare,Default,Fee Schedule,0.69,,,,0.5,0.69
CONTRAST ISOVUE 300 WASTE,Q9967,HCPCS,636,RC,JW,both,0.82,0.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.57,,,,0.48,0.67
CONTRAST ISOVUE 300 WASTE,Q9967,HCPCS,636,RC,JW,both,0.82,0.74,Cigna,Default,Percent of Total Billed Charges,0.48,,,,0.48,0.67
CONTRAST ISOVUE 300 WASTE,Q9967,HCPCS,636,RC,JW,both,0.82,0.74,United Healthcare,Default,Fee Schedule,0.67,,,,0.48,0.67
ANG ABDOMINAL AORTOGRPHY,75625,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG ABDOMINAL AORTOGRPHY,75625,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG ABDOMINAL AORTOGRPHY,75625,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG THORACTIC AORTOGRAPHY,75605,HCPCS,323,RC,,both,16205.89,14585.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.12,,,,9561.48,13224.01
ANG THORACTIC AORTOGRAPHY,75605,HCPCS,323,RC,,both,16205.89,14585.3,Cigna,Default,Percent of Total Billed Charges,9561.48,,,,9561.48,13224.01
ANG THORACTIC AORTOGRAPHY,75605,HCPCS,323,RC,,both,16205.89,14585.3,United Healthcare,Default,Fee Schedule,13224.01,,,,9561.48,13224.01
ANG ABDM AORTGRPHY W ROFF,75630,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG ABDM AORTGRPHY W ROFF,75630,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG ABDM AORTGRPHY W ROFF,75630,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG PULMONARY ANGIO UNIL,75741,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG PULMONARY ANGIO UNIL,75741,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG PULMONARY ANGIO UNIL,75741,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG HEPATIC VENOGRAM,75889,HCPCS,320,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG HEPATIC VENOGRAM,75889,HCPCS,320,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG HEPATIC VENOGRAM,75889,HCPCS,320,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG INFERIOR VENACAVGRPH,75825,HCPCS,320,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG INFERIOR VENACAVGRPH,75825,HCPCS,320,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG INFERIOR VENACAVGRPH,75825,HCPCS,320,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG SUPERIOR VENACAVOGRP,75827,HCPCS,320,RC,,both,2367.91,2131.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1657.54,,,,1397.07,1932.21
ANG SUPERIOR VENACAVOGRP,75827,HCPCS,320,RC,,both,2367.91,2131.12,Cigna,Default,Percent of Total Billed Charges,1397.07,,,,1397.07,1932.21
ANG SUPERIOR VENACAVOGRP,75827,HCPCS,320,RC,,both,2367.91,2131.12,United Healthcare,Default,Fee Schedule,1932.21,,,,1397.07,1932.21
ANG PULMONARY ANGIO BILAT,75743,HCPCS,321,RC,,both,6659.46,5993.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4661.62,,,,3929.08,5434.12
ANG PULMONARY ANGIO BILAT,75743,HCPCS,321,RC,,both,6659.46,5993.51,Cigna,Default,Percent of Total Billed Charges,3929.08,,,,3929.08,5434.12
ANG PULMONARY ANGIO BILAT,75743,HCPCS,321,RC,,both,6659.46,5993.51,United Healthcare,Default,Fee Schedule,5434.12,,,,3929.08,5434.12
ANG SELECTIVE UNILATERAL RENAL,36251,HCPCS,360,RC,,both,9638.68,8674.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6747.08,,,,5686.82,7865.16
ANG SELECTIVE UNILATERAL RENAL,36251,HCPCS,360,RC,,both,9638.68,8674.81,Cigna,Default,Percent of Total Billed Charges,5686.82,,,,5686.82,7865.16
ANG SELECTIVE UNILATERAL RENAL,36251,HCPCS,360,RC,,both,9638.68,8674.81,United Healthcare,Default,Fee Schedule,7865.16,,,,5686.82,7865.16
SUPER SELECTIVE RENAL UNILATERAL,36253,HCPCS,360,RC,,both,16205.89,14585.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.12,,,,9561.48,13224.01
SUPER SELECTIVE RENAL UNILATERAL,36253,HCPCS,360,RC,,both,16205.89,14585.3,Cigna,Default,Percent of Total Billed Charges,9561.48,,,,9561.48,13224.01
SUPER SELECTIVE RENAL UNILATERAL,36253,HCPCS,360,RC,,both,16205.89,14585.3,United Healthcare,Default,Fee Schedule,13224.01,,,,9561.48,13224.01
SUPER SELECTIVE RENAL BILATERAL,36254,HCPCS,360,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
SUPER SELECTIVE RENAL BILATERAL,36254,HCPCS,360,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
SUPER SELECTIVE RENAL BILATERAL,36254,HCPCS,360,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG SELECTIV RENAL BILAT,36252,HCPCS,360,RC,,both,15353.19,13817.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10747.23,,,,9058.38,12528.2
ANG SELECTIV RENAL BILAT,36252,HCPCS,360,RC,,both,15353.19,13817.87,Cigna,Default,Percent of Total Billed Charges,9058.38,,,,9058.38,12528.2
ANG SELECTIV RENAL BILAT,36252,HCPCS,360,RC,,both,15353.19,13817.87,United Healthcare,Default,Fee Schedule,12528.2,,,,9058.38,12528.2
ANG GREENFIELD FILTER,37191,HCPCS,360,RC,,both,2041.25,1837.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1428.88,,,,1204.34,1665.66
ANG GREENFIELD FILTER,37191,HCPCS,360,RC,,both,2041.25,1837.13,Cigna,Default,Percent of Total Billed Charges,1204.34,,,,1204.34,1665.66
ANG GREENFIELD FILTER,37191,HCPCS,360,RC,,both,2041.25,1837.13,United Healthcare,Default,Fee Schedule,1665.66,,,,1204.34,1665.66
ANG RENAL VEIN RENIN,75893,HCPCS,321,RC,,both,665.75,599.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,466.02,,,,392.79,543.25
ANG RENAL VEIN RENIN,75893,HCPCS,321,RC,,both,665.75,599.18,Cigna,Default,Percent of Total Billed Charges,392.79,,,,392.79,543.25
ANG RENAL VEIN RENIN,75893,HCPCS,321,RC,,both,665.75,599.18,United Healthcare,Default,Fee Schedule,543.25,,,,392.79,543.25
ANG EXTREMITY BILATERAL ANGIOGRAPHY,75716,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG EXTREMITY BILATERAL ANGIOGRAPHY,75716,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG EXTREMITY BILATERAL ANGIOGRAPHY,75716,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG EXTREMITY UNILATER ANGIO,75710,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG EXTREMITY UNILATER ANGIO,75710,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG EXTREMITY UNILATER ANGIO,75710,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG ILIAL/FEMORAL W CORONARY ANGIO,G0278,HCPCS,321,RC,,both,1248.5,1123.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,873.95,,,,736.62,1018.78
ANG ILIAL/FEMORAL W CORONARY ANGIO,G0278,HCPCS,321,RC,,both,1248.5,1123.65,Cigna,Default,Percent of Total Billed Charges,736.62,,,,736.62,1018.78
ANG ILIAL/FEMORAL W CORONARY ANGIO,G0278,HCPCS,321,RC,,both,1248.5,1123.65,United Healthcare,Default,Fee Schedule,1018.78,,,,736.62,1018.78
ANG SELECTIVE VISCERAL,75726,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG SELECTIVE VISCERAL,75726,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG SELECTIVE VISCERAL,75726,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG ADD SELECTIVE VESSEL ADD ON,75774,HCPCS,323,RC,,both,7445.86,6701.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5212.1,,,,4393.06,6075.82
ANG ADD SELECTIVE VESSEL ADD ON,75774,HCPCS,323,RC,,both,7445.86,6701.27,Cigna,Default,Percent of Total Billed Charges,4393.06,,,,4393.06,6075.82
ANG ADD SELECTIVE VESSEL ADD ON,75774,HCPCS,323,RC,,both,7445.86,6701.27,United Healthcare,Default,Fee Schedule,6075.82,,,,4393.06,6075.82
ANG TRANSCATHETER PERCUTANEOUS STENT,37236,HCPCS,360,RC,,both,34936.71,31443.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24455.7,,,,20612.66,28508.36
ANG TRANSCATHETER PERCUTANEOUS STENT,37236,HCPCS,360,RC,,both,34936.71,31443.04,Cigna,Default,Percent of Total Billed Charges,20612.66,,,,20612.66,28508.36
ANG TRANSCATHETER PERCUTANEOUS STENT,37236,HCPCS,360,RC,,both,34936.71,31443.04,United Healthcare,Default,Fee Schedule,28508.36,,,,20612.66,28508.36
ANG EMBOLIZATION OR OCCLUSION VEIN,37241,HCPCS,360,RC,,both,35810.13,32229.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25067.09,,,,21127.98,29221.07
ANG EMBOLIZATION OR OCCLUSION VEIN,37241,HCPCS,360,RC,,both,35810.13,32229.12,Cigna,Default,Percent of Total Billed Charges,21127.98,,,,21127.98,29221.07
ANG EMBOLIZATION OR OCCLUSION VEIN,37241,HCPCS,360,RC,,both,35810.13,32229.12,United Healthcare,Default,Fee Schedule,29221.07,,,,21127.98,29221.07
ANG TRANSCATHETER EMBOLIZATION,75894,HCPCS,320,RC,,both,25103.59,22593.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17572.51,,,,14811.12,20484.53
ANG TRANSCATHETER EMBOLIZATION,75894,HCPCS,320,RC,,both,25103.59,22593.23,Cigna,Default,Percent of Total Billed Charges,14811.12,,,,14811.12,20484.53
ANG TRANSCATHETER EMBOLIZATION,75894,HCPCS,320,RC,,both,25103.59,22593.23,United Healthcare,Default,Fee Schedule,20484.53,,,,14811.12,20484.53
ANG VENOGRPHY EXT UNILAT,75820,HCPCS,320,RC,,both,2367.91,2131.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1657.54,,,,1397.07,1932.21
ANG VENOGRPHY EXT UNILAT,75820,HCPCS,320,RC,,both,2367.91,2131.12,Cigna,Default,Percent of Total Billed Charges,1397.07,,,,1397.07,1932.21
ANG VENOGRPHY EXT UNILAT,75820,HCPCS,320,RC,,both,2367.91,2131.12,United Healthcare,Default,Fee Schedule,1932.21,,,,1397.07,1932.21
ANG VENOUS SAMPLE COLLECTION,36500,HCPCS,360,RC,,both,2148.03,1933.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1503.62,,,,1267.34,1752.79
ANG VENOUS SAMPLE COLLECTION,36500,HCPCS,360,RC,,both,2148.03,1933.23,Cigna,Default,Percent of Total Billed Charges,1267.34,,,,1267.34,1752.79
ANG VENOUS SAMPLE COLLECTION,36500,HCPCS,360,RC,,both,2148.03,1933.23,United Healthcare,Default,Fee Schedule,1752.79,,,,1267.34,1752.79
ANG VENOGRPHY EXTR BILAT,75822,HCPCS,320,RC,,both,5751.27,5176.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4025.89,,,,3393.25,4693.04
ANG VENOGRPHY EXTR BILAT,75822,HCPCS,320,RC,,both,5751.27,5176.14,Cigna,Default,Percent of Total Billed Charges,3393.25,,,,3393.25,4693.04
ANG VENOGRPHY EXTR BILAT,75822,HCPCS,320,RC,,both,5751.27,5176.14,United Healthcare,Default,Fee Schedule,4693.04,,,,3393.25,4693.04
ANG RENAL VENOGRAPHY - UNILATERAL,75831,HCPCS,320,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG RENAL VENOGRAPHY - UNILATERAL,75831,HCPCS,320,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG RENAL VENOGRAPHY - UNILATERAL,75831,HCPCS,320,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG RENAL VENOGRPHY BIL,75833,HCPCS,320,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG RENAL VENOGRPHY BIL,75833,HCPCS,320,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG RENAL VENOGRPHY BIL,75833,HCPCS,320,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG VENOUS SAMPLING,75893,HCPCS,320,RC,,both,16205.89,14585.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.12,,,,9561.48,13224.01
ANG VENOUS SAMPLING,75893,HCPCS,320,RC,,both,16205.89,14585.3,Cigna,Default,Percent of Total Billed Charges,9561.48,,,,9561.48,13224.01
ANG VENOUS SAMPLING,75893,HCPCS,320,RC,,both,16205.89,14585.3,United Healthcare,Default,Fee Schedule,13224.01,,,,9561.48,13224.01
ANG PELVIC SELECTIVE,75736,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG PELVIC SELECTIVE,75736,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG PELVIC SELECTIVE,75736,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG EXTREMITY UNILATERAL,75710,HCPCS,323,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG EXTREMITY UNILATERAL,75710,HCPCS,323,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG EXTREMITY UNILATERAL,75710,HCPCS,323,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG ANGIOGRAM EXISNG CATH,75898,HCPCS,320,RC,,both,5895.05,5305.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4126.54,,,,3478.08,4810.36
ANG ANGIOGRAM EXISNG CATH,75898,HCPCS,320,RC,,both,5895.05,5305.55,Cigna,Default,Percent of Total Billed Charges,3478.08,,,,3478.08,4810.36
ANG ANGIOGRAM EXISNG CATH,75898,HCPCS,320,RC,,both,5895.05,5305.55,United Healthcare,Default,Fee Schedule,4810.36,,,,3478.08,4810.36
ANG CATHETER IN CORONARY ARTERY ANGIO,93454,HCPCS,481,RC,,both,10299.97,9269.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7209.98,,,,6076.98,8404.78
ANG CATHETER IN CORONARY ARTERY ANGIO,93454,HCPCS,481,RC,,both,10299.97,9269.97,Cigna,Default,Percent of Total Billed Charges,6076.98,,,,6076.98,8404.78
ANG CATHETER IN CORONARY ARTERY ANGIO,93454,HCPCS,481,RC,,both,10299.97,9269.97,United Healthcare,Default,Fee Schedule,8404.78,,,,6076.98,8404.78
ANG ANGIO BYPASS GRAFT,93455,HCPCS,481,RC,,both,10299.97,9269.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7209.98,,,,6076.98,8404.78
ANG ANGIO BYPASS GRAFT,93455,HCPCS,481,RC,,both,10299.97,9269.97,Cigna,Default,Percent of Total Billed Charges,6076.98,,,,6076.98,8404.78
ANG ANGIO BYPASS GRAFT,93455,HCPCS,481,RC,,both,10299.97,9269.97,United Healthcare,Default,Fee Schedule,8404.78,,,,6076.98,8404.78
ANG LEFT HEART CATH WITH VENTRICLE,93452,HCPCS,481,RC,,both,10299.97,9269.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7209.98,,,,6076.98,8404.78
ANG LEFT HEART CATH WITH VENTRICLE,93452,HCPCS,481,RC,,both,10299.97,9269.97,Cigna,Default,Percent of Total Billed Charges,6076.98,,,,6076.98,8404.78
ANG LEFT HEART CATH WITH VENTRICLE,93452,HCPCS,481,RC,,both,10299.97,9269.97,United Healthcare,Default,Fee Schedule,8404.78,,,,6076.98,8404.78
ANG RIGHT HEART CATH WITH 02,93451,HCPCS,481,RC,,both,10299.97,9269.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7209.98,,,,6076.98,8404.78
ANG RIGHT HEART CATH WITH 02,93451,HCPCS,481,RC,,both,10299.97,9269.97,Cigna,Default,Percent of Total Billed Charges,6076.98,,,,6076.98,8404.78
ANG RIGHT HEART CATH WITH 02,93451,HCPCS,481,RC,,both,10299.97,9269.97,United Healthcare,Default,Fee Schedule,8404.78,,,,6076.98,8404.78
ANG NATIVE CORONARY ANGIL W/L+ HEART,93458,HCPCS,481,RC,,both,10299.97,9269.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7209.98,,,,6076.98,8404.78
ANG NATIVE CORONARY ANGIL W/L+ HEART,93458,HCPCS,481,RC,,both,10299.97,9269.97,Cigna,Default,Percent of Total Billed Charges,6076.98,,,,6076.98,8404.78
ANG NATIVE CORONARY ANGIL W/L+ HEART,93458,HCPCS,481,RC,,both,10299.97,9269.97,United Healthcare,Default,Fee Schedule,8404.78,,,,6076.98,8404.78
ANG NATIVE CORONARY AND BYPASS GRAFT,93459,HCPCS,481,RC,,both,10299.97,9269.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7209.98,,,,6076.98,8404.78
ANG NATIVE CORONARY AND BYPASS GRAFT,93459,HCPCS,481,RC,,both,10299.97,9269.97,Cigna,Default,Percent of Total Billed Charges,6076.98,,,,6076.98,8404.78
ANG NATIVE CORONARY AND BYPASS GRAFT,93459,HCPCS,481,RC,,both,10299.97,9269.97,United Healthcare,Default,Fee Schedule,8404.78,,,,6076.98,8404.78
ANG SUPRAVALVULAR AORTOGRAPHY,93567,HCPCS,481,RC,,both,7948.56,7153.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5563.99,,,,4689.65,6486.02
ANG SUPRAVALVULAR AORTOGRAPHY,93567,HCPCS,481,RC,,both,7948.56,7153.7,Cigna,Default,Percent of Total Billed Charges,4689.65,,,,4689.65,6486.02
ANG SUPRAVALVULAR AORTOGRAPHY,93567,HCPCS,481,RC,,both,7948.56,7153.7,United Healthcare,Default,Fee Schedule,6486.02,,,,4689.65,6486.02
ANG SWAN-GUNZ CATHETERIZATION,93503,HCPCS,481,RC,,both,5895.05,5305.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4126.54,,,,3478.08,4810.36
ANG SWAN-GUNZ CATHETERIZATION,93503,HCPCS,481,RC,,both,5895.05,5305.55,Cigna,Default,Percent of Total Billed Charges,3478.08,,,,3478.08,4810.36
ANG SWAN-GUNZ CATHETERIZATION,93503,HCPCS,481,RC,,both,5895.05,5305.55,United Healthcare,Default,Fee Schedule,4810.36,,,,3478.08,4810.36
ANG PTA ILIAL ARTERY,37220,HCPCS,360,RC,,both,17991.21,16192.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12593.85,,,,10614.81,14680.83
ANG PTA ILIAL ARTERY,37220,HCPCS,360,RC,,both,17991.21,16192.09,Cigna,Default,Percent of Total Billed Charges,10614.81,,,,10614.81,14680.83
ANG PTA ILIAL ARTERY,37220,HCPCS,360,RC,,both,17991.21,16192.09,United Healthcare,Default,Fee Schedule,14680.83,,,,10614.81,14680.83
ANG PTA/STENT ILIAL ARTERY,37221,HCPCS,360,RC,,both,34936.71,31443.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24455.7,,,,20612.66,28508.36
ANG PTA/STENT ILIAL ARTERY,37221,HCPCS,360,RC,,both,34936.71,31443.04,Cigna,Default,Percent of Total Billed Charges,20612.66,,,,20612.66,28508.36
ANG PTA/STENT ILIAL ARTERY,37221,HCPCS,360,RC,,both,34936.71,31443.04,United Healthcare,Default,Fee Schedule,28508.36,,,,20612.66,28508.36
ANG PTA ADDITIONAL ILIAC ARTERY,37222,HCPCS,360,RC,,both,12069.15,10862.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8448.4,,,,7120.8,9848.43
ANG PTA ADDITIONAL ILIAC ARTERY,37222,HCPCS,360,RC,,both,12069.15,10862.24,Cigna,Default,Percent of Total Billed Charges,7120.8,,,,7120.8,9848.43
ANG PTA ADDITIONAL ILIAC ARTERY,37222,HCPCS,360,RC,,both,12069.15,10862.24,United Healthcare,Default,Fee Schedule,9848.43,,,,7120.8,9848.43
ANG PTA FEMORAL-POPLITEAL ARTERY,37224,HCPCS,360,RC,,both,17467.19,15720.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12227.03,,,,10305.64,14253.23
ANG PTA FEMORAL-POPLITEAL ARTERY,37224,HCPCS,360,RC,,both,17467.19,15720.47,Cigna,Default,Percent of Total Billed Charges,10305.64,,,,10305.64,14253.23
ANG PTA FEMORAL-POPLITEAL ARTERY,37224,HCPCS,360,RC,,both,17467.19,15720.47,United Healthcare,Default,Fee Schedule,14253.23,,,,10305.64,14253.23
ANG PTA AND STENT ADDITIONAL ILIAC,37223,HCPCS,360,RC,,both,20159.79,18143.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14111.85,,,,11894.28,16450.39
ANG PTA AND STENT ADDITIONAL ILIAC,37223,HCPCS,360,RC,,both,20159.79,18143.81,Cigna,Default,Percent of Total Billed Charges,11894.28,,,,11894.28,16450.39
ANG PTA AND STENT ADDITIONAL ILIAC,37223,HCPCS,360,RC,,both,20159.79,18143.81,United Healthcare,Default,Fee Schedule,16450.39,,,,11894.28,16450.39
ANG PTA FEMORAL-POPLITEAL W/STENT,37226,HCPCS,360,RC,,both,34936.71,31443.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24455.7,,,,20612.66,28508.36
ANG PTA FEMORAL-POPLITEAL W/STENT,37226,HCPCS,360,RC,,both,34936.71,31443.04,Cigna,Default,Percent of Total Billed Charges,20612.66,,,,20612.66,28508.36
ANG PTA FEMORAL-POPLITEAL W/STENT,37226,HCPCS,360,RC,,both,34936.71,31443.04,United Healthcare,Default,Fee Schedule,28508.36,,,,20612.66,28508.36
ANG PTA TIBIAL ARTERY,37228,HCPCS,360,RC,,both,34936.71,31443.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24455.7,,,,20612.66,28508.36
ANG PTA TIBIAL ARTERY,37228,HCPCS,360,RC,,both,34936.71,31443.04,Cigna,Default,Percent of Total Billed Charges,20612.66,,,,20612.66,28508.36
ANG PTA TIBIAL ARTERY,37228,HCPCS,360,RC,,both,34936.71,31443.04,United Healthcare,Default,Fee Schedule,28508.36,,,,20612.66,28508.36
ANG PTA STENT TIBIAL ARTERY,37230,HCPCS,360,RC,,both,56203.38,50583.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39342.37,,,,33159.99,45861.96
ANG PTA STENT TIBIAL ARTERY,37230,HCPCS,360,RC,,both,56203.38,50583.04,Cigna,Default,Percent of Total Billed Charges,33159.99,,,,33159.99,45861.96
ANG PTA STENT TIBIAL ARTERY,37230,HCPCS,360,RC,,both,56203.38,50583.04,United Healthcare,Default,Fee Schedule,45861.96,,,,33159.99,45861.96
ANG ADDITIONAL PTA TIBIAL ARTERY,37232,HCPCS,360,RC,,both,12069.15,10862.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8448.4,,,,7120.8,9848.43
ANG ADDITIONAL PTA TIBIAL ARTERY,37232,HCPCS,360,RC,,both,12069.15,10862.24,Cigna,Default,Percent of Total Billed Charges,7120.8,,,,7120.8,9848.43
ANG ADDITIONAL PTA TIBIAL ARTERY,37232,HCPCS,360,RC,,both,12069.15,10862.24,United Healthcare,Default,Fee Schedule,9848.43,,,,7120.8,9848.43
ANG ADDITIONAL PTA W/STENT TIBIAL,37234,HCPCS,360,RC,,both,20255.94,18230.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14179.16,,,,11951,16528.85
ANG ADDITIONAL PTA W/STENT TIBIAL,37234,HCPCS,360,RC,,both,20255.94,18230.35,Cigna,Default,Percent of Total Billed Charges,11951,,,,11951,16528.85
ANG ADDITIONAL PTA W/STENT TIBIAL,37234,HCPCS,360,RC,,both,20255.94,18230.35,United Healthcare,Default,Fee Schedule,16528.85,,,,11951,16528.85
ANG CAROTID STENT W/ PROTECTION,37215,HCPCS,360,RC,,inpatient,29178.92,26261.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20425.24,,,,17215.56,23810
ANG CAROTID STENT W/ PROTECTION,37215,HCPCS,360,RC,,inpatient,29178.92,26261.03,Cigna,Default,Percent of Total Billed Charges,17215.56,,,,17215.56,23810
ANG CAROTID STENT W/ PROTECTION,37215,HCPCS,360,RC,,inpatient,29178.92,26261.03,United Healthcare,Default,Fee Schedule,23810,,,,17215.56,23810
ANG CAROTID STENT W/OUT PROTECTION,37216,HCPCS,360,RC,,both,29178.92,26261.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20425.24,,,,17215.56,23810
ANG CAROTID STENT W/OUT PROTECTION,37216,HCPCS,360,RC,,both,29178.92,26261.03,Cigna,Default,Percent of Total Billed Charges,17215.56,,,,17215.56,23810
ANG CAROTID STENT W/OUT PROTECTION,37216,HCPCS,360,RC,,both,29178.92,26261.03,United Healthcare,Default,Fee Schedule,23810,,,,17215.56,23810
ANG ART STENT NON-LWR ETRMTY IST,37236,HCPCS,360,RC,,both,22799.25,20519.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15959.48,,,,13451.56,18604.19
ANG ART STENT NON-LWR ETRMTY IST,37236,HCPCS,360,RC,,both,22799.25,20519.33,Cigna,Default,Percent of Total Billed Charges,13451.56,,,,13451.56,18604.19
ANG ART STENT NON-LWR ETRMTY IST,37236,HCPCS,360,RC,,both,22799.25,20519.33,United Healthcare,Default,Fee Schedule,18604.19,,,,13451.56,18604.19
ANG CATHETER AORTA FEMORAL ACCESS,36200,HCPCS,360,RC,,both,7669.24,6902.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5368.47,,,,4524.85,6258.1
ANG CATHETER AORTA FEMORAL ACCESS,36200,HCPCS,360,RC,,both,7669.24,6902.32,Cigna,Default,Percent of Total Billed Charges,4524.85,,,,4524.85,6258.1
ANG CATHETER AORTA FEMORAL ACCESS,36200,HCPCS,360,RC,,both,7669.24,6902.32,United Healthcare,Default,Fee Schedule,6258.1,,,,4524.85,6258.1
ANG CATHETER EXTREMITY ARTERY,36140,HCPCS,360,RC,,both,7669.24,6902.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5368.47,,,,4524.85,6258.1
ANG CATHETER EXTREMITY ARTERY,36140,HCPCS,360,RC,,both,7669.24,6902.32,Cigna,Default,Percent of Total Billed Charges,4524.85,,,,4524.85,6258.1
ANG CATHETER EXTREMITY ARTERY,36140,HCPCS,360,RC,,both,7669.24,6902.32,United Healthcare,Default,Fee Schedule,6258.1,,,,4524.85,6258.1
ANG ARTERIAL SELECTIVE 1ST ORDER,36215,HCPCS,360,RC,,both,7987.37,7188.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5591.16,,,,4712.55,6517.69
ANG ARTERIAL SELECTIVE 1ST ORDER,36215,HCPCS,360,RC,,both,7987.37,7188.63,Cigna,Default,Percent of Total Billed Charges,4712.55,,,,4712.55,6517.69
ANG ARTERIAL SELECTIVE 1ST ORDER,36215,HCPCS,360,RC,,both,7987.37,7188.63,United Healthcare,Default,Fee Schedule,6517.69,,,,4712.55,6517.69
ANG ARTERIAL SELECTIVE 2ND ORDER,36216,HCPCS,360,RC,,both,12236.72,11013.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8565.7,,,,7219.66,9985.16
ANG ARTERIAL SELECTIVE 2ND ORDER,36216,HCPCS,360,RC,,both,12236.72,11013.05,Cigna,Default,Percent of Total Billed Charges,7219.66,,,,7219.66,9985.16
ANG ARTERIAL SELECTIVE 2ND ORDER,36216,HCPCS,360,RC,,both,12236.72,11013.05,United Healthcare,Default,Fee Schedule,9985.16,,,,7219.66,9985.16
ANG ARTERIAL SELECTIVE 3RD ORDER,36217,HCPCS,360,RC,,both,12236.72,11013.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8565.7,,,,7219.66,9985.16
ANG ARTERIAL SELECTIVE 3RD ORDER,36217,HCPCS,360,RC,,both,12236.72,11013.05,Cigna,Default,Percent of Total Billed Charges,7219.66,,,,7219.66,9985.16
ANG ARTERIAL SELECTIVE 3RD ORDER,36217,HCPCS,360,RC,,both,12236.72,11013.05,United Healthcare,Default,Fee Schedule,9985.16,,,,7219.66,9985.16
ANG ARTERIAL ADDITIONAL 2ND OR 3RD,36218,HCPCS,360,RC,,both,12236.72,11013.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8565.7,,,,7219.66,9985.16
ANG ARTERIAL ADDITIONAL 2ND OR 3RD,36218,HCPCS,360,RC,,both,12236.72,11013.05,Cigna,Default,Percent of Total Billed Charges,7219.66,,,,7219.66,9985.16
ANG ARTERIAL ADDITIONAL 2ND OR 3RD,36218,HCPCS,360,RC,,both,12236.72,11013.05,United Healthcare,Default,Fee Schedule,9985.16,,,,7219.66,9985.16
ANG ABDOMEN 1ST ORDER,36245,HCPCS,360,RC,,both,12236.72,11013.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8565.7,,,,7219.66,9985.16
ANG ABDOMEN 1ST ORDER,36245,HCPCS,360,RC,,both,12236.72,11013.05,Cigna,Default,Percent of Total Billed Charges,7219.66,,,,7219.66,9985.16
ANG ABDOMEN 1ST ORDER,36245,HCPCS,360,RC,,both,12236.72,11013.05,United Healthcare,Default,Fee Schedule,9985.16,,,,7219.66,9985.16
ANG ABDOMEN 2ND ORDER,36246,HCPCS,360,RC,,both,12236.72,11013.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8565.7,,,,7219.66,9985.16
ANG ABDOMEN 2ND ORDER,36246,HCPCS,360,RC,,both,12236.72,11013.05,Cigna,Default,Percent of Total Billed Charges,7219.66,,,,7219.66,9985.16
ANG ABDOMEN 2ND ORDER,36246,HCPCS,360,RC,,both,12236.72,11013.05,United Healthcare,Default,Fee Schedule,9985.16,,,,7219.66,9985.16
ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER,36247,HCPCS,360,RC,,both,12236.72,11013.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8565.7,,,,7219.66,9985.16
ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER,36247,HCPCS,360,RC,,both,12236.72,11013.05,Cigna,Default,Percent of Total Billed Charges,7219.66,,,,7219.66,9985.16
ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER,36247,HCPCS,360,RC,,both,12236.72,11013.05,United Healthcare,Default,Fee Schedule,9985.16,,,,7219.66,9985.16
"ANG ADDITIONAL 1,2,3 ORDER, EACH",36248,HCPCS,360,RC,,both,11891.85,10702.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8324.3,,,,7016.19,9703.75
"ANG ADDITIONAL 1,2,3 ORDER, EACH",36248,HCPCS,360,RC,,both,11891.85,10702.67,Cigna,Default,Percent of Total Billed Charges,7016.19,,,,7016.19,9703.75
"ANG ADDITIONAL 1,2,3 ORDER, EACH",36248,HCPCS,360,RC,,both,11891.85,10702.67,United Healthcare,Default,Fee Schedule,9703.75,,,,7016.19,9703.75
ANG VENA CAVA VENOGRAPHY,36010,HCPCS,360,RC,,both,4075.21,3667.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2852.65,,,,2404.37,3325.37
ANG VENA CAVA VENOGRAPHY,36010,HCPCS,360,RC,,both,4075.21,3667.69,Cigna,Default,Percent of Total Billed Charges,2404.37,,,,2404.37,3325.37
ANG VENA CAVA VENOGRAPHY,36010,HCPCS,360,RC,,both,4075.21,3667.69,United Healthcare,Default,Fee Schedule,3325.37,,,,2404.37,3325.37
ANG CATHETER VEIN 1ST ORDER,36011,HCPCS,360,RC,,both,4060.93,3654.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2842.65,,,,2395.95,3313.72
ANG CATHETER VEIN 1ST ORDER,36011,HCPCS,360,RC,,both,4060.93,3654.84,Cigna,Default,Percent of Total Billed Charges,2395.95,,,,2395.95,3313.72
ANG CATHETER VEIN 1ST ORDER,36011,HCPCS,360,RC,,both,4060.93,3654.84,United Healthcare,Default,Fee Schedule,3313.72,,,,2395.95,3313.72
ANG CATHETER VEIN 2ND ORDER,36012,HCPCS,360,RC,,both,4934.49,4441.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3454.14,,,,2911.35,4026.54
ANG CATHETER VEIN 2ND ORDER,36012,HCPCS,360,RC,,both,4934.49,4441.04,Cigna,Default,Percent of Total Billed Charges,2911.35,,,,2911.35,4026.54
ANG CATHETER VEIN 2ND ORDER,36012,HCPCS,360,RC,,both,4934.49,4441.04,United Healthcare,Default,Fee Schedule,4026.54,,,,2911.35,4026.54
ANG CATHETER RV OR MAIN PA,36013,HCPCS,360,RC,,both,2721.63,2449.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1905.14,,,,1605.76,2220.85
ANG CATHETER RV OR MAIN PA,36013,HCPCS,360,RC,,both,2721.63,2449.47,Cigna,Default,Percent of Total Billed Charges,1605.76,,,,1605.76,2220.85
ANG CATHETER RV OR MAIN PA,36013,HCPCS,360,RC,,both,2721.63,2449.47,United Healthcare,Default,Fee Schedule,2220.85,,,,1605.76,2220.85
ANG SELECT RT OR LT PULMONARY ART,36014,HCPCS,360,RC,,both,4091.41,3682.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2863.99,,,,2413.93,3338.59
ANG SELECT RT OR LT PULMONARY ART,36014,HCPCS,360,RC,,both,4091.41,3682.27,Cigna,Default,Percent of Total Billed Charges,2413.93,,,,2413.93,3338.59
ANG SELECT RT OR LT PULMONARY ART,36014,HCPCS,360,RC,,both,4091.41,3682.27,United Healthcare,Default,Fee Schedule,3338.59,,,,2413.93,3338.59
ANG CATHETER SEGMENTAL PULMONARY A,36015,HCPCS,360,RC,,both,4192.02,3772.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2934.41,,,,2473.29,3420.69
ANG CATHETER SEGMENTAL PULMONARY A,36015,HCPCS,360,RC,,both,4192.02,3772.82,Cigna,Default,Percent of Total Billed Charges,2473.29,,,,2473.29,3420.69
ANG CATHETER SEGMENTAL PULMONARY A,36015,HCPCS,360,RC,,both,4192.02,3772.82,United Healthcare,Default,Fee Schedule,3420.69,,,,2473.29,3420.69
ANG INJECTION EXISTING CATHETER,36598,HCPCS,360,RC,,both,1263.19,1136.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,884.23,,,,745.28,1030.76
ANG INJECTION EXISTING CATHETER,36598,HCPCS,360,RC,,both,1263.19,1136.87,Cigna,Default,Percent of Total Billed Charges,745.28,,,,745.28,1030.76
ANG INJECTION EXISTING CATHETER,36598,HCPCS,360,RC,,both,1263.19,1136.87,United Healthcare,Default,Fee Schedule,1030.76,,,,745.28,1030.76
ANG CYSIS CLOTTED CATHETER/DEVICE,36593,HCPCS,360,RC,,both,1237.48,1113.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,866.24,,,,730.11,1009.78
ANG CYSIS CLOTTED CATHETER/DEVICE,36593,HCPCS,360,RC,,both,1237.48,1113.73,Cigna,Default,Percent of Total Billed Charges,730.11,,,,730.11,1009.78
ANG CYSIS CLOTTED CATHETER/DEVICE,36593,HCPCS,360,RC,,both,1237.48,1113.73,United Healthcare,Default,Fee Schedule,1009.78,,,,730.11,1009.78
ANG VENA LAVA FILTER PLACEMENT,37191,HCPCS,360,RC,,both,16205.78,14585.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.05,,,,9561.41,13223.92
ANG VENA LAVA FILTER PLACEMENT,37191,HCPCS,360,RC,,both,16205.78,14585.2,Cigna,Default,Percent of Total Billed Charges,9561.41,,,,9561.41,13223.92
ANG VENA LAVA FILTER PLACEMENT,37191,HCPCS,360,RC,,both,16205.78,14585.2,United Healthcare,Default,Fee Schedule,13223.92,,,,9561.41,13223.92
ANG EMBOLIZATION OCCLUSION ARTERY,37242,HCPCS,360,RC,,both,35810.13,32229.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25067.09,,,,21127.98,29221.07
ANG EMBOLIZATION OCCLUSION ARTERY,37242,HCPCS,360,RC,,both,35810.13,32229.12,Cigna,Default,Percent of Total Billed Charges,21127.98,,,,21127.98,29221.07
ANG EMBOLIZATION OCCLUSION ARTERY,37242,HCPCS,360,RC,,both,35810.13,32229.12,United Healthcare,Default,Fee Schedule,29221.07,,,,21127.98,29221.07
ANG ART STENT NON-LWR EXTMTY ADDITIONAL,37237,HCPCS,360,RC,,both,11026.03,9923.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7718.22,,,,6505.36,8997.24
ANG ART STENT NON-LWR EXTMTY ADDITIONAL,37237,HCPCS,360,RC,,both,11026.03,9923.43,Cigna,Default,Percent of Total Billed Charges,6505.36,,,,6505.36,8997.24
ANG ART STENT NON-LWR EXTMTY ADDITIONAL,37237,HCPCS,360,RC,,both,11026.03,9923.43,United Healthcare,Default,Fee Schedule,8997.24,,,,6505.36,8997.24
ANG STENT PLACEMENT VEIN INITIAL,37238,HCPCS,360,RC,,both,34674.87,31207.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24272.41,,,,20458.17,28294.69
ANG STENT PLACEMENT VEIN INITIAL,37238,HCPCS,360,RC,,both,34674.87,31207.38,Cigna,Default,Percent of Total Billed Charges,20458.17,,,,20458.17,28294.69
ANG STENT PLACEMENT VEIN INITIAL,37238,HCPCS,360,RC,,both,34674.87,31207.38,United Healthcare,Default,Fee Schedule,28294.69,,,,20458.17,28294.69
ANG STENT VEIN EACH ADDITIONAL,37239,HCPCS,360,RC,,both,14965.59,13469.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10475.91,,,,8829.7,12211.92
ANG STENT VEIN EACH ADDITIONAL,37239,HCPCS,360,RC,,both,14965.59,13469.03,Cigna,Default,Percent of Total Billed Charges,8829.7,,,,8829.7,12211.92
ANG STENT VEIN EACH ADDITIONAL,37239,HCPCS,360,RC,,both,14965.59,13469.03,United Healthcare,Default,Fee Schedule,12211.92,,,,8829.7,12211.92
"ANG PTA  AORTA , RENAL OR MESENTERIC",37246,HCPCS,360,RC,,both,16703.12,15032.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11692.18,,,,9854.84,13629.75
"ANG PTA  AORTA , RENAL OR MESENTERIC",37246,HCPCS,360,RC,,both,16703.12,15032.81,Cigna,Default,Percent of Total Billed Charges,9854.84,,,,9854.84,13629.75
"ANG PTA  AORTA , RENAL OR MESENTERIC",37246,HCPCS,360,RC,,both,16703.12,15032.81,United Healthcare,Default,Fee Schedule,13629.75,,,,9854.84,13629.75
ANG EMBOLIZATION HEMMORRHAGE A OR V,37244,HCPCS,360,RC,,both,36884.43,33195.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25819.1,,,,21761.81,30097.69
ANG EMBOLIZATION HEMMORRHAGE A OR V,37244,HCPCS,360,RC,,both,36884.43,33195.99,Cigna,Default,Percent of Total Billed Charges,21761.81,,,,21761.81,30097.69
ANG EMBOLIZATION HEMMORRHAGE A OR V,37244,HCPCS,360,RC,,both,36884.43,33195.99,United Healthcare,Default,Fee Schedule,30097.69,,,,21761.81,30097.69
INJECTION PX PRQ TX EXTREMITY PSEUDOANEU,36002,HCPCS,360,RC,,both,1949.3,1754.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1364.51,,,,1150.09,1590.63
INJECTION PX PRQ TX EXTREMITY PSEUDOANEU,36002,HCPCS,360,RC,,both,1949.3,1754.37,Cigna,Default,Percent of Total Billed Charges,1150.09,,,,1150.09,1590.63
INJECTION PX PRQ TX EXTREMITY PSEUDOANEU,36002,HCPCS,360,RC,,both,1949.3,1754.37,United Healthcare,Default,Fee Schedule,1590.63,,,,1150.09,1590.63
ANG THORACIC AORTA WITH CAROTID AN,36221,HCPCS,360,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG THORACIC AORTA WITH CAROTID AN,36221,HCPCS,360,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG THORACIC AORTA WITH CAROTID AN,36221,HCPCS,360,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG CCA SELECTIVE WITH CAROTID ANG,36222,HCPCS,360,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG CCA SELECTIVE WITH CAROTID ANG,36222,HCPCS,360,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG CCA SELECTIVE WITH CAROTID ANG,36222,HCPCS,360,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG CCA SELECTIVE WITH CEREBRAL,36223,HCPCS,360,RC,,both,16205.89,14585.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.12,,,,9561.48,13224.01
ANG CCA SELECTIVE WITH CEREBRAL,36223,HCPCS,360,RC,,both,16205.89,14585.3,Cigna,Default,Percent of Total Billed Charges,9561.48,,,,9561.48,13224.01
ANG CCA SELECTIVE WITH CEREBRAL,36223,HCPCS,360,RC,,both,16205.89,14585.3,United Healthcare,Default,Fee Schedule,13224.01,,,,9561.48,13224.01
ANG ICA SELECTIVE,36224,HCPCS,360,RC,,both,16205.89,14585.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.12,,,,9561.48,13224.01
ANG ICA SELECTIVE,36224,HCPCS,360,RC,,both,16205.89,14585.3,Cigna,Default,Percent of Total Billed Charges,9561.48,,,,9561.48,13224.01
ANG ICA SELECTIVE,36224,HCPCS,360,RC,,both,16205.89,14585.3,United Healthcare,Default,Fee Schedule,13224.01,,,,9561.48,13224.01
ANG SUBCLAVIAN/INNOMIWATE W VERT,36225,HCPCS,360,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ANG SUBCLAVIAN/INNOMIWATE W VERT,36225,HCPCS,360,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ANG SUBCLAVIAN/INNOMIWATE W VERT,36225,HCPCS,360,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ANG VERTEBRAL ARTERY SELECTIVE,36226,HCPCS,360,RC,,both,16205.89,14585.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11344.12,,,,9561.48,13224.01
ANG VERTEBRAL ARTERY SELECTIVE,36226,HCPCS,360,RC,,both,16205.89,14585.3,Cigna,Default,Percent of Total Billed Charges,9561.48,,,,9561.48,13224.01
ANG VERTEBRAL ARTERY SELECTIVE,36226,HCPCS,360,RC,,both,16205.89,14585.3,United Healthcare,Default,Fee Schedule,13224.01,,,,9561.48,13224.01
ANG ECA SELECTIVE ADD ON,36227,HCPCS,360,RC,,both,13404.93,12064.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9383.45,,,,7908.91,10938.42
ANG ECA SELECTIVE ADD ON,36227,HCPCS,360,RC,,both,13404.93,12064.44,Cigna,Default,Percent of Total Billed Charges,7908.91,,,,7908.91,10938.42
ANG ECA SELECTIVE ADD ON,36227,HCPCS,360,RC,,both,13404.93,12064.44,United Healthcare,Default,Fee Schedule,10938.42,,,,7908.91,10938.42
ANG ICA/VERTEBRAL BRANCH SELECTIVE,36228,HCPCS,360,RC,,both,10480.81,9432.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7336.57,,,,6183.68,8552.34
ANG ICA/VERTEBRAL BRANCH SELECTIVE,36228,HCPCS,360,RC,,both,10480.81,9432.73,Cigna,Default,Percent of Total Billed Charges,6183.68,,,,6183.68,8552.34
ANG ICA/VERTEBRAL BRANCH SELECTIVE,36228,HCPCS,360,RC,,both,10480.81,9432.73,United Healthcare,Default,Fee Schedule,8552.34,,,,6183.68,8552.34
ANG CATHETER EXCHANGE ART/VEIN,37213,HCPCS,360,RC,,both,8166.32,7349.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5716.42,,,,4818.13,6663.72
ANG CATHETER EXCHANGE ART/VEIN,37213,HCPCS,360,RC,,both,8166.32,7349.69,Cigna,Default,Percent of Total Billed Charges,4818.13,,,,4818.13,6663.72
ANG CATHETER EXCHANGE ART/VEIN,37213,HCPCS,360,RC,,both,8166.32,7349.69,United Healthcare,Default,Fee Schedule,6663.72,,,,4818.13,6663.72
ANG ARTERIAL INFUSION LYSIS INITIAL,37211,HCPCS,360,RC,,both,16611.03,14949.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11627.72,,,,9800.51,13554.6
ANG ARTERIAL INFUSION LYSIS INITIAL,37211,HCPCS,360,RC,,both,16611.03,14949.93,Cigna,Default,Percent of Total Billed Charges,9800.51,,,,9800.51,13554.6
ANG ARTERIAL INFUSION LYSIS INITIAL,37211,HCPCS,360,RC,,both,16611.03,14949.93,United Healthcare,Default,Fee Schedule,13554.6,,,,9800.51,13554.6
ANG VENOUS INFUSION LYSIS INITIAL,37212,HCPCS,360,RC,,both,10015.65,9014.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7010.96,,,,5909.23,8172.77
ANG VENOUS INFUSION LYSIS INITIAL,37212,HCPCS,360,RC,,both,10015.65,9014.09,Cigna,Default,Percent of Total Billed Charges,5909.23,,,,5909.23,8172.77
ANG VENOUS INFUSION LYSIS INITIAL,37212,HCPCS,360,RC,,both,10015.65,9014.09,United Healthcare,Default,Fee Schedule,8172.77,,,,5909.23,8172.77
ANG CESSATION OF THROMBOLYSIS,37214,HCPCS,360,RC,,both,8166.32,7349.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5716.42,,,,4818.13,6663.72
ANG CESSATION OF THROMBOLYSIS,37214,HCPCS,360,RC,,both,8166.32,7349.69,Cigna,Default,Percent of Total Billed Charges,4818.13,,,,4818.13,6663.72
ANG CESSATION OF THROMBOLYSIS,37214,HCPCS,360,RC,,both,8166.32,7349.69,United Healthcare,Default,Fee Schedule,6663.72,,,,4818.13,6663.72
ANG STENT PLACEMENT RETRO CCA/INNOM,37217,HCPCS,360,RC,,inpatient,4577.44,4119.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3204.21,,,,2700.69,3735.19
ANG STENT PLACEMENT RETRO CCA/INNOM,37217,HCPCS,360,RC,,inpatient,4577.44,4119.7,Cigna,Default,Percent of Total Billed Charges,2700.69,,,,2700.69,3735.19
ANG STENT PLACEMENT RETRO CCA/INNOM,37217,HCPCS,360,RC,,inpatient,4577.44,4119.7,United Healthcare,Default,Fee Schedule,3735.19,,,,2700.69,3735.19
ANG STENT PLACEMENT ANTE CCA/IMMOM,37218,HCPCS,360,RC,,inpatient,4577.44,4119.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3204.21,,,,2700.69,3735.19
ANG STENT PLACEMENT ANTE CCA/IMMOM,37218,HCPCS,360,RC,,inpatient,4577.44,4119.7,Cigna,Default,Percent of Total Billed Charges,2700.69,,,,2700.69,3735.19
ANG STENT PLACEMENT ANTE CCA/IMMOM,37218,HCPCS,360,RC,,inpatient,4577.44,4119.7,United Healthcare,Default,Fee Schedule,3735.19,,,,2700.69,3735.19
ANG INTRO CATH DIALYSIS CIRCUIT,36903,HCPCS,321,RC,,both,34936.71,31443.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24455.7,,,,20612.66,28508.36
ANG INTRO CATH DIALYSIS CIRCUIT,36903,HCPCS,321,RC,,both,34936.71,31443.04,Cigna,Default,Percent of Total Billed Charges,20612.66,,,,20612.66,28508.36
ANG INTRO CATH DIALYSIS CIRCUIT,36903,HCPCS,321,RC,,both,34936.71,31443.04,United Healthcare,Default,Fee Schedule,28508.36,,,,20612.66,28508.36
ANG AVF/GRAFT DIAGNOSTIC ANGIO,36901,HCPCS,321,RC,,both,5687.8,5119.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3981.46,,,,3355.8,4641.24
ANG AVF/GRAFT DIAGNOSTIC ANGIO,36901,HCPCS,321,RC,,both,5687.8,5119.02,Cigna,Default,Percent of Total Billed Charges,3355.8,,,,3355.8,4641.24
ANG AVF/GRAFT DIAGNOSTIC ANGIO,36901,HCPCS,321,RC,,both,5687.8,5119.02,United Healthcare,Default,Fee Schedule,4641.24,,,,3355.8,4641.24
ANG PTA AVF/GRAFT,36902,HCPCS,321,RC,,both,17467.19,15720.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12227.03,,,,10305.64,14253.23
ANG PTA AVF/GRAFT,36902,HCPCS,321,RC,,both,17467.19,15720.47,Cigna,Default,Percent of Total Billed Charges,10305.64,,,,10305.64,14253.23
ANG PTA AVF/GRAFT,36902,HCPCS,321,RC,,both,17467.19,15720.47,United Healthcare,Default,Fee Schedule,14253.23,,,,10305.64,14253.23
ENDOVENOUSE MCHNCHEM 1ST VEIN,36473,HCPCS,360,RC,,both,9771.36,8794.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6839.95,,,,5765.1,7973.43
ENDOVENOUSE MCHNCHEM 1ST VEIN,36473,HCPCS,360,RC,,both,9771.36,8794.22,Cigna,Default,Percent of Total Billed Charges,5765.1,,,,5765.1,7973.43
ENDOVENOUSE MCHNCHEM 1ST VEIN,36473,HCPCS,360,RC,,both,9771.36,8794.22,United Healthcare,Default,Fee Schedule,7973.43,,,,5765.1,7973.43
ENDOVENOUS MCHNCHEM ADD ON,36474,HCPCS,360,RC,,both,4387.78,3949,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3071.45,,,,2588.79,3580.43
ENDOVENOUS MCHNCHEM ADD ON,36474,HCPCS,360,RC,,both,4387.78,3949,Cigna,Default,Percent of Total Billed Charges,2588.79,,,,2588.79,3580.43
ENDOVENOUS MCHNCHEM ADD ON,36474,HCPCS,360,RC,,both,4387.78,3949,United Healthcare,Default,Fee Schedule,3580.43,,,,2588.79,3580.43
"ANG PTA  VEIN, INITIAL OR SAME",37248,HCPCS,360,RC,,both,15836.47,14252.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11085.53,,,,9343.52,12922.56
"ANG PTA  VEIN, INITIAL OR SAME",37248,HCPCS,360,RC,,both,15836.47,14252.82,Cigna,Default,Percent of Total Billed Charges,9343.52,,,,9343.52,12922.56
"ANG PTA  VEIN, INITIAL OR SAME",37248,HCPCS,360,RC,,both,15836.47,14252.82,United Healthcare,Default,Fee Schedule,12922.56,,,,9343.52,12922.56
ANG CCA SELECTIVE WITH CAROTID ANG BILAT,36222,HCPCS,360,RC,50,both,15023.47,13521.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10516.43,,,,8863.85,12259.15
ANG CCA SELECTIVE WITH CAROTID ANG BILAT,36222,HCPCS,360,RC,50,both,15023.47,13521.12,Cigna,Default,Percent of Total Billed Charges,8863.85,,,,8863.85,12259.15
ANG CCA SELECTIVE WITH CAROTID ANG BILAT,36222,HCPCS,360,RC,50,both,15023.47,13521.12,United Healthcare,Default,Fee Schedule,12259.15,,,,8863.85,12259.15
ANG CATHETER IN CORONARY ARTERY ANGIO BI,93454,HCPCS,481,RC,,both,15449.95,13904.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10814.96,,,,9115.47,12607.16
ANG CATHETER IN CORONARY ARTERY ANGIO BI,93454,HCPCS,481,RC,,both,15449.95,13904.96,Cigna,Default,Percent of Total Billed Charges,9115.47,,,,9115.47,12607.16
ANG CATHETER IN CORONARY ARTERY ANGIO BI,93454,HCPCS,481,RC,,both,15449.95,13904.96,United Healthcare,Default,Fee Schedule,12607.16,,,,9115.47,12607.16
ANG BILAT CCA SELECTIVE W/ CEREBRAL,36223,HCPCS,360,RC,50,both,24308.84,21877.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17016.19,,,,14342.22,19836.01
ANG BILAT CCA SELECTIVE W/ CEREBRAL,36223,HCPCS,360,RC,50,both,24308.84,21877.96,Cigna,Default,Percent of Total Billed Charges,14342.22,,,,14342.22,19836.01
ANG BILAT CCA SELECTIVE W/ CEREBRAL,36223,HCPCS,360,RC,50,both,24308.84,21877.96,United Healthcare,Default,Fee Schedule,19836.01,,,,14342.22,19836.01
SHOULDER ARTHROGRAM,73040,HCPCS,322,RC,,both,875.5,787.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,612.85,,,,516.54,714.41
SHOULDER ARTHROGRAM,73040,HCPCS,322,RC,,both,875.5,787.95,Cigna,Default,Percent of Total Billed Charges,516.54,,,,516.54,714.41
SHOULDER ARTHROGRAM,73040,HCPCS,322,RC,,both,875.5,787.95,United Healthcare,Default,Fee Schedule,714.41,,,,516.54,714.41
INJECTION PROCEDURE SHOULDER ARTHR,23350,HCPCS,360,RC,,both,724.57,652.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,507.2,,,,427.5,591.25
INJECTION PROCEDURE SHOULDER ARTHR,23350,HCPCS,360,RC,,both,724.57,652.11,Cigna,Default,Percent of Total Billed Charges,427.5,,,,427.5,591.25
INJECTION PROCEDURE SHOULDER ARTHR,23350,HCPCS,360,RC,,both,724.57,652.11,United Healthcare,Default,Fee Schedule,591.25,,,,427.5,591.25
INJECTION PROCEDURE FOR WRIST ARTHOGRAPH,25246,HCPCS,360,RC,,both,493.05,443.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,345.14,,,,290.9,402.33
INJECTION PROCEDURE FOR WRIST ARTHOGRAPH,25246,HCPCS,360,RC,,both,493.05,443.75,Cigna,Default,Percent of Total Billed Charges,290.9,,,,290.9,402.33
INJECTION PROCEDURE FOR WRIST ARTHOGRAPH,25246,HCPCS,360,RC,,both,493.05,443.75,United Healthcare,Default,Fee Schedule,402.33,,,,290.9,402.33
ILIAC ART ANGIO CARDIAC CATH,G0278,HCPCS,360,RC,,both,2008.39,1807.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1405.87,,,,1184.95,1638.85
ILIAC ART ANGIO CARDIAC CATH,G0278,HCPCS,360,RC,,both,2008.39,1807.55,Cigna,Default,Percent of Total Billed Charges,1184.95,,,,1184.95,1638.85
ILIAC ART ANGIO CARDIAC CATH,G0278,HCPCS,360,RC,,both,2008.39,1807.55,United Healthcare,Default,Fee Schedule,1638.85,,,,1184.95,1638.85
BILAT ANG PTA/STENT ILIAC ARTERY,37221,HCPCS,360,RC,,both,52404.69,47164.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36683.28,,,,30918.77,42762.23
BILAT ANG PTA/STENT ILIAC ARTERY,37221,HCPCS,360,RC,,both,52404.69,47164.22,Cigna,Default,Percent of Total Billed Charges,30918.77,,,,30918.77,42762.23
BILAT ANG PTA/STENT ILIAC ARTERY,37221,HCPCS,360,RC,,both,52404.69,47164.22,United Healthcare,Default,Fee Schedule,42762.23,,,,30918.77,42762.23
OPEN FEM ART EXPOSURE,34812,HCPCS,360,RC,,inpatient,20137.53,18123.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14096.27,,,,11881.14,16432.22
OPEN FEM ART EXPOSURE,34812,HCPCS,360,RC,,inpatient,20137.53,18123.78,Cigna,Default,Percent of Total Billed Charges,11881.14,,,,11881.14,16432.22
OPEN FEM ART EXPOSURE,34812,HCPCS,360,RC,,inpatient,20137.53,18123.78,United Healthcare,Default,Fee Schedule,16432.22,,,,11881.14,16432.22
EVASC RPR ILIO ILIAC ENDOGRAFT,34707,HCPCS,360,RC,,inpatient,25056.15,22550.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17539.3,,,,14783.13,20445.82
EVASC RPR ILIO ILIAC ENDOGRAFT,34707,HCPCS,360,RC,,inpatient,25056.15,22550.54,Cigna,Default,Percent of Total Billed Charges,14783.13,,,,14783.13,20445.82
EVASC RPR ILIO ILIAC ENDOGRAFT,34707,HCPCS,360,RC,,inpatient,25056.15,22550.54,United Healthcare,Default,Fee Schedule,20445.82,,,,14783.13,20445.82
ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS TH,35400,HCPCS,360,RC,,inpatient,2100,1890,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1470,,,,1239,1713.6
ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS TH,35400,HCPCS,360,RC,,inpatient,2100,1890,Cigna,Default,Percent of Total Billed Charges,1239,,,,1239,1713.6
ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS TH,35400,HCPCS,360,RC,,inpatient,2100,1890,United Healthcare,Default,Fee Schedule,1713.6,,,,1239,1713.6
ANG EXTREMITY VENOGRAPHY,36005,HCPCS,360,RC,,both,4075.21,3667.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2852.65,,,,2404.37,3325.37
ANG EXTREMITY VENOGRAPHY,36005,HCPCS,360,RC,,both,4075.21,3667.69,Cigna,Default,Percent of Total Billed Charges,2404.37,,,,2404.37,3325.37
ANG EXTREMITY VENOGRAPHY,36005,HCPCS,360,RC,,both,4075.21,3667.69,United Healthcare,Default,Fee Schedule,3325.37,,,,2404.37,3325.37
ANG VERTEBRAL ARTERY SELECTIVE,3622650,HCPCS,360,RC,,both,24308.84,21877.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17016.19,,,,14342.22,19836.01
ANG VERTEBRAL ARTERY SELECTIVE,3622650,HCPCS,360,RC,,both,24308.84,21877.96,Cigna,Default,Percent of Total Billed Charges,14342.22,,,,14342.22,19836.01
ANG VERTEBRAL ARTERY SELECTIVE,3622650,HCPCS,360,RC,,both,24308.84,21877.96,United Healthcare,Default,Fee Schedule,19836.01,,,,14342.22,19836.01
ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER BI,36247,HCPCS,360,RC,50,both,17820.29,16038.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12474.2,,,,10513.97,14541.36
ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER BI,36247,HCPCS,360,RC,50,both,17820.29,16038.26,Cigna,Default,Percent of Total Billed Charges,10513.97,,,,10513.97,14541.36
ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER BI,36247,HCPCS,360,RC,50,both,17820.29,16038.26,United Healthcare,Default,Fee Schedule,14541.36,,,,10513.97,14541.36
CT 3D RECONSTRUCTION,76376,HCPCS,350,RC,,both,1457.12,1311.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1019.98,,,,520,1189.01
CT 3D RECONSTRUCTION,76376,HCPCS,350,RC,,both,1457.12,1311.41,Cigna,Default,Case Rate,520,,,,520,1189.01
CT 3D RECONSTRUCTION,76376,HCPCS,350,RC,,both,1457.12,1311.41,United Healthcare,Default,Fee Schedule,1189.01,,,,520,1189.01
CT VIRTUAL COLONOSCOPY SCREENING,74263,HCPCS,350,RC,,both,559.05,503.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.34,,,,391.34,520
CT VIRTUAL COLONOSCOPY SCREENING,74263,HCPCS,350,RC,,both,559.05,503.15,Cigna,Default,Case Rate,520,,,,391.34,520
CT VIRTUAL COLONOSCOPY SCREENING,74263,HCPCS,350,RC,,both,559.05,503.15,United Healthcare,Default,Fee Schedule,456.18,,,,391.34,520
CT CORONARY CALCIUM SCORING SCREEN,75571,HCPCS,350,RC,,both,150,135,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105,,,,105,150
CT CORONARY CALCIUM SCORING SCREEN,75571,HCPCS,350,RC,,both,150,135,Cigna,Default,Case Rate,150,,,,105,150
CT CORONARY CALCIUM SCORING SCREEN,75571,HCPCS,350,RC,,both,150,135,United Healthcare,Default,Fee Schedule,122.4,,,,105,150
CT VC/CCS COMBO SCREENING,350,RC,,,,both,626.25,563.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,438.38,,,,438.38,520
CT VC/CCS COMBO SCREENING,350,RC,,,,both,626.25,563.63,Cigna,Default,Case Rate,520,,,,438.38,520
CT VC/CCS COMBO SCREENING,350,RC,,,,both,626.25,563.63,United Healthcare,Default,Fee Schedule,511.02,,,,438.38,520
CT VIRTUAL COLONOSCOPY DIAGNOSTIC,74261,HCPCS,350,RC,,both,559.05,503.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,391.34,,,,391.34,520
CT VIRTUAL COLONOSCOPY DIAGNOSTIC,74261,HCPCS,350,RC,,both,559.05,503.15,Cigna,Default,Case Rate,520,,,,391.34,520
CT VIRTUAL COLONOSCOPY DIAGNOSTIC,74261,HCPCS,350,RC,,both,559.05,503.15,United Healthcare,Default,Fee Schedule,456.18,,,,391.34,520
CT BONE MINERAL DENSITY,77078,HCPCS,350,RC,,both,302.5,272.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.75,,,,211.75,302.5
CT BONE MINERAL DENSITY,77078,HCPCS,350,RC,,both,302.5,272.25,Cigna,Default,Case Rate,302.5,,,,211.75,302.5
CT BONE MINERAL DENSITY,77078,HCPCS,350,RC,,both,302.5,272.25,United Healthcare,Default,Fee Schedule,246.84,,,,211.75,302.5
CT UPPER EXT W/ RT,73201,HCPCS,350,RC,RT,both,2782.63,2504.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1947.84,,,,520,2270.63
CT UPPER EXT W/ RT,73201,HCPCS,350,RC,RT,both,2782.63,2504.37,Cigna,Default,Case Rate,520,,,,520,2270.63
CT UPPER EXT W/ RT,73201,HCPCS,350,RC,RT,both,2782.63,2504.37,United Healthcare,Default,Fee Schedule,2270.63,,,,520,2270.63
CT MAXILLOFACIAL WO/W IV CONTRAST,70488,HCPCS,350,RC,,both,3076.38,2768.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2153.47,,,,520,2510.33
CT MAXILLOFACIAL WO/W IV CONTRAST,70488,HCPCS,350,RC,,both,3076.38,2768.74,Cigna,Default,Case Rate,520,,,,520,2510.33
CT MAXILLOFACIAL WO/W IV CONTRAST,70488,HCPCS,350,RC,,both,3076.38,2768.74,United Healthcare,Default,Fee Schedule,2510.33,,,,520,2510.33
CT MAXILLOFACIAL W/O IV CONTRAST,70486,HCPCS,350,RC,,both,1246.93,1122.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,872.85,,,,520,1017.49
CT MAXILLOFACIAL W/O IV CONTRAST,70486,HCPCS,350,RC,,both,1246.93,1122.24,Cigna,Default,Case Rate,520,,,,520,1017.49
CT MAXILLOFACIAL W/O IV CONTRAST,70486,HCPCS,350,RC,,both,1246.93,1122.24,United Healthcare,Default,Fee Schedule,1017.49,,,,520,1017.49
CT HEAD W/O IV CONTRAST,70450,HCPCS,351,RC,,both,2285.84,2057.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1600.09,,,,520,1865.25
CT HEAD W/O IV CONTRAST,70450,HCPCS,351,RC,,both,2285.84,2057.26,Cigna,Default,Case Rate,520,,,,520,1865.25
CT HEAD W/O IV CONTRAST,70450,HCPCS,351,RC,,both,2285.84,2057.26,United Healthcare,Default,Fee Schedule,1865.25,,,,520,1865.25
CT HEAD WITH IV CONTRAST,70460,HCPCS,351,RC,,both,2668.4,2401.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1867.88,,,,520,2177.41
CT HEAD WITH IV CONTRAST,70460,HCPCS,351,RC,,both,2668.4,2401.56,Cigna,Default,Case Rate,520,,,,520,2177.41
CT HEAD WITH IV CONTRAST,70460,HCPCS,351,RC,,both,2668.4,2401.56,United Healthcare,Default,Fee Schedule,2177.41,,,,520,2177.41
CT HEAD W/WO IV CONTRAST,70470,HCPCS,351,RC,,both,3005.48,2704.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2103.84,,,,520,2452.47
CT HEAD W/WO IV CONTRAST,70470,HCPCS,351,RC,,both,3005.48,2704.93,Cigna,Default,Case Rate,520,,,,520,2452.47
CT HEAD W/WO IV CONTRAST,70470,HCPCS,351,RC,,both,3005.48,2704.93,United Healthcare,Default,Fee Schedule,2452.47,,,,520,2452.47
CT IAC ORB SELLA WITH IV CONTRAST,70481,HCPCS,350,RC,,both,1282.5,1154.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,897.75,,,,520,1046.52
CT IAC ORB SELLA WITH IV CONTRAST,70481,HCPCS,350,RC,,both,1282.5,1154.25,Cigna,Default,Case Rate,520,,,,520,1046.52
CT IAC ORB SELLA WITH IV CONTRAST,70481,HCPCS,350,RC,,both,1282.5,1154.25,United Healthcare,Default,Fee Schedule,1046.52,,,,520,1046.52
CT ST NECK W/O IV CONTRAST,70490,HCPCS,350,RC,,both,2350.76,2115.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1645.53,,,,520,1918.22
CT ST NECK W/O IV CONTRAST,70490,HCPCS,350,RC,,both,2350.76,2115.68,Cigna,Default,Case Rate,520,,,,520,1918.22
CT ST NECK W/O IV CONTRAST,70490,HCPCS,350,RC,,both,2350.76,2115.68,United Healthcare,Default,Fee Schedule,1918.22,,,,520,1918.22
CT ST NECK WITH IV CONTRAST,70491,HCPCS,350,RC,,both,2742.9,2468.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1920.03,,,,520,2238.21
CT ST NECK WITH IV CONTRAST,70491,HCPCS,350,RC,,both,2742.9,2468.61,Cigna,Default,Case Rate,520,,,,520,2238.21
CT ST NECK WITH IV CONTRAST,70491,HCPCS,350,RC,,both,2742.9,2468.61,United Healthcare,Default,Fee Schedule,2238.21,,,,520,2238.21
CTA LOWER EXTREMITY ANGIO RIGHT,73706,HCPCS,350,RC,RT,both,1728,1555.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1209.6,,,,520,1410.05
CTA LOWER EXTREMITY ANGIO RIGHT,73706,HCPCS,350,RC,RT,both,1728,1555.2,Cigna,Default,Case Rate,520,,,,520,1410.05
CTA LOWER EXTREMITY ANGIO RIGHT,73706,HCPCS,350,RC,RT,both,1728,1555.2,United Healthcare,Default,Fee Schedule,1410.05,,,,520,1410.05
CTA LOWER EXTREMITY ANGIO LEFT,73706,HCPCS,350,RC,LT,both,1728,1555.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1209.6,,,,520,1410.05
CTA LOWER EXTREMITY ANGIO LEFT,73706,HCPCS,350,RC,LT,both,1728,1555.2,Cigna,Default,Case Rate,520,,,,520,1410.05
CTA LOWER EXTREMITY ANGIO LEFT,73706,HCPCS,350,RC,LT,both,1728,1555.2,United Healthcare,Default,Fee Schedule,1410.05,,,,520,1410.05
CTA ABDOMEN PELVIS,74174,HCPCS,350,RC,,both,4156.24,3740.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2909.37,,,,520,3391.49
CTA ABDOMEN PELVIS,74174,HCPCS,350,RC,,both,4156.24,3740.62,Cigna,Default,Case Rate,520,,,,520,3391.49
CTA ABDOMEN PELVIS,74174,HCPCS,350,RC,,both,4156.24,3740.62,United Healthcare,Default,Fee Schedule,3391.49,,,,520,3391.49
CTA UPPER EXTRENITY ANGIO RIGHT,73206,HCPCS,350,RC,RT,both,1728,1555.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1209.6,,,,520,1410.05
CTA UPPER EXTRENITY ANGIO RIGHT,73206,HCPCS,350,RC,RT,both,1728,1555.2,Cigna,Default,Case Rate,520,,,,520,1410.05
CTA UPPER EXTRENITY ANGIO RIGHT,73206,HCPCS,350,RC,RT,both,1728,1555.2,United Healthcare,Default,Fee Schedule,1410.05,,,,520,1410.05
CTA UPPER EXTRENITY ANGIO LEFT,73206,HCPCS,350,RC,LT,both,1728,1555.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1209.6,,,,520,1410.05
CTA UPPER EXTRENITY ANGIO LEFT,73206,HCPCS,350,RC,LT,both,1728,1555.2,Cigna,Default,Case Rate,520,,,,520,1410.05
CTA UPPER EXTRENITY ANGIO LEFT,73206,HCPCS,350,RC,LT,both,1728,1555.2,United Healthcare,Default,Fee Schedule,1410.05,,,,520,1410.05
CTA LOWER EXTREMITY ANGIO BILATERAL,73706,HCPCS,350,RC,50,both,2128,1915.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1489.6,,,,520,1736.45
CTA LOWER EXTREMITY ANGIO BILATERAL,73706,HCPCS,350,RC,50,both,2128,1915.2,Cigna,Default,Case Rate,520,,,,520,1736.45
CTA LOWER EXTREMITY ANGIO BILATERAL,73706,HCPCS,350,RC,50,both,2128,1915.2,United Healthcare,Default,Fee Schedule,1736.45,,,,520,1736.45
CT ST NECK WO/W IV CONTRAST,70492,HCPCS,350,RC,,both,3088.38,2779.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2161.87,,,,520,2520.12
CT ST NECK WO/W IV CONTRAST,70492,HCPCS,350,RC,,both,3088.38,2779.54,Cigna,Default,Case Rate,520,,,,520,2520.12
CT ST NECK WO/W IV CONTRAST,70492,HCPCS,350,RC,,both,3088.38,2779.54,United Healthcare,Default,Fee Schedule,2520.12,,,,520,2520.12
CTA UPPER EXTRENITY ANGIO BILATERAL,73206,HCPCS,350,RC,50,both,2128,1915.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1489.6,,,,520,1736.45
CTA UPPER EXTRENITY ANGIO BILATERAL,73206,HCPCS,350,RC,50,both,2128,1915.2,Cigna,Default,Case Rate,520,,,,520,1736.45
CTA UPPER EXTRENITY ANGIO BILATERAL,73206,HCPCS,350,RC,50,both,2128,1915.2,United Healthcare,Default,Fee Schedule,1736.45,,,,520,1736.45
CTA PELVIS ANGIOGRAPHY,72191,HCPCS,350,RC,,both,3580.42,3222.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2506.29,,,,520,2921.62
CTA PELVIS ANGIOGRAPHY,72191,HCPCS,350,RC,,both,3580.42,3222.38,Cigna,Default,Case Rate,520,,,,520,2921.62
CTA PELVIS ANGIOGRAPHY,72191,HCPCS,350,RC,,both,3580.42,3222.38,United Healthcare,Default,Fee Schedule,2921.62,,,,520,2921.62
CTA AORTO-ILIAC RUNOFF,75635,HCPCS,350,RC,,both,5307.86,4777.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3715.5,,,,520,4331.21
CTA AORTO-ILIAC RUNOFF,75635,HCPCS,350,RC,,both,5307.86,4777.07,Cigna,Default,Case Rate,520,,,,520,4331.21
CTA AORTO-ILIAC RUNOFF,75635,HCPCS,350,RC,,both,5307.86,4777.07,United Healthcare,Default,Fee Schedule,4331.21,,,,520,4331.21
CTA ABDOMEN ANGIOGRAPHY,74175,HCPCS,350,RC,,both,3580.42,3222.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2506.29,,,,520,2921.62
CTA ABDOMEN ANGIOGRAPHY,74175,HCPCS,350,RC,,both,3580.42,3222.38,Cigna,Default,Case Rate,520,,,,520,2921.62
CTA ABDOMEN ANGIOGRAPHY,74175,HCPCS,350,RC,,both,3580.42,3222.38,United Healthcare,Default,Fee Schedule,2921.62,,,,520,2921.62
CTA HEAD ANGIOGRAPHY,70496,HCPCS,350,RC,,both,3004.59,2704.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2103.21,,,,520,2451.75
CTA HEAD ANGIOGRAPHY,70496,HCPCS,350,RC,,both,3004.59,2704.13,Cigna,Default,Case Rate,520,,,,520,2451.75
CTA HEAD ANGIOGRAPHY,70496,HCPCS,350,RC,,both,3004.59,2704.13,United Healthcare,Default,Fee Schedule,2451.75,,,,520,2451.75
CTA NECK ANGIOGRAPHY,70498,HCPCS,350,RC,,both,3580.42,3222.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2506.29,,,,520,2921.62
CTA NECK ANGIOGRAPHY,70498,HCPCS,350,RC,,both,3580.42,3222.38,Cigna,Default,Case Rate,520,,,,520,2921.62
CTA NECK ANGIOGRAPHY,70498,HCPCS,350,RC,,both,3580.42,3222.38,United Healthcare,Default,Fee Schedule,2921.62,,,,520,2921.62
CTA CHEST ANGIOGRAPHY,71275,HCPCS,350,RC,,both,3580.42,3222.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2506.29,,,,520,2921.62
CTA CHEST ANGIOGRAPHY,71275,HCPCS,350,RC,,both,3580.42,3222.38,Cigna,Default,Case Rate,520,,,,520,2921.62
CTA CHEST ANGIOGRAPHY,71275,HCPCS,350,RC,,both,3580.42,3222.38,United Healthcare,Default,Fee Schedule,2921.62,,,,520,2921.62
CT CHEST W/O IV CONTRAST,71250,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
CT CHEST W/O IV CONTRAST,71250,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
CT CHEST W/O IV CONTRAST,71250,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
CT LUNG SCREEN DIAGNOSTIC,71250,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
CT LUNG SCREEN DIAGNOSTIC,71250,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
CT LUNG SCREEN DIAGNOSTIC,71250,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
CTA HRT W/ 3D IMAGE,75574,HCPCS,350,RC,,both,3595.39,3235.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2516.77,,,,520,2933.84
CTA HRT W/ 3D IMAGE,75574,HCPCS,350,RC,,both,3595.39,3235.85,Cigna,Default,Case Rate,520,,,,520,2933.84
CTA HRT W/ 3D IMAGE,75574,HCPCS,350,RC,,both,3595.39,3235.85,United Healthcare,Default,Fee Schedule,2933.84,,,,520,2933.84
CT CHEST WITH IV CONTRAST,71260,HCPCS,350,RC,,both,2889.44,2600.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2022.61,,,,520,2357.78
CT CHEST WITH IV CONTRAST,71260,HCPCS,350,RC,,both,2889.44,2600.5,Cigna,Default,Case Rate,520,,,,520,2357.78
CT CHEST WITH IV CONTRAST,71260,HCPCS,350,RC,,both,2889.44,2600.5,United Healthcare,Default,Fee Schedule,2357.78,,,,520,2357.78
CT CHEST W/WO IV CONTRAST,71270,HCPCS,350,RC,,both,3234.93,2911.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2264.45,,,,520,2639.7
CT CHEST W/WO IV CONTRAST,71270,HCPCS,350,RC,,both,3234.93,2911.44,Cigna,Default,Case Rate,520,,,,520,2639.7
CT CHEST W/WO IV CONTRAST,71270,HCPCS,350,RC,,both,3234.93,2911.44,United Healthcare,Default,Fee Schedule,2639.7,,,,520,2639.7
CT PELVIS W/O IV CONTRAST,72192,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
CT PELVIS W/O IV CONTRAST,72192,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
CT PELVIS W/O IV CONTRAST,72192,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
CT PELVIS WITH IV CONTRAST,72193,HCPCS,350,RC,,both,2818.97,2537.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1973.28,,,,520,2300.28
CT PELVIS WITH IV CONTRAST,72193,HCPCS,350,RC,,both,2818.97,2537.07,Cigna,Default,Case Rate,520,,,,520,2300.28
CT PELVIS WITH IV CONTRAST,72193,HCPCS,350,RC,,both,2818.97,2537.07,United Healthcare,Default,Fee Schedule,2300.28,,,,520,2300.28
CT PELVIS W/WO IV CONTRAST,72194,HCPCS,350,RC,,both,3235.81,2912.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2265.07,,,,520,2640.42
CT PELVIS W/WO IV CONTRAST,72194,HCPCS,350,RC,,both,3235.81,2912.23,Cigna,Default,Case Rate,520,,,,520,2640.42
CT PELVIS W/WO IV CONTRAST,72194,HCPCS,350,RC,,both,3235.81,2912.23,United Healthcare,Default,Fee Schedule,2640.42,,,,520,2640.42
CT ABDOMEN W/O IV CONTRAST,74150,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
CT ABDOMEN W/O IV CONTRAST,74150,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
CT ABDOMEN W/O IV CONTRAST,74150,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
CT ABDOMEN  WITH IV CONTRAST,74160,HCPCS,350,RC,,both,2818.97,2537.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1973.28,,,,520,2300.28
CT ABDOMEN  WITH IV CONTRAST,74160,HCPCS,350,RC,,both,2818.97,2537.07,Cigna,Default,Case Rate,520,,,,520,2300.28
CT ABDOMEN  WITH IV CONTRAST,74160,HCPCS,350,RC,,both,2818.97,2537.07,United Healthcare,Default,Fee Schedule,2300.28,,,,520,2300.28
CT ABD PELVIS WO IV CONTRAST,74176,HCPCS,350,RC,,both,3703.33,3333,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2592.33,,,,520,3021.92
CT ABD PELVIS WO IV CONTRAST,74176,HCPCS,350,RC,,both,3703.33,3333,Cigna,Default,Case Rate,520,,,,520,3021.92
CT ABD PELVIS WO IV CONTRAST,74176,HCPCS,350,RC,,both,3703.33,3333,United Healthcare,Default,Fee Schedule,3021.92,,,,520,3021.92
CT ABD PELVIS WITH IV CONTRAST,74177,HCPCS,350,RC,,both,4271.4,3844.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2989.98,,,,520,3485.46
CT ABD PELVIS WITH IV CONTRAST,74177,HCPCS,350,RC,,both,4271.4,3844.26,Cigna,Default,Case Rate,520,,,,520,3485.46
CT ABD PELVIS WITH IV CONTRAST,74177,HCPCS,350,RC,,both,4271.4,3844.26,United Healthcare,Default,Fee Schedule,3485.46,,,,520,3485.46
CT ABD PELVIS W/WO IV CONTRAST,74178,HCPCS,350,RC,,both,4616.89,4155.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3231.82,,,,520,3767.38
CT ABD PELVIS W/WO IV CONTRAST,74178,HCPCS,350,RC,,both,4616.89,4155.2,Cigna,Default,Case Rate,520,,,,520,3767.38
CT ABD PELVIS W/WO IV CONTRAST,74178,HCPCS,350,RC,,both,4616.89,4155.2,United Healthcare,Default,Fee Schedule,3767.38,,,,520,3767.38
CT ABDOMEN W/WO IV CONTRAST,74170,HCPCS,350,RC,,both,3234.93,2911.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2264.45,,,,520,2639.7
CT ABDOMEN W/WO IV CONTRAST,74170,HCPCS,350,RC,,both,3234.93,2911.44,Cigna,Default,Case Rate,520,,,,520,2639.7
CT ABDOMEN W/WO IV CONTRAST,74170,HCPCS,350,RC,,both,3234.93,2911.44,United Healthcare,Default,Fee Schedule,2639.7,,,,520,2639.7
CT C SPINE W/O IV CONTRAST,72125,HCPCS,350,RC,,both,2536.18,2282.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1775.33,,,,520,2069.52
CT C SPINE W/O IV CONTRAST,72125,HCPCS,350,RC,,both,2536.18,2282.56,Cigna,Default,Case Rate,520,,,,520,2069.52
CT C SPINE W/O IV CONTRAST,72125,HCPCS,350,RC,,both,2536.18,2282.56,United Healthcare,Default,Fee Schedule,2069.52,,,,520,2069.52
CT CSPINE W/ CONTRAST,72126,HCPCS,350,RC,,both,2653.02,2387.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1857.11,,,,520,2164.86
CT CSPINE W/ CONTRAST,72126,HCPCS,350,RC,,both,2653.02,2387.72,Cigna,Default,Case Rate,520,,,,520,2164.86
CT CSPINE W/ CONTRAST,72126,HCPCS,350,RC,,both,2653.02,2387.72,United Healthcare,Default,Fee Schedule,2164.86,,,,520,2164.86
CT CSPINE W & WO CONTRAST,72127,HCPCS,350,RC,,both,2653.02,2387.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1857.11,,,,520,2164.86
CT CSPINE W & WO CONTRAST,72127,HCPCS,350,RC,,both,2653.02,2387.72,Cigna,Default,Case Rate,520,,,,520,2164.86
CT CSPINE W & WO CONTRAST,72127,HCPCS,350,RC,,both,2653.02,2387.72,United Healthcare,Default,Fee Schedule,2164.86,,,,520,2164.86
CT T SPINE W/O,72128,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
CT T SPINE W/O,72128,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
CT T SPINE W/O,72128,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
CT T SPINE W/,72129,HCPCS,350,RC,,both,2653.02,2387.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1857.11,,,,520,2164.86
CT T SPINE W/,72129,HCPCS,350,RC,,both,2653.02,2387.72,Cigna,Default,Case Rate,520,,,,520,2164.86
CT T SPINE W/,72129,HCPCS,350,RC,,both,2653.02,2387.72,United Healthcare,Default,Fee Schedule,2164.86,,,,520,2164.86
CT L SPINE W/O  CONTRAST,72131,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
CT L SPINE W/O  CONTRAST,72131,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
CT L SPINE W/O  CONTRAST,72131,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
CT T SPINE W & WO,72130,HCPCS,350,RC,,both,2653.02,2387.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1857.11,,,,520,2164.86
CT T SPINE W & WO,72130,HCPCS,350,RC,,both,2653.02,2387.72,Cigna,Default,Case Rate,520,,,,520,2164.86
CT T SPINE W & WO,72130,HCPCS,350,RC,,both,2653.02,2387.72,United Healthcare,Default,Fee Schedule,2164.86,,,,520,2164.86
CT L SPINE W CONTRAST,72132,HCPCS,350,RC,,both,1269.7,1142.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,888.79,,,,520,1036.08
CT L SPINE W CONTRAST,72132,HCPCS,350,RC,,both,1269.7,1142.73,Cigna,Default,Case Rate,520,,,,520,1036.08
CT L SPINE W CONTRAST,72132,HCPCS,350,RC,,both,1269.7,1142.73,United Healthcare,Default,Fee Schedule,1036.08,,,,520,1036.08
CT L SPINE W/ & W/O,72133,HCPCS,350,RC,,both,2653.02,2387.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1857.11,,,,520,2164.86
CT L SPINE W/ & W/O,72133,HCPCS,350,RC,,both,2653.02,2387.72,Cigna,Default,Case Rate,520,,,,520,2164.86
CT L SPINE W/ & W/O,72133,HCPCS,350,RC,,both,2653.02,2387.72,United Healthcare,Default,Fee Schedule,2164.86,,,,520,2164.86
CT GUIDED FOR DRAIN PLACEMENT,75989,HCPCS,350,RC,,both,2574.31,2316.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1802.02,,,,520,2100.64
CT GUIDED FOR DRAIN PLACEMENT,75989,HCPCS,350,RC,,both,2574.31,2316.88,Cigna,Default,Case Rate,520,,,,520,2100.64
CT GUIDED FOR DRAIN PLACEMENT,75989,HCPCS,350,RC,,both,2574.31,2316.88,United Healthcare,Default,Fee Schedule,2100.64,,,,520,2100.64
CT GUIDANCE FOR NEEDLE PLACEMENT,77012,HCPCS,350,RC,,both,2634.94,2371.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1844.46,,,,520,2150.11
CT GUIDANCE FOR NEEDLE PLACEMENT,77012,HCPCS,350,RC,,both,2634.94,2371.45,Cigna,Default,Case Rate,520,,,,520,2150.11
CT GUIDANCE FOR NEEDLE PLACEMENT,77012,HCPCS,350,RC,,both,2634.94,2371.45,United Healthcare,Default,Fee Schedule,2150.11,,,,520,2150.11
CT GUIDED NEEDLE PLACEMENT BX ASP,77012,HCPCS,350,RC,,both,2450.45,2205.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1715.32,,,,520,1999.57
CT GUIDED NEEDLE PLACEMENT BX ASP,77012,HCPCS,350,RC,,both,2450.45,2205.41,Cigna,Default,Case Rate,520,,,,520,1999.57
CT GUIDED NEEDLE PLACEMENT BX ASP,77012,HCPCS,350,RC,,both,2450.45,2205.41,United Healthcare,Default,Fee Schedule,1999.57,,,,520,1999.57
CT IAC ORB SELLA W/O IV CONTRAST,70480,HCPCS,350,RC,,both,2019.12,1817.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1413.38,,,,520,1647.6
CT IAC ORB SELLA W/O IV CONTRAST,70480,HCPCS,350,RC,,both,2019.12,1817.21,Cigna,Default,Case Rate,520,,,,520,1647.6
CT IAC ORB SELLA W/O IV CONTRAST,70480,HCPCS,350,RC,,both,2019.12,1817.21,United Healthcare,Default,Fee Schedule,1647.6,,,,520,1647.6
CT IAC WO/W IV CONTRAST,70482,HCPCS,350,RC,,both,1497,1347.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1047.9,,,,520,1221.55
CT IAC WO/W IV CONTRAST,70482,HCPCS,350,RC,,both,1497,1347.3,Cigna,Default,Case Rate,520,,,,520,1221.55
CT IAC WO/W IV CONTRAST,70482,HCPCS,350,RC,,both,1497,1347.3,United Healthcare,Default,Fee Schedule,1221.55,,,,520,1221.55
CT UPP EXT W/O RIGHT,73200,HCPCS,350,RC,RT,both,2391.36,2152.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1673.95,,,,520,1951.35
CT UPP EXT W/O RIGHT,73200,HCPCS,350,RC,RT,both,2391.36,2152.22,Cigna,Default,Case Rate,520,,,,520,1951.35
CT UPP EXT W/O RIGHT,73200,HCPCS,350,RC,RT,both,2391.36,2152.22,United Healthcare,Default,Fee Schedule,1951.35,,,,520,1951.35
CT MAXILLOFACIAL WITH IV CONTRAST,70487,HCPCS,350,RC,,both,2730.88,2457.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1911.62,,,,520,2228.4
CT MAXILLOFACIAL WITH IV CONTRAST,70487,HCPCS,350,RC,,both,2730.88,2457.79,Cigna,Default,Case Rate,520,,,,520,2228.4
CT MAXILLOFACIAL WITH IV CONTRAST,70487,HCPCS,350,RC,,both,2730.88,2457.79,United Healthcare,Default,Fee Schedule,2228.4,,,,520,2228.4
CT UPPER EXTREMITY W/ & W/O RT,73202,HCPCS,350,RC,RT,both,1592.71,1433.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1114.9,,,,520,1299.65
CT UPPER EXTREMITY W/ & W/O RT,73202,HCPCS,350,RC,RT,both,1592.71,1433.44,Cigna,Default,Case Rate,520,,,,520,1299.65
CT UPPER EXTREMITY W/ & W/O RT,73202,HCPCS,350,RC,RT,both,1592.71,1433.44,United Healthcare,Default,Fee Schedule,1299.65,,,,520,1299.65
CT LOWER EXT W/O IV CONT RIGHT,73700,HCPCS,350,RC,RT,both,2391.36,2152.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1673.95,,,,520,1951.35
CT LOWER EXT W/O IV CONT RIGHT,73700,HCPCS,350,RC,RT,both,2391.36,2152.22,Cigna,Default,Case Rate,520,,,,520,1951.35
CT LOWER EXT W/O IV CONT RIGHT,73700,HCPCS,350,RC,RT,both,2391.36,2152.22,United Healthcare,Default,Fee Schedule,1951.35,,,,520,1951.35
CT LOWER EXT W/O IV CONTRAST LEFT,73700,HCPCS,350,RC,LT,both,2391.36,2152.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1673.95,,,,520,1951.35
CT LOWER EXT W/O IV CONTRAST LEFT,73700,HCPCS,350,RC,LT,both,2391.36,2152.22,Cigna,Default,Case Rate,520,,,,520,1951.35
CT LOWER EXT W/O IV CONTRAST LEFT,73700,HCPCS,350,RC,LT,both,2391.36,2152.22,United Healthcare,Default,Fee Schedule,1951.35,,,,520,1951.35
CT LOWER EXT W/O IV CONTRAST BILATERAL,73700,HCPCS,350,RC,50,both,2482.92,2234.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1738.04,,,,520,2026.06
CT LOWER EXT W/O IV CONTRAST BILATERAL,73700,HCPCS,350,RC,50,both,2482.92,2234.63,Cigna,Default,Case Rate,520,,,,520,2026.06
CT LOWER EXT W/O IV CONTRAST BILATERAL,73700,HCPCS,350,RC,50,both,2482.92,2234.63,United Healthcare,Default,Fee Schedule,2026.06,,,,520,2026.06
CT LOWER EXT WITH IV CONTRAST BILATERAL,73701,HCPCS,350,RC,50,both,1486.18,1337.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1040.33,,,,520,1212.72
CT LOWER EXT WITH IV CONTRAST BILATERAL,73701,HCPCS,350,RC,50,both,1486.18,1337.56,Cigna,Default,Case Rate,520,,,,520,1212.72
CT LOWER EXT WITH IV CONTRAST BILATERAL,73701,HCPCS,350,RC,50,both,1486.18,1337.56,United Healthcare,Default,Fee Schedule,1212.72,,,,520,1212.72
CT LOWER EXT WITH IV CONTRAST RIGHT,73701,HCPCS,350,RC,RT,both,2782.33,2504.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1947.63,,,,520,2270.38
CT LOWER EXT WITH IV CONTRAST RIGHT,73701,HCPCS,350,RC,RT,both,2782.33,2504.1,Cigna,Default,Case Rate,520,,,,520,2270.38
CT LOWER EXT WITH IV CONTRAST RIGHT,73701,HCPCS,350,RC,RT,both,2782.33,2504.1,United Healthcare,Default,Fee Schedule,2270.38,,,,520,2270.38
CT LOWER EXT WITH IV CONTRAST LEFT,73701,HCPCS,350,RC,LT,both,2782.33,2504.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1947.63,,,,520,2270.38
CT LOWER EXT WITH IV CONTRAST LEFT,73701,HCPCS,350,RC,LT,both,2782.33,2504.1,Cigna,Default,Case Rate,520,,,,520,2270.38
CT LOWER EXT WITH IV CONTRAST LEFT,73701,HCPCS,350,RC,LT,both,2782.33,2504.1,United Healthcare,Default,Fee Schedule,2270.38,,,,520,2270.38
CT LOWER EXT WO/W IV CONTRAST BILTERAL,73702,HCPCS,350,RC,50,both,2819.48,2537.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1973.64,,,,520,2300.7
CT LOWER EXT WO/W IV CONTRAST BILTERAL,73702,HCPCS,350,RC,50,both,2819.48,2537.53,Cigna,Default,Case Rate,520,,,,520,2300.7
CT LOWER EXT WO/W IV CONTRAST BILTERAL,73702,HCPCS,350,RC,50,both,2819.48,2537.53,United Healthcare,Default,Fee Schedule,2300.7,,,,520,2300.7
CT LOWER EXT WO/W IV CONTRAST RIGHT,73702,HCPCS,350,RC,RT,both,2885.99,2597.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2020.19,,,,520,2354.97
CT LOWER EXT WO/W IV CONTRAST RIGHT,73702,HCPCS,350,RC,RT,both,2885.99,2597.39,Cigna,Default,Case Rate,520,,,,520,2354.97
CT LOWER EXT WO/W IV CONTRAST RIGHT,73702,HCPCS,350,RC,RT,both,2885.99,2597.39,United Healthcare,Default,Fee Schedule,2354.97,,,,520,2354.97
CT LOWER EXT WO/W IV CONTRAST LEFT,73702,HCPCS,350,RC,LT,both,2885.99,2597.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2020.19,,,,520,2354.97
CT LOWER EXT WO/W IV CONTRAST LEFT,73702,HCPCS,350,RC,LT,both,2885.99,2597.39,Cigna,Default,Case Rate,520,,,,520,2354.97
CT LOWER EXT WO/W IV CONTRAST LEFT,73702,HCPCS,350,RC,LT,both,2885.99,2597.39,United Healthcare,Default,Fee Schedule,2354.97,,,,520,2354.97
CT COLONOGRAPHY DX,74261,HCPCS,350,RC,,both,2224.89,2002.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1557.42,,,,520,1815.51
CT COLONOGRAPHY DX,74261,HCPCS,350,RC,,both,2224.89,2002.4,Cigna,Default,Case Rate,520,,,,520,1815.51
CT COLONOGRAPHY DX,74261,HCPCS,350,RC,,both,2224.89,2002.4,United Healthcare,Default,Fee Schedule,1815.51,,,,520,1815.51
CT COLONOGRAPHY SCRN,74263,HCPCS,350,RC,,both,2713.28,2441.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1899.3,,,,520,2214.04
CT COLONOGRAPHY SCRN,74263,HCPCS,350,RC,,both,2713.28,2441.95,Cigna,Default,Case Rate,520,,,,520,2214.04
CT COLONOGRAPHY SCRN,74263,HCPCS,350,RC,,both,2713.28,2441.95,United Healthcare,Default,Fee Schedule,2214.04,,,,520,2214.04
CT LUMAR MYELOGRAM,72265,HCPCS,320,RC,,both,2396.53,2156.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1677.57,,,,1413.95,1955.57
CT LUMAR MYELOGRAM,72265,HCPCS,320,RC,,both,2396.53,2156.88,Cigna,Default,Percent of Total Billed Charges,1413.95,,,,1413.95,1955.57
CT LUMAR MYELOGRAM,72265,HCPCS,320,RC,,both,2396.53,2156.88,United Healthcare,Default,Fee Schedule,1955.57,,,,1413.95,1955.57
XR RIBS BILATERAL NO CHEST MIN 4 VWS,71110,HCPCS,320,RC,,both,370.26,333.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,259.18,,,,218.45,302.13
XR RIBS BILATERAL NO CHEST MIN 4 VWS,71110,HCPCS,320,RC,,both,370.26,333.23,Cigna,Default,Percent of Total Billed Charges,218.45,,,,218.45,302.13
XR RIBS BILATERAL NO CHEST MIN 4 VWS,71110,HCPCS,320,RC,,both,370.26,333.23,United Healthcare,Default,Fee Schedule,302.13,,,,218.45,302.13
SONO BLADDER SCAN,76775,HCPCS,402,RC,,both,1217,1095.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,851.9,,,,718.03,993.07
SONO BLADDER SCAN,76775,HCPCS,402,RC,,both,1217,1095.3,Cigna,Default,Percent of Total Billed Charges,718.03,,,,718.03,993.07
SONO BLADDER SCAN,76775,HCPCS,402,RC,,both,1217,1095.3,United Healthcare,Default,Fee Schedule,993.07,,,,718.03,993.07
VL ANKLE/BRACHIAL INDEX (ABI/TBI),93922,HCPCS,921,RC,,both,987.81,889.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,691.47,,,,582.81,806.05
VL ANKLE/BRACHIAL INDEX (ABI/TBI),93922,HCPCS,921,RC,,both,987.81,889.03,Cigna,Default,Percent of Total Billed Charges,582.81,,,,582.81,806.05
VL ANKLE/BRACHIAL INDEX (ABI/TBI),93922,HCPCS,921,RC,,both,987.81,889.03,United Healthcare,Default,Fee Schedule,806.05,,,,582.81,806.05
VL SEGMENTAL ARTERY PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,966,,,,814.2,1126.08
VL SEGMENTAL ARTERY PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,Cigna,Default,Percent of Total Billed Charges,814.2,,,,814.2,1126.08
VL SEGMENTAL ARTERY PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,United Healthcare,Default,Fee Schedule,1126.08,,,,814.2,1126.08
VL PBI WITH ABI/TBI,93923,HCPCS,921,RC,TC,both,569.5,512.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,398.65,,,,336,464.71
VL PBI WITH ABI/TBI,93923,HCPCS,921,RC,TC,both,569.5,512.55,Cigna,Default,Percent of Total Billed Charges,336,,,,336,464.71
VL PBI WITH ABI/TBI,93923,HCPCS,921,RC,TC,both,569.5,512.55,United Healthcare,Default,Fee Schedule,464.71,,,,336,464.71
VL TOE PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,966,,,,814.2,1126.08
VL TOE PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,Cigna,Default,Percent of Total Billed Charges,814.2,,,,814.2,1126.08
VL TOE PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,United Healthcare,Default,Fee Schedule,1126.08,,,,814.2,1126.08
VL FINGER PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,966,,,,814.2,1126.08
VL FINGER PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,Cigna,Default,Percent of Total Billed Charges,814.2,,,,814.2,1126.08
VL FINGER PRESSURES,93923,HCPCS,921,RC,,both,1380,1242,United Healthcare,Default,Fee Schedule,1126.08,,,,814.2,1126.08
VL ABI WITH EXERCISE,93924,HCPCS,921,RC,,both,1453.5,1308.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1017.45,,,,857.56,1186.06
VL ABI WITH EXERCISE,93924,HCPCS,921,RC,,both,1453.5,1308.15,Cigna,Default,Percent of Total Billed Charges,857.56,,,,857.56,1186.06
VL ABI WITH EXERCISE,93924,HCPCS,921,RC,,both,1453.5,1308.15,United Healthcare,Default,Fee Schedule,1186.06,,,,857.56,1186.06
VL THORACIC OUTLET EVAL,93923,HCPCS,921,RC,,both,1380,1242,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,966,,,,814.2,1126.08
VL THORACIC OUTLET EVAL,93923,HCPCS,921,RC,,both,1380,1242,Cigna,Default,Percent of Total Billed Charges,814.2,,,,814.2,1126.08
VL THORACIC OUTLET EVAL,93923,HCPCS,921,RC,,both,1380,1242,United Healthcare,Default,Fee Schedule,1126.08,,,,814.2,1126.08
VL CAROTID DUPLEX BILATERAL,93880,HCPCS,921,RC,TC,both,1321.45,1189.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,925.02,,,,779.66,1078.3
VL CAROTID DUPLEX BILATERAL,93880,HCPCS,921,RC,TC,both,1321.45,1189.31,Cigna,Default,Percent of Total Billed Charges,779.66,,,,779.66,1078.3
VL CAROTID DUPLEX BILATERAL,93880,HCPCS,921,RC,TC,both,1321.45,1189.31,United Healthcare,Default,Fee Schedule,1078.3,,,,779.66,1078.3
VL CAROTID DUPLEX LIMITED,93882,HCPCS,921,RC,,both,615.05,553.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,430.54,,,,362.88,501.88
VL CAROTID DUPLEX LIMITED,93882,HCPCS,921,RC,,both,615.05,553.55,Cigna,Default,Percent of Total Billed Charges,362.88,,,,362.88,501.88
VL CAROTID DUPLEX LIMITED,93882,HCPCS,921,RC,,both,615.05,553.55,United Healthcare,Default,Fee Schedule,501.88,,,,362.88,501.88
VL CAROTID DUPLEX RIGHT,93882,HCPCS,921,RC,RT,both,700.27,630.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,490.19,,,,413.16,571.42
VL CAROTID DUPLEX RIGHT,93882,HCPCS,921,RC,RT,both,700.27,630.24,Cigna,Default,Percent of Total Billed Charges,413.16,,,,413.16,571.42
VL CAROTID DUPLEX RIGHT,93882,HCPCS,921,RC,RT,both,700.27,630.24,United Healthcare,Default,Fee Schedule,571.42,,,,413.16,571.42
VL CAROTID DUPLEX LIMITED,93882,HCPCS,921,RC,,both,724.08,651.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,506.86,,,,427.21,590.85
VL CAROTID DUPLEX LIMITED,93882,HCPCS,921,RC,,both,724.08,651.67,Cigna,Default,Percent of Total Billed Charges,427.21,,,,427.21,590.85
VL CAROTID DUPLEX LIMITED,93882,HCPCS,921,RC,,both,724.08,651.67,United Healthcare,Default,Fee Schedule,590.85,,,,427.21,590.85
VL TEMPORAL ARTERY DUPLEX,93882,HCPCS,921,RC,,both,724.08,651.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,506.86,,,,427.21,590.85
VL TEMPORAL ARTERY DUPLEX,93882,HCPCS,921,RC,,both,724.08,651.67,Cigna,Default,Percent of Total Billed Charges,427.21,,,,427.21,590.85
VL TEMPORAL ARTERY DUPLEX,93882,HCPCS,921,RC,,both,724.08,651.67,United Healthcare,Default,Fee Schedule,590.85,,,,427.21,590.85
VL ARTERIAL DUPLEX ARM BILATERAL,93930,HCPCS,921,RC,,both,1591.88,1432.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1114.32,,,,939.21,1298.97
VL ARTERIAL DUPLEX ARM BILATERAL,93930,HCPCS,921,RC,,both,1591.88,1432.69,Cigna,Default,Percent of Total Billed Charges,939.21,,,,939.21,1298.97
VL ARTERIAL DUPLEX ARM BILATERAL,93930,HCPCS,921,RC,,both,1591.88,1432.69,United Healthcare,Default,Fee Schedule,1298.97,,,,939.21,1298.97
VL BYPASS GRAFT DUPLEX ARM BILATERAL,93930,HCPCS,921,RC,TC,both,857.75,771.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,600.42,,,,506.07,699.92
VL BYPASS GRAFT DUPLEX ARM BILATERAL,93930,HCPCS,921,RC,TC,both,857.75,771.98,Cigna,Default,Percent of Total Billed Charges,506.07,,,,506.07,699.92
VL BYPASS GRAFT DUPLEX ARM BILATERAL,93930,HCPCS,921,RC,TC,both,857.75,771.98,United Healthcare,Default,Fee Schedule,699.92,,,,506.07,699.92
VL BYPASS GRAFT RIGHT ARM,93931,HCPCS,921,RC,"TC,RT",both,571,513.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,399.7,,,,336.89,465.94
VL BYPASS GRAFT RIGHT ARM,93931,HCPCS,921,RC,"TC,RT",both,571,513.9,Cigna,Default,Percent of Total Billed Charges,336.89,,,,336.89,465.94
VL BYPASS GRAFT RIGHT ARM,93931,HCPCS,921,RC,"TC,RT",both,571,513.9,United Healthcare,Default,Fee Schedule,465.94,,,,336.89,465.94
VL ARTERIAL DUPLEX RIGHT ARM,93931,HCPCS,921,RC,RT,both,1162,1045.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,813.4,,,,685.58,948.19
VL ARTERIAL DUPLEX RIGHT ARM,93931,HCPCS,921,RC,RT,both,1162,1045.8,Cigna,Default,Percent of Total Billed Charges,685.58,,,,685.58,948.19
VL ARTERIAL DUPLEX RIGHT ARM,93931,HCPCS,921,RC,RT,both,1162,1045.8,United Healthcare,Default,Fee Schedule,948.19,,,,685.58,948.19
VL BYPASS GRAFT LEFT ARM,93931,HCPCS,921,RC,"TC,LT",both,571,513.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,399.7,,,,336.89,465.94
VL BYPASS GRAFT LEFT ARM,93931,HCPCS,921,RC,"TC,LT",both,571,513.9,Cigna,Default,Percent of Total Billed Charges,336.89,,,,336.89,465.94
VL BYPASS GRAFT LEFT ARM,93931,HCPCS,921,RC,"TC,LT",both,571,513.9,United Healthcare,Default,Fee Schedule,465.94,,,,336.89,465.94
VL ARTERIAL DUPLEX LEFT ARM,93931,HCPCS,921,RC,LT,both,1162,1045.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,813.4,,,,685.58,948.19
VL ARTERIAL DUPLEX LEFT ARM,93931,HCPCS,921,RC,LT,both,1162,1045.8,Cigna,Default,Percent of Total Billed Charges,685.58,,,,685.58,948.19
VL ARTERIAL DUPLEX LEFT ARM,93931,HCPCS,921,RC,LT,both,1162,1045.8,United Healthcare,Default,Fee Schedule,948.19,,,,685.58,948.19
VL ARTERIAL DUPLEX LEG BILATERAL,93925,HCPCS,921,RC,,both,1905,1714.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1333.5,,,,1123.95,1554.48
VL ARTERIAL DUPLEX LEG BILATERAL,93925,HCPCS,921,RC,,both,1905,1714.5,Cigna,Default,Percent of Total Billed Charges,1123.95,,,,1123.95,1554.48
VL ARTERIAL DUPLEX LEG BILATERAL,93925,HCPCS,921,RC,,both,1905,1714.5,United Healthcare,Default,Fee Schedule,1554.48,,,,1123.95,1554.48
VL ARTERIAL DUPLEX RIGHT LEG,93926,HCPCS,921,RC,RT,both,1312,1180.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,918.4,,,,774.08,1070.59
VL ARTERIAL DUPLEX RIGHT LEG,93926,HCPCS,921,RC,RT,both,1312,1180.8,Cigna,Default,Percent of Total Billed Charges,774.08,,,,774.08,1070.59
VL ARTERIAL DUPLEX RIGHT LEG,93926,HCPCS,921,RC,RT,both,1312,1180.8,United Healthcare,Default,Fee Schedule,1070.59,,,,774.08,1070.59
VL ARTERIAL DUPLEX LEFT LEG,93926,HCPCS,921,RC,LT,both,1312,1180.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,918.4,,,,774.08,1070.59
VL ARTERIAL DUPLEX LEFT LEG,93926,HCPCS,921,RC,LT,both,1312,1180.8,Cigna,Default,Percent of Total Billed Charges,774.08,,,,774.08,1070.59
VL ARTERIAL DUPLEX LEFT LEG,93926,HCPCS,921,RC,LT,both,1312,1180.8,United Healthcare,Default,Fee Schedule,1070.59,,,,774.08,1070.59
VL MESENTERIC ART DPLX,93975,HCPCS,921,RC,,both,1928,1735.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1349.6,,,,1137.52,1573.25
VL MESENTERIC ART DPLX,93975,HCPCS,921,RC,,both,1928,1735.2,Cigna,Default,Percent of Total Billed Charges,1137.52,,,,1137.52,1573.25
VL MESENTERIC ART DPLX,93975,HCPCS,921,RC,,both,1928,1735.2,United Healthcare,Default,Fee Schedule,1573.25,,,,1137.52,1573.25
VL MESENTERIC ART DPLX LTD,93976,HCPCS,921,RC,TC,both,796,716.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,557.2,,,,469.64,649.54
VL MESENTERIC ART DPLX LTD,93976,HCPCS,921,RC,TC,both,796,716.4,Cigna,Default,Percent of Total Billed Charges,469.64,,,,469.64,649.54
VL MESENTERIC ART DPLX LTD,93976,HCPCS,921,RC,TC,both,796,716.4,United Healthcare,Default,Fee Schedule,649.54,,,,469.64,649.54
VL RENAL ARTERY DUPLEX COMPLETE,93975,HCPCS,921,RC,,both,1928,1735.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1349.6,,,,1137.52,1573.25
VL RENAL ARTERY DUPLEX COMPLETE,93975,HCPCS,921,RC,,both,1928,1735.2,Cigna,Default,Percent of Total Billed Charges,1137.52,,,,1137.52,1573.25
VL RENAL ARTERY DUPLEX COMPLETE,93975,HCPCS,921,RC,,both,1928,1735.2,United Healthcare,Default,Fee Schedule,1573.25,,,,1137.52,1573.25
VL ABDOMINAL VENOUS DUPLEX,93975,HCPCS,921,RC,,both,1928,1735.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1349.6,,,,1137.52,1573.25
VL ABDOMINAL VENOUS DUPLEX,93975,HCPCS,921,RC,,both,1928,1735.2,Cigna,Default,Percent of Total Billed Charges,1137.52,,,,1137.52,1573.25
VL ABDOMINAL VENOUS DUPLEX,93975,HCPCS,921,RC,,both,1928,1735.2,United Healthcare,Default,Fee Schedule,1573.25,,,,1137.52,1573.25
VL PELVIC SCROTAL DUPLEX,93975,HCPCS,921,RC,TC,both,1186.5,1067.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,830.55,,,,700.04,968.18
VL PELVIC SCROTAL DUPLEX,93975,HCPCS,921,RC,TC,both,1186.5,1067.85,Cigna,Default,Percent of Total Billed Charges,700.04,,,,700.04,968.18
VL PELVIC SCROTAL DUPLEX,93975,HCPCS,921,RC,TC,both,1186.5,1067.85,United Healthcare,Default,Fee Schedule,968.18,,,,700.04,968.18
VL RENAL ARTERY DUPLEX LIMITED,93976,HCPCS,921,RC,,both,1507,1356.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1054.9,,,,889.13,1229.71
VL RENAL ARTERY DUPLEX LIMITED,93976,HCPCS,921,RC,,both,1507,1356.3,Cigna,Default,Percent of Total Billed Charges,889.13,,,,889.13,1229.71
VL RENAL ARTERY DUPLEX LIMITED,93976,HCPCS,921,RC,,both,1507,1356.3,United Healthcare,Default,Fee Schedule,1229.71,,,,889.13,1229.71
VL RENAL ARTERY DUPLEX LEFT,93976,HCPCS,921,RC,"TC,LT",both,796,716.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,557.2,,,,469.64,649.54
VL RENAL ARTERY DUPLEX LEFT,93976,HCPCS,921,RC,"TC,LT",both,796,716.4,Cigna,Default,Percent of Total Billed Charges,469.64,,,,469.64,649.54
VL RENAL ARTERY DUPLEX LEFT,93976,HCPCS,921,RC,"TC,LT",both,796,716.4,United Healthcare,Default,Fee Schedule,649.54,,,,469.64,649.54
VL AA ILIAC DUPLEX COMPLETE,93980,HCPCS,921,RC,,both,577.5,519.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,404.25,,,,340.72,471.24
VL AA ILIAC DUPLEX COMPLETE,93980,HCPCS,921,RC,,both,577.5,519.75,Cigna,Default,Percent of Total Billed Charges,340.72,,,,340.72,471.24
VL AA ILIAC DUPLEX COMPLETE,93980,HCPCS,921,RC,,both,577.5,519.75,United Healthcare,Default,Fee Schedule,471.24,,,,340.72,471.24
VL AA ILIAC DUPLEX,93978,HCPCS,921,RC,TC,both,1321.45,1189.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,925.02,,,,779.66,1078.3
VL AA ILIAC DUPLEX,93978,HCPCS,921,RC,TC,both,1321.45,1189.31,Cigna,Default,Percent of Total Billed Charges,779.66,,,,779.66,1078.3
VL AA ILIAC DUPLEX,93978,HCPCS,921,RC,TC,both,1321.45,1189.31,United Healthcare,Default,Fee Schedule,1078.3,,,,779.66,1078.3
VL RENAL BYPASS GRAFT DUPLEX,93978,HCPCS,921,RC,,both,1478.5,1330.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1034.95,,,,872.32,1206.46
VL RENAL BYPASS GRAFT DUPLEX,93978,HCPCS,921,RC,,both,1478.5,1330.65,Cigna,Default,Percent of Total Billed Charges,872.32,,,,872.32,1206.46
VL RENAL BYPASS GRAFT DUPLEX,93978,HCPCS,921,RC,,both,1478.5,1330.65,United Healthcare,Default,Fee Schedule,1206.46,,,,872.32,1206.46
VL VENA CAVA DUPLEX,93978,HCPCS,921,RC,TC,both,865.75,779.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,606.02,,,,510.79,706.45
VL VENA CAVA DUPLEX,93978,HCPCS,921,RC,TC,both,865.75,779.18,Cigna,Default,Percent of Total Billed Charges,510.79,,,,510.79,706.45
VL VENA CAVA DUPLEX,93978,HCPCS,921,RC,TC,both,865.75,779.18,United Healthcare,Default,Fee Schedule,706.45,,,,510.79,706.45
VL RENAL BYPASS GRAFT DUPLEX LEFT,93978,HCPCS,921,RC,"TC,LT",both,865.75,779.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,606.02,,,,510.79,706.45
VL RENAL BYPASS GRAFT DUPLEX LEFT,93978,HCPCS,921,RC,"TC,LT",both,865.75,779.18,Cigna,Default,Percent of Total Billed Charges,510.79,,,,510.79,706.45
VL RENAL BYPASS GRAFT DUPLEX LEFT,93978,HCPCS,921,RC,"TC,LT",both,865.75,779.18,United Healthcare,Default,Fee Schedule,706.45,,,,510.79,706.45
VL AA ILIAC DUPLEX LTD,93979,HCPCS,921,RC,,both,1047.2,942.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,733.04,,,,617.85,854.52
VL AA ILIAC DUPLEX LTD,93979,HCPCS,921,RC,,both,1047.2,942.48,Cigna,Default,Percent of Total Billed Charges,617.85,,,,617.85,854.52
VL AA ILIAC DUPLEX LTD,93979,HCPCS,921,RC,,both,1047.2,942.48,United Healthcare,Default,Fee Schedule,854.52,,,,617.85,854.52
VL AA LEFT ILIAC DUPLEX LTD,93979,HCPCS,921,RC,"TC,LT",both,577.5,519.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,404.25,,,,340.72,471.24
VL AA LEFT ILIAC DUPLEX LTD,93979,HCPCS,921,RC,"TC,LT",both,577.5,519.75,Cigna,Default,Percent of Total Billed Charges,340.72,,,,340.72,471.24
VL AA LEFT ILIAC DUPLEX LTD,93979,HCPCS,921,RC,"TC,LT",both,577.5,519.75,United Healthcare,Default,Fee Schedule,471.24,,,,340.72,471.24
VL BYPASS GRAFT LEG BILATERAL,93925,HCPCS,921,RC,TC,both,831.25,748.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,581.88,,,,490.44,678.3
VL BYPASS GRAFT LEG BILATERAL,93925,HCPCS,921,RC,TC,both,831.25,748.13,Cigna,Default,Percent of Total Billed Charges,490.44,,,,490.44,678.3
VL BYPASS GRAFT LEG BILATERAL,93925,HCPCS,921,RC,TC,both,831.25,748.13,United Healthcare,Default,Fee Schedule,678.3,,,,490.44,678.3
VL BYPASS GRAFT RIGHT LEG,93926,HCPCS,921,RC,RT,both,1312,1180.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,918.4,,,,774.08,1070.59
VL BYPASS GRAFT RIGHT LEG,93926,HCPCS,921,RC,RT,both,1312,1180.8,Cigna,Default,Percent of Total Billed Charges,774.08,,,,774.08,1070.59
VL BYPASS GRAFT RIGHT LEG,93926,HCPCS,921,RC,RT,both,1312,1180.8,United Healthcare,Default,Fee Schedule,1070.59,,,,774.08,1070.59
VL BYPASS GRAFT LEFT LEG,93926,HCPCS,921,RC,LT,both,1312,1180.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,918.4,,,,774.08,1070.59
VL BYPASS GRAFT LEFT LEG,93926,HCPCS,921,RC,LT,both,1312,1180.8,Cigna,Default,Percent of Total Billed Charges,774.08,,,,774.08,1070.59
VL BYPASS GRAFT LEFT LEG,93926,HCPCS,921,RC,LT,both,1312,1180.8,United Healthcare,Default,Fee Schedule,1070.59,,,,774.08,1070.59
VL DEEP VEIN DUPLEX BIL. LEG,93970,HCPCS,921,RC,,both,1044.41,939.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,731.09,,,,616.2,852.24
VL DEEP VEIN DUPLEX BIL. LEG,93970,HCPCS,921,RC,,both,1044.41,939.97,Cigna,Default,Percent of Total Billed Charges,616.2,,,,616.2,852.24
VL DEEP VEIN DUPLEX BIL. LEG,93970,HCPCS,921,RC,,both,1044.41,939.97,United Healthcare,Default,Fee Schedule,852.24,,,,616.2,852.24
VL DEEP VEIN DUPLEX RIGHT LEG,93971,HCPCS,921,RC,RT,both,829.46,746.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,580.62,,,,489.38,676.84
VL DEEP VEIN DUPLEX RIGHT LEG,93971,HCPCS,921,RC,RT,both,829.46,746.51,Cigna,Default,Percent of Total Billed Charges,489.38,,,,489.38,676.84
VL DEEP VEIN DUPLEX RIGHT LEG,93971,HCPCS,921,RC,RT,both,829.46,746.51,United Healthcare,Default,Fee Schedule,676.84,,,,489.38,676.84
VL DEEP VEIN DUPLEX LEFT LEG,93971,HCPCS,921,RC,LT,both,829.46,746.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,580.62,,,,489.38,676.84
VL DEEP VEIN DUPLEX LEFT LEG,93971,HCPCS,921,RC,LT,both,829.46,746.51,Cigna,Default,Percent of Total Billed Charges,489.38,,,,489.38,676.84
VL DEEP VEIN DUPLEX LEFT LEG,93971,HCPCS,921,RC,LT,both,829.46,746.51,United Healthcare,Default,Fee Schedule,676.84,,,,489.38,676.84
VL DEEP VEIN DUPLEX BIL. ARM,93970,HCPCS,921,RC,,both,1044.41,939.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,731.09,,,,616.2,852.24
VL DEEP VEIN DUPLEX BIL. ARM,93970,HCPCS,921,RC,,both,1044.41,939.97,Cigna,Default,Percent of Total Billed Charges,616.2,,,,616.2,852.24
VL DEEP VEIN DUPLEX BIL. ARM,93970,HCPCS,921,RC,,both,1044.41,939.97,United Healthcare,Default,Fee Schedule,852.24,,,,616.2,852.24
VL DEEP VEIN DUPLEX RIGHT ARM,93971,HCPCS,921,RC,RT,both,829.46,746.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,580.62,,,,489.38,676.84
VL DEEP VEIN DUPLEX RIGHT ARM,93971,HCPCS,921,RC,RT,both,829.46,746.51,Cigna,Default,Percent of Total Billed Charges,489.38,,,,489.38,676.84
VL DEEP VEIN DUPLEX RIGHT ARM,93971,HCPCS,921,RC,RT,both,829.46,746.51,United Healthcare,Default,Fee Schedule,676.84,,,,489.38,676.84
VL DEEP VEIN DUPLEX LEFT ARM,93971,HCPCS,921,RC,LT,both,829.46,746.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,580.62,,,,489.38,676.84
VL DEEP VEIN DUPLEX LEFT ARM,93971,HCPCS,921,RC,LT,both,829.46,746.51,Cigna,Default,Percent of Total Billed Charges,489.38,,,,489.38,676.84
VL DEEP VEIN DUPLEX LEFT ARM,93971,HCPCS,921,RC,LT,both,829.46,746.51,United Healthcare,Default,Fee Schedule,676.84,,,,489.38,676.84
VL VENOUS REFLUX DUPLEX,93970,HCPCS,921,RC,,both,2162,1945.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1513.4,,,,1275.58,1764.19
VL VENOUS REFLUX DUPLEX,93970,HCPCS,921,RC,,both,2162,1945.8,Cigna,Default,Percent of Total Billed Charges,1275.58,,,,1275.58,1764.19
VL VENOUS REFLUX DUPLEX,93970,HCPCS,921,RC,,both,2162,1945.8,United Healthcare,Default,Fee Schedule,1764.19,,,,1275.58,1764.19
VL VEIN MAPPING COMPLETE,93970,HCPCS,921,RC,,both,2162,1945.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1513.4,,,,1275.58,1764.19
VL VEIN MAPPING COMPLETE,93970,HCPCS,921,RC,,both,2162,1945.8,Cigna,Default,Percent of Total Billed Charges,1275.58,,,,1275.58,1764.19
VL VEIN MAPPING COMPLETE,93970,HCPCS,921,RC,,both,2162,1945.8,United Healthcare,Default,Fee Schedule,1764.19,,,,1275.58,1764.19
VL VEIN MAPPING LIMITED,93971,HCPCS,921,RC,,both,1355,1219.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,948.5,,,,799.45,1105.68
VL VEIN MAPPING LIMITED,93971,HCPCS,921,RC,,both,1355,1219.5,Cigna,Default,Percent of Total Billed Charges,799.45,,,,799.45,1105.68
VL VEIN MAPPING LIMITED,93971,HCPCS,921,RC,,both,1355,1219.5,United Healthcare,Default,Fee Schedule,1105.68,,,,799.45,1105.68
VL VEIN MAPPING LEFT LEG,93971,HCPCS,921,RC,"TC,LT",both,415.75,374.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,291.02,,,,245.29,339.25
VL VEIN MAPPING LEFT LEG,93971,HCPCS,921,RC,"TC,LT",both,415.75,374.18,Cigna,Default,Percent of Total Billed Charges,245.29,,,,245.29,339.25
VL VEIN MAPPING LEFT LEG,93971,HCPCS,921,RC,"TC,LT",both,415.75,374.18,United Healthcare,Default,Fee Schedule,339.25,,,,245.29,339.25
VL VEIN MAPPING BILATERAL ARM,93970,HCPCS,921,RC,TC,both,642,577.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,449.4,,,,378.78,523.87
VL VEIN MAPPING BILATERAL ARM,93970,HCPCS,921,RC,TC,both,642,577.8,Cigna,Default,Percent of Total Billed Charges,378.78,,,,378.78,523.87
VL VEIN MAPPING BILATERAL ARM,93970,HCPCS,921,RC,TC,both,642,577.8,United Healthcare,Default,Fee Schedule,523.87,,,,378.78,523.87
VL VEIN MAPPING RIGHT ARM,93971,HCPCS,921,RC,"TC,RT",both,415.75,374.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,291.02,,,,245.29,339.25
VL VEIN MAPPING RIGHT ARM,93971,HCPCS,921,RC,"TC,RT",both,415.75,374.18,Cigna,Default,Percent of Total Billed Charges,245.29,,,,245.29,339.25
VL VEIN MAPPING RIGHT ARM,93971,HCPCS,921,RC,"TC,RT",both,415.75,374.18,United Healthcare,Default,Fee Schedule,339.25,,,,245.29,339.25
VL VEIN MAPPING LEFT ARM,93971,HCPCS,921,RC,"TC,LT",both,744.75,670.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,521.32,,,,439.4,607.72
VL VEIN MAPPING LEFT ARM,93971,HCPCS,921,RC,"TC,LT",both,744.75,670.28,Cigna,Default,Percent of Total Billed Charges,439.4,,,,439.4,607.72
VL VEIN MAPPING LEFT ARM,93971,HCPCS,921,RC,"TC,LT",both,744.75,670.28,United Healthcare,Default,Fee Schedule,607.72,,,,439.4,607.72
VL DIALYSIS ACCESS DUPLEX,93990,HCPCS,921,RC,,both,1225,1102.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,857.5,,,,722.75,999.6
VL DIALYSIS ACCESS DUPLEX,93990,HCPCS,921,RC,,both,1225,1102.5,Cigna,Default,Percent of Total Billed Charges,722.75,,,,722.75,999.6
VL DIALYSIS ACCESS DUPLEX,93990,HCPCS,921,RC,,both,1225,1102.5,United Healthcare,Default,Fee Schedule,999.6,,,,722.75,999.6
VL US GUIDED VASCULAR ACCESS,76937,HCPCS,402,RC,,both,280.89,252.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.62,,,,165.73,229.21
VL US GUIDED VASCULAR ACCESS,76937,HCPCS,402,RC,,both,280.89,252.8,Cigna,Default,Percent of Total Billed Charges,165.73,,,,165.73,229.21
VL US GUIDED VASCULAR ACCESS,76937,HCPCS,402,RC,,both,280.89,252.8,United Healthcare,Default,Fee Schedule,229.21,,,,165.73,229.21
VL VIDEO OR CD COPY OF PATIENT EXAM,921,RC,,,,both,15.75,14.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.02,,,,9.29,12.85
VL VIDEO OR CD COPY OF PATIENT EXAM,921,RC,,,,both,15.75,14.18,Cigna,Default,Percent of Total Billed Charges,9.29,,,,9.29,12.85
VL VIDEO OR CD COPY OF PATIENT EXAM,921,RC,,,,both,15.75,14.18,United Healthcare,Default,Fee Schedule,12.85,,,,9.29,12.85
ECHO TEE IMAGING,93312,HCPCS,480,RC,,both,2551.12,2296.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1785.78,,,,1505.16,2081.71
ECHO TEE IMAGING,93312,HCPCS,480,RC,,both,2551.12,2296.01,Cigna,Default,Percent of Total Billed Charges,1505.16,,,,1505.16,2081.71
ECHO TEE IMAGING,93312,HCPCS,480,RC,,both,2551.12,2296.01,United Healthcare,Default,Fee Schedule,2081.71,,,,1505.16,2081.71
ECHO DOPPLER STUDY OF HEART COMPLETE,93320,HCPCS,480,RC,TC,both,444.75,400.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.32,,,,262.4,362.92
ECHO DOPPLER STUDY OF HEART COMPLETE,93320,HCPCS,480,RC,TC,both,444.75,400.28,Cigna,Default,Percent of Total Billed Charges,262.4,,,,262.4,362.92
ECHO DOPPLER STUDY OF HEART COMPLETE,93320,HCPCS,480,RC,TC,both,444.75,400.28,United Healthcare,Default,Fee Schedule,362.92,,,,262.4,362.92
ECHO DOPPLER COLOR FLOW MAPPING ADD ON,93325,HCPCS,480,RC,,both,471.47,424.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,330.03,,,,278.17,384.72
ECHO DOPPLER COLOR FLOW MAPPING ADD ON,93325,HCPCS,480,RC,,both,471.47,424.32,Cigna,Default,Percent of Total Billed Charges,278.17,,,,278.17,384.72
ECHO DOPPLER COLOR FLOW MAPPING ADD ON,93325,HCPCS,480,RC,,both,471.47,424.32,United Healthcare,Default,Fee Schedule,384.72,,,,278.17,384.72
ECHO DOPPLER OF HEART LIMITED STUDY,93321,HCPCS,480,RC,TC,both,444.75,400.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.32,,,,262.4,362.92
ECHO DOPPLER OF HEART LIMITED STUDY,93321,HCPCS,480,RC,TC,both,444.75,400.28,Cigna,Default,Percent of Total Billed Charges,262.4,,,,262.4,362.92
ECHO DOPPLER OF HEART LIMITED STUDY,93321,HCPCS,480,RC,TC,both,444.75,400.28,United Healthcare,Default,Fee Schedule,362.92,,,,262.4,362.92
ECHO 2-D ECHOCARDIOGRAM LIMITED STUDY,93308,HCPCS,480,RC,,both,695.92,626.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,487.14,,,,410.59,567.87
ECHO 2-D ECHOCARDIOGRAM LIMITED STUDY,93308,HCPCS,480,RC,,both,695.92,626.33,Cigna,Default,Percent of Total Billed Charges,410.59,,,,410.59,567.87
ECHO 2-D ECHOCARDIOGRAM LIMITED STUDY,93308,HCPCS,480,RC,,both,695.92,626.33,United Healthcare,Default,Fee Schedule,567.87,,,,410.59,567.87
ECHO 2-D IMAGE ONLY,93307,HCPCS,480,RC,,both,585.75,527.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,410.02,,,,345.59,477.97
ECHO 2-D IMAGE ONLY,93307,HCPCS,480,RC,,both,585.75,527.18,Cigna,Default,Percent of Total Billed Charges,345.59,,,,345.59,477.97
ECHO 2-D IMAGE ONLY,93307,HCPCS,480,RC,,both,585.75,527.18,United Healthcare,Default,Fee Schedule,477.97,,,,345.59,477.97
ECHO LIMITED STUDY CONGENITAL DEFECT,93303,HCPCS,480,RC,TC,both,452.75,407.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.92,,,,267.12,369.44
ECHO LIMITED STUDY CONGENITAL DEFECT,93303,HCPCS,480,RC,TC,both,452.75,407.48,Cigna,Default,Percent of Total Billed Charges,267.12,,,,267.12,369.44
ECHO LIMITED STUDY CONGENITAL DEFECT,93303,HCPCS,480,RC,TC,both,452.75,407.48,United Healthcare,Default,Fee Schedule,369.44,,,,267.12,369.44
ADULT ECHO COMPLETE W/O CONTRAST,93306,HCPCS,480,RC,,both,3525,3172.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2467.5,,,,2079.75,2876.4
ADULT ECHO COMPLETE W/O CONTRAST,93306,HCPCS,480,RC,,both,3525,3172.5,Cigna,Default,Percent of Total Billed Charges,2079.75,,,,2079.75,2876.4
ADULT ECHO COMPLETE W/O CONTRAST,93306,HCPCS,480,RC,,both,3525,3172.5,United Healthcare,Default,Fee Schedule,2876.4,,,,2079.75,2876.4
ECHO DOBUTAMINE STRESS ECHOCARDIOGRAM,93350,HCPCS,480,RC,,both,4282.6,3854.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2997.82,,,,2526.73,3494.6
ECHO DOBUTAMINE STRESS ECHOCARDIOGRAM,93350,HCPCS,480,RC,,both,4282.6,3854.34,Cigna,Default,Percent of Total Billed Charges,2526.73,,,,2526.73,3494.6
ECHO DOBUTAMINE STRESS ECHOCARDIOGRAM,93350,HCPCS,480,RC,,both,4282.6,3854.34,United Healthcare,Default,Fee Schedule,3494.6,,,,2526.73,3494.6
ECHO INJECTION DOBUTAMINE PER 250MG,250,RC,,,,both,51.25,46.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.88,,,,30.24,41.82
ECHO INJECTION DOBUTAMINE PER 250MG,250,RC,,,,both,51.25,46.13,Cigna,Default,Percent of Total Billed Charges,30.24,,,,30.24,41.82
ECHO INJECTION DOBUTAMINE PER 250MG,250,RC,,,,both,51.25,46.13,United Healthcare,Default,Fee Schedule,41.82,,,,30.24,41.82
ECHO STRESS ECHO PHYSICIAN SUPERVISION,93016,HCPCS,482,RC,,both,89.25,80.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.48,,,,52.66,72.83
ECHO STRESS ECHO PHYSICIAN SUPERVISION,93016,HCPCS,482,RC,,both,89.25,80.33,Cigna,Default,Percent of Total Billed Charges,52.66,,,,52.66,72.83
ECHO STRESS ECHO PHYSICIAN SUPERVISION,93016,HCPCS,482,RC,,both,89.25,80.33,United Healthcare,Default,Fee Schedule,72.83,,,,52.66,72.83
ECHO INJECTION OF OPTISON CONTRAST,636,RC,,,,both,595.75,536.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,417.02,,,,351.49,486.13
ECHO INJECTION OF OPTISON CONTRAST,636,RC,,,,both,595.75,536.18,Cigna,Default,Percent of Total Billed Charges,351.49,,,,351.49,486.13
ECHO INJECTION OF OPTISON CONTRAST,636,RC,,,,both,595.75,536.18,United Healthcare,Default,Fee Schedule,486.13,,,,351.49,486.13
ECHO TREADMILL STRESS ECHOCARDIOGRAM,93350,HCPCS,480,RC,,both,1521.95,1369.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1065.36,,,,897.95,1241.91
ECHO TREADMILL STRESS ECHOCARDIOGRAM,93350,HCPCS,480,RC,,both,1521.95,1369.76,Cigna,Default,Percent of Total Billed Charges,897.95,,,,897.95,1241.91
ECHO TREADMILL STRESS ECHOCARDIOGRAM,93350,HCPCS,480,RC,,both,1521.95,1369.76,United Healthcare,Default,Fee Schedule,1241.91,,,,897.95,1241.91
ADULT ECHO COMPLETE WITH CONTRAST,C8929,HCPCS,480,RC,,both,3185,2866.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2229.5,,,,1879.15,2598.96
ADULT ECHO COMPLETE WITH CONTRAST,C8929,HCPCS,480,RC,,both,3185,2866.5,Cigna,Default,Percent of Total Billed Charges,1879.15,,,,1879.15,2598.96
ADULT ECHO COMPLETE WITH CONTRAST,C8929,HCPCS,480,RC,,both,3185,2866.5,United Healthcare,Default,Fee Schedule,2598.96,,,,1879.15,2598.96
ECHO 2D TTE W/ OR W/O FOL W/ CONT F/U,C8924,HCPCS,480,RC,,both,1501.44,1351.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1051.01,,,,885.85,1225.18
ECHO 2D TTE W/ OR W/O FOL W/ CONT F/U,C8924,HCPCS,480,RC,,both,1501.44,1351.3,Cigna,Default,Percent of Total Billed Charges,885.85,,,,885.85,1225.18
ECHO 2D TTE W/ OR W/O FOL W/ CONT F/U,C8924,HCPCS,480,RC,,both,1501.44,1351.3,United Healthcare,Default,Fee Schedule,1225.18,,,,885.85,1225.18
ECHO 2D TEE W/ OR W/O FOL W/ CONT INTERP,C8925,HCPCS,480,RC,,both,2398.72,2158.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1679.1,,,,1415.24,1957.36
ECHO 2D TEE W/ OR W/O FOL W/ CONT INTERP,C8925,HCPCS,480,RC,,both,2398.72,2158.85,Cigna,Default,Percent of Total Billed Charges,1415.24,,,,1415.24,1957.36
ECHO 2D TEE W/ OR W/O FOL W/ CONT INTERP,C8925,HCPCS,480,RC,,both,2398.72,2158.85,United Healthcare,Default,Fee Schedule,1957.36,,,,1415.24,1957.36
ADULT ECHO W/CONTRAST W/STRESS,C8928,HCPCS,480,RC,,both,3338.59,3004.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2337.01,,,,1969.77,2724.29
ADULT ECHO W/CONTRAST W/STRESS,C8928,HCPCS,480,RC,,both,3338.59,3004.73,Cigna,Default,Percent of Total Billed Charges,1969.77,,,,1969.77,2724.29
ADULT ECHO W/CONTRAST W/STRESS,C8928,HCPCS,480,RC,,both,3338.59,3004.73,United Healthcare,Default,Fee Schedule,2724.29,,,,1969.77,2724.29
ECHO TTE W/ OR W/O CONTR CONT ECG,C8930,HCPCS,480,RC,,both,4183.51,3765.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2928.46,,,,2468.27,3413.74
ECHO TTE W/ OR W/O CONTR CONT ECG,C8930,HCPCS,480,RC,,both,4183.51,3765.16,Cigna,Default,Percent of Total Billed Charges,2468.27,,,,2468.27,3413.74
ECHO TTE W/ OR W/O CONTR CONT ECG,C8930,HCPCS,480,RC,,both,4183.51,3765.16,United Healthcare,Default,Fee Schedule,3413.74,,,,2468.27,3413.74
"DEFINITY INJ, PERFLUTREN LIPID MICROSPHE",Q9957,HCPCS,254,RC,,both,451.91,406.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.34,,,,266.63,368.76
"DEFINITY INJ, PERFLUTREN LIPID MICROSPHE",Q9957,HCPCS,254,RC,,both,451.91,406.72,Cigna,Default,Percent of Total Billed Charges,266.63,,,,266.63,368.76
"DEFINITY INJ, PERFLUTREN LIPID MICROSPHE",Q9957,HCPCS,254,RC,,both,451.91,406.72,United Healthcare,Default,Fee Schedule,368.76,,,,266.63,368.76
DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,93985,HCPCS,921,RC,,both,2669,2402.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1868.3,,,,1574.71,2177.9
DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,93985,HCPCS,921,RC,,both,2669,2402.1,Cigna,Default,Percent of Total Billed Charges,1574.71,,,,1574.71,2177.9
DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,93985,HCPCS,921,RC,,both,2669,2402.1,United Healthcare,Default,Fee Schedule,2177.9,,,,1574.71,2177.9
DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,93986,HCPCS,921,RC,,both,1175,1057.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,822.5,,,,693.25,958.8
DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,93986,HCPCS,921,RC,,both,1175,1057.5,Cigna,Default,Percent of Total Billed Charges,693.25,,,,693.25,958.8
DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,93986,HCPCS,921,RC,,both,1175,1057.5,United Healthcare,Default,Fee Schedule,958.8,,,,693.25,958.8
"DEFINITY INJ, PERFLUTREN LIPID MICROS ML",Q9957,HCPCS,254,RC,JW,both,438.75,394.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,307.12,,,,258.86,358.02
"DEFINITY INJ, PERFLUTREN LIPID MICROS ML",Q9957,HCPCS,254,RC,JW,both,438.75,394.88,Cigna,Default,Percent of Total Billed Charges,258.86,,,,258.86,358.02
"DEFINITY INJ, PERFLUTREN LIPID MICROS ML",Q9957,HCPCS,254,RC,JW,both,438.75,394.88,United Healthcare,Default,Fee Schedule,358.02,,,,258.86,358.02
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,490,RC,,both,204.34,183.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.04,,,,120.56,166.74
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,490,RC,,both,204.34,183.91,Cigna,Default,Percent of Total Billed Charges,120.56,,,,120.56,166.74
US PV RESIDUAL URINE BLDR SCAN,51798,HCPCS,490,RC,,both,204.34,183.91,United Healthcare,Default,Fee Schedule,166.74,,,,120.56,166.74
ADULT ECHO LIMITED WITH CONTRAST,C8924,HCPCS,480,RC,,both,1808,1627.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1265.6,,,,1066.72,1475.33
ADULT ECHO LIMITED WITH CONTRAST,C8924,HCPCS,480,RC,,both,1808,1627.2,Cigna,Default,Percent of Total Billed Charges,1066.72,,,,1066.72,1475.33
ADULT ECHO LIMITED WITH CONTRAST,C8924,HCPCS,480,RC,,both,1808,1627.2,United Healthcare,Default,Fee Schedule,1475.33,,,,1066.72,1475.33
MRI BRAIN /+CONT,70553,HCPCS,611,RC,,both,2681.05,2412.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1876.74,,,,910,2187.74
MRI BRAIN /+CONT,70553,HCPCS,611,RC,,both,2681.05,2412.95,Cigna,Default,Case Rate,910,,,,910,2187.74
MRI BRAIN /+CONT,70553,HCPCS,611,RC,,both,2681.05,2412.95,United Healthcare,Default,Fee Schedule,2187.74,,,,910,2187.74
MRI CONTRAST MEDIA,A9579,HCPCS,636,RC,,both,292.51,263.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,204.76,,,,172.58,238.69
MRI CONTRAST MEDIA,A9579,HCPCS,636,RC,,both,292.51,263.26,Cigna,Default,Percent of Total Billed Charges,172.58,,,,172.58,238.69
MRI CONTRAST MEDIA,A9579,HCPCS,636,RC,,both,292.51,263.26,United Healthcare,Default,Fee Schedule,238.69,,,,172.58,238.69
MRI CONTRAST GADOLINIUM,A9579,HCPCS,636,RC,,both,12.38,11.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.67,,,,7.3,10.1
MRI CONTRAST GADOLINIUM,A9579,HCPCS,636,RC,,both,12.38,11.14,Cigna,Default,Percent of Total Billed Charges,7.3,,,,7.3,10.1
MRI CONTRAST GADOLINIUM,A9579,HCPCS,636,RC,,both,12.38,11.14,United Healthcare,Default,Fee Schedule,10.1,,,,7.3,10.1
MMRA NECK WO W/ CONTRAST,70549,HCPCS,615,RC,,both,3679.6,3311.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2575.72,,,,910,3002.55
MMRA NECK WO W/ CONTRAST,70549,HCPCS,615,RC,,both,3679.6,3311.64,Cigna,Default,Case Rate,910,,,,910,3002.55
MMRA NECK WO W/ CONTRAST,70549,HCPCS,615,RC,,both,3679.6,3311.64,United Healthcare,Default,Fee Schedule,3002.55,,,,910,3002.55
CT Lung Cancer Screening,71271,HCPCS,350,RC,,both,508.07,457.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,355.65,,,,355.65,508.07
CT Lung Cancer Screening,71271,HCPCS,350,RC,,both,508.07,457.26,Cigna,Default,Case Rate,508.07,,,,355.65,508.07
CT Lung Cancer Screening,71271,HCPCS,350,RC,,both,508.07,457.26,United Healthcare,Default,Fee Schedule,414.59,,,,355.65,508.07
HIGH RESOLUTION CT CHEST,71250,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
HIGH RESOLUTION CT CHEST,71250,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
HIGH RESOLUTION CT CHEST,71250,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
MMRA ABDOMEN WO CONTRAST,C8901,HCPCS,610,RC,,both,3165.05,2848.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2215.54,,,,910,2582.68
MMRA ABDOMEN WO CONTRAST,C8901,HCPCS,610,RC,,both,3165.05,2848.55,Cigna,Default,Case Rate,910,,,,910,2582.68
MMRA ABDOMEN WO CONTRAST,C8901,HCPCS,610,RC,,both,3165.05,2848.55,United Healthcare,Default,Fee Schedule,2582.68,,,,910,2582.68
DIAGNOSTIC CHEST LDLS,71250,HCPCS,350,RC,,both,2501.92,2251.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1751.34,,,,520,2041.57
DIAGNOSTIC CHEST LDLS,71250,HCPCS,350,RC,,both,2501.92,2251.73,Cigna,Default,Case Rate,520,,,,520,2041.57
DIAGNOSTIC CHEST LDLS,71250,HCPCS,350,RC,,both,2501.92,2251.73,United Healthcare,Default,Fee Schedule,2041.57,,,,520,2041.57
XR ANKLE LT 1-2V,73600,HCPCS,320,RC,LT,both,357.55,321.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,250.28,,,,210.95,291.76
XR ANKLE LT 1-2V,73600,HCPCS,320,RC,LT,both,357.55,321.8,Cigna,Default,Percent of Total Billed Charges,210.95,,,,210.95,291.76
XR ANKLE LT 1-2V,73600,HCPCS,320,RC,LT,both,357.55,321.8,United Healthcare,Default,Fee Schedule,291.76,,,,210.95,291.76
XR ANKLE RT 1-2V,73600,HCPCS,320,RC,RT,both,358.13,322.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,250.69,,,,211.3,292.23
XR ANKLE RT 1-2V,73600,HCPCS,320,RC,RT,both,358.13,322.32,Cigna,Default,Percent of Total Billed Charges,211.3,,,,211.3,292.23
XR ANKLE RT 1-2V,73600,HCPCS,320,RC,RT,both,358.13,322.32,United Healthcare,Default,Fee Schedule,292.23,,,,211.3,292.23
MMRI WRIST JT LEFT W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3482.87,3134.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2438.01,,,,910,2842.02
MMRI WRIST JT LEFT W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3482.87,3134.58,Cigna,Default,Case Rate,910,,,,910,2842.02
MMRI WRIST JT LEFT W/O CONTRAST,73221,HCPCS,610,RC,LT,both,3482.87,3134.58,United Healthcare,Default,Fee Schedule,2842.02,,,,910,2842.02
MMRI WRIST JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3482.87,3134.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2438.01,,,,910,2842.02
MMRI WRIST JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3482.87,3134.58,Cigna,Default,Case Rate,910,,,,910,2842.02
MMRI WRIST JT RIGHT W/O CONTRAST,73221,HCPCS,610,RC,RT,both,3482.87,3134.58,United Healthcare,Default,Fee Schedule,2842.02,,,,910,2842.02
MMRI WRIST JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,4155.22,3739.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2908.65,,,,910,3390.66
MMRI WRIST JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,4155.22,3739.7,Cigna,Default,Case Rate,910,,,,910,3390.66
MMRI WRIST JT RIGHT WO/W CONTRAST,73223,HCPCS,610,RC,RT,both,4155.22,3739.7,United Healthcare,Default,Fee Schedule,3390.66,,,,910,3390.66
MMRI WRIST JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,3818.62,3436.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2673.03,,,,910,3115.99
MMRI WRIST JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,3818.62,3436.76,Cigna,Default,Case Rate,910,,,,910,3115.99
MMRI WRIST JT LEFT WO/W CONTRAST,73223,HCPCS,610,RC,LT,both,3818.62,3436.76,United Healthcare,Default,Fee Schedule,3115.99,,,,910,3115.99
"XR NOSE TO RECTUM,1V FOR FOREIGN BODY",76010,HCPCS,320,RC,,both,283.34,255.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.34,,,,167.17,231.21
"XR NOSE TO RECTUM,1V FOR FOREIGN BODY",76010,HCPCS,320,RC,,both,283.34,255.01,Cigna,Default,Percent of Total Billed Charges,167.17,,,,167.17,231.21
"XR NOSE TO RECTUM,1V FOR FOREIGN BODY",76010,HCPCS,320,RC,,both,283.34,255.01,United Healthcare,Default,Fee Schedule,231.21,,,,167.17,231.21
XR RIBS LEFT MIN 3 VWS,71100,HCPCS,320,RC,LT,both,283.34,255.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.34,,,,167.17,231.21
XR RIBS LEFT MIN 3 VWS,71100,HCPCS,320,RC,LT,both,283.34,255.01,Cigna,Default,Percent of Total Billed Charges,167.17,,,,167.17,231.21
XR RIBS LEFT MIN 3 VWS,71100,HCPCS,320,RC,LT,both,283.34,255.01,United Healthcare,Default,Fee Schedule,231.21,,,,167.17,231.21
XR RIBS RIGHT MIN 3 VWS,71100,HCPCS,320,RC,RT,both,283.34,255.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.34,,,,167.17,231.21
XR RIBS RIGHT MIN 3 VWS,71100,HCPCS,320,RC,RT,both,283.34,255.01,Cigna,Default,Percent of Total Billed Charges,167.17,,,,167.17,231.21
XR RIBS RIGHT MIN 3 VWS,71100,HCPCS,320,RC,RT,both,283.34,255.01,United Healthcare,Default,Fee Schedule,231.21,,,,167.17,231.21
Adult Echo with contrast,C8929,HCPCS,480,RC,,both,4131,3717.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2891.7,,,,2437.29,3370.9
Adult Echo with contrast,C8929,HCPCS,480,RC,,both,4131,3717.9,Cigna,Default,Percent of Total Billed Charges,2437.29,,,,2437.29,3370.9
Adult Echo with contrast,C8929,HCPCS,480,RC,,both,4131,3717.9,United Healthcare,Default,Fee Schedule,3370.9,,,,2437.29,3370.9
ADULT ECHO LIMITED W/OUT CONTRAST,93308,HCPCS,480,RC,,both,1178,1060.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,824.6,,,,695.02,961.25
ADULT ECHO LIMITED W/OUT CONTRAST,93308,HCPCS,480,RC,,both,1178,1060.2,Cigna,Default,Percent of Total Billed Charges,695.02,,,,695.02,961.25
ADULT ECHO LIMITED W/OUT CONTRAST,93308,HCPCS,480,RC,,both,1178,1060.2,United Healthcare,Default,Fee Schedule,961.25,,,,695.02,961.25
ADULT ECHO LIMITED WITH CONTRAST,C8924,HCPCS,480,RC,,both,1808,1627.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1265.6,,,,1066.72,1475.33
ADULT ECHO LIMITED WITH CONTRAST,C8924,HCPCS,480,RC,,both,1808,1627.2,Cigna,Default,Percent of Total Billed Charges,1066.72,,,,1066.72,1475.33
ADULT ECHO LIMITED WITH CONTRAST,C8924,HCPCS,480,RC,,both,1808,1627.2,United Healthcare,Default,Fee Schedule,1475.33,,,,1066.72,1475.33
HETASTARCH 6% 500ML INJ (HESPAN),258,RC,,,,both,196.62,176.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.63,,,,116.01,160.44
HETASTARCH 6% 500ML INJ (HESPAN),258,RC,,,,both,196.62,176.96,Cigna,Default,Percent of Total Billed Charges,116.01,,,,116.01,160.44
HETASTARCH 6% 500ML INJ (HESPAN),258,RC,,,,both,196.62,176.96,United Healthcare,Default,Fee Schedule,160.44,,,,116.01,160.44
BENZONATATE 100MG CAP (TESSALON),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
BENZONATATE 100MG CAP (TESSALON),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
BENZONATATE 100MG CAP (TESSALON),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CLARITIN D 5MG/120MG TAB 12 HOUR,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CLARITIN D 5MG/120MG TAB 12 HOUR,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CLARITIN D 5MG/120MG TAB 12 HOUR,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CENTRUM SILVER TAB,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CENTRUM SILVER TAB,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CENTRUM SILVER TAB,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CYCLOPENTOLATE OPTH SOL 1% 5ML (CYCLOGYL,250,RC,,,,both,77.15,69.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54,,,,45.52,62.95
CYCLOPENTOLATE OPTH SOL 1% 5ML (CYCLOGYL,250,RC,,,,both,77.15,69.44,Cigna,Default,Percent of Total Billed Charges,45.52,,,,45.52,62.95
CYCLOPENTOLATE OPTH SOL 1% 5ML (CYCLOGYL,250,RC,,,,both,77.15,69.44,United Healthcare,Default,Fee Schedule,62.95,,,,45.52,62.95
FAMCICLOVIR 500MG TAB (FAMVIR),637,RC,,,,both,31.81,28.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.27,,,,18.77,25.96
FAMCICLOVIR 500MG TAB (FAMVIR),637,RC,,,,both,31.81,28.63,Cigna,Default,Percent of Total Billed Charges,18.77,,,,18.77,25.96
FAMCICLOVIR 500MG TAB (FAMVIR),637,RC,,,,both,31.81,28.63,United Healthcare,Default,Fee Schedule,25.96,,,,18.77,25.96
PHENOBARBITAL 60MG/ML 2ML INJ,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
PHENOBARBITAL 60MG/ML 2ML INJ,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
PHENOBARBITAL 60MG/ML 2ML INJ,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
HYOSCYAMINE 0.375MG TAB (LEVBID),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
HYOSCYAMINE 0.375MG TAB (LEVBID),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
HYOSCYAMINE 0.375MG TAB (LEVBID),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ROPIVACAINE 1% 10MG/ML 10ML INJ (NAROPIN,J2795,HCPCS,636,RC,,both,31.81,28.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.27,,,,18.77,25.96
ROPIVACAINE 1% 10MG/ML 10ML INJ (NAROPIN,J2795,HCPCS,636,RC,,both,31.81,28.63,Cigna,Default,Percent of Total Billed Charges,18.77,,,,18.77,25.96
ROPIVACAINE 1% 10MG/ML 10ML INJ (NAROPIN,J2795,HCPCS,636,RC,,both,31.81,28.63,United Healthcare,Default,Fee Schedule,25.96,,,,18.77,25.96
GUAIFENESIN DM 20mg/200MG 10ML(ROBITUSSI,637,RC,,,,both,6.31,5.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.42,,,,3.72,5.15
GUAIFENESIN DM 20mg/200MG 10ML(ROBITUSSI,637,RC,,,,both,6.31,5.68,Cigna,Default,Percent of Total Billed Charges,3.72,,,,3.72,5.15
GUAIFENESIN DM 20mg/200MG 10ML(ROBITUSSI,637,RC,,,,both,6.31,5.68,United Healthcare,Default,Fee Schedule,5.15,,,,3.72,5.15
TRACE ELEMENTS INJ 1ML,250,RC,,,,both,127.5,114.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,89.25,,,,75.22,104.04
TRACE ELEMENTS INJ 1ML,250,RC,,,,both,127.5,114.75,Cigna,Default,Percent of Total Billed Charges,75.22,,,,75.22,104.04
TRACE ELEMENTS INJ 1ML,250,RC,,,,both,127.5,114.75,United Healthcare,Default,Fee Schedule,104.04,,,,75.22,104.04
ESTRADIOL 0.5MG TAB (ESTRACE),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ESTRADIOL 0.5MG TAB (ESTRACE),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ESTRADIOL 0.5MG TAB (ESTRACE),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CIMETIDINE 800MG TAB (TEGAMET),250,RC,,,,both,13.65,12.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.56,,,,8.05,11.14
CIMETIDINE 800MG TAB (TEGAMET),250,RC,,,,both,13.65,12.29,Cigna,Default,Percent of Total Billed Charges,8.05,,,,8.05,11.14
CIMETIDINE 800MG TAB (TEGAMET),250,RC,,,,both,13.65,12.29,United Healthcare,Default,Fee Schedule,11.14,,,,8.05,11.14
LISINOPRIL 10MG TAB (ZESTRIL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
LISINOPRIL 10MG TAB (ZESTRIL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
LISINOPRIL 10MG TAB (ZESTRIL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
SPIRONOLACTONE/HCTZ 25/25MG TAB (ALDACTA,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
SPIRONOLACTONE/HCTZ 25/25MG TAB (ALDACTA,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
SPIRONOLACTONE/HCTZ 25/25MG TAB (ALDACTA,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
SPIRONOLACTONE 25MG TAB (ALDACTONE),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
SPIRONOLACTONE 25MG TAB (ALDACTONE),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
SPIRONOLACTONE 25MG TAB (ALDACTONE),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
MELPHALAN 2MG TAB (ALKERAN),J8600,HCPCS,636,RC,,both,11.62,10.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.13,,,,6.86,9.48
MELPHALAN 2MG TAB (ALKERAN),J8600,HCPCS,636,RC,,both,11.62,10.46,Cigna,Default,Percent of Total Billed Charges,6.86,,,,6.86,9.48
MELPHALAN 2MG TAB (ALKERAN),J8600,HCPCS,636,RC,,both,11.62,10.46,United Healthcare,Default,Fee Schedule,9.48,,,,6.86,9.48
ENOXAPARIN SQ 150MG/ML  (LOVENOX),250,RC,,,,both,346.33,311.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,242.43,,,,204.33,282.61
ENOXAPARIN SQ 150MG/ML  (LOVENOX),250,RC,,,,both,346.33,311.7,Cigna,Default,Percent of Total Billed Charges,204.33,,,,204.33,282.61
ENOXAPARIN SQ 150MG/ML  (LOVENOX),250,RC,,,,both,346.33,311.7,United Healthcare,Default,Fee Schedule,282.61,,,,204.33,282.61
AMITRIPTYLINE 25MG TAB (ELAVIL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
AMITRIPTYLINE 25MG TAB (ELAVIL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
AMITRIPTYLINE 25MG TAB (ELAVIL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
SODIUM CHLORIDE 1000MG TAB,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
SODIUM CHLORIDE 1000MG TAB,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
SODIUM CHLORIDE 1000MG TAB,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
AMPICILLIN 500MG CAP,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
AMPICILLIN 500MG CAP,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
AMPICILLIN 500MG CAP,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
ALUMINUM HYDROXIDE 320MG/5ML GEL 120ML,637,RC,,,,both,20.33,18.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.23,,,,11.99,16.59
ALUMINUM HYDROXIDE 320MG/5ML GEL 120ML,637,RC,,,,both,20.33,18.3,Cigna,Default,Percent of Total Billed Charges,11.99,,,,11.99,16.59
ALUMINUM HYDROXIDE 320MG/5ML GEL 120ML,637,RC,,,,both,20.33,18.3,United Healthcare,Default,Fee Schedule,16.59,,,,11.99,16.59
CEFADROXIL 500MG CAP (DURICEF),637,RC,,,,both,19.36,17.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.55,,,,11.42,15.8
CEFADROXIL 500MG CAP (DURICEF),637,RC,,,,both,19.36,17.42,Cigna,Default,Percent of Total Billed Charges,11.42,,,,11.42,15.8
CEFADROXIL 500MG CAP (DURICEF),637,RC,,,,both,19.36,17.42,United Healthcare,Default,Fee Schedule,15.8,,,,11.42,15.8
AMPHOTERICIN INJ 50MG,J0285,HCPCS,636,RC,,both,120.86,108.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.6,,,,71.31,98.62
AMPHOTERICIN INJ 50MG,J0285,HCPCS,636,RC,,both,120.86,108.77,Cigna,Default,Percent of Total Billed Charges,71.31,,,,71.31,98.62
AMPHOTERICIN INJ 50MG,J0285,HCPCS,636,RC,,both,120.86,108.77,United Healthcare,Default,Fee Schedule,98.62,,,,71.31,98.62
ACETOHEXAMIDE 500MG TAB (DYMELOR),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ACETOHEXAMIDE 500MG TAB (DYMELOR),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ACETOHEXAMIDE 500MG TAB (DYMELOR),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
SERTRALINE 50MG TAB (ZOLOFT),637,RC,,,,both,11.06,9.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.74,,,,6.53,9.02
SERTRALINE 50MG TAB (ZOLOFT),637,RC,,,,both,11.06,9.95,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.02
SERTRALINE 50MG TAB (ZOLOFT),637,RC,,,,both,11.06,9.95,United Healthcare,Default,Fee Schedule,9.02,,,,6.53,9.02
NITROPRUSSIDE 50MG/2ML INJ (NITROPRESS),250,RC,,,,both,5495.06,4945.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3846.54,,,,3242.09,4483.97
NITROPRUSSIDE 50MG/2ML INJ (NITROPRESS),250,RC,,,,both,5495.06,4945.55,Cigna,Default,Percent of Total Billed Charges,3242.09,,,,3242.09,4483.97
NITROPRUSSIDE 50MG/2ML INJ (NITROPRESS),250,RC,,,,both,5495.06,4945.55,United Healthcare,Default,Fee Schedule,4483.97,,,,3242.09,4483.97
FLEXALL GEL,250,RC,,,,both,13.25,11.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.28,,,,7.82,10.81
FLEXALL GEL,250,RC,,,,both,13.25,11.93,Cigna,Default,Percent of Total Billed Charges,7.82,,,,7.82,10.81
FLEXALL GEL,250,RC,,,,both,13.25,11.93,United Healthcare,Default,Fee Schedule,10.81,,,,7.82,10.81
ADRIAMYCIN INJ 10MG/5ML,J9000,HCPCS,636,RC,,both,113.66,102.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.56,,,,67.06,92.75
ADRIAMYCIN INJ 10MG/5ML,J9000,HCPCS,636,RC,,both,113.66,102.29,Cigna,Default,Percent of Total Billed Charges,67.06,,,,67.06,92.75
ADRIAMYCIN INJ 10MG/5ML,J9000,HCPCS,636,RC,,both,113.66,102.29,United Healthcare,Default,Fee Schedule,92.75,,,,67.06,92.75
NYSTATIN SUSP 100MU/ML 60ML,250,RC,,,,both,45.04,40.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.53,,,,26.57,36.75
NYSTATIN SUSP 100MU/ML 60ML,250,RC,,,,both,45.04,40.54,Cigna,Default,Percent of Total Billed Charges,26.57,,,,26.57,36.75
NYSTATIN SUSP 100MU/ML 60ML,250,RC,,,,both,45.04,40.54,United Healthcare,Default,Fee Schedule,36.75,,,,26.57,36.75
CIPRODEX OTIC SUSP 7.5ML,250,RC,,,,both,767.91,691.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,537.54,,,,453.07,626.61
CIPRODEX OTIC SUSP 7.5ML,250,RC,,,,both,767.91,691.12,Cigna,Default,Percent of Total Billed Charges,453.07,,,,453.07,626.61
CIPRODEX OTIC SUSP 7.5ML,250,RC,,,,both,767.91,691.12,United Healthcare,Default,Fee Schedule,626.61,,,,453.07,626.61
LANSOPRAZOLE 30MG SOLUTAB (PREVACID),250,RC,,,,both,53.37,48.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.36,,,,31.49,43.55
LANSOPRAZOLE 30MG SOLUTAB (PREVACID),250,RC,,,,both,53.37,48.03,Cigna,Default,Percent of Total Billed Charges,31.49,,,,31.49,43.55
LANSOPRAZOLE 30MG SOLUTAB (PREVACID),250,RC,,,,both,53.37,48.03,United Healthcare,Default,Fee Schedule,43.55,,,,31.49,43.55
AMIKIN INJ 1GM/4ML,S0072,HCPCS,258,RC,,both,322.5,290.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,225.75,,,,190.28,263.16
AMIKIN INJ 1GM/4ML,S0072,HCPCS,258,RC,,both,322.5,290.25,Cigna,Default,Percent of Total Billed Charges,190.28,,,,190.28,263.16
AMIKIN INJ 1GM/4ML,S0072,HCPCS,258,RC,,both,322.5,290.25,United Healthcare,Default,Fee Schedule,263.16,,,,190.28,263.16
VINCRISTINE (VINCASAR PFS),J9370,HCPCS,636,RC,,both,48.95,44.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.26,,,,28.88,39.94
VINCRISTINE (VINCASAR PFS),J9370,HCPCS,636,RC,,both,48.95,44.06,Cigna,Default,Percent of Total Billed Charges,28.88,,,,28.88,39.94
VINCRISTINE (VINCASAR PFS),J9370,HCPCS,636,RC,,both,48.95,44.06,United Healthcare,Default,Fee Schedule,39.94,,,,28.88,39.94
CYCLOPHOSPHAMIDE 2 GRM SDV (CYTOXAN),J9073,HCPCS,636,RC,,both,4831.77,4348.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3382.24,,,,2850.74,3942.72
CYCLOPHOSPHAMIDE 2 GRM SDV (CYTOXAN),J9073,HCPCS,636,RC,,both,4831.77,4348.59,Cigna,Default,Percent of Total Billed Charges,2850.74,,,,2850.74,3942.72
CYCLOPHOSPHAMIDE 2 GRM SDV (CYTOXAN),J9073,HCPCS,636,RC,,both,4831.77,4348.59,United Healthcare,Default,Fee Schedule,3942.72,,,,2850.74,3942.72
PALONOSETRON 0.25MG/5ML (ALOXI),J2469,HCPCS,636,RC,,both,2177.33,1959.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1524.13,,,,1284.62,1776.7
PALONOSETRON 0.25MG/5ML (ALOXI),J2469,HCPCS,636,RC,,both,2177.33,1959.6,Cigna,Default,Percent of Total Billed Charges,1284.62,,,,1284.62,1776.7
PALONOSETRON 0.25MG/5ML (ALOXI),J2469,HCPCS,636,RC,,both,2177.33,1959.6,United Healthcare,Default,Fee Schedule,1776.7,,,,1284.62,1776.7
WARFARIN 2.5MG TAB (COUMADIN),250,RC,,,,both,6.68,6.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.68,,,,3.94,5.45
WARFARIN 2.5MG TAB (COUMADIN),250,RC,,,,both,6.68,6.01,Cigna,Default,Percent of Total Billed Charges,3.94,,,,3.94,5.45
WARFARIN 2.5MG TAB (COUMADIN),250,RC,,,,both,6.68,6.01,United Healthcare,Default,Fee Schedule,5.45,,,,3.94,5.45
CEFTRIAXONE INJ 500MG (ROCEPHIN),J0696,HCPCS,636,RC,,both,103.16,92.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.21,,,,60.86,84.18
CEFTRIAXONE INJ 500MG (ROCEPHIN),J0696,HCPCS,636,RC,,both,103.16,92.84,Cigna,Default,Percent of Total Billed Charges,60.86,,,,60.86,84.18
CEFTRIAXONE INJ 500MG (ROCEPHIN),J0696,HCPCS,636,RC,,both,103.16,92.84,United Healthcare,Default,Fee Schedule,84.18,,,,60.86,84.18
HYPOTEARS OPTH OINT,250,RC,,,,both,41,36.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.7,,,,24.19,33.46
HYPOTEARS OPTH OINT,250,RC,,,,both,41,36.9,Cigna,Default,Percent of Total Billed Charges,24.19,,,,24.19,33.46
HYPOTEARS OPTH OINT,250,RC,,,,both,41,36.9,United Healthcare,Default,Fee Schedule,33.46,,,,24.19,33.46
NEO/POLY/HC OTIC SUSP(CORTISPORIN OTIC),250,RC,,,,both,468.02,421.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,327.61,,,,276.13,381.9
NEO/POLY/HC OTIC SUSP(CORTISPORIN OTIC),250,RC,,,,both,468.02,421.22,Cigna,Default,Percent of Total Billed Charges,276.13,,,,276.13,381.9
NEO/POLY/HC OTIC SUSP(CORTISPORIN OTIC),250,RC,,,,both,468.02,421.22,United Healthcare,Default,Fee Schedule,381.9,,,,276.13,381.9
NABUMETONE 500MG TAB (RELAFEN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
NABUMETONE 500MG TAB (RELAFEN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
NABUMETONE 500MG TAB (RELAFEN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
WARFARIN 10MG TAB (COUMADIN),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
WARFARIN 10MG TAB (COUMADIN),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
WARFARIN 10MG TAB (COUMADIN),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DIVALPROEX DR 250MG TAB (DEPAKOTE),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DIVALPROEX DR 250MG TAB (DEPAKOTE),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DIVALPROEX DR 250MG TAB (DEPAKOTE),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
BENAZEPRIL 10MG TAB(LOTENSIN),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
BENAZEPRIL 10MG TAB(LOTENSIN),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
BENAZEPRIL 10MG TAB(LOTENSIN),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
POLYETHYLENEGLYCOL PWD (COLYTE),250,RC,,,,both,22.95,20.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.06,,,,13.54,18.73
POLYETHYLENEGLYCOL PWD (COLYTE),250,RC,,,,both,22.95,20.66,Cigna,Default,Percent of Total Billed Charges,13.54,,,,13.54,18.73
POLYETHYLENEGLYCOL PWD (COLYTE),250,RC,,,,both,22.95,20.66,United Healthcare,Default,Fee Schedule,18.73,,,,13.54,18.73
RU TUSS TAB,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
RU TUSS TAB,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
RU TUSS TAB,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
VERAPAMIL SR 180MG TAB (ISOPTIN SR),637,RC,,,,both,11.02,9.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.71,,,,6.5,8.99
VERAPAMIL SR 180MG TAB (ISOPTIN SR),637,RC,,,,both,11.02,9.92,Cigna,Default,Percent of Total Billed Charges,6.5,,,,6.5,8.99
VERAPAMIL SR 180MG TAB (ISOPTIN SR),637,RC,,,,both,11.02,9.92,United Healthcare,Default,Fee Schedule,8.99,,,,6.5,8.99
LITHIUM CARBONATE CR 300MG TAB (LITHOBID,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
LITHIUM CARBONATE CR 300MG TAB (LITHOBID,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
LITHIUM CARBONATE CR 300MG TAB (LITHOBID,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
FENTANYL 500MCG/10ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,27.9,25.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.53,,,,16.46,22.77
FENTANYL 500MCG/10ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,27.9,25.11,Cigna,Default,Percent of Total Billed Charges,16.46,,,,16.46,22.77
FENTANYL 500MCG/10ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,27.9,25.11,United Healthcare,Default,Fee Schedule,22.77,,,,16.46,22.77
SULFASALAZINE DR 500MG TAB (SULFAZINE),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
SULFASALAZINE DR 500MG TAB (SULFAZINE),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
SULFASALAZINE DR 500MG TAB (SULFAZINE),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DOXEPIN HCL 100MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DOXEPIN HCL 100MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DOXEPIN HCL 100MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
IBUPROFEN 600MG TAB (MOTRIN),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
IBUPROFEN 600MG TAB (MOTRIN),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
IBUPROFEN 600MG TAB (MOTRIN),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ISONIAZID 300MG TAB (NIAZID),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
ISONIAZID 300MG TAB (NIAZID),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
ISONIAZID 300MG TAB (NIAZID),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
MAGNESIUM SULFATE SYR INJ 50% 10ML,250,RC,,,,both,73.8,66.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.66,,,,43.54,60.22
MAGNESIUM SULFATE SYR INJ 50% 10ML,250,RC,,,,both,73.8,66.42,Cigna,Default,Percent of Total Billed Charges,43.54,,,,43.54,60.22
MAGNESIUM SULFATE SYR INJ 50% 10ML,250,RC,,,,both,73.8,66.42,United Healthcare,Default,Fee Schedule,60.22,,,,43.54,60.22
STERILE WATER INJ 10ML,250,RC,,,,both,16.87,15.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.81,,,,9.95,13.77
STERILE WATER INJ 10ML,250,RC,,,,both,16.87,15.18,Cigna,Default,Percent of Total Billed Charges,9.95,,,,9.95,13.77
STERILE WATER INJ 10ML,250,RC,,,,both,16.87,15.18,United Healthcare,Default,Fee Schedule,13.77,,,,9.95,13.77
FLUMAZENIL 0.5MG/5ML INJ (ROMAZICON),250,RC,,,,both,47.64,42.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.35,,,,28.11,38.87
FLUMAZENIL 0.5MG/5ML INJ (ROMAZICON),250,RC,,,,both,47.64,42.88,Cigna,Default,Percent of Total Billed Charges,28.11,,,,28.11,38.87
FLUMAZENIL 0.5MG/5ML INJ (ROMAZICON),250,RC,,,,both,47.64,42.88,United Healthcare,Default,Fee Schedule,38.87,,,,28.11,38.87
ECONAZOLE CRM 1% 15GM (SPECTAZOLE),637,RC,,,,both,125.23,112.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.66,,,,73.89,102.19
ECONAZOLE CRM 1% 15GM (SPECTAZOLE),637,RC,,,,both,125.23,112.71,Cigna,Default,Percent of Total Billed Charges,73.89,,,,73.89,102.19
ECONAZOLE CRM 1% 15GM (SPECTAZOLE),637,RC,,,,both,125.23,112.71,United Healthcare,Default,Fee Schedule,102.19,,,,73.89,102.19
CARB/LEVO 25/250MG TAB (SINEMET),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CARB/LEVO 25/250MG TAB (SINEMET),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CARB/LEVO 25/250MG TAB (SINEMET),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
SILVER SULFADIAZINE 1%CREAM 50GM (SILVAD,250,RC,,,,both,69.15,62.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.4,,,,40.8,56.43
SILVER SULFADIAZINE 1%CREAM 50GM (SILVAD,250,RC,,,,both,69.15,62.24,Cigna,Default,Percent of Total Billed Charges,40.8,,,,40.8,56.43
SILVER SULFADIAZINE 1%CREAM 50GM (SILVAD,250,RC,,,,both,69.15,62.24,United Healthcare,Default,Fee Schedule,56.43,,,,40.8,56.43
SOD CHLORIDE 250ML ADV,250,RC,,,,both,26.5,23.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.55,,,,15.64,21.62
SOD CHLORIDE 250ML ADV,250,RC,,,,both,26.5,23.85,Cigna,Default,Percent of Total Billed Charges,15.64,,,,15.64,21.62
SOD CHLORIDE 250ML ADV,250,RC,,,,both,26.5,23.85,United Healthcare,Default,Fee Schedule,21.62,,,,15.64,21.62
SOD CHLORIDE 3% 500ML,250,RC,,,,both,125.51,112.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.86,,,,74.05,102.42
SOD CHLORIDE 3% 500ML,250,RC,,,,both,125.51,112.96,Cigna,Default,Percent of Total Billed Charges,74.05,,,,74.05,102.42
SOD CHLORIDE 3% 500ML,250,RC,,,,both,125.51,112.96,United Healthcare,Default,Fee Schedule,102.42,,,,74.05,102.42
AMINO ACID 10% INJ (AMINOSYN),258,RC,,,,both,270.78,243.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,189.55,,,,159.76,220.96
AMINO ACID 10% INJ (AMINOSYN),258,RC,,,,both,270.78,243.7,Cigna,Default,Percent of Total Billed Charges,159.76,,,,159.76,220.96
AMINO ACID 10% INJ (AMINOSYN),258,RC,,,,both,270.78,243.7,United Healthcare,Default,Fee Schedule,220.96,,,,159.76,220.96
LIPOSYN II 20% 500ML INJ,258,RC,,,,both,284.01,255.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.81,,,,167.57,231.75
LIPOSYN II 20% 500ML INJ,258,RC,,,,both,284.01,255.61,Cigna,Default,Percent of Total Billed Charges,167.57,,,,167.57,231.75
LIPOSYN II 20% 500ML INJ,258,RC,,,,both,284.01,255.61,United Healthcare,Default,Fee Schedule,231.75,,,,167.57,231.75
D 70W 70% 500ML,258,RC,,,,both,112.27,101.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.59,,,,66.24,91.61
D 70W 70% 500ML,258,RC,,,,both,112.27,101.04,Cigna,Default,Percent of Total Billed Charges,66.24,,,,66.24,91.61
D 70W 70% 500ML,258,RC,,,,both,112.27,101.04,United Healthcare,Default,Fee Schedule,91.61,,,,66.24,91.61
D10W 10% 1000ML IV FLUID,258,RC,,,,both,37.89,34.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.52,,,,22.36,30.92
D10W 10% 1000ML IV FLUID,258,RC,,,,both,37.89,34.1,Cigna,Default,Percent of Total Billed Charges,22.36,,,,22.36,30.92
D10W 10% 1000ML IV FLUID,258,RC,,,,both,37.89,34.1,United Healthcare,Default,Fee Schedule,30.92,,,,22.36,30.92
A & D OINT 60GM,250,RC,,,,both,24.4,21.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.08,,,,14.4,19.91
A & D OINT 60GM,250,RC,,,,both,24.4,21.96,Cigna,Default,Percent of Total Billed Charges,14.4,,,,14.4,19.91
A & D OINT 60GM,250,RC,,,,both,24.4,21.96,United Healthcare,Default,Fee Schedule,19.91,,,,14.4,19.91
"HEPARIN SOD/0.45%NS 25,000U/250ML PREMIX",J1644,HCPCS,636,RC,,both,61.02,54.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.71,,,,36,49.79
"HEPARIN SOD/0.45%NS 25,000U/250ML PREMIX",J1644,HCPCS,636,RC,,both,61.02,54.92,Cigna,Default,Percent of Total Billed Charges,36,,,,36,49.79
"HEPARIN SOD/0.45%NS 25,000U/250ML PREMIX",J1644,HCPCS,636,RC,,both,61.02,54.92,United Healthcare,Default,Fee Schedule,49.79,,,,36,49.79
D5W 5% 100ML IV FLUID,J7060,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
D5W 5% 100ML IV FLUID,J7060,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
D5W 5% 100ML IV FLUID,J7060,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
DEXTROSE INJ 5% 250ML,258,RC,,,,both,30.8,27.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.56,,,,18.17,25.13
DEXTROSE INJ 5% 250ML,258,RC,,,,both,30.8,27.72,Cigna,Default,Percent of Total Billed Charges,18.17,,,,18.17,25.13
DEXTROSE INJ 5% 250ML,258,RC,,,,both,30.8,27.72,United Healthcare,Default,Fee Schedule,25.13,,,,18.17,25.13
D5W 5% 500ML IV FLUID,J7060,HCPCS,636,RC,,both,30.8,27.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.56,,,,18.17,25.13
D5W 5% 500ML IV FLUID,J7060,HCPCS,636,RC,,both,30.8,27.72,Cigna,Default,Percent of Total Billed Charges,18.17,,,,18.17,25.13
D5W 5% 500ML IV FLUID,J7060,HCPCS,636,RC,,both,30.8,27.72,United Healthcare,Default,Fee Schedule,25.13,,,,18.17,25.13
D5W/0.45% NS 1000ML IV FLUID,J7042,HCPCS,636,RC,,both,36.61,32.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.63,,,,21.6,29.87
D5W/0.45% NS 1000ML IV FLUID,J7042,HCPCS,636,RC,,both,36.61,32.95,Cigna,Default,Percent of Total Billed Charges,21.6,,,,21.6,29.87
D5W/0.45% NS 1000ML IV FLUID,J7042,HCPCS,636,RC,,both,36.61,32.95,United Healthcare,Default,Fee Schedule,29.87,,,,21.6,29.87
D5W/0.9%NS 1000ML IV FLUID,258,RC,,,,both,34.84,31.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.39,,,,20.56,28.43
D5W/0.9%NS 1000ML IV FLUID,258,RC,,,,both,34.84,31.36,Cigna,Default,Percent of Total Billed Charges,20.56,,,,20.56,28.43
D5W/0.9%NS 1000ML IV FLUID,258,RC,,,,both,34.84,31.36,United Healthcare,Default,Fee Schedule,28.43,,,,20.56,28.43
D5W/LR  1000ML IV FLUID,258,RC,,,,both,40.66,36.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.46,,,,23.99,33.18
D5W/LR  1000ML IV FLUID,258,RC,,,,both,40.66,36.59,Cigna,Default,Percent of Total Billed Charges,23.99,,,,23.99,33.18
D5W/LR  1000ML IV FLUID,258,RC,,,,both,40.66,36.59,United Healthcare,Default,Fee Schedule,33.18,,,,23.99,33.18
LACTATED RINGER 1000ML IV FLUID,258,RC,,,,both,36.51,32.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.56,,,,21.54,29.79
LACTATED RINGER 1000ML IV FLUID,258,RC,,,,both,36.51,32.86,Cigna,Default,Percent of Total Billed Charges,21.54,,,,21.54,29.79
LACTATED RINGER 1000ML IV FLUID,258,RC,,,,both,36.51,32.86,United Healthcare,Default,Fee Schedule,29.79,,,,21.54,29.79
NACL 0.45% 1000ML IV FLUID,258,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
NACL 0.45% 1000ML IV FLUID,258,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
NACL 0.45% 1000ML IV FLUID,258,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
FILGRASTIM 300MCG/ML INJ (NEUPOGEN),J1442,HCPCS,636,RC,,both,802.53,722.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,561.77,,,,473.49,654.86
FILGRASTIM 300MCG/ML INJ (NEUPOGEN),J1442,HCPCS,636,RC,,both,802.53,722.28,Cigna,Default,Percent of Total Billed Charges,473.49,,,,473.49,654.86
FILGRASTIM 300MCG/ML INJ (NEUPOGEN),J1442,HCPCS,636,RC,,both,802.53,722.28,United Healthcare,Default,Fee Schedule,654.86,,,,473.49,654.86
NACL 0.9% 100ML IV FLUID,258,RC,,,,both,30.42,27.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.29,,,,17.95,24.82
NACL 0.9% 100ML IV FLUID,258,RC,,,,both,30.42,27.38,Cigna,Default,Percent of Total Billed Charges,17.95,,,,17.95,24.82
NACL 0.9% 100ML IV FLUID,258,RC,,,,both,30.42,27.38,United Healthcare,Default,Fee Schedule,24.82,,,,17.95,24.82
NACL 0.9% IV 250ML IV FLUID,J7050,HCPCS,258,RC,,both,43.58,39.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.51,,,,25.71,35.56
NACL 0.9% IV 250ML IV FLUID,J7050,HCPCS,258,RC,,both,43.58,39.22,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.56
NACL 0.9% IV 250ML IV FLUID,J7050,HCPCS,258,RC,,both,43.58,39.22,United Healthcare,Default,Fee Schedule,35.56,,,,25.71,35.56
NACL 0.9% 100ML IV MINI BAG,258,RC,,,,both,45.5,40.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.85,,,,26.84,37.13
NACL 0.9% 100ML IV MINI BAG,258,RC,,,,both,45.5,40.95,Cigna,Default,Percent of Total Billed Charges,26.84,,,,26.84,37.13
NACL 0.9% 100ML IV MINI BAG,258,RC,,,,both,45.5,40.95,United Healthcare,Default,Fee Schedule,37.13,,,,26.84,37.13
NACL 0.9% IV 500ML IV FLUID,J7040,HCPCS,636,RC,,both,30.8,27.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.56,,,,18.17,25.13
NACL 0.9% IV 500ML IV FLUID,J7040,HCPCS,636,RC,,both,30.8,27.72,Cigna,Default,Percent of Total Billed Charges,18.17,,,,18.17,25.13
NACL 0.9% IV 500ML IV FLUID,J7040,HCPCS,636,RC,,both,30.8,27.72,United Healthcare,Default,Fee Schedule,25.13,,,,18.17,25.13
NACL 0.9% 1000ML IV FLUID,J7030,HCPCS,258,RC,,both,32.25,29.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.58,,,,19.03,26.32
NACL 0.9% 1000ML IV FLUID,J7030,HCPCS,258,RC,,both,32.25,29.03,Cigna,Default,Percent of Total Billed Charges,19.03,,,,19.03,26.32
NACL 0.9% 1000ML IV FLUID,J7030,HCPCS,258,RC,,both,32.25,29.03,United Healthcare,Default,Fee Schedule,26.32,,,,19.03,26.32
STERILE WATER IRRIG 500ML,258,RC,,,,both,39.27,35.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.49,,,,23.17,32.04
STERILE WATER IRRIG 500ML,258,RC,,,,both,39.27,35.34,Cigna,Default,Percent of Total Billed Charges,23.17,,,,23.17,32.04
STERILE WATER IRRIG 500ML,258,RC,,,,both,39.27,35.34,United Healthcare,Default,Fee Schedule,32.04,,,,23.17,32.04
ACETIC ACID SOL 0.25%,250,RC,,,,both,134.22,120.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.95,,,,79.19,109.52
ACETIC ACID SOL 0.25%,250,RC,,,,both,134.22,120.8,Cigna,Default,Percent of Total Billed Charges,79.19,,,,79.19,109.52
ACETIC ACID SOL 0.25%,250,RC,,,,both,134.22,120.8,United Healthcare,Default,Fee Schedule,109.52,,,,79.19,109.52
D 50W 50% 500ML,258,RC,,,,both,90.43,81.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.3,,,,53.35,73.79
D 50W 50% 500ML,258,RC,,,,both,90.43,81.39,Cigna,Default,Percent of Total Billed Charges,53.35,,,,53.35,73.79
D 50W 50% 500ML,258,RC,,,,both,90.43,81.39,United Healthcare,Default,Fee Schedule,73.79,,,,53.35,73.79
SELENIUM SUL SHAMPOO 2.5% 118ML,250,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
SELENIUM SUL SHAMPOO 2.5% 118ML,250,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
SELENIUM SUL SHAMPOO 2.5% 118ML,250,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
SODIUM CHLOR SOL 0.9% 1000ML,258,RC,,,,both,91.81,82.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.27,,,,54.17,74.92
SODIUM CHLOR SOL 0.9% 1000ML,258,RC,,,,both,91.81,82.63,Cigna,Default,Percent of Total Billed Charges,54.17,,,,54.17,74.92
SODIUM CHLOR SOL 0.9% 1000ML,258,RC,,,,both,91.81,82.63,United Healthcare,Default,Fee Schedule,74.92,,,,54.17,74.92
SODIUM CHLORIDE 100MEQ/40ML INJ,250,RC,,,,both,39.42,35.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.59,,,,23.26,32.17
SODIUM CHLORIDE 100MEQ/40ML INJ,250,RC,,,,both,39.42,35.48,Cigna,Default,Percent of Total Billed Charges,23.26,,,,23.26,32.17
SODIUM CHLORIDE 100MEQ/40ML INJ,250,RC,,,,both,39.42,35.48,United Healthcare,Default,Fee Schedule,32.17,,,,23.26,32.17
SELENIUM AC INJ 40MCG/ML 10ML,250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
SELENIUM AC INJ 40MCG/ML 10ML,250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
SELENIUM AC INJ 40MCG/ML 10ML,250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
POTASSIUM PHOSPHATE 3MM/ML 15ML INJ,250,RC,,,,both,206.4,185.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,144.48,,,,121.78,168.42
POTASSIUM PHOSPHATE 3MM/ML 15ML INJ,250,RC,,,,both,206.4,185.76,Cigna,Default,Percent of Total Billed Charges,121.78,,,,121.78,168.42
POTASSIUM PHOSPHATE 3MM/ML 15ML INJ,250,RC,,,,both,206.4,185.76,United Healthcare,Default,Fee Schedule,168.42,,,,121.78,168.42
SODIUM ACETATE 2MEQ/ML 50ML,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
SODIUM ACETATE 2MEQ/ML 50ML,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
SODIUM ACETATE 2MEQ/ML 50ML,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
POTASSIUM ACETATE 40MEQ/20ML 20ML INJ,250,RC,,,,both,33.46,30.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.42,,,,19.74,27.3
POTASSIUM ACETATE 40MEQ/20ML 20ML INJ,250,RC,,,,both,33.46,30.11,Cigna,Default,Percent of Total Billed Charges,19.74,,,,19.74,27.3
POTASSIUM ACETATE 40MEQ/20ML 20ML INJ,250,RC,,,,both,33.46,30.11,United Healthcare,Default,Fee Schedule,27.3,,,,19.74,27.3
CHLORHEXIDINE GLUCONATE 4% 120ML SOL (HI,250,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
CHLORHEXIDINE GLUCONATE 4% 120ML SOL (HI,250,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
CHLORHEXIDINE GLUCONATE 4% 120ML SOL (HI,250,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
FINASTERIDE 5MG TAB (PROSCAR),637,RC,,,,both,12.2,10.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.54,,,,7.2,9.96
FINASTERIDE 5MG TAB (PROSCAR),637,RC,,,,both,12.2,10.98,Cigna,Default,Percent of Total Billed Charges,7.2,,,,7.2,9.96
FINASTERIDE 5MG TAB (PROSCAR),637,RC,,,,both,12.2,10.98,United Healthcare,Default,Fee Schedule,9.96,,,,7.2,9.96
THIAMINE HCL  200MG/2ML INJ,J3411,HCPCS,636,RC,,both,50.85,45.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.6,,,,30,41.49
THIAMINE HCL  200MG/2ML INJ,J3411,HCPCS,636,RC,,both,50.85,45.77,Cigna,Default,Percent of Total Billed Charges,30,,,,30,41.49
THIAMINE HCL  200MG/2ML INJ,J3411,HCPCS,636,RC,,both,50.85,45.77,United Healthcare,Default,Fee Schedule,41.49,,,,30,41.49
SUCRALFATE 1GM/10ML 120ML SUSP,250,RC,,,,both,53.75,48.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.62,,,,31.71,43.86
SUCRALFATE 1GM/10ML 120ML SUSP,250,RC,,,,both,53.75,48.38,Cigna,Default,Percent of Total Billed Charges,31.71,,,,31.71,43.86
SUCRALFATE 1GM/10ML 120ML SUSP,250,RC,,,,both,53.75,48.38,United Healthcare,Default,Fee Schedule,43.86,,,,31.71,43.86
SODIUM CHLORIDE SOL 0.9% 3000ML,258,RC,,,,both,36.61,32.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.63,,,,21.6,29.87
SODIUM CHLORIDE SOL 0.9% 3000ML,258,RC,,,,both,36.61,32.95,Cigna,Default,Percent of Total Billed Charges,21.6,,,,21.6,29.87
SODIUM CHLORIDE SOL 0.9% 3000ML,258,RC,,,,both,36.61,32.95,United Healthcare,Default,Fee Schedule,29.87,,,,21.6,29.87
D5W/0.225% NS 1000ML IV FLUID,J7042,HCPCS,636,RC,,both,36.61,32.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.63,,,,21.6,29.87
D5W/0.225% NS 1000ML IV FLUID,J7042,HCPCS,636,RC,,both,36.61,32.95,Cigna,Default,Percent of Total Billed Charges,21.6,,,,21.6,29.87
D5W/0.225% NS 1000ML IV FLUID,J7042,HCPCS,636,RC,,both,36.61,32.95,United Healthcare,Default,Fee Schedule,29.87,,,,21.6,29.87
D5W 5% 1000ML IV FLUID,J7040,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
D5W 5% 1000ML IV FLUID,J7040,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
D5W 5% 1000ML IV FLUID,J7040,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
EUCERIN 120GM CRM,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
EUCERIN 120GM CRM,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
EUCERIN 120GM CRM,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
MEGESTROL ORAL SUSP 40MG/ML 240ML (MEGAC,637,RC,,,,both,258.59,232.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,181.01,,,,152.57,211.01
MEGESTROL ORAL SUSP 40MG/ML 240ML (MEGAC,637,RC,,,,both,258.59,232.73,Cigna,Default,Percent of Total Billed Charges,152.57,,,,152.57,211.01
MEGESTROL ORAL SUSP 40MG/ML 240ML (MEGAC,637,RC,,,,both,258.59,232.73,United Healthcare,Default,Fee Schedule,211.01,,,,152.57,211.01
GENTAMICIN 80MG/2ML INJ,J1580,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
GENTAMICIN 80MG/2ML INJ,J1580,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
GENTAMICIN 80MG/2ML INJ,J1580,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ETOMIDATE 2MG/ML 20ML INJ (AMIDATE),250,RC,,,,both,137.17,123.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.02,,,,80.93,111.93
ETOMIDATE 2MG/ML 20ML INJ (AMIDATE),250,RC,,,,both,137.17,123.45,Cigna,Default,Percent of Total Billed Charges,80.93,,,,80.93,111.93
ETOMIDATE 2MG/ML 20ML INJ (AMIDATE),250,RC,,,,both,137.17,123.45,United Healthcare,Default,Fee Schedule,111.93,,,,80.93,111.93
DESMOPRESSIN 4MCG/ML 10ML MDV INJ (DDAVP,J2597,HCPCS,636,RC,,both,824.27,741.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,576.99,,,,486.32,672.6
DESMOPRESSIN 4MCG/ML 10ML MDV INJ (DDAVP,J2597,HCPCS,636,RC,,both,824.27,741.84,Cigna,Default,Percent of Total Billed Charges,486.32,,,,486.32,672.6
DESMOPRESSIN 4MCG/ML 10ML MDV INJ (DDAVP,J2597,HCPCS,636,RC,,both,824.27,741.84,United Healthcare,Default,Fee Schedule,672.6,,,,486.32,672.6
DESMOPRESSIN 0.01% NASAL SPRAY (DDAVP),250,RC,,,,both,584.59,526.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,409.21,,,,344.91,477.03
DESMOPRESSIN 0.01% NASAL SPRAY (DDAVP),250,RC,,,,both,584.59,526.13,Cigna,Default,Percent of Total Billed Charges,344.91,,,,344.91,477.03
DESMOPRESSIN 0.01% NASAL SPRAY (DDAVP),250,RC,,,,both,584.59,526.13,United Healthcare,Default,Fee Schedule,477.03,,,,344.91,477.03
INTRACONAZOLE 10 MG/ML 120ML ORAL SUSP,637,RC,,,,both,1197.62,1077.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,838.33,,,,706.6,977.26
INTRACONAZOLE 10 MG/ML 120ML ORAL SUSP,637,RC,,,,both,1197.62,1077.86,Cigna,Default,Percent of Total Billed Charges,706.6,,,,706.6,977.26
INTRACONAZOLE 10 MG/ML 120ML ORAL SUSP,637,RC,,,,both,1197.62,1077.86,United Healthcare,Default,Fee Schedule,977.26,,,,706.6,977.26
METHOTREXATE INJ 50MG/2ML,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
METHOTREXATE INJ 50MG/2ML,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
METHOTREXATE INJ 50MG/2ML,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
PSEUDOEPHEDRINE 30MG TAB (SUDAFED),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
PSEUDOEPHEDRINE 30MG TAB (SUDAFED),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
PSEUDOEPHEDRINE 30MG TAB (SUDAFED),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
HYDROCORTISONE 25MG SUPPS (ANUSOL),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HYDROCORTISONE 25MG SUPPS (ANUSOL),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HYDROCORTISONE 25MG SUPPS (ANUSOL),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
PIPERACILLIN/TAZOBACTAM 3GM/.375GM INJ,J2543,HCPCS,636,RC,,both,73.65,66.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.56,,,,43.45,60.1
PIPERACILLIN/TAZOBACTAM 3GM/.375GM INJ,J2543,HCPCS,636,RC,,both,73.65,66.29,Cigna,Default,Percent of Total Billed Charges,43.45,,,,43.45,60.1
PIPERACILLIN/TAZOBACTAM 3GM/.375GM INJ,J2543,HCPCS,636,RC,,both,73.65,66.29,United Healthcare,Default,Fee Schedule,60.1,,,,43.45,60.1
NACL 0.9% 20ML INJ,250,RC,,,,both,9.44,8.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.61,,,,5.57,7.7
NACL 0.9% 20ML INJ,250,RC,,,,both,9.44,8.5,Cigna,Default,Percent of Total Billed Charges,5.57,,,,5.57,7.7
NACL 0.9% 20ML INJ,250,RC,,,,both,9.44,8.5,United Healthcare,Default,Fee Schedule,7.7,,,,5.57,7.7
ETHYL CHLOR AER,250,RC,,,,both,56.94,51.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.86,,,,33.59,46.46
ETHYL CHLOR AER,250,RC,,,,both,56.94,51.25,Cigna,Default,Percent of Total Billed Charges,33.59,,,,33.59,46.46
ETHYL CHLOR AER,250,RC,,,,both,56.94,51.25,United Healthcare,Default,Fee Schedule,46.46,,,,33.59,46.46
ESMOLOL 100MG/10ML INJ  (BREVIBLOC),250,RC,,,,both,86,77.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.2,,,,50.74,70.18
ESMOLOL 100MG/10ML INJ  (BREVIBLOC),250,RC,,,,both,86,77.4,Cigna,Default,Percent of Total Billed Charges,50.74,,,,50.74,70.18
ESMOLOL 100MG/10ML INJ  (BREVIBLOC),250,RC,,,,both,86,77.4,United Healthcare,Default,Fee Schedule,70.18,,,,50.74,70.18
MORPHINE 1MG/ML 2ML AMP (ASTRAMORPH),250,RC,,,,both,53.74,48.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.62,,,,31.71,43.85
MORPHINE 1MG/ML 2ML AMP (ASTRAMORPH),250,RC,,,,both,53.74,48.37,Cigna,Default,Percent of Total Billed Charges,31.71,,,,31.71,43.85
MORPHINE 1MG/ML 2ML AMP (ASTRAMORPH),250,RC,,,,both,53.74,48.37,United Healthcare,Default,Fee Schedule,43.85,,,,31.71,43.85
LEVOTHYROXINE  0.075MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
LEVOTHYROXINE  0.075MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
LEVOTHYROXINE  0.075MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MYCOLOG 30GR CRM (NYSTATIN/TRIAMCIN),250,RC,,,,both,164.09,147.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.86,,,,96.81,133.9
MYCOLOG 30GR CRM (NYSTATIN/TRIAMCIN),250,RC,,,,both,164.09,147.68,Cigna,Default,Percent of Total Billed Charges,96.81,,,,96.81,133.9
MYCOLOG 30GR CRM (NYSTATIN/TRIAMCIN),250,RC,,,,both,164.09,147.68,United Healthcare,Default,Fee Schedule,133.9,,,,96.81,133.9
GAVISCON SUSP,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
GAVISCON SUSP,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
GAVISCON SUSP,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
DEXTROSE 50% SYRINGE  25GM/50ML,250,RC,,,,both,94.42,84.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.09,,,,55.71,77.05
DEXTROSE 50% SYRINGE  25GM/50ML,250,RC,,,,both,94.42,84.98,Cigna,Default,Percent of Total Billed Charges,55.71,,,,55.71,77.05
DEXTROSE 50% SYRINGE  25GM/50ML,250,RC,,,,both,94.42,84.98,United Healthcare,Default,Fee Schedule,77.05,,,,55.71,77.05
XYLOCAINE HCL INJ 4%,250,RC,,,,both,41.25,37.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.88,,,,24.34,33.66
XYLOCAINE HCL INJ 4%,250,RC,,,,both,41.25,37.13,Cigna,Default,Percent of Total Billed Charges,24.34,,,,24.34,33.66
XYLOCAINE HCL INJ 4%,250,RC,,,,both,41.25,37.13,United Healthcare,Default,Fee Schedule,33.66,,,,24.34,33.66
ALBUMIN 25% 50ML (PLASBUMIN),250,RC,,,,both,981.46,883.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,687.02,,,,579.06,800.87
ALBUMIN 25% 50ML (PLASBUMIN),250,RC,,,,both,981.46,883.31,Cigna,Default,Percent of Total Billed Charges,579.06,,,,579.06,800.87
ALBUMIN 25% 50ML (PLASBUMIN),250,RC,,,,both,981.46,883.31,United Healthcare,Default,Fee Schedule,800.87,,,,579.06,800.87
CHARCOAL AQUA  ACTIDOSE 50GM,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
CHARCOAL AQUA  ACTIDOSE 50GM,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
CHARCOAL AQUA  ACTIDOSE 50GM,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
LEVOTHYROXINE  0.05MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
LEVOTHYROXINE  0.05MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
LEVOTHYROXINE  0.05MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ROCURONIUM 100MG/10ML INJ,250,RC,,,,both,175.49,157.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.84,,,,103.54,143.2
ROCURONIUM 100MG/10ML INJ,250,RC,,,,both,175.49,157.94,Cigna,Default,Percent of Total Billed Charges,103.54,,,,103.54,143.2
ROCURONIUM 100MG/10ML INJ,250,RC,,,,both,175.49,157.94,United Healthcare,Default,Fee Schedule,143.2,,,,103.54,143.2
ALFENTANIL INJ 500MCG/ML (ALFENTA),250,RC,,,,both,34.25,30.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.98,,,,20.21,27.95
ALFENTANIL INJ 500MCG/ML (ALFENTA),250,RC,,,,both,34.25,30.83,Cigna,Default,Percent of Total Billed Charges,20.21,,,,20.21,27.95
ALFENTANIL INJ 500MCG/ML (ALFENTA),250,RC,,,,both,34.25,30.83,United Healthcare,Default,Fee Schedule,27.95,,,,20.21,27.95
DAKINS FULL STR 1000ML,250,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
DAKINS FULL STR 1000ML,250,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
DAKINS FULL STR 1000ML,250,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
KETOCONAZOLE 2% 15GM CRM (NIZORAL),250,RC,,,,both,85.71,77.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60,,,,50.57,69.94
KETOCONAZOLE 2% 15GM CRM (NIZORAL),250,RC,,,,both,85.71,77.14,Cigna,Default,Percent of Total Billed Charges,50.57,,,,50.57,69.94
KETOCONAZOLE 2% 15GM CRM (NIZORAL),250,RC,,,,both,85.71,77.14,United Healthcare,Default,Fee Schedule,69.94,,,,50.57,69.94
SOLU MDRL INJ 250MG,J2919,HCPCS,636,RC,,both,122.23,110.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.56,,,,72.12,99.74
SOLU MDRL INJ 250MG,J2919,HCPCS,636,RC,,both,122.23,110.01,Cigna,Default,Percent of Total Billed Charges,72.12,,,,72.12,99.74
SOLU MDRL INJ 250MG,J2919,HCPCS,636,RC,,both,122.23,110.01,United Healthcare,Default,Fee Schedule,99.74,,,,72.12,99.74
LIDOCAINE/PRILOCAINE 2.5-2.5% CRM 5GM,250,RC,,,,both,42.64,38.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.85,,,,25.16,34.79
LIDOCAINE/PRILOCAINE 2.5-2.5% CRM 5GM,250,RC,,,,both,42.64,38.38,Cigna,Default,Percent of Total Billed Charges,25.16,,,,25.16,34.79
LIDOCAINE/PRILOCAINE 2.5-2.5% CRM 5GM,250,RC,,,,both,42.64,38.38,United Healthcare,Default,Fee Schedule,34.79,,,,25.16,34.79
GENTAMICIN OPTH SOL 0.3% 5ML (GENTAK),250,RC,,,,both,184.26,165.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.98,,,,108.71,150.36
GENTAMICIN OPTH SOL 0.3% 5ML (GENTAK),250,RC,,,,both,184.26,165.83,Cigna,Default,Percent of Total Billed Charges,108.71,,,,108.71,150.36
GENTAMICIN OPTH SOL 0.3% 5ML (GENTAK),250,RC,,,,both,184.26,165.83,United Healthcare,Default,Fee Schedule,150.36,,,,108.71,150.36
SODIUM BICARB 8.4 % INJ 50ML VIAL,250,RC,,,,both,60.48,54.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.34,,,,35.68,49.35
SODIUM BICARB 8.4 % INJ 50ML VIAL,250,RC,,,,both,60.48,54.43,Cigna,Default,Percent of Total Billed Charges,35.68,,,,35.68,49.35
SODIUM BICARB 8.4 % INJ 50ML VIAL,250,RC,,,,both,60.48,54.43,United Healthcare,Default,Fee Schedule,49.35,,,,35.68,49.35
BENZOCAINE SPRY  0.5ML (HURRICAINE),250,RC,,,,both,169.21,152.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.45,,,,99.83,138.08
BENZOCAINE SPRY  0.5ML (HURRICAINE),250,RC,,,,both,169.21,152.29,Cigna,Default,Percent of Total Billed Charges,99.83,,,,99.83,138.08
BENZOCAINE SPRY  0.5ML (HURRICAINE),250,RC,,,,both,169.21,152.29,United Healthcare,Default,Fee Schedule,138.08,,,,99.83,138.08
ALUMINUM SULF & CALC ACETATE 2%(DOMBERO),250,RC,,,,both,39.8,35.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.86,,,,23.48,32.48
ALUMINUM SULF & CALC ACETATE 2%(DOMBERO),250,RC,,,,both,39.8,35.82,Cigna,Default,Percent of Total Billed Charges,23.48,,,,23.48,32.48
ALUMINUM SULF & CALC ACETATE 2%(DOMBERO),250,RC,,,,both,39.8,35.82,United Healthcare,Default,Fee Schedule,32.48,,,,23.48,32.48
TRIMOX SUSP: 250/5ML 80ML,637,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
TRIMOX SUSP: 250/5ML 80ML,637,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
TRIMOX SUSP: 250/5ML 80ML,637,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
CECLOR SUSP 250/5ML,250,RC,,,,both,152.82,137.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.97,,,,90.16,124.7
CECLOR SUSP 250/5ML,250,RC,,,,both,152.82,137.54,Cigna,Default,Percent of Total Billed Charges,90.16,,,,90.16,124.7
CECLOR SUSP 250/5ML,250,RC,,,,both,152.82,137.54,United Healthcare,Default,Fee Schedule,124.7,,,,90.16,124.7
ALBUTEROL 2MG/5ML 5ML SYRUP,250,RC,,,,both,41.54,37.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.08,,,,24.51,33.9
ALBUTEROL 2MG/5ML 5ML SYRUP,250,RC,,,,both,41.54,37.39,Cigna,Default,Percent of Total Billed Charges,24.51,,,,24.51,33.9
ALBUTEROL 2MG/5ML 5ML SYRUP,250,RC,,,,both,41.54,37.39,United Healthcare,Default,Fee Schedule,33.9,,,,24.51,33.9
SSD CRM 1%,250,RC,,,,both,271.95,244.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,190.36,,,,160.45,221.91
SSD CRM 1%,250,RC,,,,both,271.95,244.76,Cigna,Default,Percent of Total Billed Charges,160.45,,,,160.45,221.91
SSD CRM 1%,250,RC,,,,both,271.95,244.76,United Healthcare,Default,Fee Schedule,221.91,,,,160.45,221.91
CORTISONE 25MG TAB (CORTONE),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
CORTISONE 25MG TAB (CORTONE),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
CORTISONE 25MG TAB (CORTONE),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
PROPRANOLOL 10MG TAB (INDERAL),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PROPRANOLOL 10MG TAB (INDERAL),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PROPRANOLOL 10MG TAB (INDERAL),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
VASOPRESSIN  20U/1ML INJ (PITRESSIN),250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
VASOPRESSIN  20U/1ML INJ (PITRESSIN),250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
VASOPRESSIN  20U/1ML INJ (PITRESSIN),250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
BUTALBITAL/ASA/CAFFEINE CAP (FIORINAL),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
BUTALBITAL/ASA/CAFFEINE CAP (FIORINAL),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
BUTALBITAL/ASA/CAFFEINE CAP (FIORINAL),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
BUPIVACAINE SPINAL 0.75% 2ML AMP (MARCAI,250,RC,,,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
BUPIVACAINE SPINAL 0.75% 2ML AMP (MARCAI,250,RC,,,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
BUPIVACAINE SPINAL 0.75% 2ML AMP (MARCAI,250,RC,,,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
LITHIUM CARBONATE CAP 300MG,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
LITHIUM CARBONATE CAP 300MG,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
LITHIUM CARBONATE CAP 300MG,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CALCIUM ACETATE 667MG CAP (PHOSLO),637,RC,,,,both,7.22,6.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.05,,,,4.26,5.89
CALCIUM ACETATE 667MG CAP (PHOSLO),637,RC,,,,both,7.22,6.5,Cigna,Default,Percent of Total Billed Charges,4.26,,,,4.26,5.89
CALCIUM ACETATE 667MG CAP (PHOSLO),637,RC,,,,both,7.22,6.5,United Healthcare,Default,Fee Schedule,5.89,,,,4.26,5.89
NACL 0.9% IV 50ML IV FLUID,250,RC,,,,both,23.22,20.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.25,,,,13.7,18.95
NACL 0.9% IV 50ML IV FLUID,250,RC,,,,both,23.22,20.9,Cigna,Default,Percent of Total Billed Charges,13.7,,,,13.7,18.95
NACL 0.9% IV 50ML IV FLUID,250,RC,,,,both,23.22,20.9,United Healthcare,Default,Fee Schedule,18.95,,,,13.7,18.95
NOVOCAIN INJ 10%,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
NOVOCAIN INJ 10%,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
NOVOCAIN INJ 10%,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
THIOPENTAL 500MG INJ (PENTOTHAL),250,RC,,,,both,84.07,75.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.85,,,,49.6,68.6
THIOPENTAL 500MG INJ (PENTOTHAL),250,RC,,,,both,84.07,75.66,Cigna,Default,Percent of Total Billed Charges,49.6,,,,49.6,68.6
THIOPENTAL 500MG INJ (PENTOTHAL),250,RC,,,,both,84.07,75.66,United Healthcare,Default,Fee Schedule,68.6,,,,49.6,68.6
LIDOCAINE/PRILOCAINE 2.5%/2.5% 5GM TUBE,250,RC,,,,both,42.71,38.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.9,,,,25.2,34.85
LIDOCAINE/PRILOCAINE 2.5%/2.5% 5GM TUBE,250,RC,,,,both,42.71,38.44,Cigna,Default,Percent of Total Billed Charges,25.2,,,,25.2,34.85
LIDOCAINE/PRILOCAINE 2.5%/2.5% 5GM TUBE,250,RC,,,,both,42.71,38.44,United Healthcare,Default,Fee Schedule,34.85,,,,25.2,34.85
ARTIFICIAL TEARS OPHTH SOLN,250,RC,,,,both,34.1,30.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.87,,,,20.12,27.83
ARTIFICIAL TEARS OPHTH SOLN,250,RC,,,,both,34.1,30.69,Cigna,Default,Percent of Total Billed Charges,20.12,,,,20.12,27.83
ARTIFICIAL TEARS OPHTH SOLN,250,RC,,,,both,34.1,30.69,United Healthcare,Default,Fee Schedule,27.83,,,,20.12,27.83
SODIUM BICARB 8.4% PEDIATRIC ABBOJECT,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
SODIUM BICARB 8.4% PEDIATRIC ABBOJECT,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
SODIUM BICARB 8.4% PEDIATRIC ABBOJECT,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
CEFAZOLIN SODIUM INJ 1GM,J0690,HCPCS,250,RC,,both,38.25,34.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.78,,,,22.57,31.21
CEFAZOLIN SODIUM INJ 1GM,J0690,HCPCS,250,RC,,both,38.25,34.43,Cigna,Default,Percent of Total Billed Charges,22.57,,,,22.57,31.21
CEFAZOLIN SODIUM INJ 1GM,J0690,HCPCS,250,RC,,both,38.25,34.43,United Healthcare,Default,Fee Schedule,31.21,,,,22.57,31.21
GARAMYCIN OINT 0.1% 15GM,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
GARAMYCIN OINT 0.1% 15GM,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
GARAMYCIN OINT 0.1% 15GM,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
SILVER NITRATE STICK,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
SILVER NITRATE STICK,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
SILVER NITRATE STICK,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
SMZ TMP 400-80/5 10ML INJ (BACTRIM),S0039,HCPCS,636,RC,,both,44.45,40.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.12,,,,26.23,36.27
SMZ TMP 400-80/5 10ML INJ (BACTRIM),S0039,HCPCS,636,RC,,both,44.45,40.01,Cigna,Default,Percent of Total Billed Charges,26.23,,,,26.23,36.27
SMZ TMP 400-80/5 10ML INJ (BACTRIM),S0039,HCPCS,636,RC,,both,44.45,40.01,United Healthcare,Default,Fee Schedule,36.27,,,,26.23,36.27
DURAGESIC SYSTEM 100MCG,250,RC,,,,both,162.12,145.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.48,,,,95.65,132.29
DURAGESIC SYSTEM 100MCG,250,RC,,,,both,162.12,145.91,Cigna,Default,Percent of Total Billed Charges,95.65,,,,95.65,132.29
DURAGESIC SYSTEM 100MCG,250,RC,,,,both,162.12,145.91,United Healthcare,Default,Fee Schedule,132.29,,,,95.65,132.29
SUCCINYLCHOLINE 20MG/ML 10ML INJ (ANECTI,250,RC,,,,both,163.71,147.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,114.6,,,,96.59,133.59
SUCCINYLCHOLINE 20MG/ML 10ML INJ (ANECTI,250,RC,,,,both,163.71,147.34,Cigna,Default,Percent of Total Billed Charges,96.59,,,,96.59,133.59
SUCCINYLCHOLINE 20MG/ML 10ML INJ (ANECTI,250,RC,,,,both,163.71,147.34,United Healthcare,Default,Fee Schedule,133.59,,,,96.59,133.59
FAMOTIDINE 20MG/2ML INJ,S0028,HCPCS,636,RC,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
FAMOTIDINE 20MG/2ML INJ,S0028,HCPCS,636,RC,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
FAMOTIDINE 20MG/2ML INJ,S0028,HCPCS,636,RC,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
DILTIAZEM INJ 25MG/5ML,250,RC,,,,both,62.46,56.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.72,,,,36.85,50.97
DILTIAZEM INJ 25MG/5ML,250,RC,,,,both,62.46,56.21,Cigna,Default,Percent of Total Billed Charges,36.85,,,,36.85,50.97
DILTIAZEM INJ 25MG/5ML,250,RC,,,,both,62.46,56.21,United Healthcare,Default,Fee Schedule,50.97,,,,36.85,50.97
SODIUM BICARB 8.4% ABBOJECT 50ML,250,RC,,,,both,81.79,73.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.25,,,,48.26,66.74
SODIUM BICARB 8.4% ABBOJECT 50ML,250,RC,,,,both,81.79,73.61,Cigna,Default,Percent of Total Billed Charges,48.26,,,,48.26,66.74
SODIUM BICARB 8.4% ABBOJECT 50ML,250,RC,,,,both,81.79,73.61,United Healthcare,Default,Fee Schedule,66.74,,,,48.26,66.74
PROLASTIN INJ 1000MG,J0256,HCPCS,636,RC,,both,767.61,690.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,537.33,,,,452.89,626.37
PROLASTIN INJ 1000MG,J0256,HCPCS,636,RC,,both,767.61,690.85,Cigna,Default,Percent of Total Billed Charges,452.89,,,,452.89,626.37
PROLASTIN INJ 1000MG,J0256,HCPCS,636,RC,,both,767.61,690.85,United Healthcare,Default,Fee Schedule,626.37,,,,452.89,626.37
NACL 0.9% 250ML ADV,250,RC,,,,both,42.31,38.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.62,,,,24.96,34.52
NACL 0.9% 250ML ADV,250,RC,,,,both,42.31,38.08,Cigna,Default,Percent of Total Billed Charges,24.96,,,,24.96,34.52
NACL 0.9% 250ML ADV,250,RC,,,,both,42.31,38.08,United Healthcare,Default,Fee Schedule,34.52,,,,24.96,34.52
D5W 5% 250ML IV FLUID,J7060,HCPCS,636,RC,,both,43.58,39.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.51,,,,25.71,35.56
D5W 5% 250ML IV FLUID,J7060,HCPCS,636,RC,,both,43.58,39.22,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.56
D5W 5% 250ML IV FLUID,J7060,HCPCS,636,RC,,both,43.58,39.22,United Healthcare,Default,Fee Schedule,35.56,,,,25.71,35.56
ALLOPURINOL 100MG TAB (ZYLOPRIM),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
ALLOPURINOL 100MG TAB (ZYLOPRIM),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
ALLOPURINOL 100MG TAB (ZYLOPRIM),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
BACIT/POLYM OPTH OINT (POLYSPORIN),250,RC,,,,both,101.11,91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.78,,,,59.65,82.51
BACIT/POLYM OPTH OINT (POLYSPORIN),250,RC,,,,both,101.11,91,Cigna,Default,Percent of Total Billed Charges,59.65,,,,59.65,82.51
BACIT/POLYM OPTH OINT (POLYSPORIN),250,RC,,,,both,101.11,91,United Healthcare,Default,Fee Schedule,82.51,,,,59.65,82.51
DOXEPIN HCL 75MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DOXEPIN HCL 75MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DOXEPIN HCL 75MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
VALPROIC ACID 250MG/5ML SYRUP (DEPAKENE),250,RC,,,,both,91.81,82.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.27,,,,54.17,74.92
VALPROIC ACID 250MG/5ML SYRUP (DEPAKENE),250,RC,,,,both,91.81,82.63,Cigna,Default,Percent of Total Billed Charges,54.17,,,,54.17,74.92
VALPROIC ACID 250MG/5ML SYRUP (DEPAKENE),250,RC,,,,both,91.81,82.63,United Healthcare,Default,Fee Schedule,74.92,,,,54.17,74.92
LEVOTHYROXINE  0.15MG TAB (SYNTHROID),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHYROXINE  0.15MG TAB (SYNTHROID),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHYROXINE  0.15MG TAB (SYNTHROID),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
NEOSTIGMINE 10MG/10ML INJ(PROSTIGMIN),250,RC,,,,both,545.29,490.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,381.7,,,,321.72,444.96
NEOSTIGMINE 10MG/10ML INJ(PROSTIGMIN),250,RC,,,,both,545.29,490.76,Cigna,Default,Percent of Total Billed Charges,321.72,,,,321.72,444.96
NEOSTIGMINE 10MG/10ML INJ(PROSTIGMIN),250,RC,,,,both,545.29,490.76,United Healthcare,Default,Fee Schedule,444.96,,,,321.72,444.96
SOTALOL 80MG TAB (BETAPACE),637,RC,,,,both,12.2,10.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.54,,,,7.2,9.96
SOTALOL 80MG TAB (BETAPACE),637,RC,,,,both,12.2,10.98,Cigna,Default,Percent of Total Billed Charges,7.2,,,,7.2,9.96
SOTALOL 80MG TAB (BETAPACE),637,RC,,,,both,12.2,10.98,United Healthcare,Default,Fee Schedule,9.96,,,,7.2,9.96
ETHACRYNIC ACID 50MG INJ (EDECRIN),250,RC,,,,both,81.75,73.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.22,,,,48.23,66.71
ETHACRYNIC ACID 50MG INJ (EDECRIN),250,RC,,,,both,81.75,73.58,Cigna,Default,Percent of Total Billed Charges,48.23,,,,48.23,66.71
ETHACRYNIC ACID 50MG INJ (EDECRIN),250,RC,,,,both,81.75,73.58,United Healthcare,Default,Fee Schedule,66.71,,,,48.23,66.71
CARB/LEVO CR 50/200MG TAB (SINEMET),637,RC,,,,both,9.29,8.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.5,,,,5.48,7.58
CARB/LEVO CR 50/200MG TAB (SINEMET),637,RC,,,,both,9.29,8.36,Cigna,Default,Percent of Total Billed Charges,5.48,,,,5.48,7.58
CARB/LEVO CR 50/200MG TAB (SINEMET),637,RC,,,,both,9.29,8.36,United Healthcare,Default,Fee Schedule,7.58,,,,5.48,7.58
CARB/LEVO CR 25/100MG TAB (SINEMET),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CARB/LEVO CR 25/100MG TAB (SINEMET),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CARB/LEVO CR 25/100MG TAB (SINEMET),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MAGNESIUM SU INJ 50%,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
MAGNESIUM SU INJ 50%,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
MAGNESIUM SU INJ 50%,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
CAPSAICIN 0.025% CRM,250,RC,,,,both,42.79,38.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.95,,,,25.25,34.92
CAPSAICIN 0.025% CRM,250,RC,,,,both,42.79,38.51,Cigna,Default,Percent of Total Billed Charges,25.25,,,,25.25,34.92
CAPSAICIN 0.025% CRM,250,RC,,,,both,42.79,38.51,United Healthcare,Default,Fee Schedule,34.92,,,,25.25,34.92
LIOTHYRONINE 25MCG TAB,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LIOTHYRONINE 25MCG TAB,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LIOTHYRONINE 25MCG TAB,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
INDIGO CARMINE 5ML INJ,250,RC,,,,both,972.25,875.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,680.58,,,,573.63,793.36
INDIGO CARMINE 5ML INJ,250,RC,,,,both,972.25,875.03,Cigna,Default,Percent of Total Billed Charges,573.63,,,,573.63,793.36
INDIGO CARMINE 5ML INJ,250,RC,,,,both,972.25,875.03,United Healthcare,Default,Fee Schedule,793.36,,,,573.63,793.36
CENTRUM LIQ,250,RC,,,,both,39.8,35.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.86,,,,23.48,32.48
CENTRUM LIQ,250,RC,,,,both,39.8,35.82,Cigna,Default,Percent of Total Billed Charges,23.48,,,,23.48,32.48
CENTRUM LIQ,250,RC,,,,both,39.8,35.82,United Healthcare,Default,Fee Schedule,32.48,,,,23.48,32.48
RACEMIC EPINEPHRINE INH SOLN 2.25% 0.5ML,250,RC,,,,both,56.94,51.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.86,,,,33.59,46.46
RACEMIC EPINEPHRINE INH SOLN 2.25% 0.5ML,250,RC,,,,both,56.94,51.25,Cigna,Default,Percent of Total Billed Charges,33.59,,,,33.59,46.46
RACEMIC EPINEPHRINE INH SOLN 2.25% 0.5ML,250,RC,,,,both,56.94,51.25,United Healthcare,Default,Fee Schedule,46.46,,,,33.59,46.46
PAROXETINE 20MG TAB (PAXIL),637,RC,,,,both,10.51,9.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.36,,,,6.2,8.58
PAROXETINE 20MG TAB (PAXIL),637,RC,,,,both,10.51,9.46,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.58
PAROXETINE 20MG TAB (PAXIL),637,RC,,,,both,10.51,9.46,United Healthcare,Default,Fee Schedule,8.58,,,,6.2,8.58
MINERAL OIL USP 160Z,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
MINERAL OIL USP 160Z,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
MINERAL OIL USP 160Z,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
NITROGLYCERIN 2%OINT 30GM TUBE (NITROB,637,RC,,,,both,110.68,99.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.48,,,,65.3,90.31
NITROGLYCERIN 2%OINT 30GM TUBE (NITROB,637,RC,,,,both,110.68,99.61,Cigna,Default,Percent of Total Billed Charges,65.3,,,,65.3,90.31
NITROGLYCERIN 2%OINT 30GM TUBE (NITROB,637,RC,,,,both,110.68,99.61,United Healthcare,Default,Fee Schedule,90.31,,,,65.3,90.31
POTASSIUM 20 MEQ/15ML ELIXER,250,RC,,,,both,97.11,87.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.98,,,,57.29,79.24
POTASSIUM 20 MEQ/15ML ELIXER,250,RC,,,,both,97.11,87.4,Cigna,Default,Percent of Total Billed Charges,57.29,,,,57.29,79.24
POTASSIUM 20 MEQ/15ML ELIXER,250,RC,,,,both,97.11,87.4,United Healthcare,Default,Fee Schedule,79.24,,,,57.29,79.24
ZOLPIDEM 5MG TAB (AMBIEN),637,RC,,,,both,8.29,7.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.8,,,,4.89,6.76
ZOLPIDEM 5MG TAB (AMBIEN),637,RC,,,,both,8.29,7.46,Cigna,Default,Percent of Total Billed Charges,4.89,,,,4.89,6.76
ZOLPIDEM 5MG TAB (AMBIEN),637,RC,,,,both,8.29,7.46,United Healthcare,Default,Fee Schedule,6.76,,,,4.89,6.76
SODIUM ACETATE 40MEQ/20ML INJ,250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
SODIUM ACETATE 40MEQ/20ML INJ,250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
SODIUM ACETATE 40MEQ/20ML INJ,250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ONDANSETRON 4MG/2ML INJ (ZOFRAN),J2405,HCPCS,636,RC,,both,31.66,28.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.16,,,,18.68,25.83
ONDANSETRON 4MG/2ML INJ (ZOFRAN),J2405,HCPCS,636,RC,,both,31.66,28.49,Cigna,Default,Percent of Total Billed Charges,18.68,,,,18.68,25.83
ONDANSETRON 4MG/2ML INJ (ZOFRAN),J2405,HCPCS,636,RC,,both,31.66,28.49,United Healthcare,Default,Fee Schedule,25.83,,,,18.68,25.83
STERILE WATER  20ML INJ,250,RC,,,,both,29.32,26.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.52,,,,17.3,23.93
STERILE WATER  20ML INJ,250,RC,,,,both,29.32,26.39,Cigna,Default,Percent of Total Billed Charges,17.3,,,,17.3,23.93
STERILE WATER  20ML INJ,250,RC,,,,both,29.32,26.39,United Healthcare,Default,Fee Schedule,23.93,,,,17.3,23.93
DILTIAZEM CD 120MG CAP (CARDIZEM),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
DILTIAZEM CD 120MG CAP (CARDIZEM),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
DILTIAZEM CD 120MG CAP (CARDIZEM),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PHYTONADIONE 10MG/ML INJ (VITAMIN K),J3430,HCPCS,636,RC,,both,279.46,251.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.62,,,,164.88,228.04
PHYTONADIONE 10MG/ML INJ (VITAMIN K),J3430,HCPCS,636,RC,,both,279.46,251.51,Cigna,Default,Percent of Total Billed Charges,164.88,,,,164.88,228.04
PHYTONADIONE 10MG/ML INJ (VITAMIN K),J3430,HCPCS,636,RC,,both,279.46,251.51,United Healthcare,Default,Fee Schedule,228.04,,,,164.88,228.04
BUMETANIDE 2.5MG/10ML INJ(BUMEX),250,RC,,,,both,20.33,18.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.23,,,,11.99,16.59
BUMETANIDE 2.5MG/10ML INJ(BUMEX),250,RC,,,,both,20.33,18.3,Cigna,Default,Percent of Total Billed Charges,11.99,,,,11.99,16.59
BUMETANIDE 2.5MG/10ML INJ(BUMEX),250,RC,,,,both,20.33,18.3,United Healthcare,Default,Fee Schedule,16.59,,,,11.99,16.59
METHYLPREDNISOLONE 2GM INJ (SOLU-MEDROL),J2919,HCPCS,636,RC,,both,247.23,222.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.06,,,,145.87,201.74
METHYLPREDNISOLONE 2GM INJ (SOLU-MEDROL),J2919,HCPCS,636,RC,,both,247.23,222.51,Cigna,Default,Percent of Total Billed Charges,145.87,,,,145.87,201.74
METHYLPREDNISOLONE 2GM INJ (SOLU-MEDROL),J2919,HCPCS,636,RC,,both,247.23,222.51,United Healthcare,Default,Fee Schedule,201.74,,,,145.87,201.74
METFORMIN 500MG TAB (GLUCOPHAGE),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
METFORMIN 500MG TAB (GLUCOPHAGE),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
METFORMIN 500MG TAB (GLUCOPHAGE),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
SMZ/TMP 200MG/40MG/5ML  SUSP (SEPTRA),250,RC,,,,both,52.5,47.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.75,,,,30.98,42.84
SMZ/TMP 200MG/40MG/5ML  SUSP (SEPTRA),250,RC,,,,both,52.5,47.25,Cigna,Default,Percent of Total Billed Charges,30.98,,,,30.98,42.84
SMZ/TMP 200MG/40MG/5ML  SUSP (SEPTRA),250,RC,,,,both,52.5,47.25,United Healthcare,Default,Fee Schedule,42.84,,,,30.98,42.84
IPRATROPIUM BROM HFA 18MCG INHALER(ATROV,J3535,HCPCS,636,RC,,both,339.64,305.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,237.75,,,,200.39,277.15
IPRATROPIUM BROM HFA 18MCG INHALER(ATROV,J3535,HCPCS,636,RC,,both,339.64,305.68,Cigna,Default,Percent of Total Billed Charges,200.39,,,,200.39,277.15
IPRATROPIUM BROM HFA 18MCG INHALER(ATROV,J3535,HCPCS,636,RC,,both,339.64,305.68,United Healthcare,Default,Fee Schedule,277.15,,,,200.39,277.15
IMIPRAMINE HCL 10MG TAB (TOFRANIL),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
IMIPRAMINE HCL 10MG TAB (TOFRANIL),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
IMIPRAMINE HCL 10MG TAB (TOFRANIL),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
"HEPARIN 5,000units/ML INJ",J1644,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
"HEPARIN 5,000units/ML INJ",J1644,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
"HEPARIN 5,000units/ML INJ",J1644,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
IPRATROPIUM BROM U/D NEB (ATROVENT),J7644,HCPCS,250,RC,,both,11.06,9.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.74,,,,6.53,9.02
IPRATROPIUM BROM U/D NEB (ATROVENT),J7644,HCPCS,250,RC,,both,11.06,9.95,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.02
IPRATROPIUM BROM U/D NEB (ATROVENT),J7644,HCPCS,250,RC,,both,11.06,9.95,United Healthcare,Default,Fee Schedule,9.02,,,,6.53,9.02
DILTIAZEM INJ 50MG/10ML,250,RC,,,,both,97.62,87.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.33,,,,57.6,79.66
DILTIAZEM INJ 50MG/10ML,250,RC,,,,both,97.62,87.86,Cigna,Default,Percent of Total Billed Charges,57.6,,,,57.6,79.66
DILTIAZEM INJ 50MG/10ML,250,RC,,,,both,97.62,87.86,United Healthcare,Default,Fee Schedule,79.66,,,,57.6,79.66
OXYMETAZOLINE 0.05% NASAL SPRAY(AFRIN),637,RC,,,,both,27.9,25.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.53,,,,16.46,22.77
OXYMETAZOLINE 0.05% NASAL SPRAY(AFRIN),637,RC,,,,both,27.9,25.11,Cigna,Default,Percent of Total Billed Charges,16.46,,,,16.46,22.77
OXYMETAZOLINE 0.05% NASAL SPRAY(AFRIN),637,RC,,,,both,27.9,25.11,United Healthcare,Default,Fee Schedule,22.77,,,,16.46,22.77
SIMETHICONE 40MG/0.6ML DROP (GAS-X),250,RC,,,,both,58.01,52.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.61,,,,34.23,47.34
SIMETHICONE 40MG/0.6ML DROP (GAS-X),250,RC,,,,both,58.01,52.21,Cigna,Default,Percent of Total Billed Charges,34.23,,,,34.23,47.34
SIMETHICONE 40MG/0.6ML DROP (GAS-X),250,RC,,,,both,58.01,52.21,United Healthcare,Default,Fee Schedule,47.34,,,,34.23,47.34
ALBUTEROL SULF NEB SOL 0.083% 3ML,J7613,HCPCS,250,RC,,both,11.09,9.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.76,,,,6.54,9.05
ALBUTEROL SULF NEB SOL 0.083% 3ML,J7613,HCPCS,250,RC,,both,11.09,9.98,Cigna,Default,Percent of Total Billed Charges,6.54,,,,6.54,9.05
ALBUTEROL SULF NEB SOL 0.083% 3ML,J7613,HCPCS,250,RC,,both,11.09,9.98,United Healthcare,Default,Fee Schedule,9.05,,,,6.54,9.05
CIPROFLOXACIN 400MG/200ML IVPB(CIPRO),J0744,HCPCS,636,RC,,both,122.32,110.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.62,,,,72.17,99.81
CIPROFLOXACIN 400MG/200ML IVPB(CIPRO),J0744,HCPCS,636,RC,,both,122.32,110.09,Cigna,Default,Percent of Total Billed Charges,72.17,,,,72.17,99.81
CIPROFLOXACIN 400MG/200ML IVPB(CIPRO),J0744,HCPCS,636,RC,,both,122.32,110.09,United Healthcare,Default,Fee Schedule,99.81,,,,72.17,99.81
ESTERIFIED ESTROGENS & METHYLTESTOSTERON,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
ESTERIFIED ESTROGENS & METHYLTESTOSTERON,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
ESTERIFIED ESTROGENS & METHYLTESTOSTERON,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CHLOROPROCAINE MPF 3% INJ (NESACAINE),250,RC,,,,both,107.45,96.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.22,,,,63.4,87.68
CHLOROPROCAINE MPF 3% INJ (NESACAINE),250,RC,,,,both,107.45,96.71,Cigna,Default,Percent of Total Billed Charges,63.4,,,,63.4,87.68
CHLOROPROCAINE MPF 3% INJ (NESACAINE),250,RC,,,,both,107.45,96.71,United Healthcare,Default,Fee Schedule,87.68,,,,63.4,87.68
NALOXONE HCL INJ 0.4MG/,258,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
NALOXONE HCL INJ 0.4MG/,258,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
NALOXONE HCL INJ 0.4MG/,258,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
VENLAFAXINE XR 37.5MG TAB (EFFEXOR),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
VENLAFAXINE XR 37.5MG TAB (EFFEXOR),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
VENLAFAXINE XR 37.5MG TAB (EFFEXOR),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
BACITRACIN OINT 30GM TUBE,250,RC,,,,both,20.33,18.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.23,,,,11.99,16.59
BACITRACIN OINT 30GM TUBE,250,RC,,,,both,20.33,18.3,Cigna,Default,Percent of Total Billed Charges,11.99,,,,11.99,16.59
BACITRACIN OINT 30GM TUBE,250,RC,,,,both,20.33,18.3,United Healthcare,Default,Fee Schedule,16.59,,,,11.99,16.59
PHENYLEPHRINE PED DROP (NEO-SYNEPHRINE),250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
PHENYLEPHRINE PED DROP (NEO-SYNEPHRINE),250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
PHENYLEPHRINE PED DROP (NEO-SYNEPHRINE),250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
ASPIRIN EC 81MG TAB,637,RC,,,,both,6.43,5.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.5,,,,3.79,5.25
ASPIRIN EC 81MG TAB,637,RC,,,,both,6.43,5.79,Cigna,Default,Percent of Total Billed Charges,3.79,,,,3.79,5.25
ASPIRIN EC 81MG TAB,637,RC,,,,both,6.43,5.79,United Healthcare,Default,Fee Schedule,5.25,,,,3.79,5.25
ULTRAM TAB 50MG,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ULTRAM TAB 50MG,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ULTRAM TAB 50MG,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DIPRIVAN INJ 10MG/ML,250,RC,,,,both,88.62,79.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.03,,,,52.29,72.31
DIPRIVAN INJ 10MG/ML,250,RC,,,,both,88.62,79.76,Cigna,Default,Percent of Total Billed Charges,52.29,,,,52.29,72.31
DIPRIVAN INJ 10MG/ML,250,RC,,,,both,88.62,79.76,United Healthcare,Default,Fee Schedule,72.31,,,,52.29,72.31
SODIUM POLYSTYRENE 15GM/60ML SUSP (KAYEX,250,RC,,,,both,80.18,72.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.13,,,,47.31,65.43
SODIUM POLYSTYRENE 15GM/60ML SUSP (KAYEX,250,RC,,,,both,80.18,72.16,Cigna,Default,Percent of Total Billed Charges,47.31,,,,47.31,65.43
SODIUM POLYSTYRENE 15GM/60ML SUSP (KAYEX,250,RC,,,,both,80.18,72.16,United Healthcare,Default,Fee Schedule,65.43,,,,47.31,65.43
SODIUM POLYSTYRENE 15GM/60ML (KAYEXALATE,250,RC,,,,both,130.61,117.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.43,,,,77.06,106.58
SODIUM POLYSTYRENE 15GM/60ML (KAYEXALATE,250,RC,,,,both,130.61,117.55,Cigna,Default,Percent of Total Billed Charges,77.06,,,,77.06,106.58
SODIUM POLYSTYRENE 15GM/60ML (KAYEXALATE,250,RC,,,,both,130.61,117.55,United Healthcare,Default,Fee Schedule,106.58,,,,77.06,106.58
TECHNETIUM Tc 99 EXAMETAZIME DOSE,A9569,HCPCS,343,RC,,both,448.89,404,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.22,,,,264.85,366.29
TECHNETIUM Tc 99 EXAMETAZIME DOSE,A9569,HCPCS,343,RC,,both,448.89,404,Cigna,Default,Percent of Total Billed Charges,264.85,,,,264.85,366.29
TECHNETIUM Tc 99 EXAMETAZIME DOSE,A9569,HCPCS,343,RC,,both,448.89,404,United Healthcare,Default,Fee Schedule,366.29,,,,264.85,366.29
HYDROXYCHLOROQUINE 200MG TAB (PLAQUENIL),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
HYDROXYCHLOROQUINE 200MG TAB (PLAQUENIL),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
HYDROXYCHLOROQUINE 200MG TAB (PLAQUENIL),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
THALLIUM TI 201 THALLOUS CHLORIDE,A9505,HCPCS,343,RC,,both,448.89,404,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.22,,,,264.85,366.29
THALLIUM TI 201 THALLOUS CHLORIDE,A9505,HCPCS,343,RC,,both,448.89,404,Cigna,Default,Percent of Total Billed Charges,264.85,,,,264.85,366.29
THALLIUM TI 201 THALLOUS CHLORIDE,A9505,HCPCS,343,RC,,both,448.89,404,United Healthcare,Default,Fee Schedule,366.29,,,,264.85,366.29
TERAZOSIN 2MG CAP (HYTRIN),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
TERAZOSIN 2MG CAP (HYTRIN),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
TERAZOSIN 2MG CAP (HYTRIN),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
CEFTRIAXONE 1000MG INJ (ROCEPHIN),J0696,HCPCS,636,RC,,both,213.6,192.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.52,,,,126.02,174.3
CEFTRIAXONE 1000MG INJ (ROCEPHIN),J0696,HCPCS,636,RC,,both,213.6,192.24,Cigna,Default,Percent of Total Billed Charges,126.02,,,,126.02,174.3
CEFTRIAXONE 1000MG INJ (ROCEPHIN),J0696,HCPCS,636,RC,,both,213.6,192.24,United Healthcare,Default,Fee Schedule,174.3,,,,126.02,174.3
NYSTATIN OINT 100MU/GM 30GM TUBE,637,RC,,,,both,114.38,102.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.07,,,,67.48,93.33
NYSTATIN OINT 100MU/GM 30GM TUBE,637,RC,,,,both,114.38,102.94,Cigna,Default,Percent of Total Billed Charges,67.48,,,,67.48,93.33
NYSTATIN OINT 100MU/GM 30GM TUBE,637,RC,,,,both,114.38,102.94,United Healthcare,Default,Fee Schedule,93.33,,,,67.48,93.33
TERAZOSIN 5MG CAP (HYTRIN),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
TERAZOSIN 5MG CAP (HYTRIN),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
TERAZOSIN 5MG CAP (HYTRIN),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
RISPERDONE 1MG TAB (RISPERDAL),637,RC,,,,both,12.44,11.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.71,,,,7.34,10.15
RISPERDONE 1MG TAB (RISPERDAL),637,RC,,,,both,12.44,11.2,Cigna,Default,Percent of Total Billed Charges,7.34,,,,7.34,10.15
RISPERDONE 1MG TAB (RISPERDAL),637,RC,,,,both,12.44,11.2,United Healthcare,Default,Fee Schedule,10.15,,,,7.34,10.15
HYDROCORTISONE 2.5% 30GM CRM (CORTIZONE),637,RC,,,,both,43.58,39.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.51,,,,25.71,35.56
HYDROCORTISONE 2.5% 30GM CRM (CORTIZONE),637,RC,,,,both,43.58,39.22,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.56
HYDROCORTISONE 2.5% 30GM CRM (CORTIZONE),637,RC,,,,both,43.58,39.22,United Healthcare,Default,Fee Schedule,35.56,,,,25.71,35.56
FLUPHENAZINE HCL TAB 5MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
FLUPHENAZINE HCL TAB 5MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
FLUPHENAZINE HCL TAB 5MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
FLUPHENAZINE HCL 1MG TAB (PROLIXIN),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
FLUPHENAZINE HCL 1MG TAB (PROLIXIN),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
FLUPHENAZINE HCL 1MG TAB (PROLIXIN),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
ALBUTEROL SOL 0.5%-  2.5MG/0.5ML,J7611,HCPCS,250,RC,,both,7.25,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ALBUTEROL SOL 0.5%-  2.5MG/0.5ML,J7611,HCPCS,250,RC,,both,7.25,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ALBUTEROL SOL 0.5%-  2.5MG/0.5ML,J7611,HCPCS,250,RC,,both,7.25,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ITRACONAZOLE 100MG CAP (SPORANOX),637,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
ITRACONAZOLE 100MG CAP (SPORANOX),637,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
ITRACONAZOLE 100MG CAP (SPORANOX),637,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
CONTIGEN SKIN TEST SYR,250,RC,,,,both,166.77,150.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.74,,,,98.39,136.08
CONTIGEN SKIN TEST SYR,250,RC,,,,both,166.77,150.09,Cigna,Default,Percent of Total Billed Charges,98.39,,,,98.39,136.08
CONTIGEN SKIN TEST SYR,250,RC,,,,both,166.77,150.09,United Healthcare,Default,Fee Schedule,136.08,,,,98.39,136.08
ALENDRONATE 10MG TAB (FOSAMAX),250,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
ALENDRONATE 10MG TAB (FOSAMAX),250,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
ALENDRONATE 10MG TAB (FOSAMAX),250,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
DOXORUBICIN 50MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,548.94,494.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,384.26,,,,323.87,447.94
DOXORUBICIN 50MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,548.94,494.05,Cigna,Default,Percent of Total Billed Charges,323.87,,,,323.87,447.94
DOXORUBICIN 50MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,548.94,494.05,United Healthcare,Default,Fee Schedule,447.94,,,,323.87,447.94
CONTIGEN IMPLANT SYR,278,RC,,,,both,1695.32,1525.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1186.72,,,,1000.24,1383.38
CONTIGEN IMPLANT SYR,278,RC,,,,both,1695.32,1525.79,Cigna,Default,Percent of Total Billed Charges,1000.24,,,,1000.24,1383.38
CONTIGEN IMPLANT SYR,278,RC,,,,both,1695.32,1525.79,United Healthcare,Default,Fee Schedule,1383.38,,,,1000.24,1383.38
AMMONIUM LACTATE LOT 12% (LAC-HYDRIN),250,RC,,,,both,68.85,61.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.2,,,,40.62,56.18
AMMONIUM LACTATE LOT 12% (LAC-HYDRIN),250,RC,,,,both,68.85,61.97,Cigna,Default,Percent of Total Billed Charges,40.62,,,,40.62,56.18
AMMONIUM LACTATE LOT 12% (LAC-HYDRIN),250,RC,,,,both,68.85,61.97,United Healthcare,Default,Fee Schedule,56.18,,,,40.62,56.18
CALCITONIN SALMON 200IU/ML 2ML INJ,J0630,HCPCS,636,RC,,both,177.54,159.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.28,,,,104.75,144.87
CALCITONIN SALMON 200IU/ML 2ML INJ,J0630,HCPCS,636,RC,,both,177.54,159.79,Cigna,Default,Percent of Total Billed Charges,104.75,,,,104.75,144.87
CALCITONIN SALMON 200IU/ML 2ML INJ,J0630,HCPCS,636,RC,,both,177.54,159.79,United Healthcare,Default,Fee Schedule,144.87,,,,104.75,144.87
CEFTAZIDIME 1000MG INJ (FORTAZ),J0713,HCPCS,636,RC,,both,59.56,53.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.69,,,,35.14,48.6
CEFTAZIDIME 1000MG INJ (FORTAZ),J0713,HCPCS,636,RC,,both,59.56,53.6,Cigna,Default,Percent of Total Billed Charges,35.14,,,,35.14,48.6
CEFTAZIDIME 1000MG INJ (FORTAZ),J0713,HCPCS,636,RC,,both,59.56,53.6,United Healthcare,Default,Fee Schedule,48.6,,,,35.14,48.6
RANITIDINE 150MG TAB (ZANTAC),637,RC,,,,both,8.72,7.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.1,,,,5.14,7.12
RANITIDINE 150MG TAB (ZANTAC),637,RC,,,,both,8.72,7.85,Cigna,Default,Percent of Total Billed Charges,5.14,,,,5.14,7.12
RANITIDINE 150MG TAB (ZANTAC),637,RC,,,,both,8.72,7.85,United Healthcare,Default,Fee Schedule,7.12,,,,5.14,7.12
GABAPENTIN 100MG CAP (NEURONTIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
GABAPENTIN 100MG CAP (NEURONTIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
GABAPENTIN 100MG CAP (NEURONTIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CYCLOSPORINE 25MG CAP (SANDIMMUNE),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
CYCLOSPORINE 25MG CAP (SANDIMMUNE),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
CYCLOSPORINE 25MG CAP (SANDIMMUNE),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
FLUOXETINE 10MG CAP,250,RC,,,,both,11.62,10.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.13,,,,6.86,9.48
FLUOXETINE 10MG CAP,250,RC,,,,both,11.62,10.46,Cigna,Default,Percent of Total Billed Charges,6.86,,,,6.86,9.48
FLUOXETINE 10MG CAP,250,RC,,,,both,11.62,10.46,United Healthcare,Default,Fee Schedule,9.48,,,,6.86,9.48
FAMCICLOVIR 250MG TAB (FAMVIR),250,RC,,,,both,16.32,14.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.42,,,,9.63,13.32
FAMCICLOVIR 250MG TAB (FAMVIR),250,RC,,,,both,16.32,14.69,Cigna,Default,Percent of Total Billed Charges,9.63,,,,9.63,13.32
FAMCICLOVIR 250MG TAB (FAMVIR),250,RC,,,,both,16.32,14.69,United Healthcare,Default,Fee Schedule,13.32,,,,9.63,13.32
SUMATRIPTAN 50MG TAB (IMITREX),250,RC,,,,both,74.96,67.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.47,,,,44.23,61.17
SUMATRIPTAN 50MG TAB (IMITREX),250,RC,,,,both,74.96,67.46,Cigna,Default,Percent of Total Billed Charges,44.23,,,,44.23,61.17
SUMATRIPTAN 50MG TAB (IMITREX),250,RC,,,,both,74.96,67.46,United Healthcare,Default,Fee Schedule,61.17,,,,44.23,61.17
ISOSORBIDE MONONITRATE ER 60MG TAB(IMDUR,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ISOSORBIDE MONONITRATE ER 60MG TAB(IMDUR,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ISOSORBIDE MONONITRATE ER 60MG TAB(IMDUR,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CISTRACURIUM 2MG/ML INJ (NIMBEX),250,RC,,,,both,87.44,78.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.21,,,,51.59,71.35
CISTRACURIUM 2MG/ML INJ (NIMBEX),250,RC,,,,both,87.44,78.7,Cigna,Default,Percent of Total Billed Charges,51.59,,,,51.59,71.35
CISTRACURIUM 2MG/ML INJ (NIMBEX),250,RC,,,,both,87.44,78.7,United Healthcare,Default,Fee Schedule,71.35,,,,51.59,71.35
METHACHOLINE 100MG PWD (PROVOCHOLINE),250,RC,,,,both,269.35,242.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,188.54,,,,158.92,219.79
METHACHOLINE 100MG PWD (PROVOCHOLINE),250,RC,,,,both,269.35,242.42,Cigna,Default,Percent of Total Billed Charges,158.92,,,,158.92,219.79
METHACHOLINE 100MG PWD (PROVOCHOLINE),250,RC,,,,both,269.35,242.42,United Healthcare,Default,Fee Schedule,219.79,,,,158.92,219.79
ANASTRAZOLE 1MG TAB (ARIMIDEX),637,RC,,,,both,31.81,28.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.27,,,,18.77,25.96
ANASTRAZOLE 1MG TAB (ARIMIDEX),637,RC,,,,both,31.81,28.63,Cigna,Default,Percent of Total Billed Charges,18.77,,,,18.77,25.96
ANASTRAZOLE 1MG TAB (ARIMIDEX),637,RC,,,,both,31.81,28.63,United Healthcare,Default,Fee Schedule,25.96,,,,18.77,25.96
GLIPIZIDE XL 5MG TAB (GLUCOTROL XL),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
GLIPIZIDE XL 5MG TAB (GLUCOTROL XL),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
GLIPIZIDE XL 5MG TAB (GLUCOTROL XL),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CHROMAGEN FORTE CAP,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHROMAGEN FORTE CAP,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHROMAGEN FORTE CAP,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DEMEROL CARPUJECT 100MG,J2175,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
DEMEROL CARPUJECT 100MG,J2175,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
DEMEROL CARPUJECT 100MG,J2175,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
FLUTICASONE HFA 220MCG MDI (FLOVENT),J3535,HCPCS,636,RC,,both,2171.31,1954.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1519.92,,,,1281.07,1771.79
FLUTICASONE HFA 220MCG MDI (FLOVENT),J3535,HCPCS,636,RC,,both,2171.31,1954.18,Cigna,Default,Percent of Total Billed Charges,1281.07,,,,1281.07,1771.79
FLUTICASONE HFA 220MCG MDI (FLOVENT),J3535,HCPCS,636,RC,,both,2171.31,1954.18,United Healthcare,Default,Fee Schedule,1771.79,,,,1281.07,1771.79
FLUTICASONE HFA 110MCG MDI (FLOVENT),250,RC,,,,both,1397.91,1258.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,978.54,,,,824.77,1140.69
FLUTICASONE HFA 110MCG MDI (FLOVENT),250,RC,,,,both,1397.91,1258.12,Cigna,Default,Percent of Total Billed Charges,824.77,,,,824.77,1140.69
FLUTICASONE HFA 110MCG MDI (FLOVENT),250,RC,,,,both,1397.91,1258.12,United Healthcare,Default,Fee Schedule,1140.69,,,,824.77,1140.69
LORAZEPAM 2MG/1ML INJ (ATIVAN),J2060,HCPCS,636,RC,,both,51.13,46.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.79,,,,30.17,41.72
LORAZEPAM 2MG/1ML INJ (ATIVAN),J2060,HCPCS,636,RC,,both,51.13,46.02,Cigna,Default,Percent of Total Billed Charges,30.17,,,,30.17,41.72
LORAZEPAM 2MG/1ML INJ (ATIVAN),J2060,HCPCS,636,RC,,both,51.13,46.02,United Healthcare,Default,Fee Schedule,41.72,,,,30.17,41.72
IONAMIN CAP 15MG,250,RC,,,,both,1.25,1.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.88,,,,0.74,1.02
IONAMIN CAP 15MG,250,RC,,,,both,1.25,1.13,Cigna,Default,Percent of Total Billed Charges,0.74,,,,0.74,1.02
IONAMIN CAP 15MG,250,RC,,,,both,1.25,1.13,United Healthcare,Default,Fee Schedule,1.02,,,,0.74,1.02
FLUTICASONE HFA 44MCG MDI (FLOVENT),250,RC,,,,both,196.25,176.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.38,,,,115.79,160.14
FLUTICASONE HFA 44MCG MDI (FLOVENT),250,RC,,,,both,196.25,176.63,Cigna,Default,Percent of Total Billed Charges,115.79,,,,115.79,160.14
FLUTICASONE HFA 44MCG MDI (FLOVENT),250,RC,,,,both,196.25,176.63,United Healthcare,Default,Fee Schedule,160.14,,,,115.79,160.14
BUPIVACAINE 0.75% 30ML INJ (MARCAINE),J0665,HCPCS,636,RC,,both,44.45,40.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.12,,,,26.23,36.27
BUPIVACAINE 0.75% 30ML INJ (MARCAINE),J0665,HCPCS,636,RC,,both,44.45,40.01,Cigna,Default,Percent of Total Billed Charges,26.23,,,,26.23,36.27
BUPIVACAINE 0.75% 30ML INJ (MARCAINE),J0665,HCPCS,636,RC,,both,44.45,40.01,United Healthcare,Default,Fee Schedule,36.27,,,,26.23,36.27
CETIRIZINE 10MG TAB (ZYRTEC),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
CETIRIZINE 10MG TAB (ZYRTEC),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
CETIRIZINE 10MG TAB (ZYRTEC),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
"BACITRACIN INJ 50,000 UNITS",250,RC,,,,both,61.88,55.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.32,,,,36.51,50.49
"BACITRACIN INJ 50,000 UNITS",250,RC,,,,both,61.88,55.69,Cigna,Default,Percent of Total Billed Charges,36.51,,,,36.51,50.49
"BACITRACIN INJ 50,000 UNITS",250,RC,,,,both,61.88,55.69,United Healthcare,Default,Fee Schedule,50.49,,,,36.51,50.49
DNAZOL100MG CAP (DANOCRINE),250,RC,,,,both,9.25,8.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.48,,,,5.46,7.55
DNAZOL100MG CAP (DANOCRINE),250,RC,,,,both,9.25,8.33,Cigna,Default,Percent of Total Billed Charges,5.46,,,,5.46,7.55
DNAZOL100MG CAP (DANOCRINE),250,RC,,,,both,9.25,8.33,United Healthcare,Default,Fee Schedule,7.55,,,,5.46,7.55
MORPHINE SULFATE CR 15MG TAB (MS CONTIN),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
MORPHINE SULFATE CR 15MG TAB (MS CONTIN),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
MORPHINE SULFATE CR 15MG TAB (MS CONTIN),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
AMINOACID 8% INJ (HEPATAMINE),250,RC,,,,both,545.93,491.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,382.15,,,,322.1,445.48
AMINOACID 8% INJ (HEPATAMINE),250,RC,,,,both,545.93,491.34,Cigna,Default,Percent of Total Billed Charges,322.1,,,,322.1,445.48
AMINOACID 8% INJ (HEPATAMINE),250,RC,,,,both,545.93,491.34,United Healthcare,Default,Fee Schedule,445.48,,,,322.1,445.48
BOTOX INJ 200 UNITS,J0585,HCPCS,636,RC,,both,1983.64,1785.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1388.55,,,,1170.35,1618.65
BOTOX INJ 200 UNITS,J0585,HCPCS,636,RC,,both,1983.64,1785.28,Cigna,Default,Percent of Total Billed Charges,1170.35,,,,1170.35,1618.65
BOTOX INJ 200 UNITS,J0585,HCPCS,636,RC,,both,1983.64,1785.28,United Healthcare,Default,Fee Schedule,1618.65,,,,1170.35,1618.65
INSULIN LISPRO 100U/ML 3ML VIAL INJ (HUM,J1815,HCPCS,636,RC,,both,221.24,199.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,154.87,,,,130.53,180.53
INSULIN LISPRO 100U/ML 3ML VIAL INJ (HUM,J1815,HCPCS,636,RC,,both,221.24,199.12,Cigna,Default,Percent of Total Billed Charges,130.53,,,,130.53,180.53
INSULIN LISPRO 100U/ML 3ML VIAL INJ (HUM,J1815,HCPCS,636,RC,,both,221.24,199.12,United Healthcare,Default,Fee Schedule,180.53,,,,130.53,180.53
METHYLPREDNISOLONE 4MG TAB (MEDROL),J7509,HCPCS,636,RC,,both,148.95,134.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.26,,,,87.88,121.54
METHYLPREDNISOLONE 4MG TAB (MEDROL),J7509,HCPCS,636,RC,,both,148.95,134.06,Cigna,Default,Percent of Total Billed Charges,87.88,,,,87.88,121.54
METHYLPREDNISOLONE 4MG TAB (MEDROL),J7509,HCPCS,636,RC,,both,148.95,134.06,United Healthcare,Default,Fee Schedule,121.54,,,,87.88,121.54
AMOXICILLIN/CLAVULANATE 875/125MG TAB,637,RC,,,,both,22.95,20.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.06,,,,13.54,18.73
AMOXICILLIN/CLAVULANATE 875/125MG TAB,637,RC,,,,both,22.95,20.66,Cigna,Default,Percent of Total Billed Charges,13.54,,,,13.54,18.73
AMOXICILLIN/CLAVULANATE 875/125MG TAB,637,RC,,,,both,22.95,20.66,United Healthcare,Default,Fee Schedule,18.73,,,,13.54,18.73
PHENOBARBITAL 40MG/10ML U/D ELIXIR,250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
PHENOBARBITAL 40MG/10ML U/D ELIXIR,250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
PHENOBARBITAL 40MG/10ML U/D ELIXIR,250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
CONGO RED AMPULE,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
CONGO RED AMPULE,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
CONGO RED AMPULE,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
DIPYRIDAMOLE 50MG/10ML SDV (PERSANTINE),J1245,HCPCS,636,RC,,both,54.34,48.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.04,,,,32.06,44.34
DIPYRIDAMOLE 50MG/10ML SDV (PERSANTINE),J1245,HCPCS,636,RC,,both,54.34,48.91,Cigna,Default,Percent of Total Billed Charges,32.06,,,,32.06,44.34
DIPYRIDAMOLE 50MG/10ML SDV (PERSANTINE),J1245,HCPCS,636,RC,,both,54.34,48.91,United Healthcare,Default,Fee Schedule,44.34,,,,32.06,44.34
LATANOPROST EYE DROP 0.005% 2.5ML (XALAT,637,RC,,,,both,178.97,161.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.28,,,,105.59,146.04
LATANOPROST EYE DROP 0.005% 2.5ML (XALAT,637,RC,,,,both,178.97,161.07,Cigna,Default,Percent of Total Billed Charges,105.59,,,,105.59,146.04
LATANOPROST EYE DROP 0.005% 2.5ML (XALAT,637,RC,,,,both,178.97,161.07,United Healthcare,Default,Fee Schedule,146.04,,,,105.59,146.04
LORATIDINE/PSEUDOEPHEDRINE 10MG/240MG TA,637,RC,,,,both,13.65,12.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.56,,,,8.05,11.14
LORATIDINE/PSEUDOEPHEDRINE 10MG/240MG TA,637,RC,,,,both,13.65,12.29,Cigna,Default,Percent of Total Billed Charges,8.05,,,,8.05,11.14
LORATIDINE/PSEUDOEPHEDRINE 10MG/240MG TA,637,RC,,,,both,13.65,12.29,United Healthcare,Default,Fee Schedule,11.14,,,,8.05,11.14
REMIFENTANIL 2MG INJ (ULTIVA),250,RC,,,,both,103.42,93.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,72.39,,,,61.02,84.39
REMIFENTANIL 2MG INJ (ULTIVA),250,RC,,,,both,103.42,93.08,Cigna,Default,Percent of Total Billed Charges,61.02,,,,61.02,84.39
REMIFENTANIL 2MG INJ (ULTIVA),250,RC,,,,both,103.42,93.08,United Healthcare,Default,Fee Schedule,84.39,,,,61.02,84.39
REMIFENTANIL 1MG/3ML INJ (ULTIVA),250,RC,,,,both,256.43,230.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,179.5,,,,151.29,209.25
REMIFENTANIL 1MG/3ML INJ (ULTIVA),250,RC,,,,both,256.43,230.79,Cigna,Default,Percent of Total Billed Charges,151.29,,,,151.29,209.25
REMIFENTANIL 1MG/3ML INJ (ULTIVA),250,RC,,,,both,256.43,230.79,United Healthcare,Default,Fee Schedule,209.25,,,,151.29,209.25
MELATONIN 3MG TAB,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
MELATONIN 3MG TAB,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
MELATONIN 3MG TAB,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
CAFF/NA BENZ INJ 500MG,250,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
CAFF/NA BENZ INJ 500MG,250,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
CAFF/NA BENZ INJ 500MG,250,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
VITAMIN E 400U CAP,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
VITAMIN E 400U CAP,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
VITAMIN E 400U CAP,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
ACARBOSE 25MG TAB (PRECOSE),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ACARBOSE 25MG TAB (PRECOSE),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ACARBOSE 25MG TAB (PRECOSE),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
HYDROCORTISONE CRM (ANUSOL-HC),250,RC,,,,both,140.61,126.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.43,,,,82.96,114.74
HYDROCORTISONE CRM (ANUSOL-HC),250,RC,,,,both,140.61,126.55,Cigna,Default,Percent of Total Billed Charges,82.96,,,,82.96,114.74
HYDROCORTISONE CRM (ANUSOL-HC),250,RC,,,,both,140.61,126.55,United Healthcare,Default,Fee Schedule,114.74,,,,82.96,114.74
BRIMONIDINE OPHTH SOL (ALPHAGAN),250,RC,,,,both,119.42,107.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.59,,,,70.46,97.45
BRIMONIDINE OPHTH SOL (ALPHAGAN),250,RC,,,,both,119.42,107.48,Cigna,Default,Percent of Total Billed Charges,70.46,,,,70.46,97.45
BRIMONIDINE OPHTH SOL (ALPHAGAN),250,RC,,,,both,119.42,107.48,United Healthcare,Default,Fee Schedule,97.45,,,,70.46,97.45
DALTEPARIN 2500U/0.2ML INJ,J1645,HCPCS,636,RC,,both,72.64,65.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.85,,,,42.86,59.27
DALTEPARIN 2500U/0.2ML INJ,J1645,HCPCS,636,RC,,both,72.64,65.38,Cigna,Default,Percent of Total Billed Charges,42.86,,,,42.86,59.27
DALTEPARIN 2500U/0.2ML INJ,J1645,HCPCS,636,RC,,both,72.64,65.38,United Healthcare,Default,Fee Schedule,59.27,,,,42.86,59.27
SSD CRE 1% 400 GRAM,250,RC,,,,both,135.96,122.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.17,,,,80.22,110.94
SSD CRE 1% 400 GRAM,250,RC,,,,both,135.96,122.36,Cigna,Default,Percent of Total Billed Charges,80.22,,,,80.22,110.94
SSD CRE 1% 400 GRAM,250,RC,,,,both,135.96,122.36,United Healthcare,Default,Fee Schedule,110.94,,,,80.22,110.94
DALTEPARIN 5000U/0.2ML INJ,J1645,HCPCS,636,RC,,both,197.74,177.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,138.42,,,,116.67,161.36
DALTEPARIN 5000U/0.2ML INJ,J1645,HCPCS,636,RC,,both,197.74,177.97,Cigna,Default,Percent of Total Billed Charges,116.67,,,,116.67,161.36
DALTEPARIN 5000U/0.2ML INJ,J1645,HCPCS,636,RC,,both,197.74,177.97,United Healthcare,Default,Fee Schedule,161.36,,,,116.67,161.36
AZITHROMYCIN 200MG/5ML 15ML SUSP,Q0144,HCPCS,636,RC,,both,149.98,134.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.99,,,,88.49,122.38
AZITHROMYCIN 200MG/5ML 15ML SUSP,Q0144,HCPCS,636,RC,,both,149.98,134.98,Cigna,Default,Percent of Total Billed Charges,88.49,,,,88.49,122.38
AZITHROMYCIN 200MG/5ML 15ML SUSP,Q0144,HCPCS,636,RC,,both,149.98,134.98,United Healthcare,Default,Fee Schedule,122.38,,,,88.49,122.38
ATROPINE SULF 0.4MG/ML INJ,J0461,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
ATROPINE SULF 0.4MG/ML INJ,J0461,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
ATROPINE SULF 0.4MG/ML INJ,J0461,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
MULTI VITAMIN TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
MULTI VITAMIN TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
MULTI VITAMIN TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
SUMATRIPTAN 6MG/0.5ML INJ (IMITREX),J3030,HCPCS,636,RC,,both,376.1,338.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.27,,,,221.9,306.9
SUMATRIPTAN 6MG/0.5ML INJ (IMITREX),J3030,HCPCS,636,RC,,both,376.1,338.49,Cigna,Default,Percent of Total Billed Charges,221.9,,,,221.9,306.9
SUMATRIPTAN 6MG/0.5ML INJ (IMITREX),J3030,HCPCS,636,RC,,both,376.1,338.49,United Healthcare,Default,Fee Schedule,306.9,,,,221.9,306.9
SYNTHROID TAB 175MCG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
SYNTHROID TAB 175MCG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
SYNTHROID TAB 175MCG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
ADENOSINE 6MG/2ML INJ (ADENOCARD),J0153,HCPCS,636,RC,,both,54.34,48.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.04,,,,32.06,44.34
ADENOSINE 6MG/2ML INJ (ADENOCARD),J0153,HCPCS,636,RC,,both,54.34,48.91,Cigna,Default,Percent of Total Billed Charges,32.06,,,,32.06,44.34
ADENOSINE 6MG/2ML INJ (ADENOCARD),J0153,HCPCS,636,RC,,both,54.34,48.91,United Healthcare,Default,Fee Schedule,44.34,,,,32.06,44.34
WARFARIN 3MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
WARFARIN 3MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
WARFARIN 3MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
IBUTILIDE INJ 1MG/10ML INJ (CORVERT),J1742,HCPCS,636,RC,,both,934.1,840.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,653.87,,,,551.12,762.23
IBUTILIDE INJ 1MG/10ML INJ (CORVERT),J1742,HCPCS,636,RC,,both,934.1,840.69,Cigna,Default,Percent of Total Billed Charges,551.12,,,,551.12,762.23
IBUTILIDE INJ 1MG/10ML INJ (CORVERT),J1742,HCPCS,636,RC,,both,934.1,840.69,United Healthcare,Default,Fee Schedule,762.23,,,,551.12,762.23
METFORMIN 850MG TAB (GLUCOPHAGE),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
METFORMIN 850MG TAB (GLUCOPHAGE),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
METFORMIN 850MG TAB (GLUCOPHAGE),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
LEVOFLOXACIN 500MG TAB (LEVAQUIN),637,RC,,,,both,46.78,42.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.75,,,,27.6,38.17
LEVOFLOXACIN 500MG TAB (LEVAQUIN),637,RC,,,,both,46.78,42.1,Cigna,Default,Percent of Total Billed Charges,27.6,,,,27.6,38.17
LEVOFLOXACIN 500MG TAB (LEVAQUIN),637,RC,,,,both,46.78,42.1,United Healthcare,Default,Fee Schedule,38.17,,,,27.6,38.17
FLUCONAZOLE 50MG/5ML SUSP (DIFLUCAN),250,RC,,,,both,152.82,137.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.97,,,,90.16,124.7
FLUCONAZOLE 50MG/5ML SUSP (DIFLUCAN),250,RC,,,,both,152.82,137.54,Cigna,Default,Percent of Total Billed Charges,90.16,,,,90.16,124.7
FLUCONAZOLE 50MG/5ML SUSP (DIFLUCAN),250,RC,,,,both,152.82,137.54,United Healthcare,Default,Fee Schedule,124.7,,,,90.16,124.7
FLUCONAZOLE 200MG/5ML SUSP (DIFLUCAN),250,RC,,,,both,553.19,497.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,387.23,,,,326.38,451.4
FLUCONAZOLE 200MG/5ML SUSP (DIFLUCAN),250,RC,,,,both,553.19,497.87,Cigna,Default,Percent of Total Billed Charges,326.38,,,,326.38,451.4
FLUCONAZOLE 200MG/5ML SUSP (DIFLUCAN),250,RC,,,,both,553.19,497.87,United Healthcare,Default,Fee Schedule,451.4,,,,326.38,451.4
SULFACETAMIDE 10% OPHTH SOLN (BLEPH-10),250,RC,,,,both,262.3,236.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.61,,,,154.76,214.04
SULFACETAMIDE 10% OPHTH SOLN (BLEPH-10),250,RC,,,,both,262.3,236.07,Cigna,Default,Percent of Total Billed Charges,154.76,,,,154.76,214.04
SULFACETAMIDE 10% OPHTH SOLN (BLEPH-10),250,RC,,,,both,262.3,236.07,United Healthcare,Default,Fee Schedule,214.04,,,,154.76,214.04
NALOXONE HCL 0.4MG/ML INJ (NARCAN),J2310,HCPCS,636,RC,,both,88.32,79.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.82,,,,52.11,72.07
NALOXONE HCL 0.4MG/ML INJ (NARCAN),J2310,HCPCS,636,RC,,both,88.32,79.49,Cigna,Default,Percent of Total Billed Charges,52.11,,,,52.11,72.07
NALOXONE HCL 0.4MG/ML INJ (NARCAN),J2310,HCPCS,636,RC,,both,88.32,79.49,United Healthcare,Default,Fee Schedule,72.07,,,,52.11,72.07
"PANCRELIPASE 12,000 UNIT CAP",637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
"PANCRELIPASE 12,000 UNIT CAP",637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
"PANCRELIPASE 12,000 UNIT CAP",637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CLONAZEPAM TAB 1MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
CLONAZEPAM TAB 1MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
CLONAZEPAM TAB 1MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
DISOPYRAMIDE PHOS CAP 150MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
DISOPYRAMIDE PHOS CAP 150MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
DISOPYRAMIDE PHOS CAP 150MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
DIBUCAINE 1% OINT (NUPERCAINAL),250,RC,,,,both,26.45,23.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.52,,,,15.61,21.58
DIBUCAINE 1% OINT (NUPERCAINAL),250,RC,,,,both,26.45,23.81,Cigna,Default,Percent of Total Billed Charges,15.61,,,,15.61,21.58
DIBUCAINE 1% OINT (NUPERCAINAL),250,RC,,,,both,26.45,23.81,United Healthcare,Default,Fee Schedule,21.58,,,,15.61,21.58
ORPHENADRINE 100MG TAB (NORFLEX),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
ORPHENADRINE 100MG TAB (NORFLEX),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
ORPHENADRINE 100MG TAB (NORFLEX),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
QUINIDEX EXTENTAB 300MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
QUINIDEX EXTENTAB 300MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
QUINIDEX EXTENTAB 300MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
PROPRANOLOL LA 60MG CAP (INDERAL LA),637,RC,,,,both,9.11,8.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.38,,,,5.37,7.43
PROPRANOLOL LA 60MG CAP (INDERAL LA),637,RC,,,,both,9.11,8.2,Cigna,Default,Percent of Total Billed Charges,5.37,,,,5.37,7.43
PROPRANOLOL LA 60MG CAP (INDERAL LA),637,RC,,,,both,9.11,8.2,United Healthcare,Default,Fee Schedule,7.43,,,,5.37,7.43
POTASSIUM CAP 10MEQ,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
POTASSIUM CAP 10MEQ,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
POTASSIUM CAP 10MEQ,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
VALSARTAN 80MG TAB (DIOVAN),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
VALSARTAN 80MG TAB (DIOVAN),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
VALSARTAN 80MG TAB (DIOVAN),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
BUPROPION SR 150MG TAB (WELLBUTRIN SR),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
BUPROPION SR 150MG TAB (WELLBUTRIN SR),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
BUPROPION SR 150MG TAB (WELLBUTRIN SR),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
ALBUMIN INJ 25GM/100ML,636,RC,,,,both,731.25,658.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,511.88,,,,431.44,596.7
ALBUMIN INJ 25GM/100ML,636,RC,,,,both,731.25,658.13,Cigna,Default,Percent of Total Billed Charges,431.44,,,,431.44,596.7
ALBUMIN INJ 25GM/100ML,636,RC,,,,both,731.25,658.13,United Healthcare,Default,Fee Schedule,596.7,,,,431.44,596.7
LEVOBUNOLOL OPTH SOL 0.5% (BETAGAN),250,RC,,,,both,83.97,75.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.78,,,,49.54,68.52
LEVOBUNOLOL OPTH SOL 0.5% (BETAGAN),250,RC,,,,both,83.97,75.57,Cigna,Default,Percent of Total Billed Charges,49.54,,,,49.54,68.52
LEVOBUNOLOL OPTH SOL 0.5% (BETAGAN),250,RC,,,,both,83.97,75.57,United Healthcare,Default,Fee Schedule,68.52,,,,49.54,68.52
MAGNESIUM OXIDE 400MG TAB (MAG OX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
MAGNESIUM OXIDE 400MG TAB (MAG OX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
MAGNESIUM OXIDE 400MG TAB (MAG OX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
SUMATRIPTAN 100MG TAB (IMITREX),250,RC,,,,both,116.85,105.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.8,,,,68.94,95.35
SUMATRIPTAN 100MG TAB (IMITREX),250,RC,,,,both,116.85,105.17,Cigna,Default,Percent of Total Billed Charges,68.94,,,,68.94,95.35
SUMATRIPTAN 100MG TAB (IMITREX),250,RC,,,,both,116.85,105.17,United Healthcare,Default,Fee Schedule,95.35,,,,68.94,95.35
TROLAMINE (ASPERCREME),250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
TROLAMINE (ASPERCREME),250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
TROLAMINE (ASPERCREME),250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
CROMOLYN SODIUM 20MG NEB (GASTROCROM),250,RC,,,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
CROMOLYN SODIUM 20MG NEB (GASTROCROM),250,RC,,,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
CROMOLYN SODIUM 20MG NEB (GASTROCROM),250,RC,,,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
DOCUSATE SODIUM 60MG/15ML SYRUP (DSS),250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
DOCUSATE SODIUM 60MG/15ML SYRUP (DSS),250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
DOCUSATE SODIUM 60MG/15ML SYRUP (DSS),250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
NEO/POLY/DEX SUSP 0.1%,250,RC,,,,both,42.71,38.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.9,,,,25.2,34.85
NEO/POLY/DEX SUSP 0.1%,250,RC,,,,both,42.71,38.44,Cigna,Default,Percent of Total Billed Charges,25.2,,,,25.2,34.85
NEO/POLY/DEX SUSP 0.1%,250,RC,,,,both,42.71,38.44,United Healthcare,Default,Fee Schedule,34.85,,,,25.2,34.85
SSD CREAM 1% 50 GRAM,250,RC,,,,both,39.8,35.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.86,,,,23.48,32.48
SSD CREAM 1% 50 GRAM,250,RC,,,,both,39.8,35.82,Cigna,Default,Percent of Total Billed Charges,23.48,,,,23.48,32.48
SSD CREAM 1% 50 GRAM,250,RC,,,,both,39.8,35.82,United Healthcare,Default,Fee Schedule,32.48,,,,23.48,32.48
AMIODARONE 150MG/3ML (50MG/ML)(CORDARONE,J0282,HCPCS,636,RC,,both,67.99,61.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.48
AMIODARONE 150MG/3ML (50MG/ML)(CORDARONE,J0282,HCPCS,636,RC,,both,67.99,61.19,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.48
AMIODARONE 150MG/3ML (50MG/ML)(CORDARONE,J0282,HCPCS,636,RC,,both,67.99,61.19,United Healthcare,Default,Fee Schedule,55.48,,,,40.11,55.48
MIDAZOLAM 5MG/5ML VIAL (VERSED),J2250,HCPCS,636,RC,,both,47.94,43.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.56,,,,28.28,39.12
MIDAZOLAM 5MG/5ML VIAL (VERSED),J2250,HCPCS,636,RC,,both,47.94,43.15,Cigna,Default,Percent of Total Billed Charges,28.28,,,,28.28,39.12
MIDAZOLAM 5MG/5ML VIAL (VERSED),J2250,HCPCS,636,RC,,both,47.94,43.15,United Healthcare,Default,Fee Schedule,39.12,,,,28.28,39.12
DURICEF CAP 500MG,250,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
DURICEF CAP 500MG,250,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
DURICEF CAP 500MG,250,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
GLYBURIDE 3MG (DIABETA),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
GLYBURIDE 3MG (DIABETA),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
GLYBURIDE 3MG (DIABETA),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
CYCLOPHPSPHAMIDE INJ 100MG (CYTOXAN),J9073,HCPCS,636,RC,,both,29.32,26.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.52,,,,17.3,23.93
CYCLOPHPSPHAMIDE INJ 100MG (CYTOXAN),J9073,HCPCS,636,RC,,both,29.32,26.39,Cigna,Default,Percent of Total Billed Charges,17.3,,,,17.3,23.93
CYCLOPHPSPHAMIDE INJ 100MG (CYTOXAN),J9073,HCPCS,636,RC,,both,29.32,26.39,United Healthcare,Default,Fee Schedule,23.93,,,,17.3,23.93
JOBST THIGH HIGH LARGE B,258,RC,,,,both,337.9,304.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,236.53,,,,199.36,275.73
JOBST THIGH HIGH LARGE B,258,RC,,,,both,337.9,304.11,Cigna,Default,Percent of Total Billed Charges,199.36,,,,199.36,275.73
JOBST THIGH HIGH LARGE B,258,RC,,,,both,337.9,304.11,United Healthcare,Default,Fee Schedule,275.73,,,,199.36,275.73
TETRACYCLINE SUSP 125MG,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
TETRACYCLINE SUSP 125MG,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
TETRACYCLINE SUSP 125MG,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
ACETYLCYSTINE 20% 30ML ORAL SOL(MUCO,250,RC,,,,both,41.48,37.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.04,,,,24.47,33.85
ACETYLCYSTINE 20% 30ML ORAL SOL(MUCO,250,RC,,,,both,41.48,37.33,Cigna,Default,Percent of Total Billed Charges,24.47,,,,24.47,33.85
ACETYLCYSTINE 20% 30ML ORAL SOL(MUCO,250,RC,,,,both,41.48,37.33,United Healthcare,Default,Fee Schedule,33.85,,,,24.47,33.85
TERBINAFINE 250MG TAB (LAMISIL),637,RC,,,,both,34.84,31.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.39,,,,20.56,28.43
TERBINAFINE 250MG TAB (LAMISIL),637,RC,,,,both,34.84,31.36,Cigna,Default,Percent of Total Billed Charges,20.56,,,,20.56,28.43
TERBINAFINE 250MG TAB (LAMISIL),637,RC,,,,both,34.84,31.36,United Healthcare,Default,Fee Schedule,28.43,,,,20.56,28.43
TORSEMIDE 20MG TAB (DEMADEX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
TORSEMIDE 20MG TAB (DEMADEX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
TORSEMIDE 20MG TAB (DEMADEX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DOXORUBICIN 10MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,240.03,216.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,168.02,,,,141.62,195.86
DOXORUBICIN 10MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,240.03,216.03,Cigna,Default,Percent of Total Billed Charges,141.62,,,,141.62,195.86
DOXORUBICIN 10MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,240.03,216.03,United Healthcare,Default,Fee Schedule,195.86,,,,141.62,195.86
RANITIDINE HCL TAB 300MG,250,RC,,,,both,13.25,11.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.28,,,,7.82,10.81
RANITIDINE HCL TAB 300MG,250,RC,,,,both,13.25,11.93,Cigna,Default,Percent of Total Billed Charges,7.82,,,,7.82,10.81
RANITIDINE HCL TAB 300MG,250,RC,,,,both,13.25,11.93,United Healthcare,Default,Fee Schedule,10.81,,,,7.82,10.81
LIDOCAINE 1% W/EPI 20ML (XYLOCAINE),250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
LIDOCAINE 1% W/EPI 20ML (XYLOCAINE),250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
LIDOCAINE 1% W/EPI 20ML (XYLOCAINE),250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ALUMINUM HYDROXIDE 600MG/5ML SUSP (AMPHO,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
ALUMINUM HYDROXIDE 600MG/5ML SUSP (AMPHO,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
ALUMINUM HYDROXIDE 600MG/5ML SUSP (AMPHO,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
ROPIVACAINE 1% 10MG/ML 20ML INJ (NAROPIN,J2795,HCPCS,636,RC,,both,120.53,108.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.37,,,,71.11,98.35
ROPIVACAINE 1% 10MG/ML 20ML INJ (NAROPIN,J2795,HCPCS,636,RC,,both,120.53,108.48,Cigna,Default,Percent of Total Billed Charges,71.11,,,,71.11,98.35
ROPIVACAINE 1% 10MG/ML 20ML INJ (NAROPIN,J2795,HCPCS,636,RC,,both,120.53,108.48,United Healthcare,Default,Fee Schedule,98.35,,,,71.11,98.35
HYDROXYZINE HCL 50MG TAB (ATARAX),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HYDROXYZINE HCL 50MG TAB (ATARAX),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HYDROXYZINE HCL 50MG TAB (ATARAX),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
PRAMOXINE & HYDROCORTISONE 1% 10GM AEROS,637,RC,,,,both,157.77,141.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.44,,,,93.08,128.74
PRAMOXINE & HYDROCORTISONE 1% 10GM AEROS,637,RC,,,,both,157.77,141.99,Cigna,Default,Percent of Total Billed Charges,93.08,,,,93.08,128.74
PRAMOXINE & HYDROCORTISONE 1% 10GM AEROS,637,RC,,,,both,157.77,141.99,United Healthcare,Default,Fee Schedule,128.74,,,,93.08,128.74
CARVEDILOL 6.25MG TAB (COREG),637,RC,,,,both,8.72,7.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.1,,,,5.14,7.12
CARVEDILOL 6.25MG TAB (COREG),637,RC,,,,both,8.72,7.85,Cigna,Default,Percent of Total Billed Charges,5.14,,,,5.14,7.12
CARVEDILOL 6.25MG TAB (COREG),637,RC,,,,both,8.72,7.85,United Healthcare,Default,Fee Schedule,7.12,,,,5.14,7.12
TOBRAMYCIN & DEXAMETHASONE 3.5GM OINT,637,RC,,,,both,134.22,120.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.95,,,,79.19,109.52
TOBRAMYCIN & DEXAMETHASONE 3.5GM OINT,637,RC,,,,both,134.22,120.8,Cigna,Default,Percent of Total Billed Charges,79.19,,,,79.19,109.52
TOBRAMYCIN & DEXAMETHASONE 3.5GM OINT,637,RC,,,,both,134.22,120.8,United Healthcare,Default,Fee Schedule,109.52,,,,79.19,109.52
MECLIZINE HCL 25MG TAB (ANTIVERT),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
MECLIZINE HCL 25MG TAB (ANTIVERT),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
MECLIZINE HCL 25MG TAB (ANTIVERT),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
METOPROLOL XL SUCC 50MG (TOPROL XL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
METOPROLOL XL SUCC 50MG (TOPROL XL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
METOPROLOL XL SUCC 50MG (TOPROL XL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
KETAMINE 500MG/10 ML INJ (KETALAR),250,RC,,,,both,86,77.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.2,,,,50.74,70.18
KETAMINE 500MG/10 ML INJ (KETALAR),250,RC,,,,both,86,77.4,Cigna,Default,Percent of Total Billed Charges,50.74,,,,50.74,70.18
KETAMINE 500MG/10 ML INJ (KETALAR),250,RC,,,,both,86,77.4,United Healthcare,Default,Fee Schedule,70.18,,,,50.74,70.18
VANCOMYCIN 1000MG INJ (VANCOCIN),J3370,HCPCS,636,RC,,both,77.29,69.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.1,,,,45.6,63.07
VANCOMYCIN 1000MG INJ (VANCOCIN),J3370,HCPCS,636,RC,,both,77.29,69.56,Cigna,Default,Percent of Total Billed Charges,45.6,,,,45.6,63.07
VANCOMYCIN 1000MG INJ (VANCOCIN),J3370,HCPCS,636,RC,,both,77.29,69.56,United Healthcare,Default,Fee Schedule,63.07,,,,45.6,63.07
CARBAMAZEPINE ER 200MG TAB (TEGRETOL),637,RC,,,,both,18.89,17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.22,,,,11.15,15.41
CARBAMAZEPINE ER 200MG TAB (TEGRETOL),637,RC,,,,both,18.89,17,Cigna,Default,Percent of Total Billed Charges,11.15,,,,11.15,15.41
CARBAMAZEPINE ER 200MG TAB (TEGRETOL),637,RC,,,,both,18.89,17,United Healthcare,Default,Fee Schedule,15.41,,,,11.15,15.41
DAKINS 1/2 STR  0.25%  473ML,250,RC,,,,both,47.57,42.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.3,,,,28.07,38.82
DAKINS 1/2 STR  0.25%  473ML,250,RC,,,,both,47.57,42.81,Cigna,Default,Percent of Total Billed Charges,28.07,,,,28.07,38.82
DAKINS 1/2 STR  0.25%  473ML,250,RC,,,,both,47.57,42.81,United Healthcare,Default,Fee Schedule,38.82,,,,28.07,38.82
BICALUTAMIDE 50MG TAB (CASODEX),637,RC,,,,both,56.69,51.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.68,,,,33.45,46.26
BICALUTAMIDE 50MG TAB (CASODEX),637,RC,,,,both,56.69,51.02,Cigna,Default,Percent of Total Billed Charges,33.45,,,,33.45,46.26
BICALUTAMIDE 50MG TAB (CASODEX),637,RC,,,,both,56.69,51.02,United Healthcare,Default,Fee Schedule,46.26,,,,33.45,46.26
RALOXIFENE 60MG TAB,637,RC,,,,both,32.44,29.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.71,,,,19.14,26.47
RALOXIFENE 60MG TAB,637,RC,,,,both,32.44,29.2,Cigna,Default,Percent of Total Billed Charges,19.14,,,,19.14,26.47
RALOXIFENE 60MG TAB,637,RC,,,,both,32.44,29.2,United Healthcare,Default,Fee Schedule,26.47,,,,19.14,26.47
STERILE TALC PACKET,250,RC,,,,both,181.89,163.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.32,,,,107.32,148.42
STERILE TALC PACKET,250,RC,,,,both,181.89,163.7,Cigna,Default,Percent of Total Billed Charges,107.32,,,,107.32,148.42
STERILE TALC PACKET,250,RC,,,,both,181.89,163.7,United Healthcare,Default,Fee Schedule,148.42,,,,107.32,148.42
CLOPIDOGREL 75MG TAB (PLAVIX),637,RC,,,,both,15.21,13.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.65,,,,8.97,12.41
CLOPIDOGREL 75MG TAB (PLAVIX),637,RC,,,,both,15.21,13.69,Cigna,Default,Percent of Total Billed Charges,8.97,,,,8.97,12.41
CLOPIDOGREL 75MG TAB (PLAVIX),637,RC,,,,both,15.21,13.69,United Healthcare,Default,Fee Schedule,12.41,,,,8.97,12.41
OLOPATADINE OPHTH 0.1% 5ML (PATANOL),637,RC,,,,both,250.74,225.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,175.52,,,,147.94,204.6
OLOPATADINE OPHTH 0.1% 5ML (PATANOL),637,RC,,,,both,250.74,225.67,Cigna,Default,Percent of Total Billed Charges,147.94,,,,147.94,204.6
OLOPATADINE OPHTH 0.1% 5ML (PATANOL),637,RC,,,,both,250.74,225.67,United Healthcare,Default,Fee Schedule,204.6,,,,147.94,204.6
MIRTAZAPINE 15MG TAB,637,RC,,,,both,11.06,9.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.74,,,,6.53,9.02
MIRTAZAPINE 15MG TAB,637,RC,,,,both,11.06,9.95,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.02
MIRTAZAPINE 15MG TAB,637,RC,,,,both,11.06,9.95,United Healthcare,Default,Fee Schedule,9.02,,,,6.53,9.02
FLUTICASONE NASAL SPRAY 0.05% (FLONASE),250,RC,,,,both,212.39,191.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,148.67,,,,125.31,173.31
FLUTICASONE NASAL SPRAY 0.05% (FLONASE),250,RC,,,,both,212.39,191.15,Cigna,Default,Percent of Total Billed Charges,125.31,,,,125.31,173.31
FLUTICASONE NASAL SPRAY 0.05% (FLONASE),250,RC,,,,both,212.39,191.15,United Healthcare,Default,Fee Schedule,173.31,,,,125.31,173.31
LEVOFLOXACIN 25MG/ML 20ML (LEVAQUIN),250,RC,,,,both,247.26,222.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.08,,,,145.88,201.76
LEVOFLOXACIN 25MG/ML 20ML (LEVAQUIN),250,RC,,,,both,247.26,222.53,Cigna,Default,Percent of Total Billed Charges,145.88,,,,145.88,201.76
LEVOFLOXACIN 25MG/ML 20ML (LEVAQUIN),250,RC,,,,both,247.26,222.53,United Healthcare,Default,Fee Schedule,201.76,,,,145.88,201.76
LEVOFLOXACIN 500MG/100ML IVPB PREMIX,J1956,HCPCS,636,RC,,both,189.43,170.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.6,,,,111.76,154.57
LEVOFLOXACIN 500MG/100ML IVPB PREMIX,J1956,HCPCS,636,RC,,both,189.43,170.49,Cigna,Default,Percent of Total Billed Charges,111.76,,,,111.76,154.57
LEVOFLOXACIN 500MG/100ML IVPB PREMIX,J1956,HCPCS,636,RC,,both,189.43,170.49,United Healthcare,Default,Fee Schedule,154.57,,,,111.76,154.57
HYDROCORTISONE 25MG SUPPS (ANUCORT HC),637,RC,,,,both,105.29,94.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.7,,,,62.12,85.92
HYDROCORTISONE 25MG SUPPS (ANUCORT HC),637,RC,,,,both,105.29,94.76,Cigna,Default,Percent of Total Billed Charges,62.12,,,,62.12,85.92
HYDROCORTISONE 25MG SUPPS (ANUCORT HC),637,RC,,,,both,105.29,94.76,United Healthcare,Default,Fee Schedule,85.92,,,,62.12,85.92
SSD CREAM 1% 50GM,250,RC,,,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
SSD CREAM 1% 50GM,250,RC,,,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
SSD CREAM 1% 50GM,250,RC,,,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
TETANUS TOX PF SDV VIAL,90389,HCPCS,636,RC,,both,108.08,97.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.66,,,,63.77,88.19
TETANUS TOX PF SDV VIAL,90389,HCPCS,636,RC,,both,108.08,97.27,Cigna,Default,Percent of Total Billed Charges,63.77,,,,63.77,88.19
TETANUS TOX PF SDV VIAL,90389,HCPCS,636,RC,,both,108.08,97.27,United Healthcare,Default,Fee Schedule,88.19,,,,63.77,88.19
CARBAMAZEPINE XR 400MG TAB (TEGRETOL XR),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
CARBAMAZEPINE XR 400MG TAB (TEGRETOL XR),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
CARBAMAZEPINE XR 400MG TAB (TEGRETOL XR),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
BECAPLERMIN GEL 0.01% 15GM (REGRANEX),S0157,HCPCS,636,RC,,both,1988.77,1789.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1392.14,,,,1173.37,1622.84
BECAPLERMIN GEL 0.01% 15GM (REGRANEX),S0157,HCPCS,636,RC,,both,1988.77,1789.89,Cigna,Default,Percent of Total Billed Charges,1173.37,,,,1173.37,1622.84
BECAPLERMIN GEL 0.01% 15GM (REGRANEX),S0157,HCPCS,636,RC,,both,1988.77,1789.89,United Healthcare,Default,Fee Schedule,1622.84,,,,1173.37,1622.84
FENTANYL 100MCG/2ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
FENTANYL 100MCG/2ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
FENTANYL 100MCG/2ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
NACL 0.9% 10ML SALINE LOCK/ FLUSH,250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
NACL 0.9% 10ML SALINE LOCK/ FLUSH,250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
NACL 0.9% 10ML SALINE LOCK/ FLUSH,250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
NEO/POLY/DEX EYE DROP 5ML,250,RC,,,,both,30.97,27.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.68,,,,18.27,25.27
NEO/POLY/DEX EYE DROP 5ML,250,RC,,,,both,30.97,27.87,Cigna,Default,Percent of Total Billed Charges,18.27,,,,18.27,25.27
NEO/POLY/DEX EYE DROP 5ML,250,RC,,,,both,30.97,27.87,United Healthcare,Default,Fee Schedule,25.27,,,,18.27,25.27
HYDRALAZINE 25MG TAB,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HYDRALAZINE 25MG TAB,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HYDRALAZINE 25MG TAB,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
MORRHUATE SOD INJ 5% 30ML VIAL,250,RC,,,,both,234.18,210.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.93,,,,138.17,191.09
MORRHUATE SOD INJ 5% 30ML VIAL,250,RC,,,,both,234.18,210.76,Cigna,Default,Percent of Total Billed Charges,138.17,,,,138.17,191.09
MORRHUATE SOD INJ 5% 30ML VIAL,250,RC,,,,both,234.18,210.76,United Healthcare,Default,Fee Schedule,191.09,,,,138.17,191.09
LEVOTHYROXINE  0.112MG TAB (SYNTHROID),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHYROXINE  0.112MG TAB (SYNTHROID),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHYROXINE  0.112MG TAB (SYNTHROID),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
MONTELUKAST 10MG TAB,250,RC,,,,both,11.06,9.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.74,,,,6.53,9.02
MONTELUKAST 10MG TAB,250,RC,,,,both,11.06,9.95,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.02
MONTELUKAST 10MG TAB,250,RC,,,,both,11.06,9.95,United Healthcare,Default,Fee Schedule,9.02,,,,6.53,9.02
ANTIPYRINE/BENZOCAINE OTIC SOLN(AURALGAN,250,RC,,,,both,27.01,24.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.91,,,,15.94,22.04
ANTIPYRINE/BENZOCAINE OTIC SOLN(AURALGAN,250,RC,,,,both,27.01,24.31,Cigna,Default,Percent of Total Billed Charges,15.94,,,,15.94,22.04
ANTIPYRINE/BENZOCAINE OTIC SOLN(AURALGAN,250,RC,,,,both,27.01,24.31,United Healthcare,Default,Fee Schedule,22.04,,,,15.94,22.04
ASPIRIN 325MG TAB,637,RC,,,,both,6.95,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.1,5.67
ASPIRIN 325MG TAB,637,RC,,,,both,6.95,6.26,Cigna,Default,Percent of Total Billed Charges,4.1,,,,4.1,5.67
ASPIRIN 325MG TAB,637,RC,,,,both,6.95,6.26,United Healthcare,Default,Fee Schedule,5.67,,,,4.1,5.67
PENTOSAN POLYSULFATE SODIUM 100MG CAP,250,RC,,,,both,9.29,8.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.5,,,,5.48,7.58
PENTOSAN POLYSULFATE SODIUM 100MG CAP,250,RC,,,,both,9.29,8.36,Cigna,Default,Percent of Total Billed Charges,5.48,,,,5.48,7.58
PENTOSAN POLYSULFATE SODIUM 100MG CAP,250,RC,,,,both,9.29,8.36,United Healthcare,Default,Fee Schedule,7.58,,,,5.48,7.58
DOXAZOSIN 4MG TAB (CARDURA),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
DOXAZOSIN 4MG TAB (CARDURA),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
DOXAZOSIN 4MG TAB (CARDURA),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
AMOXICILLIN 250MG/5ML 80ML SUSP,637,RC,,,,both,38,34.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.6,,,,22.42,31.01
AMOXICILLIN 250MG/5ML 80ML SUSP,637,RC,,,,both,38,34.2,Cigna,Default,Percent of Total Billed Charges,22.42,,,,22.42,31.01
AMOXICILLIN 250MG/5ML 80ML SUSP,637,RC,,,,both,38,34.2,United Healthcare,Default,Fee Schedule,31.01,,,,22.42,31.01
HYDROCORTISONE 30MG SUPP (PROCTOCORT),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HYDROCORTISONE 30MG SUPP (PROCTOCORT),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HYDROCORTISONE 30MG SUPP (PROCTOCORT),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
HEP-LOCK INJ 100U/ML 30ML,J1642,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
HEP-LOCK INJ 100U/ML 30ML,J1642,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
HEP-LOCK INJ 100U/ML 30ML,J1642,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
GAS-X EX ST LIQ 50MG/5ML,250,RC,,,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
GAS-X EX ST LIQ 50MG/5ML,250,RC,,,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
GAS-X EX ST LIQ 50MG/5ML,250,RC,,,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
OLANZAPINE 5MG TAB (ZYPREXA),637,RC,,,,both,94.45,85.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.12,,,,55.73,77.07
OLANZAPINE 5MG TAB (ZYPREXA),637,RC,,,,both,94.45,85.01,Cigna,Default,Percent of Total Billed Charges,55.73,,,,55.73,77.07
OLANZAPINE 5MG TAB (ZYPREXA),637,RC,,,,both,94.45,85.01,United Healthcare,Default,Fee Schedule,77.07,,,,55.73,77.07
RIZATRIPTAN MLT 10MG TAB (MAXALT),250,RC,,,,both,142.92,128.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.04,,,,84.32,116.62
RIZATRIPTAN MLT 10MG TAB (MAXALT),250,RC,,,,both,142.92,128.63,Cigna,Default,Percent of Total Billed Charges,84.32,,,,84.32,116.62
RIZATRIPTAN MLT 10MG TAB (MAXALT),250,RC,,,,both,142.92,128.63,United Healthcare,Default,Fee Schedule,116.62,,,,84.32,116.62
REMERON TAB 30MG,250,RC,,,,both,11.62,10.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.13,,,,6.86,9.48
REMERON TAB 30MG,250,RC,,,,both,11.62,10.46,Cigna,Default,Percent of Total Billed Charges,6.86,,,,6.86,9.48
REMERON TAB 30MG,250,RC,,,,both,11.62,10.46,United Healthcare,Default,Fee Schedule,9.48,,,,6.86,9.48
BUDESONIDE 180MCG (PULMICORT &FLEXIHALER,637,RC,,,,both,402.11,361.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,281.48,,,,237.24,328.12
BUDESONIDE 180MCG (PULMICORT &FLEXIHALER,637,RC,,,,both,402.11,361.9,Cigna,Default,Percent of Total Billed Charges,237.24,,,,237.24,328.12
BUDESONIDE 180MCG (PULMICORT &FLEXIHALER,637,RC,,,,both,402.11,361.9,United Healthcare,Default,Fee Schedule,328.12,,,,237.24,328.12
MYCOPHENOLATE 500MG TAB (CELLCEPT),J7517,HCPCS,637,RC,,both,24.5,22.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.15,,,,14.46,19.99
MYCOPHENOLATE 500MG TAB (CELLCEPT),J7517,HCPCS,637,RC,,both,24.5,22.05,Cigna,Default,Percent of Total Billed Charges,14.46,,,,14.46,19.99
MYCOPHENOLATE 500MG TAB (CELLCEPT),J7517,HCPCS,637,RC,,both,24.5,22.05,United Healthcare,Default,Fee Schedule,19.99,,,,14.46,19.99
GLYBURIDE 2.5MG TAB (DIABETA),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
GLYBURIDE 2.5MG TAB (DIABETA),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
GLYBURIDE 2.5MG TAB (DIABETA),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
HYDROXYZINE HCL 25MG TAB (ATARAX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
HYDROXYZINE HCL 25MG TAB (ATARAX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
HYDROXYZINE HCL 25MG TAB (ATARAX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
BELLADONNA&OPIUM 16A 16.2MG/60MG SUPP,250,RC,,,,both,233.23,209.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,163.26,,,,137.61,190.32
BELLADONNA&OPIUM 16A 16.2MG/60MG SUPP,250,RC,,,,both,233.23,209.91,Cigna,Default,Percent of Total Billed Charges,137.61,,,,137.61,190.32
BELLADONNA&OPIUM 16A 16.2MG/60MG SUPP,250,RC,,,,both,233.23,209.91,United Healthcare,Default,Fee Schedule,190.32,,,,137.61,190.32
CYANOCOBALAMIN INJ 1000,250,RC,,,,both,17.15,15.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12,,,,10.12,13.99
CYANOCOBALAMIN INJ 1000,250,RC,,,,both,17.15,15.44,Cigna,Default,Percent of Total Billed Charges,10.12,,,,10.12,13.99
CYANOCOBALAMIN INJ 1000,250,RC,,,,both,17.15,15.44,United Healthcare,Default,Fee Schedule,13.99,,,,10.12,13.99
LORAZEPAM TAB 0.5MG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LORAZEPAM TAB 0.5MG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LORAZEPAM TAB 0.5MG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
LORAZEPAM 1MG TAB (ATIVAN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
LORAZEPAM 1MG TAB (ATIVAN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
LORAZEPAM 1MG TAB (ATIVAN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ESMOLOL 250MG/ML INJ (BREVIBLOC),250,RC,,,,both,429.42,386.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,300.59,,,,253.36,350.41
ESMOLOL 250MG/ML INJ (BREVIBLOC),250,RC,,,,both,429.42,386.48,Cigna,Default,Percent of Total Billed Charges,253.36,,,,253.36,350.41
ESMOLOL 250MG/ML INJ (BREVIBLOC),250,RC,,,,both,429.42,386.48,United Healthcare,Default,Fee Schedule,350.41,,,,253.36,350.41
AMOXICILLIN/CLAVULANATE 500/125MG TAB,637,RC,,,,both,20.33,18.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.23,,,,11.99,16.59
AMOXICILLIN/CLAVULANATE 500/125MG TAB,637,RC,,,,both,20.33,18.3,Cigna,Default,Percent of Total Billed Charges,11.99,,,,11.99,16.59
AMOXICILLIN/CLAVULANATE 500/125MG TAB,637,RC,,,,both,20.33,18.3,United Healthcare,Default,Fee Schedule,16.59,,,,11.99,16.59
HYDROCORTISONE 250MG/2ML  INJ (SOLU-CORT,250,RC,,,,both,194.79,175.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.35,,,,114.93,158.95
HYDROCORTISONE 250MG/2ML  INJ (SOLU-CORT,250,RC,,,,both,194.79,175.31,Cigna,Default,Percent of Total Billed Charges,114.93,,,,114.93,158.95
HYDROCORTISONE 250MG/2ML  INJ (SOLU-CORT,250,RC,,,,both,194.79,175.31,United Healthcare,Default,Fee Schedule,158.95,,,,114.93,158.95
BUTORPHANOL 2MG/ML INJ (STADOL),250,RC,,,,both,39.8,35.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.86,,,,23.48,32.48
BUTORPHANOL 2MG/ML INJ (STADOL),250,RC,,,,both,39.8,35.82,Cigna,Default,Percent of Total Billed Charges,23.48,,,,23.48,32.48
BUTORPHANOL 2MG/ML INJ (STADOL),250,RC,,,,both,39.8,35.82,United Healthcare,Default,Fee Schedule,32.48,,,,23.48,32.48
HYDROCORTISONE 100MG/2ML INJ (SOLU-CORTE,250,RC,,,,both,100.29,90.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.2,,,,59.17,81.84
HYDROCORTISONE 100MG/2ML INJ (SOLU-CORTE,250,RC,,,,both,100.29,90.26,Cigna,Default,Percent of Total Billed Charges,59.17,,,,59.17,81.84
HYDROCORTISONE 100MG/2ML INJ (SOLU-CORTE,250,RC,,,,both,100.29,90.26,United Healthcare,Default,Fee Schedule,81.84,,,,59.17,81.84
BACITRACIN OINT 500U/G,250,RC,,,,both,27.9,25.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.53,,,,16.46,22.77
BACITRACIN OINT 500U/G,250,RC,,,,both,27.9,25.11,Cigna,Default,Percent of Total Billed Charges,16.46,,,,16.46,22.77
BACITRACIN OINT 500U/G,250,RC,,,,both,27.9,25.11,United Healthcare,Default,Fee Schedule,22.77,,,,16.46,22.77
TERBUTALINE 2.5MG TAB (BRETHINE),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
TERBUTALINE 2.5MG TAB (BRETHINE),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
TERBUTALINE 2.5MG TAB (BRETHINE),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
BRETHINE TAB 5MG (TERBUTALINE),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
BRETHINE TAB 5MG (TERBUTALINE),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
BRETHINE TAB 5MG (TERBUTALINE),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
METHYLPREDNISOLONE 500MG/4ML INJ,J2919,HCPCS,636,RC,,both,217.7,195.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.39,,,,128.44,177.64
METHYLPREDNISOLONE 500MG/4ML INJ,J2919,HCPCS,636,RC,,both,217.7,195.93,Cigna,Default,Percent of Total Billed Charges,128.44,,,,128.44,177.64
METHYLPREDNISOLONE 500MG/4ML INJ,J2919,HCPCS,636,RC,,both,217.7,195.93,United Healthcare,Default,Fee Schedule,177.64,,,,128.44,177.64
SODIUM CITRATE/CITRIC ACID 120ML (BICITR,250,RC,,,,both,20.33,18.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.23,,,,11.99,16.59
SODIUM CITRATE/CITRIC ACID 120ML (BICITR,250,RC,,,,both,20.33,18.3,Cigna,Default,Percent of Total Billed Charges,11.99,,,,11.99,16.59
SODIUM CITRATE/CITRIC ACID 120ML (BICITR,250,RC,,,,both,20.33,18.3,United Healthcare,Default,Fee Schedule,16.59,,,,11.99,16.59
POTASSIUM IODIDE SOLUTION 1000MG/ML,250,RC,,,,both,56.94,51.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.86,,,,33.59,46.46
POTASSIUM IODIDE SOLUTION 1000MG/ML,250,RC,,,,both,56.94,51.25,Cigna,Default,Percent of Total Billed Charges,33.59,,,,33.59,46.46
POTASSIUM IODIDE SOLUTION 1000MG/ML,250,RC,,,,both,56.94,51.25,United Healthcare,Default,Fee Schedule,46.46,,,,33.59,46.46
BUMETANIDE 1MG TAB (BUMEX),637,RC,,,,both,9.2,8.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.44,,,,5.43,7.51
BUMETANIDE 1MG TAB (BUMEX),637,RC,,,,both,9.2,8.28,Cigna,Default,Percent of Total Billed Charges,5.43,,,,5.43,7.51
BUMETANIDE 1MG TAB (BUMEX),637,RC,,,,both,9.2,8.28,United Healthcare,Default,Fee Schedule,7.51,,,,5.43,7.51
BUMETANIDE 0.5MG TAB (BUMEX),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
BUMETANIDE 0.5MG TAB (BUMEX),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
BUMETANIDE 0.5MG TAB (BUMEX),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DONEPEZIL 10MG TAB (ARICEPT),637,RC,,,,both,20.47,18.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.33,,,,12.08,16.7
DONEPEZIL 10MG TAB (ARICEPT),637,RC,,,,both,20.47,18.42,Cigna,Default,Percent of Total Billed Charges,12.08,,,,12.08,16.7
DONEPEZIL 10MG TAB (ARICEPT),637,RC,,,,both,20.47,18.42,United Healthcare,Default,Fee Schedule,16.7,,,,12.08,16.7
BUSPIRONE 5MG TAB (BUSPAR),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
BUSPIRONE 5MG TAB (BUSPAR),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
BUSPIRONE 5MG TAB (BUSPAR),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
PRAMIPEXOLE 0.125MG TAB (MIRAPEX),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PRAMIPEXOLE 0.125MG TAB (MIRAPEX),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PRAMIPEXOLE 0.125MG TAB (MIRAPEX),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
BICILLIN CR INJ 600000 UNITS,J0558,HCPCS,636,RC,,both,58.11,52.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.68,,,,34.28,47.42
BICILLIN CR INJ 600000 UNITS,J0558,HCPCS,636,RC,,both,58.11,52.3,Cigna,Default,Percent of Total Billed Charges,34.28,,,,34.28,47.42
BICILLIN CR INJ 600000 UNITS,J0558,HCPCS,636,RC,,both,58.11,52.3,United Healthcare,Default,Fee Schedule,47.42,,,,34.28,47.42
DIGIBIND INJ 38MG,J1162,HCPCS,636,RC,,both,1614,1452.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1129.8,,,,952.26,1317.02
DIGIBIND INJ 38MG,J1162,HCPCS,636,RC,,both,1614,1452.6,Cigna,Default,Percent of Total Billed Charges,952.26,,,,952.26,1317.02
DIGIBIND INJ 38MG,J1162,HCPCS,636,RC,,both,1614,1452.6,United Healthcare,Default,Fee Schedule,1317.02,,,,952.26,1317.02
CAPTOPRIL 25MG TAB (CAPOTEN),637,RC,,,,both,13,11.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.1,,,,7.67,10.61
CAPTOPRIL 25MG TAB (CAPOTEN),637,RC,,,,both,13,11.7,Cigna,Default,Percent of Total Billed Charges,7.67,,,,7.67,10.61
CAPTOPRIL 25MG TAB (CAPOTEN),637,RC,,,,both,13,11.7,United Healthcare,Default,Fee Schedule,10.61,,,,7.67,10.61
AMPICILLIN 250MG CAP,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
AMPICILLIN 250MG CAP,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
AMPICILLIN 250MG CAP,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DIPYRIDAMOLE 75MG TAB (PERSANTINE),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
DIPYRIDAMOLE 75MG TAB (PERSANTINE),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
DIPYRIDAMOLE 75MG TAB (PERSANTINE),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
SUCRALFATE 1000MG TAB (CARAFATE),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
SUCRALFATE 1000MG TAB (CARAFATE),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
SUCRALFATE 1000MG TAB (CARAFATE),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DILTIAZEM HCL 30MG TAB (CARDIZEM),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DILTIAZEM HCL 30MG TAB (CARDIZEM),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DILTIAZEM HCL 30MG TAB (CARDIZEM),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DILTIAZEM HCL 60MG TAB (CARDIZEM),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DILTIAZEM HCL 60MG TAB (CARDIZEM),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DILTIAZEM HCL 60MG TAB (CARDIZEM),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
HYDROCORTISONE OINT (ANUSOL HC),250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
HYDROCORTISONE OINT (ANUSOL HC),250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
HYDROCORTISONE OINT (ANUSOL HC),250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
SILVER SULFADIAZINE 1% CREAM 400GM(SILVA,250,RC,,,,both,279.29,251.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.5,,,,164.78,227.9
SILVER SULFADIAZINE 1% CREAM 400GM(SILVA,250,RC,,,,both,279.29,251.36,Cigna,Default,Percent of Total Billed Charges,164.78,,,,164.78,227.9
SILVER SULFADIAZINE 1% CREAM 400GM(SILVA,250,RC,,,,both,279.29,251.36,United Healthcare,Default,Fee Schedule,227.9,,,,164.78,227.9
MULTIVITAMIN 10ML INJ,250,RC,,,,both,296.45,266.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,207.52,,,,174.91,241.9
MULTIVITAMIN 10ML INJ,250,RC,,,,both,296.45,266.81,Cigna,Default,Percent of Total Billed Charges,174.91,,,,174.91,241.9
MULTIVITAMIN 10ML INJ,250,RC,,,,both,296.45,266.81,United Healthcare,Default,Fee Schedule,241.9,,,,174.91,241.9
LEVOTHYROXINE 0.125MG TAB (SYNTHROID),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
LEVOTHYROXINE 0.125MG TAB (SYNTHROID),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
LEVOTHYROXINE 0.125MG TAB (SYNTHROID),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
LEVALBUTEROL 0.63MG NEB (XOPENEX),J7614,HCPCS,250,RC,,both,31.15,28.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.8,,,,18.38,25.42
LEVALBUTEROL 0.63MG NEB (XOPENEX),J7614,HCPCS,250,RC,,both,31.15,28.04,Cigna,Default,Percent of Total Billed Charges,18.38,,,,18.38,25.42
LEVALBUTEROL 0.63MG NEB (XOPENEX),J7614,HCPCS,250,RC,,both,31.15,28.04,United Healthcare,Default,Fee Schedule,25.42,,,,18.38,25.42
IPRATROPIUM/ALBUTEROL INHALER (COMBIVENT,250,RC,,,,both,2378.97,2141.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1665.28,,,,1403.59,1941.24
IPRATROPIUM/ALBUTEROL INHALER (COMBIVENT,250,RC,,,,both,2378.97,2141.07,Cigna,Default,Percent of Total Billed Charges,1403.59,,,,1403.59,1941.24
IPRATROPIUM/ALBUTEROL INHALER (COMBIVENT,250,RC,,,,both,2378.97,2141.07,United Healthcare,Default,Fee Schedule,1941.24,,,,1403.59,1941.24
CARVEDILOL 3.125MG TAB (COREG),250,RC,,,,both,9.29,8.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.5,,,,5.48,7.58
CARVEDILOL 3.125MG TAB (COREG),250,RC,,,,both,9.29,8.36,Cigna,Default,Percent of Total Billed Charges,5.48,,,,5.48,7.58
CARVEDILOL 3.125MG TAB (COREG),250,RC,,,,both,9.29,8.36,United Healthcare,Default,Fee Schedule,7.58,,,,5.48,7.58
OPRELVEKIN 5MG INJ (NEUMEGA),J2355,HCPCS,636,RC,,both,1113.07,1001.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,779.15,,,,656.71,908.27
OPRELVEKIN 5MG INJ (NEUMEGA),J2355,HCPCS,636,RC,,both,1113.07,1001.76,Cigna,Default,Percent of Total Billed Charges,656.71,,,,656.71,908.27
OPRELVEKIN 5MG INJ (NEUMEGA),J2355,HCPCS,636,RC,,both,1113.07,1001.76,United Healthcare,Default,Fee Schedule,908.27,,,,656.71,908.27
DIPHENHYDRAMINE 1% CRM (BENADRYL),250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
DIPHENHYDRAMINE 1% CRM (BENADRYL),250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
DIPHENHYDRAMINE 1% CRM (BENADRYL),250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
AYR SALINE GEL NASAL,250,RC,,,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
AYR SALINE GEL NASAL,250,RC,,,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
AYR SALINE GEL NASAL,250,RC,,,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
SCLEROSOL AEROSOL (STERILE TALC),250,RC,,,,both,683.7,615.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,478.59,,,,403.38,557.9
SCLEROSOL AEROSOL (STERILE TALC),250,RC,,,,both,683.7,615.33,Cigna,Default,Percent of Total Billed Charges,403.38,,,,403.38,557.9
SCLEROSOL AEROSOL (STERILE TALC),250,RC,,,,both,683.7,615.33,United Healthcare,Default,Fee Schedule,557.9,,,,403.38,557.9
PAROXETINE 10MG TAB (PAXIL),637,RC,,,,both,11.62,10.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.13,,,,6.86,9.48
PAROXETINE 10MG TAB (PAXIL),637,RC,,,,both,11.62,10.46,Cigna,Default,Percent of Total Billed Charges,6.86,,,,6.86,9.48
PAROXETINE 10MG TAB (PAXIL),637,RC,,,,both,11.62,10.46,United Healthcare,Default,Fee Schedule,9.48,,,,6.86,9.48
SODIUM BICARB 650MG TAB,637,RC,,,,both,5.81,5.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.07,,,,3.43,4.74
SODIUM BICARB 650MG TAB,637,RC,,,,both,5.81,5.23,Cigna,Default,Percent of Total Billed Charges,3.43,,,,3.43,4.74
SODIUM BICARB 650MG TAB,637,RC,,,,both,5.81,5.23,United Healthcare,Default,Fee Schedule,4.74,,,,3.43,4.74
TAMULOSIN 0.4MG CAP (FLOMAX),637,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
TAMULOSIN 0.4MG CAP (FLOMAX),637,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
TAMULOSIN 0.4MG CAP (FLOMAX),637,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
CHLORPROMAZINE HCL 25MG TAB (THORAZINE,Q0161,HCPCS,636,RC,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLORPROMAZINE HCL 25MG TAB (THORAZINE,Q0161,HCPCS,636,RC,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLORPROMAZINE HCL 25MG TAB (THORAZINE,Q0161,HCPCS,636,RC,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
TERBUTALINE 1MG/ML 1ML INJ (BRETHINE),J3105,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
TERBUTALINE 1MG/ML 1ML INJ (BRETHINE),J3105,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
TERBUTALINE 1MG/ML 1ML INJ (BRETHINE),J3105,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
LORATADINE 10MG TAB (CLARITIN),637,RC,,,,both,11.06,9.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.74,,,,6.53,9.02
LORATADINE 10MG TAB (CLARITIN),637,RC,,,,both,11.06,9.95,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.02
LORATADINE 10MG TAB (CLARITIN),637,RC,,,,both,11.06,9.95,United Healthcare,Default,Fee Schedule,9.02,,,,6.53,9.02
CLINDAMYCIN HCL 150MG CAP (CLEOCIN),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CLINDAMYCIN HCL 150MG CAP (CLEOCIN),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CLINDAMYCIN HCL 150MG CAP (CLEOCIN),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
SULINDAC 200MG TAB (CLINORIL),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
SULINDAC 200MG TAB (CLINORIL),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
SULINDAC 200MG TAB (CLINORIL),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
BENZTROPINE MESYLATE 1MG TAB (COGENTIN),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
BENZTROPINE MESYLATE 1MG TAB (COGENTIN),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
BENZTROPINE MESYLATE 1MG TAB (COGENTIN),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CLARITHROMYCIN 500MG TAB (BIAXIN),637,RC,,,,both,27.55,24.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.28,,,,16.25,22.48
CLARITHROMYCIN 500MG TAB (BIAXIN),637,RC,,,,both,27.55,24.8,Cigna,Default,Percent of Total Billed Charges,16.25,,,,16.25,22.48
CLARITHROMYCIN 500MG TAB (BIAXIN),637,RC,,,,both,27.55,24.8,United Healthcare,Default,Fee Schedule,22.48,,,,16.25,22.48
BETOPTIC OPTH SOL 0.5% 5ML,250,RC,,,,both,115.04,103.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.53,,,,67.87,93.87
BETOPTIC OPTH SOL 0.5% 5ML,250,RC,,,,both,115.04,103.54,Cigna,Default,Percent of Total Billed Charges,67.87,,,,67.87,93.87
BETOPTIC OPTH SOL 0.5% 5ML,250,RC,,,,both,115.04,103.54,United Healthcare,Default,Fee Schedule,93.87,,,,67.87,93.87
BETAMETHASONE S OPTH 0.25% 5ML SUSP,637,RC,,,,both,156.03,140.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,109.22,,,,92.06,127.32
BETAMETHASONE S OPTH 0.25% 5ML SUSP,637,RC,,,,both,156.03,140.43,Cigna,Default,Percent of Total Billed Charges,92.06,,,,92.06,127.32
BETAMETHASONE S OPTH 0.25% 5ML SUSP,637,RC,,,,both,156.03,140.43,United Healthcare,Default,Fee Schedule,127.32,,,,92.06,127.32
COLCHICINE 0.6MG TAB (COLCRYS),250,RC,,,,both,51.84,46.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.29,,,,30.59,42.3
COLCHICINE 0.6MG TAB (COLCRYS),250,RC,,,,both,51.84,46.66,Cigna,Default,Percent of Total Billed Charges,30.59,,,,30.59,42.3
COLCHICINE 0.6MG TAB (COLCRYS),250,RC,,,,both,51.84,46.66,United Healthcare,Default,Fee Schedule,42.3,,,,30.59,42.3
CARBAMAZEPINE 100MG CHEW TAB (TEGRETOL),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CARBAMAZEPINE 100MG CHEW TAB (TEGRETOL),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CARBAMAZEPINE 100MG CHEW TAB (TEGRETOL),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
BISMUTH SUSP 8OZ (KAOPECTATE),250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
BISMUTH SUSP 8OZ (KAOPECTATE),250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
BISMUTH SUSP 8OZ (KAOPECTATE),250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
OXYBUTYNIN 5MG TAB (DITROPAN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
OXYBUTYNIN 5MG TAB (DITROPAN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
OXYBUTYNIN 5MG TAB (DITROPAN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PROCHLORPERAZINE 10MG TAB (COMPAZINE),Q0164,HCPCS,636,RC,,both,7.63,6.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.34,,,,4.5,6.23
PROCHLORPERAZINE 10MG TAB (COMPAZINE),Q0164,HCPCS,636,RC,,both,7.63,6.87,Cigna,Default,Percent of Total Billed Charges,4.5,,,,4.5,6.23
PROCHLORPERAZINE 10MG TAB (COMPAZINE),Q0164,HCPCS,636,RC,,both,7.63,6.87,United Healthcare,Default,Fee Schedule,6.23,,,,4.5,6.23
THEOCLEAR LA 260 CAPS 2,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
THEOCLEAR LA 260 CAPS 2,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
THEOCLEAR LA 260 CAPS 2,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
MUPIROCIN OINT 2% 22 GM (BACTROBAN),250,RC,,,,both,183.34,165.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.34,,,,108.17,149.61
MUPIROCIN OINT 2% 22 GM (BACTROBAN),250,RC,,,,both,183.34,165.01,Cigna,Default,Percent of Total Billed Charges,108.17,,,,108.17,149.61
MUPIROCIN OINT 2% 22 GM (BACTROBAN),250,RC,,,,both,183.34,165.01,United Healthcare,Default,Fee Schedule,149.61,,,,108.17,149.61
NADOLOL 40MG TAB (CORGARD),250,RC,,,,both,17.57,15.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.3,,,,10.37,14.34
NADOLOL 40MG TAB (CORGARD),250,RC,,,,both,17.57,15.81,Cigna,Default,Percent of Total Billed Charges,10.37,,,,10.37,14.34
NADOLOL 40MG TAB (CORGARD),250,RC,,,,both,17.57,15.81,United Healthcare,Default,Fee Schedule,14.34,,,,10.37,14.34
FLUDROCORTISONE 0.1MG TAB (FLORINEF),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
FLUDROCORTISONE 0.1MG TAB (FLORINEF),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
FLUDROCORTISONE 0.1MG TAB (FLORINEF),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
LIDOCAINE INJ 1% 50ML MDV (XYLOCAINE),250,RC,,,,both,29.35,26.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.54,,,,17.32,23.95
LIDOCAINE INJ 1% 50ML MDV (XYLOCAINE),250,RC,,,,both,29.35,26.42,Cigna,Default,Percent of Total Billed Charges,17.32,,,,17.32,23.95
LIDOCAINE INJ 1% 50ML MDV (XYLOCAINE),250,RC,,,,both,29.35,26.42,United Healthcare,Default,Fee Schedule,23.95,,,,17.32,23.95
COUMADIN TAB 2.5MG,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
COUMADIN TAB 2.5MG,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
COUMADIN TAB 2.5MG,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
WARFARIN 2MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
WARFARIN 2MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
WARFARIN 2MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
WARFARIN 4MG TAB,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
WARFARIN 4MG TAB,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
WARFARIN 4MG TAB,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
AMOXICILLIN/CLAVULANATE 250MG TAB (AUGME,250,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
AMOXICILLIN/CLAVULANATE 250MG TAB (AUGME,250,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
AMOXICILLIN/CLAVULANATE 250MG TAB (AUGME,250,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
CEFAZOLIN 1GM INJ ADV (KEFZOL),250,RC,,,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
CEFAZOLIN 1GM INJ ADV (KEFZOL),250,RC,,,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
CEFAZOLIN 1GM INJ ADV (KEFZOL),250,RC,,,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
DILTIAZEM CD 180MG CAP (CARDIZEM),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
DILTIAZEM CD 180MG CAP (CARDIZEM),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
DILTIAZEM CD 180MG CAP (CARDIZEM),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
MAGNESIUM ALUM 30ML U/D SUSP (MAALOX),637,RC,,,,both,19.66,17.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.76,,,,11.6,16.04
MAGNESIUM ALUM 30ML U/D SUSP (MAALOX),637,RC,,,,both,19.66,17.69,Cigna,Default,Percent of Total Billed Charges,11.6,,,,11.6,16.04
MAGNESIUM ALUM 30ML U/D SUSP (MAALOX),637,RC,,,,both,19.66,17.69,United Healthcare,Default,Fee Schedule,16.04,,,,11.6,16.04
NIFEDIPINE 10MG CAP (PROCARDIA),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
NIFEDIPINE 10MG CAP (PROCARDIA),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
NIFEDIPINE 10MG CAP (PROCARDIA),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
ACYCLOVIR 500MG INJ (ZOVIRAX),J0133,HCPCS,636,RC,,both,231.5,208.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,162.05,,,,136.58,188.9
ACYCLOVIR 500MG INJ (ZOVIRAX),J0133,HCPCS,636,RC,,both,231.5,208.35,Cigna,Default,Percent of Total Billed Charges,136.58,,,,136.58,188.9
ACYCLOVIR 500MG INJ (ZOVIRAX),J0133,HCPCS,636,RC,,both,231.5,208.35,United Healthcare,Default,Fee Schedule,188.9,,,,136.58,188.9
TRAZODONE 50MG TAB (DESERYL),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
TRAZODONE 50MG TAB (DESERYL),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
TRAZODONE 50MG TAB (DESERYL),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DAPSONE 25MG TAB,250,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
DAPSONE 25MG TAB,250,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
DAPSONE 25MG TAB,250,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
RIFAMPIN 300MG TAB,637,RC,,,,both,8.68,7.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.08,,,,5.12,7.08
RIFAMPIN 300MG TAB,637,RC,,,,both,8.68,7.81,Cigna,Default,Percent of Total Billed Charges,5.12,,,,5.12,7.08
RIFAMPIN 300MG TAB,637,RC,,,,both,8.68,7.81,United Healthcare,Default,Fee Schedule,7.08,,,,5.12,7.08
FUROSEMIDE 40MG/4ML INJ (LASIX),J1940,HCPCS,636,RC,,both,50.26,45.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.18,,,,29.65,41.01
FUROSEMIDE 40MG/4ML INJ (LASIX),J1940,HCPCS,636,RC,,both,50.26,45.23,Cigna,Default,Percent of Total Billed Charges,29.65,,,,29.65,41.01
FUROSEMIDE 40MG/4ML INJ (LASIX),J1940,HCPCS,636,RC,,both,50.26,45.23,United Healthcare,Default,Fee Schedule,41.01,,,,29.65,41.01
DEXAMETHASONE 4MG TAB,J8540,HCPCS,636,RC,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
DEXAMETHASONE 4MG TAB,J8540,HCPCS,636,RC,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
DEXAMETHASONE 4MG TAB,J8540,HCPCS,636,RC,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
DOXAPRAM 20MG/ML 20ML (DOPRAM),250,RC,,,,both,384.12,345.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.88,,,,226.63,313.44
DOXAPRAM 20MG/ML 20ML (DOPRAM),250,RC,,,,both,384.12,345.71,Cigna,Default,Percent of Total Billed Charges,226.63,,,,226.63,313.44
DOXAPRAM 20MG/ML 20ML (DOPRAM),250,RC,,,,both,384.12,345.71,United Healthcare,Default,Fee Schedule,313.44,,,,226.63,313.44
CEPHALEXIN 125MG/5ML SUSP (KEFLEX),637,RC,,,,both,39.8,35.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.86,,,,23.48,32.48
CEPHALEXIN 125MG/5ML SUSP (KEFLEX),637,RC,,,,both,39.8,35.82,Cigna,Default,Percent of Total Billed Charges,23.48,,,,23.48,32.48
CEPHALEXIN 125MG/5ML SUSP (KEFLEX),637,RC,,,,both,39.8,35.82,United Healthcare,Default,Fee Schedule,32.48,,,,23.48,32.48
AZITHROMYCIN 250MG TAB-PACK  (Z-PAK),637,RC,,,,both,208.02,187.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.61,,,,122.73,169.74
AZITHROMYCIN 250MG TAB-PACK  (Z-PAK),637,RC,,,,both,208.02,187.22,Cigna,Default,Percent of Total Billed Charges,122.73,,,,122.73,169.74
AZITHROMYCIN 250MG TAB-PACK  (Z-PAK),637,RC,,,,both,208.02,187.22,United Healthcare,Default,Fee Schedule,169.74,,,,122.73,169.74
PHYSOSTIGMINE 1MG/1ML,250,RC,,,,both,19.76,17.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.83,,,,11.66,16.12
PHYSOSTIGMINE 1MG/1ML,250,RC,,,,both,19.76,17.78,Cigna,Default,Percent of Total Billed Charges,11.66,,,,11.66,16.12
PHYSOSTIGMINE 1MG/1ML,250,RC,,,,both,19.76,17.78,United Healthcare,Default,Fee Schedule,16.12,,,,11.66,16.12
GLYBURIDE 5MG TAB (DIABETA),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
GLYBURIDE 5MG TAB (DIABETA),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
GLYBURIDE 5MG TAB (DIABETA),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
TOBRAMYCIN  80MG/2ML INJ,250,RC,,,,both,47.5,42.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.25,,,,28.02,38.76
TOBRAMYCIN  80MG/2ML INJ,250,RC,,,,both,47.5,42.75,Cigna,Default,Percent of Total Billed Charges,28.02,,,,28.02,38.76
TOBRAMYCIN  80MG/2ML INJ,250,RC,,,,both,47.5,42.75,United Healthcare,Default,Fee Schedule,38.76,,,,28.02,38.76
BUPRENORPHINE 0.324MG/ML INJ (BUPRENEX),250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
BUPRENORPHINE 0.324MG/ML INJ (BUPRENEX),250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
BUPRENORPHINE 0.324MG/ML INJ (BUPRENEX),250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
ISOSORBIDE MONO 20MG,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ISOSORBIDE MONO 20MG,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ISOSORBIDE MONO 20MG,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DICLOXACILLIN 500MG CAP,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
DICLOXACILLIN 500MG CAP,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
DICLOXACILLIN 500MG CAP,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
TETANUS TOX PED VACCINE,250,RC,,,,both,89.78,80.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.85,,,,52.97,73.26
TETANUS TOX PED VACCINE,250,RC,,,,both,89.78,80.8,Cigna,Default,Percent of Total Billed Charges,52.97,,,,52.97,73.26
TETANUS TOX PED VACCINE,250,RC,,,,both,89.78,80.8,United Healthcare,Default,Fee Schedule,73.26,,,,52.97,73.26
DIGOXIN 0.25MG TAB (LANOXIN),637,RC,,,,both,11.33,10.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.93,,,,6.68,9.25
DIGOXIN 0.25MG TAB (LANOXIN),637,RC,,,,both,11.33,10.2,Cigna,Default,Percent of Total Billed Charges,6.68,,,,6.68,9.25
DIGOXIN 0.25MG TAB (LANOXIN),637,RC,,,,both,11.33,10.2,United Healthcare,Default,Fee Schedule,9.25,,,,6.68,9.25
DIGOXIN 0.125MG TAB (LANOXIN),250,RC,,,,both,13.37,12.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.36,,,,7.89,10.91
DIGOXIN 0.125MG TAB (LANOXIN),250,RC,,,,both,13.37,12.03,Cigna,Default,Percent of Total Billed Charges,7.89,,,,7.89,10.91
DIGOXIN 0.125MG TAB (LANOXIN),250,RC,,,,both,13.37,12.03,United Healthcare,Default,Fee Schedule,10.91,,,,7.89,10.91
SINCALIDE 5MCG INJ (KINEVAC),J2805,HCPCS,636,RC,,both,705.01,634.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,493.51,,,,415.96,575.29
SINCALIDE 5MCG INJ (KINEVAC),J2805,HCPCS,636,RC,,both,705.01,634.51,Cigna,Default,Percent of Total Billed Charges,415.96,,,,415.96,575.29
SINCALIDE 5MCG INJ (KINEVAC),J2805,HCPCS,636,RC,,both,705.01,634.51,United Healthcare,Default,Fee Schedule,575.29,,,,415.96,575.29
GEMFIBROZIL 600MG TAB (LOPID),637,RC,,,,both,9.95,8.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.96,,,,5.87,8.12
GEMFIBROZIL 600MG TAB (LOPID),637,RC,,,,both,9.95,8.96,Cigna,Default,Percent of Total Billed Charges,5.87,,,,5.87,8.12
GEMFIBROZIL 600MG TAB (LOPID),637,RC,,,,both,9.95,8.96,United Healthcare,Default,Fee Schedule,8.12,,,,5.87,8.12
PHENYTOIN 100MG CAP (DILANTIN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PHENYTOIN 100MG CAP (DILANTIN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PHENYTOIN 100MG CAP (DILANTIN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
SCOPOLAMINE SCOP DISC (TRANSDERM SCOP),250,RC,,,,both,37.19,33.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.03,,,,21.94,30.35
SCOPOLAMINE SCOP DISC (TRANSDERM SCOP),250,RC,,,,both,37.19,33.47,Cigna,Default,Percent of Total Billed Charges,21.94,,,,21.94,30.35
SCOPOLAMINE SCOP DISC (TRANSDERM SCOP),250,RC,,,,both,37.19,33.47,United Healthcare,Default,Fee Schedule,30.35,,,,21.94,30.35
CAPTOPRIL 12.5MG TAB (CAPOTEN),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CAPTOPRIL 12.5MG TAB (CAPOTEN),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CAPTOPRIL 12.5MG TAB (CAPOTEN),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DIGOXIN 0.50MG/2ML INJ (LANOXIN),J1160,HCPCS,636,RC,,both,70.95,63.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.66,,,,41.86,57.9
DIGOXIN 0.50MG/2ML INJ (LANOXIN),J1160,HCPCS,636,RC,,both,70.95,63.86,Cigna,Default,Percent of Total Billed Charges,41.86,,,,41.86,57.9
DIGOXIN 0.50MG/2ML INJ (LANOXIN),J1160,HCPCS,636,RC,,both,70.95,63.86,United Healthcare,Default,Fee Schedule,57.9,,,,41.86,57.9
ASPIRIN 600MG SUPP,637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ASPIRIN 600MG SUPP,637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ASPIRIN 600MG SUPP,637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
BUSPIRONE 10MG TAB (BUSPAR),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
BUSPIRONE 10MG TAB (BUSPAR),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
BUSPIRONE 10MG TAB (BUSPAR),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
ASPIRIN 300MG SUPP,637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ASPIRIN 300MG SUPP,637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ASPIRIN 300MG SUPP,637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
CEPHALEXIN 500MG CAP (KEFLEX),250,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
CEPHALEXIN 500MG CAP (KEFLEX),250,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
CEPHALEXIN 500MG CAP (KEFLEX),250,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
AMPICILLIN 1000 MG INJ,J0290,HCPCS,636,RC,,both,43.58,39.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.51,,,,25.71,35.56
AMPICILLIN 1000 MG INJ,J0290,HCPCS,636,RC,,both,43.58,39.22,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.56
AMPICILLIN 1000 MG INJ,J0290,HCPCS,636,RC,,both,43.58,39.22,United Healthcare,Default,Fee Schedule,35.56,,,,25.71,35.56
ACETAMINOPHEN 325MG SUPP (TYLENOL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ACETAMINOPHEN 325MG SUPP (TYLENOL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ACETAMINOPHEN 325MG SUPP (TYLENOL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CLONAZEPAM 0.5MG TAB (KLONOPIN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CLONAZEPAM 0.5MG TAB (KLONOPIN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CLONAZEPAM 0.5MG TAB (KLONOPIN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
AMPICILLIN 2000MG INJ,J0290,HCPCS,636,RC,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
AMPICILLIN 2000MG INJ,J0290,HCPCS,636,RC,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
AMPICILLIN 2000MG INJ,J0290,HCPCS,636,RC,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
CIPROFLOXACIN 500MG TAB (CIPRO),637,RC,,,,both,20.33,18.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.23,,,,11.99,16.59
CIPROFLOXACIN 500MG TAB (CIPRO),637,RC,,,,both,20.33,18.3,Cigna,Default,Percent of Total Billed Charges,11.99,,,,11.99,16.59
CIPROFLOXACIN 500MG TAB (CIPRO),637,RC,,,,both,20.33,18.3,United Healthcare,Default,Fee Schedule,16.59,,,,11.99,16.59
TRIMETHOBENZAMIDE 200MG/2ML INJ (TIGAN),J3250,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
TRIMETHOBENZAMIDE 200MG/2ML INJ (TIGAN),J3250,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
TRIMETHOBENZAMIDE 200MG/2ML INJ (TIGAN),J3250,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
CHLORPROMAZINE 100MG TAB (THORAZINE),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLORPROMAZINE 100MG TAB (THORAZINE),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLORPROMAZINE 100MG TAB (THORAZINE),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
AMINOPHYLLINE INJ 25MG/ML 10ML,J0280,HCPCS,636,RC,,both,73.82,66.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.67,,,,43.55,60.24
AMINOPHYLLINE INJ 25MG/ML 10ML,J0280,HCPCS,636,RC,,both,73.82,66.44,Cigna,Default,Percent of Total Billed Charges,43.55,,,,43.55,60.24
AMINOPHYLLINE INJ 25MG/ML 10ML,J0280,HCPCS,636,RC,,both,73.82,66.44,United Healthcare,Default,Fee Schedule,60.24,,,,43.55,60.24
DIPHENHYDRAMINE 50MG/ML INJ  (BENADRYL),J1200,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
DIPHENHYDRAMINE 50MG/ML INJ  (BENADRYL),J1200,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
DIPHENHYDRAMINE 50MG/ML INJ  (BENADRYL),J1200,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
TRIAM/HCTZ 37.5/25MG CAP (DYAZIDE),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
TRIAM/HCTZ 37.5/25MG CAP (DYAZIDE),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
TRIAM/HCTZ 37.5/25MG CAP (DYAZIDE),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ASPIRIN EC 325MG TAB,637,RC,,,,both,6.95,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.1,5.67
ASPIRIN EC 325MG TAB,637,RC,,,,both,6.95,6.26,Cigna,Default,Percent of Total Billed Charges,4.1,,,,4.1,5.67
ASPIRIN EC 325MG TAB,637,RC,,,,both,6.95,6.26,United Healthcare,Default,Fee Schedule,5.67,,,,4.1,5.67
ERYTHROMYCIN 400MG FILMTABS (E.E.S.),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ERYTHROMYCIN 400MG FILMTABS (E.E.S.),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ERYTHROMYCIN 400MG FILMTABS (E.E.S.),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
CARISOPRODOL 350MG TAB (SOMA),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
CARISOPRODOL 350MG TAB (SOMA),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
CARISOPRODOL 350MG TAB (SOMA),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
CLINDAMYCIN 600MG/4ML  4ML INJ (CLEOCIN),250,RC,,,,both,54.2,48.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.94,,,,31.98,44.23
CLINDAMYCIN 600MG/4ML  4ML INJ (CLEOCIN),250,RC,,,,both,54.2,48.78,Cigna,Default,Percent of Total Billed Charges,31.98,,,,31.98,44.23
CLINDAMYCIN 600MG/4ML  4ML INJ (CLEOCIN),250,RC,,,,both,54.2,48.78,United Healthcare,Default,Fee Schedule,44.23,,,,31.98,44.23
GUAIFENESIN W/CODEINE 5ML U/D ELIXIR (T,637,RC,,,,both,5.8,5.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.06,,,,3.42,4.73
GUAIFENESIN W/CODEINE 5ML U/D ELIXIR (T,637,RC,,,,both,5.8,5.22,Cigna,Default,Percent of Total Billed Charges,3.42,,,,3.42,4.73
GUAIFENESIN W/CODEINE 5ML U/D ELIXIR (T,637,RC,,,,both,5.8,5.22,United Healthcare,Default,Fee Schedule,4.73,,,,3.42,4.73
TRIAMCINOLONE 40MG/ML 5ML MDV (KENALOG),J3301,HCPCS,636,RC,,both,173.94,156.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.76,,,,102.62,141.94
TRIAMCINOLONE 40MG/ML 5ML MDV (KENALOG),J3301,HCPCS,636,RC,,both,173.94,156.55,Cigna,Default,Percent of Total Billed Charges,102.62,,,,102.62,141.94
TRIAMCINOLONE 40MG/ML 5ML MDV (KENALOG),J3301,HCPCS,636,RC,,both,173.94,156.55,United Healthcare,Default,Fee Schedule,141.94,,,,102.62,141.94
THROMBIN TOPICAL 5000 IU,250,RC,,,,both,383,344.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,268.1,,,,225.97,312.53
THROMBIN TOPICAL 5000 IU,250,RC,,,,both,383,344.7,Cigna,Default,Percent of Total Billed Charges,225.97,,,,225.97,312.53
THROMBIN TOPICAL 5000 IU,250,RC,,,,both,383,344.7,United Healthcare,Default,Fee Schedule,312.53,,,,225.97,312.53
ERYTHROMYCIN 250MG TAB (ERY-TAB),250,RC,,,,both,71.13,64.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.79,,,,41.97,58.04
ERYTHROMYCIN 250MG TAB (ERY-TAB),250,RC,,,,both,71.13,64.02,Cigna,Default,Percent of Total Billed Charges,41.97,,,,41.97,58.04
ERYTHROMYCIN 250MG TAB (ERY-TAB),250,RC,,,,both,71.13,64.02,United Healthcare,Default,Fee Schedule,58.04,,,,41.97,58.04
TRIAMCINOLONE 0.025% 80 GM CRM (KENALOG),637,RC,,,,both,51.84,46.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.29,,,,30.59,42.3
TRIAMCINOLONE 0.025% 80 GM CRM (KENALOG),637,RC,,,,both,51.84,46.66,Cigna,Default,Percent of Total Billed Charges,30.59,,,,30.59,42.3
TRIAMCINOLONE 0.025% 80 GM CRM (KENALOG),637,RC,,,,both,51.84,46.66,United Healthcare,Default,Fee Schedule,42.3,,,,30.59,42.3
ESTRADIOL 1MG TAB (ESTRACE),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ESTRADIOL 1MG TAB (ESTRACE),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ESTRADIOL 1MG TAB (ESTRACE),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
SALINE ENEMA (FLEET),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
SALINE ENEMA (FLEET),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
SALINE ENEMA (FLEET),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
FERROUS SULFATE 325 MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
FERROUS SULFATE 325 MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
FERROUS SULFATE 325 MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ERYTHROMYCIN 500MG ADV (ERYTHROCIN),250,RC,,,,both,45,40.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.5,,,,26.55,36.72
ERYTHROMYCIN 500MG ADV (ERYTHROCIN),250,RC,,,,both,45,40.5,Cigna,Default,Percent of Total Billed Charges,26.55,,,,26.55,36.72
ERYTHROMYCIN 500MG ADV (ERYTHROCIN),250,RC,,,,both,45,40.5,United Healthcare,Default,Fee Schedule,36.72,,,,26.55,36.72
CHLORPROMAZINE 50MG TAB (THORAZINE),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLORPROMAZINE 50MG TAB (THORAZINE),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLORPROMAZINE 50MG TAB (THORAZINE),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
ERYTHROMYCIN 1000MG INJ (ERITHROCIN),J1364,HCPCS,636,RC,,both,93.27,83.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.29,,,,55.03,76.11
ERYTHROMYCIN 1000MG INJ (ERITHROCIN),J1364,HCPCS,636,RC,,both,93.27,83.94,Cigna,Default,Percent of Total Billed Charges,55.03,,,,55.03,76.11
ERYTHROMYCIN 1000MG INJ (ERITHROCIN),J1364,HCPCS,636,RC,,both,93.27,83.94,United Healthcare,Default,Fee Schedule,76.11,,,,55.03,76.11
BUTALBITAL/ASPIRIN/CAFFEINE TAB,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
BUTALBITAL/ASPIRIN/CAFFEINE TAB,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
BUTALBITAL/ASPIRIN/CAFFEINE TAB,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
TRIAMCINOLONE 40MG/1ML INJ (KENALOG),J3301,HCPCS,636,RC,,both,49.69,44.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.78,,,,29.32,40.55
TRIAMCINOLONE 40MG/1ML INJ (KENALOG),J3301,HCPCS,636,RC,,both,49.69,44.72,Cigna,Default,Percent of Total Billed Charges,29.32,,,,29.32,40.55
TRIAMCINOLONE 40MG/1ML INJ (KENALOG),J3301,HCPCS,636,RC,,both,49.69,44.72,United Healthcare,Default,Fee Schedule,40.55,,,,29.32,40.55
POTASSIUM CHLORIDE 40MEQ/20ML INJ,250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
POTASSIUM CHLORIDE 40MEQ/20ML INJ,250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
POTASSIUM CHLORIDE 40MEQ/20ML INJ,250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
CLONIDINE TTS-3 PATCH (CATAPRES),637,RC,,,,both,332.65,299.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,232.86,,,,196.26,271.44
CLONIDINE TTS-3 PATCH (CATAPRES),637,RC,,,,both,332.65,299.39,Cigna,Default,Percent of Total Billed Charges,196.26,,,,196.26,271.44
CLONIDINE TTS-3 PATCH (CATAPRES),637,RC,,,,both,332.65,299.39,United Healthcare,Default,Fee Schedule,271.44,,,,196.26,271.44
POTASSIUM CHLORIDE 10MEQ/5ML INJ,250,RC,,,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
POTASSIUM CHLORIDE 10MEQ/5ML INJ,250,RC,,,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
POTASSIUM CHLORIDE 10MEQ/5ML INJ,250,RC,,,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
CYCLOBENZAPRINE 10MG TAB (FLEXERIL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CYCLOBENZAPRINE 10MG TAB (FLEXERIL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CYCLOBENZAPRINE 10MG TAB (FLEXERIL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
FOLIC ACID 1MG TAB,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
FOLIC ACID 1MG TAB,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
FOLIC ACID 1MG TAB,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
FOLIC ACID INJ 5MG/ML,250,RC,,,,both,59.56,53.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.69,,,,35.14,48.6
FOLIC ACID INJ 5MG/ML,250,RC,,,,both,59.56,53.6,Cigna,Default,Percent of Total Billed Charges,35.14,,,,35.14,48.6
FOLIC ACID INJ 5MG/ML,250,RC,,,,both,59.56,53.6,United Healthcare,Default,Fee Schedule,48.6,,,,35.14,48.6
LACTULOSE 10GM/15ML U/D CUP,250,RC,,,,both,10.74,9.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.52,,,,6.34,8.76
LACTULOSE 10GM/15ML U/D CUP,250,RC,,,,both,10.74,9.67,Cigna,Default,Percent of Total Billed Charges,6.34,,,,6.34,8.76
LACTULOSE 10GM/15ML U/D CUP,250,RC,,,,both,10.74,9.67,United Healthcare,Default,Fee Schedule,8.76,,,,6.34,8.76
LINCOMYCIN 300MG/ML INJ (LINCOCIN),250,RC,,,,both,130.38,117.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.27,,,,76.92,106.39
LINCOMYCIN 300MG/ML INJ (LINCOCIN),250,RC,,,,both,130.38,117.34,Cigna,Default,Percent of Total Billed Charges,76.92,,,,76.92,106.39
LINCOMYCIN 300MG/ML INJ (LINCOCIN),250,RC,,,,both,130.38,117.34,United Healthcare,Default,Fee Schedule,106.39,,,,76.92,106.39
POLYCARBOPHIL 500MG TAB (FIBERCON),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
POLYCARBOPHIL 500MG TAB (FIBERCON),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
POLYCARBOPHIL 500MG TAB (FIBERCON),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
HALOPERIDOL 5MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
HALOPERIDOL 5MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
HALOPERIDOL 5MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
HALOPERIDOL 1MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
HALOPERIDOL 1MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
HALOPERIDOL 1MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CEFOXITIN 1000MG INJ (MEFOXIN),J0694,HCPCS,636,RC,,both,54.34,48.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.04,,,,32.06,44.34
CEFOXITIN 1000MG INJ (MEFOXIN),J0694,HCPCS,636,RC,,both,54.34,48.91,Cigna,Default,Percent of Total Billed Charges,32.06,,,,32.06,44.34
CEFOXITIN 1000MG INJ (MEFOXIN),J0694,HCPCS,636,RC,,both,54.34,48.91,United Healthcare,Default,Fee Schedule,44.34,,,,32.06,44.34
HALOPERIDOL 0.5MG TAB (HALDOL),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HALOPERIDOL 0.5MG TAB (HALDOL),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HALOPERIDOL 0.5MG TAB (HALDOL),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CHLORPROMAZINE 25MG/1ML INJ (THORAZIN,J3230,HCPCS,636,RC,,both,38.36,34.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.85,,,,22.63,31.3
CHLORPROMAZINE 25MG/1ML INJ (THORAZIN,J3230,HCPCS,636,RC,,both,38.36,34.52,Cigna,Default,Percent of Total Billed Charges,22.63,,,,22.63,31.3
CHLORPROMAZINE 25MG/1ML INJ (THORAZIN,J3230,HCPCS,636,RC,,both,38.36,34.52,United Healthcare,Default,Fee Schedule,31.3,,,,22.63,31.3
CHLORPROMAZINE 25MG TAB,Q0161,HCPCS,636,RC,,both,35.62,32.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.93,,,,21.02,29.07
CHLORPROMAZINE 25MG TAB,Q0161,HCPCS,636,RC,,both,35.62,32.06,Cigna,Default,Percent of Total Billed Charges,21.02,,,,21.02,29.07
CHLORPROMAZINE 25MG TAB,Q0161,HCPCS,636,RC,,both,35.62,32.06,United Healthcare,Default,Fee Schedule,29.07,,,,21.02,29.07
HALOPERIDOL TABS 2MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
HALOPERIDOL TABS 2MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
HALOPERIDOL TABS 2MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
CITRATE OF MAG 300ML LIQ,637,RC,,,,both,10.84,9.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.59,,,,6.4,8.85
CITRATE OF MAG 300ML LIQ,637,RC,,,,both,10.84,9.76,Cigna,Default,Percent of Total Billed Charges,6.4,,,,6.4,8.85
CITRATE OF MAG 300ML LIQ,637,RC,,,,both,10.84,9.76,United Healthcare,Default,Fee Schedule,8.85,,,,6.4,8.85
MINERAL OIL 472ML BOTTLE,250,RC,,,,both,30.53,27.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.37,,,,18.01,24.91
MINERAL OIL 472ML BOTTLE,250,RC,,,,both,30.53,27.48,Cigna,Default,Percent of Total Billed Charges,18.01,,,,18.01,24.91
MINERAL OIL 472ML BOTTLE,250,RC,,,,both,30.53,27.48,United Healthcare,Default,Fee Schedule,24.91,,,,18.01,24.91
MYLANTA SUSP,250,RC,,,,both,14.75,13.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.32,,,,8.7,12.04
MYLANTA SUSP,250,RC,,,,both,14.75,13.28,Cigna,Default,Percent of Total Billed Charges,8.7,,,,8.7,12.04
MYLANTA SUSP,250,RC,,,,both,14.75,13.28,United Healthcare,Default,Fee Schedule,12.04,,,,8.7,12.04
HYDROXYUREA 500MG CAP (HYDREA),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HYDROXYUREA 500MG CAP (HYDREA),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HYDROXYUREA 500MG CAP (HYDREA),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
MILK OF MAG SUSP 30 ML,250,RC,,,,both,10.36,9.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.25,,,,6.11,8.45
MILK OF MAG SUSP 30 ML,250,RC,,,,both,10.36,9.32,Cigna,Default,Percent of Total Billed Charges,6.11,,,,6.11,8.45
MILK OF MAG SUSP 30 ML,250,RC,,,,both,10.36,9.32,United Healthcare,Default,Fee Schedule,8.45,,,,6.11,8.45
NUPERCAINAL 1% OINT 60 GM TUBE,250,RC,,,,both,26.45,23.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.52,,,,15.61,21.58
NUPERCAINAL 1% OINT 60 GM TUBE,250,RC,,,,both,26.45,23.81,Cigna,Default,Percent of Total Billed Charges,15.61,,,,15.61,21.58
NUPERCAINAL 1% OINT 60 GM TUBE,250,RC,,,,both,26.45,23.81,United Healthcare,Default,Fee Schedule,21.58,,,,15.61,21.58
HYDROCODONE & CHLORPHENIRAMINE 5ML SUSP,637,RC,,,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
HYDROCODONE & CHLORPHENIRAMINE 5ML SUSP,637,RC,,,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
HYDROCODONE & CHLORPHENIRAMINE 5ML SUSP,637,RC,,,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
HEXACHLOROPHENE 3% LIQ SOAP(PHISOHEX),250,RC,,,,both,65.67,59.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.97,,,,38.75,53.59
HEXACHLOROPHENE 3% LIQ SOAP(PHISOHEX),250,RC,,,,both,65.67,59.1,Cigna,Default,Percent of Total Billed Charges,38.75,,,,38.75,53.59
HEXACHLOROPHENE 3% LIQ SOAP(PHISOHEX),250,RC,,,,both,65.67,59.1,United Healthcare,Default,Fee Schedule,53.59,,,,38.75,53.59
GUAIFENESIN 200MG/10ML (ROBITUSSIN),637,RC,,,,both,6.63,5.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.64,,,,3.91,5.41
GUAIFENESIN 200MG/10ML (ROBITUSSIN),637,RC,,,,both,6.63,5.97,Cigna,Default,Percent of Total Billed Charges,3.91,,,,3.91,5.41
GUAIFENESIN 200MG/10ML (ROBITUSSIN),637,RC,,,,both,6.63,5.97,United Healthcare,Default,Fee Schedule,5.41,,,,3.91,5.41
LOPERAMIDE HCL 2MG CAP (IMODIUM),637,RC,,,,both,8.92,8.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.24,,,,5.26,7.28
LOPERAMIDE HCL 2MG CAP (IMODIUM),637,RC,,,,both,8.92,8.03,Cigna,Default,Percent of Total Billed Charges,5.26,,,,5.26,7.28
LOPERAMIDE HCL 2MG CAP (IMODIUM),637,RC,,,,both,8.92,8.03,United Healthcare,Default,Fee Schedule,7.28,,,,5.26,7.28
METHYLPREDNISOLONE 40MG/1ML INJ (SOLU-ME,J2919,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
METHYLPREDNISOLONE 40MG/1ML INJ (SOLU-ME,J2919,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
METHYLPREDNISOLONE 40MG/1ML INJ (SOLU-ME,J2919,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ACETAMINOPHEN SUPP 650MG (TYLENOL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ACETAMINOPHEN SUPP 650MG (TYLENOL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ACETAMINOPHEN SUPP 650MG (TYLENOL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
METHYLPREDNISOLONE 1000 MG/8ML INJ,J2919,HCPCS,636,RC,,both,301.59,271.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.11,,,,177.94,246.1
METHYLPREDNISOLONE 1000 MG/8ML INJ,J2919,HCPCS,636,RC,,both,301.59,271.43,Cigna,Default,Percent of Total Billed Charges,177.94,,,,177.94,246.1
METHYLPREDNISOLONE 1000 MG/8ML INJ,J2919,HCPCS,636,RC,,both,301.59,271.43,United Healthcare,Default,Fee Schedule,246.1,,,,177.94,246.1
METHYLPREDNISOLONE 125 MG/2ML INJ,J2919,HCPCS,636,RC,,both,60.11,54.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.08,,,,35.46,49.05
METHYLPREDNISOLONE 125 MG/2ML INJ,J2919,HCPCS,636,RC,,both,60.11,54.1,Cigna,Default,Percent of Total Billed Charges,35.46,,,,35.46,49.05
METHYLPREDNISOLONE 125 MG/2ML INJ,J2919,HCPCS,636,RC,,both,60.11,54.1,United Healthcare,Default,Fee Schedule,49.05,,,,35.46,49.05
PROPRANOLOL LA 80MG CAP (INDERAL LA),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PROPRANOLOL LA 80MG CAP (INDERAL LA),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PROPRANOLOL LA 80MG CAP (INDERAL LA),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
STADOL INJ 2MG/ML,J0595,HCPCS,636,RC,,both,41.25,37.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.88,,,,24.34,33.66
STADOL INJ 2MG/ML,J0595,HCPCS,636,RC,,both,41.25,37.13,Cigna,Default,Percent of Total Billed Charges,24.34,,,,24.34,33.66
STADOL INJ 2MG/ML,J0595,HCPCS,636,RC,,both,41.25,37.13,United Healthcare,Default,Fee Schedule,33.66,,,,24.34,33.66
PROPRANOLOL 40MG TAB (INDERAL),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PROPRANOLOL 40MG TAB (INDERAL),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PROPRANOLOL 40MG TAB (INDERAL),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
OCTREOTICLE 0.05MG (SANDOSTATIN),J2354,HCPCS,636,RC,,both,38.72,34.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.1,,,,22.84,31.6
OCTREOTICLE 0.05MG (SANDOSTATIN),J2354,HCPCS,636,RC,,both,38.72,34.85,Cigna,Default,Percent of Total Billed Charges,22.84,,,,22.84,31.6
OCTREOTICLE 0.05MG (SANDOSTATIN),J2354,HCPCS,636,RC,,both,38.72,34.85,United Healthcare,Default,Fee Schedule,31.6,,,,22.84,31.6
CLONIDINE HCL 0.1MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CLONIDINE HCL 0.1MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CLONIDINE HCL 0.1MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CLONIDINE HCL 0.2MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CLONIDINE HCL 0.2MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CLONIDINE HCL 0.2MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DIAZEPAM 10MG/2ML INJ (VALIUM),J3360,HCPCS,636,RC,,both,160.1,144.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.07,,,,94.46,130.64
DIAZEPAM 10MG/2ML INJ (VALIUM),J3360,HCPCS,636,RC,,both,160.1,144.09,Cigna,Default,Percent of Total Billed Charges,94.46,,,,94.46,130.64
DIAZEPAM 10MG/2ML INJ (VALIUM),J3360,HCPCS,636,RC,,both,160.1,144.09,United Healthcare,Default,Fee Schedule,130.64,,,,94.46,130.64
INDOMETHACIN 50MG CAP (INDOCIN),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
INDOMETHACIN 50MG CAP (INDOCIN),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
INDOMETHACIN 50MG CAP (INDOCIN),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
INDOMETHACIN 25MG CAP (INDOCIN),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
INDOMETHACIN 25MG CAP (INDOCIN),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
INDOMETHACIN 25MG CAP (INDOCIN),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CARA KLENZ WOUND CLEANSE,250,RC,,,,both,76.41,68.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.49,,,,45.08,62.35
CARA KLENZ WOUND CLEANSE,250,RC,,,,both,76.41,68.77,Cigna,Default,Percent of Total Billed Charges,45.08,,,,45.08,62.35
CARA KLENZ WOUND CLEANSE,250,RC,,,,both,76.41,68.77,United Healthcare,Default,Fee Schedule,62.35,,,,45.08,62.35
MORPHINE SULFATE 2MG/ML INJ,J2270,HCPCS,636,RC,,both,33.46,30.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.42,,,,19.74,27.3
MORPHINE SULFATE 2MG/ML INJ,J2270,HCPCS,636,RC,,both,33.46,30.11,Cigna,Default,Percent of Total Billed Charges,19.74,,,,19.74,27.3
MORPHINE SULFATE 2MG/ML INJ,J2270,HCPCS,636,RC,,both,33.46,30.11,United Healthcare,Default,Fee Schedule,27.3,,,,19.74,27.3
COUMADIN TABS 7.5MG,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
COUMADIN TABS 7.5MG,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
COUMADIN TABS 7.5MG,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
NEO/POLY/HC OTIC SOLN (CORTISPORIN),250,RC,,,,both,70.9,63.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.63,,,,41.83,57.85
NEO/POLY/HC OTIC SOLN (CORTISPORIN),250,RC,,,,both,70.9,63.81,Cigna,Default,Percent of Total Billed Charges,41.83,,,,41.83,57.85
NEO/POLY/HC OTIC SOLN (CORTISPORIN),250,RC,,,,both,70.9,63.81,United Healthcare,Default,Fee Schedule,57.85,,,,41.83,57.85
D5W/0.45%NS + 20MEQ KCL 1000ML IV FLUID,J3480,HCPCS,636,RC,,both,81.05,72.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.74,,,,47.82,66.14
D5W/0.45%NS + 20MEQ KCL 1000ML IV FLUID,J3480,HCPCS,636,RC,,both,81.05,72.95,Cigna,Default,Percent of Total Billed Charges,47.82,,,,47.82,66.14
D5W/0.45%NS + 20MEQ KCL 1000ML IV FLUID,J3480,HCPCS,636,RC,,both,81.05,72.95,United Healthcare,Default,Fee Schedule,66.14,,,,47.82,66.14
VERAPAMIL HCL 120MG TAB (CALAN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
VERAPAMIL HCL 120MG TAB (CALAN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
VERAPAMIL HCL 120MG TAB (CALAN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
TOBRAMYCIN & DEXAMETHASONE OPTH 2.5ML,637,RC,,,,both,267.88,241.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.52,,,,158.05,218.59
TOBRAMYCIN & DEXAMETHASONE OPTH 2.5ML,637,RC,,,,both,267.88,241.09,Cigna,Default,Percent of Total Billed Charges,158.05,,,,158.05,218.59
TOBRAMYCIN & DEXAMETHASONE OPTH 2.5ML,637,RC,,,,both,267.88,241.09,United Healthcare,Default,Fee Schedule,218.59,,,,158.05,218.59
LIDOCAINE 2% 50ML INJ (XYLOCAINE),250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
LIDOCAINE 2% 50ML INJ (XYLOCAINE),250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
LIDOCAINE 2% 50ML INJ (XYLOCAINE),250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
ISOSORBIDE DINITRATE 20MG TAB (ISORDIL),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ISOSORBIDE DINITRATE 20MG TAB (ISORDIL),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ISOSORBIDE DINITRATE 20MG TAB (ISORDIL),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
ISOSORBIDE DIN 10MG (ISORDIL TITRADOSE),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
ISOSORBIDE DIN 10MG (ISORDIL TITRADOSE),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
ISOSORBIDE DIN 10MG (ISORDIL TITRADOSE),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CEPHALEXIN 250MG CAP (KEFLEX),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CEPHALEXIN 250MG CAP (KEFLEX),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CEPHALEXIN 250MG CAP (KEFLEX),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
NEO/POLY/HC OTIC SUSP (CORTISPORIN),250,RC,,,,both,432.92,389.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,303.04,,,,255.42,353.26
NEO/POLY/HC OTIC SUSP (CORTISPORIN),250,RC,,,,both,432.92,389.63,Cigna,Default,Percent of Total Billed Charges,255.42,,,,255.42,353.26
NEO/POLY/HC OTIC SUSP (CORTISPORIN),250,RC,,,,both,432.92,389.63,United Healthcare,Default,Fee Schedule,353.26,,,,255.42,353.26
FUROSEMIDE 100MG/10ML INJ (LASIX),J1940,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
FUROSEMIDE 100MG/10ML INJ (LASIX),J1940,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
FUROSEMIDE 100MG/10ML INJ (LASIX),J1940,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
HYDROCORTISONE 100MG/60ML (CORTENEMA),250,RC,,,,both,110.57,99.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,77.4,,,,65.24,90.23
HYDROCORTISONE 100MG/60ML (CORTENEMA),250,RC,,,,both,110.57,99.51,Cigna,Default,Percent of Total Billed Charges,65.24,,,,65.24,90.23
HYDROCORTISONE 100MG/60ML (CORTENEMA),250,RC,,,,both,110.57,99.51,United Healthcare,Default,Fee Schedule,90.23,,,,65.24,90.23
FUROSEMIDE 40MG TAB (LASIX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
FUROSEMIDE 40MG TAB (LASIX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
FUROSEMIDE 40MG TAB (LASIX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
FUROSEMIDE 20MG TAB (LASIX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
FUROSEMIDE 20MG TAB (LASIX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
FUROSEMIDE 20MG TAB (LASIX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
FUROSEMIDE 80MG TAB (LASIX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
FUROSEMIDE 80MG TAB (LASIX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
FUROSEMIDE 80MG TAB (LASIX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
BETHANECHOL 25MG TAB (URECHOLINE),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
BETHANECHOL 25MG TAB (URECHOLINE),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
BETHANECHOL 25MG TAB (URECHOLINE),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
LEVOTHROID TABS 25MCG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHROID TABS 25MCG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHROID TABS 25MCG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
LEVOTHROID TABS 150MCG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHROID TABS 150MCG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHROID TABS 150MCG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
LEVOTHROID TABS 200MCG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
LEVOTHROID TABS 200MCG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
LEVOTHROID TABS 200MCG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
AZTREONAM INJ 1000MG (AZACTAM),J0457,HCPCS,250,RC,,both,186.17,167.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,130.32,,,,109.84,151.91
AZTREONAM INJ 1000MG (AZACTAM),J0457,HCPCS,250,RC,,both,186.17,167.55,Cigna,Default,Percent of Total Billed Charges,109.84,,,,109.84,151.91
AZTREONAM INJ 1000MG (AZACTAM),J0457,HCPCS,250,RC,,both,186.17,167.55,United Healthcare,Default,Fee Schedule,151.91,,,,109.84,151.91
LEVOTHROID TABS 100MCG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHROID TABS 100MCG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHROID TABS 100MCG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
LEVOTHROID TABS 50MCG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHROID TABS 50MCG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHROID TABS 50MCG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
LEVOTHYROXINE  0.1MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
LEVOTHYROXINE  0.1MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
LEVOTHYROXINE  0.1MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CALCIUM CHLORIDE 10ML INJ,250,RC,,,,both,26.83,24.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.78,,,,15.83,21.89
CALCIUM CHLORIDE 10ML INJ,250,RC,,,,both,26.83,24.15,Cigna,Default,Percent of Total Billed Charges,15.83,,,,15.83,21.89
CALCIUM CHLORIDE 10ML INJ,250,RC,,,,both,26.83,24.15,United Healthcare,Default,Fee Schedule,21.89,,,,15.83,21.89
CHLORDIAZEPOXIDE 25MG CAP (LIBRIUM),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CHLORDIAZEPOXIDE 25MG CAP (LIBRIUM),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CHLORDIAZEPOXIDE 25MG CAP (LIBRIUM),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CHLORDIAZEPOXIDE 10MG CAP (LIBRIUM),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLORDIAZEPOXIDE 10MG CAP (LIBRIUM),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLORDIAZEPOXIDE 10MG CAP (LIBRIUM),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DIPHENOXYLATE/ATROPINE TAB (LOMOTIL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DIPHENOXYLATE/ATROPINE TAB (LOMOTIL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DIPHENOXYLATE/ATROPINE TAB (LOMOTIL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
INDAPAMIDE 2.5MG TAB (LOZOL),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
INDAPAMIDE 2.5MG TAB (LOZOL),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
INDAPAMIDE 2.5MG TAB (LOZOL),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
CALCIUM GLUCONATE 10% 50ML INJ,J0612,HCPCS,250,RC,,both,33.46,30.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.42,,,,19.74,27.3
CALCIUM GLUCONATE 10% 50ML INJ,J0612,HCPCS,250,RC,,both,33.46,30.11,Cigna,Default,Percent of Total Billed Charges,19.74,,,,19.74,27.3
CALCIUM GLUCONATE 10% 50ML INJ,J0612,HCPCS,250,RC,,both,33.46,30.11,United Healthcare,Default,Fee Schedule,27.3,,,,19.74,27.3
HYOSCYAMINE 0.125MG SL TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
HYOSCYAMINE 0.125MG SL TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
HYOSCYAMINE 0.125MG SL TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
METOPROLOL TART 50MG TAB (LOPRESSOR),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
METOPROLOL TART 50MG TAB (LOPRESSOR),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
METOPROLOL TART 50MG TAB (LOPRESSOR),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
NOREPINEPHRINE BITART 4MG/4ML INJ (LE,250,RC,,,,both,55.21,49.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.65,,,,32.57,45.05
NOREPINEPHRINE BITART 4MG/4ML INJ (LE,250,RC,,,,both,55.21,49.69,Cigna,Default,Percent of Total Billed Charges,32.57,,,,32.57,45.05
NOREPINEPHRINE BITART 4MG/4ML INJ (LE,250,RC,,,,both,55.21,49.69,United Healthcare,Default,Fee Schedule,45.05,,,,32.57,45.05
NITROFURANTOIN 100MG CAP (MACROBID),637,RC,,,,both,16.19,14.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.33,,,,9.55,13.21
NITROFURANTOIN 100MG CAP (MACROBID),637,RC,,,,both,16.19,14.57,Cigna,Default,Percent of Total Billed Charges,9.55,,,,9.55,13.21
NITROFURANTOIN 100MG CAP (MACROBID),637,RC,,,,both,16.19,14.57,United Healthcare,Default,Fee Schedule,13.21,,,,9.55,13.21
NITROFURANTOIN 50MG CAP (MACRODANTIN),637,RC,,,,both,19,17.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.3,,,,11.21,15.5
NITROFURANTOIN 50MG CAP (MACRODANTIN),637,RC,,,,both,19,17.1,Cigna,Default,Percent of Total Billed Charges,11.21,,,,11.21,15.5
NITROFURANTOIN 50MG CAP (MACRODANTIN),637,RC,,,,both,19,17.1,United Healthcare,Default,Fee Schedule,15.5,,,,11.21,15.5
CHLORDIAZEPOXIDE 5MG CAP (LIBRIUM),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLORDIAZEPOXIDE 5MG CAP (LIBRIUM),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLORDIAZEPOXIDE 5MG CAP (LIBRIUM),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
AMOXICILLIN 875MG TAB,637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
AMOXICILLIN 875MG TAB,637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
AMOXICILLIN 875MG TAB,637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
LEFLUNOMIDE 20MG TAB (ARAVA),250,RC,,,,both,38.25,34.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.78,,,,22.57,31.21
LEFLUNOMIDE 20MG TAB (ARAVA),250,RC,,,,both,38.25,34.43,Cigna,Default,Percent of Total Billed Charges,22.57,,,,22.57,31.21
LEFLUNOMIDE 20MG TAB (ARAVA),250,RC,,,,both,38.25,34.43,United Healthcare,Default,Fee Schedule,31.21,,,,22.57,31.21
GLYCOPYRROLATE 0.4MG/2ML INJ (ROBINUL),J1596,HCPCS,636,RC,,both,133.66,120.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.56,,,,78.86,109.07
GLYCOPYRROLATE 0.4MG/2ML INJ (ROBINUL),J1596,HCPCS,636,RC,,both,133.66,120.29,Cigna,Default,Percent of Total Billed Charges,78.86,,,,78.86,109.07
GLYCOPYRROLATE 0.4MG/2ML INJ (ROBINUL),J1596,HCPCS,636,RC,,both,133.66,120.29,United Healthcare,Default,Fee Schedule,109.07,,,,78.86,109.07
CHLOROTHIAZIDE 500MG TAB  (DIURIL),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLOROTHIAZIDE 500MG TAB  (DIURIL),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLOROTHIAZIDE 500MG TAB  (DIURIL),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
TIROFIBAN 12.5 MG/250ML PREMIX (AGGRASTA,J3246,HCPCS,636,RC,,both,2070.12,1863.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1449.08,,,,1221.37,1689.22
TIROFIBAN 12.5 MG/250ML PREMIX (AGGRASTA,J3246,HCPCS,636,RC,,both,2070.12,1863.11,Cigna,Default,Percent of Total Billed Charges,1221.37,,,,1221.37,1689.22
TIROFIBAN 12.5 MG/250ML PREMIX (AGGRASTA,J3246,HCPCS,636,RC,,both,2070.12,1863.11,United Healthcare,Default,Fee Schedule,1689.22,,,,1221.37,1689.22
DEXTROSE 5% 100 CC BAG,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
DEXTROSE 5% 100 CC BAG,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
DEXTROSE 5% 100 CC BAG,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
IRON DEXTRAN 100MG/2ML INJ (INFED),J1750,HCPCS,636,RC,,both,183.23,164.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,128.26,,,,108.11,149.52
IRON DEXTRAN 100MG/2ML INJ (INFED),J1750,HCPCS,636,RC,,both,183.23,164.91,Cigna,Default,Percent of Total Billed Charges,108.11,,,,108.11,149.52
IRON DEXTRAN 100MG/2ML INJ (INFED),J1750,HCPCS,636,RC,,both,183.23,164.91,United Healthcare,Default,Fee Schedule,149.52,,,,108.11,149.52
CERUMENEX DROP,250,RC,,,,both,97.91,88.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.54,,,,57.77,79.89
CERUMENEX DROP,250,RC,,,,both,97.91,88.12,Cigna,Default,Percent of Total Billed Charges,57.77,,,,57.77,79.89
CERUMENEX DROP,250,RC,,,,both,97.91,88.12,United Healthcare,Default,Fee Schedule,79.89,,,,57.77,79.89
ESTRATEST TAB,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
ESTRATEST TAB,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
ESTRATEST TAB,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
CELECOXIB 100MG CAP (CELEBREX),637,RC,,,,both,10.74,9.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.52,,,,6.34,8.76
CELECOXIB 100MG CAP (CELEBREX),637,RC,,,,both,10.74,9.67,Cigna,Default,Percent of Total Billed Charges,6.34,,,,6.34,8.76
CELECOXIB 100MG CAP (CELEBREX),637,RC,,,,both,10.74,9.67,United Healthcare,Default,Fee Schedule,8.76,,,,6.34,8.76
CELECOXIB 200MG CAP (CELEBREX),250,RC,,,,both,32.6,29.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.82,,,,19.23,26.6
CELECOXIB 200MG CAP (CELEBREX),250,RC,,,,both,32.6,29.34,Cigna,Default,Percent of Total Billed Charges,19.23,,,,19.23,26.6
CELECOXIB 200MG CAP (CELEBREX),250,RC,,,,both,32.6,29.34,United Healthcare,Default,Fee Schedule,26.6,,,,19.23,26.6
CYCLOSPORINE 50MG/ML 5ML INJ (SANDIMMUNE,250,RC,,,,both,129.42,116.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.59,,,,76.36,105.61
CYCLOSPORINE 50MG/ML 5ML INJ (SANDIMMUNE,250,RC,,,,both,129.42,116.48,Cigna,Default,Percent of Total Billed Charges,76.36,,,,76.36,105.61
CYCLOSPORINE 50MG/ML 5ML INJ (SANDIMMUNE,250,RC,,,,both,129.42,116.48,United Healthcare,Default,Fee Schedule,105.61,,,,76.36,105.61
LEVOTHYROXINE SOD 0.088MG,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
LEVOTHYROXINE SOD 0.088MG,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
LEVOTHYROXINE SOD 0.088MG,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CITALOPRAM 20MG TAB (CELEXA),637,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
CITALOPRAM 20MG TAB (CELEXA),637,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
CITALOPRAM 20MG TAB (CELEXA),637,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
METRONIDAZOLE 0.75% TOPICAL GEL,637,RC,,,,both,148.46,133.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.92,,,,87.59,121.14
METRONIDAZOLE 0.75% TOPICAL GEL,637,RC,,,,both,148.46,133.61,Cigna,Default,Percent of Total Billed Charges,87.59,,,,87.59,121.14
METRONIDAZOLE 0.75% TOPICAL GEL,637,RC,,,,both,148.46,133.61,United Healthcare,Default,Fee Schedule,121.14,,,,87.59,121.14
BETAMETHASONE AF 0.05% CRM (DIPROLENE),J0702,HCPCS,636,RC,,both,328.61,295.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,230.03,,,,193.88,268.15
BETAMETHASONE AF 0.05% CRM (DIPROLENE),J0702,HCPCS,636,RC,,both,328.61,295.75,Cigna,Default,Percent of Total Billed Charges,193.88,,,,193.88,268.15
BETAMETHASONE AF 0.05% CRM (DIPROLENE),J0702,HCPCS,636,RC,,both,328.61,295.75,United Healthcare,Default,Fee Schedule,268.15,,,,193.88,268.15
BAC/NEO/POLY OPHTH OINT 3.5GM OINT(NEOSP,250,RC,,,,both,72.34,65.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.64,,,,42.68,59.03
BAC/NEO/POLY OPHTH OINT 3.5GM OINT(NEOSP,250,RC,,,,both,72.34,65.11,Cigna,Default,Percent of Total Billed Charges,42.68,,,,42.68,59.03
BAC/NEO/POLY OPHTH OINT 3.5GM OINT(NEOSP,250,RC,,,,both,72.34,65.11,United Healthcare,Default,Fee Schedule,59.03,,,,42.68,59.03
FUROSEMIDE 20MG INJ (LASIX),J1940,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
FUROSEMIDE 20MG INJ (LASIX),J1940,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
FUROSEMIDE 20MG INJ (LASIX),J1940,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
APRACLONIDINE OPTH SOL 0.5% 5ML (IOPIDIN,637,RC,,,,both,212.39,191.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,148.67,,,,125.31,173.31
APRACLONIDINE OPTH SOL 0.5% 5ML (IOPIDIN,637,RC,,,,both,212.39,191.15,Cigna,Default,Percent of Total Billed Charges,125.31,,,,125.31,173.31
APRACLONIDINE OPTH SOL 0.5% 5ML (IOPIDIN,637,RC,,,,both,212.39,191.15,United Healthcare,Default,Fee Schedule,173.31,,,,125.31,173.31
CALCITONIN NASAL SPRAY 3.7ML (MIACALCIN),637,RC,,,,both,133.07,119.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.15,,,,78.51,108.59
CALCITONIN NASAL SPRAY 3.7ML (MIACALCIN),637,RC,,,,both,133.07,119.76,Cigna,Default,Percent of Total Billed Charges,78.51,,,,78.51,108.59
CALCITONIN NASAL SPRAY 3.7ML (MIACALCIN),637,RC,,,,both,133.07,119.76,United Healthcare,Default,Fee Schedule,108.59,,,,78.51,108.59
DORZOLAMIDE/TIMOLOL EYE DROP (COSOPT),637,RC,,,,both,209.48,188.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,146.64,,,,123.59,170.94
DORZOLAMIDE/TIMOLOL EYE DROP (COSOPT),637,RC,,,,both,209.48,188.53,Cigna,Default,Percent of Total Billed Charges,123.59,,,,123.59,170.94
DORZOLAMIDE/TIMOLOL EYE DROP (COSOPT),637,RC,,,,both,209.48,188.53,United Healthcare,Default,Fee Schedule,170.94,,,,123.59,170.94
PROCHLORPERAZINE 25MG SUPPS,J8498,HCPCS,636,RC,,both,15.98,14.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.19,,,,9.43,13.04
PROCHLORPERAZINE 25MG SUPPS,J8498,HCPCS,636,RC,,both,15.98,14.38,Cigna,Default,Percent of Total Billed Charges,9.43,,,,9.43,13.04
PROCHLORPERAZINE 25MG SUPPS,J8498,HCPCS,636,RC,,both,15.98,14.38,United Healthcare,Default,Fee Schedule,13.04,,,,9.43,13.04
PSYLLIUM PKT (METAMUCIL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PSYLLIUM PKT (METAMUCIL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PSYLLIUM PKT (METAMUCIL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ENALAPRILAT 1.25MG/ML  SDV (VASOTEC),250,RC,,,,both,67.99,61.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.59,,,,40.11,55.48
ENALAPRILAT 1.25MG/ML  SDV (VASOTEC),250,RC,,,,both,67.99,61.19,Cigna,Default,Percent of Total Billed Charges,40.11,,,,40.11,55.48
ENALAPRILAT 1.25MG/ML  SDV (VASOTEC),250,RC,,,,both,67.99,61.19,United Healthcare,Default,Fee Schedule,55.48,,,,40.11,55.48
OMEPRAZOLE 20MG CAP (PRILOSEC),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
OMEPRAZOLE 20MG CAP (PRILOSEC),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
OMEPRAZOLE 20MG CAP (PRILOSEC),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
METHYLPREDNISOLONE 80MG/ML INJ (DEPO-MED,J1010,HCPCS,636,RC,,both,46.74,42.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.72,,,,27.58,38.14
METHYLPREDNISOLONE 80MG/ML INJ (DEPO-MED,J1010,HCPCS,636,RC,,both,46.74,42.07,Cigna,Default,Percent of Total Billed Charges,27.58,,,,27.58,38.14
METHYLPREDNISOLONE 80MG/ML INJ (DEPO-MED,J1010,HCPCS,636,RC,,both,46.74,42.07,United Healthcare,Default,Fee Schedule,38.14,,,,27.58,38.14
METHYLPREDNISOLONE ACE 40MG/ML INJ (DEPO,J1010,HCPCS,636,RC,,both,56.13,50.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.29,,,,33.12,45.8
METHYLPREDNISOLONE ACE 40MG/ML INJ (DEPO,J1010,HCPCS,636,RC,,both,56.13,50.52,Cigna,Default,Percent of Total Billed Charges,33.12,,,,33.12,45.8
METHYLPREDNISOLONE ACE 40MG/ML INJ (DEPO,J1010,HCPCS,636,RC,,both,56.13,50.52,United Healthcare,Default,Fee Schedule,45.8,,,,33.12,45.8
DOXYCYCLINE 200MG INJ (DOXY-200),250,RC,,,,both,144.08,129.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.86,,,,85.01,117.57
DOXYCYCLINE 200MG INJ (DOXY-200),250,RC,,,,both,144.08,129.67,Cigna,Default,Percent of Total Billed Charges,85.01,,,,85.01,117.57
DOXYCYCLINE 200MG INJ (DOXY-200),250,RC,,,,both,144.08,129.67,United Healthcare,Default,Fee Schedule,117.57,,,,85.01,117.57
MEPERIDINE HCL 100MG INJ (DEMEROL),J2175,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
MEPERIDINE HCL 100MG INJ (DEMEROL),J2175,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
MEPERIDINE HCL 100MG INJ (DEMEROL),J2175,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
TRIFLURIDINE OPTH SOL 1% (VIROPTIC),250,RC,,,,both,279.8,251.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,195.86,,,,165.08,228.32
TRIFLURIDINE OPTH SOL 1% (VIROPTIC),250,RC,,,,both,279.8,251.82,Cigna,Default,Percent of Total Billed Charges,165.08,,,,165.08,228.32
TRIFLURIDINE OPTH SOL 1% (VIROPTIC),250,RC,,,,both,279.8,251.82,United Healthcare,Default,Fee Schedule,228.32,,,,165.08,228.32
FENTANYL 25MCG/HR PATCH (DURAGESIC),250,RC,,,,both,94.38,84.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.07,,,,55.68,77.01
FENTANYL 25MCG/HR PATCH (DURAGESIC),250,RC,,,,both,94.38,84.94,Cigna,Default,Percent of Total Billed Charges,55.68,,,,55.68,77.01
FENTANYL 25MCG/HR PATCH (DURAGESIC),250,RC,,,,both,94.38,84.94,United Healthcare,Default,Fee Schedule,77.01,,,,55.68,77.01
MEPERIDINE HCL INJ 25MG,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
MEPERIDINE HCL INJ 25MG,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
MEPERIDINE HCL INJ 25MG,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
MEPERIDINE HCL 50MG INJ (DEMEROL),J2175,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
MEPERIDINE HCL 50MG INJ (DEMEROL),J2175,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
MEPERIDINE HCL 50MG INJ (DEMEROL),J2175,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
MEPERIDINE HCL INJ 75MG,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
MEPERIDINE HCL INJ 75MG,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
MEPERIDINE HCL INJ 75MG,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
MORPHINE SULFATE CR 30MG TAB (MS CONTIN),250,RC,,,,both,10.18,9.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.13,,,,6.01,8.31
MORPHINE SULFATE CR 30MG TAB (MS CONTIN),250,RC,,,,both,10.18,9.16,Cigna,Default,Percent of Total Billed Charges,6.01,,,,6.01,8.31
MORPHINE SULFATE CR 30MG TAB (MS CONTIN),250,RC,,,,both,10.18,9.16,United Healthcare,Default,Fee Schedule,8.31,,,,6.01,8.31
BACLOFEN 10MG TAB,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
BACLOFEN 10MG TAB,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
BACLOFEN 10MG TAB,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
SIMETHICONE 80MG CHEW TAB,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
SIMETHICONE 80MG CHEW TAB,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
SIMETHICONE 80MG CHEW TAB,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
MIDAZOLAM 2MG/2ML VIAL (VERSED),J2250,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
MIDAZOLAM 2MG/2ML VIAL (VERSED),J2250,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
MIDAZOLAM 2MG/2ML VIAL (VERSED),J2250,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
SODIUM PHOSPHATE 45MMOL/15ML INJ,250,RC,,,,both,94.31,84.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.02,,,,55.64,76.96
SODIUM PHOSPHATE 45MMOL/15ML INJ,250,RC,,,,both,94.31,84.88,Cigna,Default,Percent of Total Billed Charges,55.64,,,,55.64,76.96
SODIUM PHOSPHATE 45MMOL/15ML INJ,250,RC,,,,both,94.31,84.88,United Healthcare,Default,Fee Schedule,76.96,,,,55.64,76.96
VANCOMYCIN INJ 500MG,J3370,HCPCS,636,RC,,both,53.74,48.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.62,,,,31.71,43.85
VANCOMYCIN INJ 500MG,J3370,HCPCS,636,RC,,both,53.74,48.37,Cigna,Default,Percent of Total Billed Charges,31.71,,,,31.71,43.85
VANCOMYCIN INJ 500MG,J3370,HCPCS,636,RC,,both,53.74,48.37,United Healthcare,Default,Fee Schedule,43.85,,,,31.71,43.85
NAPROXEN 500MG TAB (NAPROSYN),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
NAPROXEN 500MG TAB (NAPROSYN),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
NAPROXEN 500MG TAB (NAPROSYN),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
NYSTOP 60GM TOPICAL PWD (MYCOSTATIN),250,RC,,,,both,412.28,371.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,288.6,,,,243.25,336.42
NYSTOP 60GM TOPICAL PWD (MYCOSTATIN),250,RC,,,,both,412.28,371.05,Cigna,Default,Percent of Total Billed Charges,243.25,,,,243.25,336.42
NYSTOP 60GM TOPICAL PWD (MYCOSTATIN),250,RC,,,,both,412.28,371.05,United Healthcare,Default,Fee Schedule,336.42,,,,243.25,336.42
CYANOCOBALAMIN 1000MCG INJ (VIT B12),J3420,HCPCS,636,RC,,both,55.69,50.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.98,,,,32.86,45.44
CYANOCOBALAMIN 1000MCG INJ (VIT B12),J3420,HCPCS,636,RC,,both,55.69,50.12,Cigna,Default,Percent of Total Billed Charges,32.86,,,,32.86,45.44
CYANOCOBALAMIN 1000MCG INJ (VIT B12),J3420,HCPCS,636,RC,,both,55.69,50.12,United Healthcare,Default,Fee Schedule,45.44,,,,32.86,45.44
NEOMYCIN SULF 500MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
NEOMYCIN SULF 500MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
NEOMYCIN SULF 500MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
NITROGLYCERIN 0.4MG/HR PATCH (NITRO-DUR),637,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NITROGLYCERIN 0.4MG/HR PATCH (NITRO-DUR),637,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NITROGLYCERIN 0.4MG/HR PATCH (NITRO-DUR),637,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
FENTANYL 50MCG/HR PATCH (DURAGESIC),250,RC,,,,both,113.35,102.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.34,,,,66.88,92.49
FENTANYL 50MCG/HR PATCH (DURAGESIC),250,RC,,,,both,113.35,102.02,Cigna,Default,Percent of Total Billed Charges,66.88,,,,66.88,92.49
FENTANYL 50MCG/HR PATCH (DURAGESIC),250,RC,,,,both,113.35,102.02,United Healthcare,Default,Fee Schedule,92.49,,,,66.88,92.49
VEPESID INJ 20MG/ML,250,RC,,,,both,620.6,558.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,434.42,,,,366.15,506.41
VEPESID INJ 20MG/ML,250,RC,,,,both,620.6,558.54,Cigna,Default,Percent of Total Billed Charges,366.15,,,,366.15,506.41
VEPESID INJ 20MG/ML,250,RC,,,,both,620.6,558.54,United Healthcare,Default,Fee Schedule,506.41,,,,366.15,506.41
DIPHENHYDRAMINE 12.5MG/5ML ELIXIR (BENAD,Q0163,HCPCS,636,RC,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
DIPHENHYDRAMINE 12.5MG/5ML ELIXIR (BENAD,Q0163,HCPCS,636,RC,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
DIPHENHYDRAMINE 12.5MG/5ML ELIXIR (BENAD,Q0163,HCPCS,636,RC,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
CARBAMIDE PEROXIDE 6.5% EARWAX REMOVAL,250,RC,,,,both,32.64,29.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.85,,,,19.26,26.63
CARBAMIDE PEROXIDE 6.5% EARWAX REMOVAL,250,RC,,,,both,32.64,29.38,Cigna,Default,Percent of Total Billed Charges,19.26,,,,19.26,26.63
CARBAMIDE PEROXIDE 6.5% EARWAX REMOVAL,250,RC,,,,both,32.64,29.38,United Healthcare,Default,Fee Schedule,26.63,,,,19.26,26.63
LACRALUBE OPHTH OINT 3.5GM TUBE,250,RC,,,,both,27.01,24.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.91,,,,15.94,22.04
LACRALUBE OPHTH OINT 3.5GM TUBE,250,RC,,,,both,27.01,24.31,Cigna,Default,Percent of Total Billed Charges,15.94,,,,15.94,22.04
LACRALUBE OPHTH OINT 3.5GM TUBE,250,RC,,,,both,27.01,24.31,United Healthcare,Default,Fee Schedule,22.04,,,,15.94,22.04
VANCOMYCIN 500MG INJ (VANCOCIN),J3370,HCPCS,636,RC,,both,44.45,40.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.12,,,,26.23,36.27
VANCOMYCIN 500MG INJ (VANCOCIN),J3370,HCPCS,636,RC,,both,44.45,40.01,Cigna,Default,Percent of Total Billed Charges,26.23,,,,26.23,36.27
VANCOMYCIN 500MG INJ (VANCOCIN),J3370,HCPCS,636,RC,,both,44.45,40.01,United Healthcare,Default,Fee Schedule,36.27,,,,26.23,36.27
NORMODYNE TABS 100MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
NORMODYNE TABS 100MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
NORMODYNE TABS 100MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
ACETIC ACID 2% W/ HYDROCORTISONE 15ML,250,RC,,,,both,42.71,38.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.9,,,,25.2,34.85
ACETIC ACID 2% W/ HYDROCORTISONE 15ML,250,RC,,,,both,42.71,38.44,Cigna,Default,Percent of Total Billed Charges,25.2,,,,25.2,34.85
ACETIC ACID 2% W/ HYDROCORTISONE 15ML,250,RC,,,,both,42.71,38.44,United Healthcare,Default,Fee Schedule,34.85,,,,25.2,34.85
DESIPRAMINE HCL 75MG TAB (NORPRAMIN),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
DESIPRAMINE HCL 75MG TAB (NORPRAMIN),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
DESIPRAMINE HCL 75MG TAB (NORPRAMIN),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
GUAIFENSIN 200MG TAB (ORGANIDIN),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
GUAIFENSIN 200MG TAB (ORGANIDIN),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
GUAIFENSIN 200MG TAB (ORGANIDIN),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
BUPIVACAINE 0.25% W/ EPI 30ML VIAL,250,RC,,,,both,59.86,53.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.9,,,,35.32,48.85
BUPIVACAINE 0.25% W/ EPI 30ML VIAL,250,RC,,,,both,59.86,53.87,Cigna,Default,Percent of Total Billed Charges,35.32,,,,35.32,48.85
BUPIVACAINE 0.25% W/ EPI 30ML VIAL,250,RC,,,,both,59.86,53.87,United Healthcare,Default,Fee Schedule,48.85,,,,35.32,48.85
NEO/POLY/DEX OPHTH SUSP(MAXITROL SUSP),250,RC,,,,both,92.32,83.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.62,,,,54.47,75.33
NEO/POLY/DEX OPHTH SUSP(MAXITROL SUSP),250,RC,,,,both,92.32,83.09,Cigna,Default,Percent of Total Billed Charges,54.47,,,,54.47,75.33
NEO/POLY/DEX OPHTH SUSP(MAXITROL SUSP),250,RC,,,,both,92.32,83.09,United Healthcare,Default,Fee Schedule,75.33,,,,54.47,75.33
CALCIUM W/VITAMIN D 250/125MG TAB,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CALCIUM W/VITAMIN D 250/125MG TAB,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CALCIUM W/VITAMIN D 250/125MG TAB,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CALCIUM 500+D TAB (OS-CAL+D),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CALCIUM 500+D TAB (OS-CAL+D),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CALCIUM 500+D TAB (OS-CAL+D),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DEXTRAN 40 10%-NACL 0.9% 500ML,258,RC,,,,both,129.42,116.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.59,,,,76.36,105.61
DEXTRAN 40 10%-NACL 0.9% 500ML,258,RC,,,,both,129.42,116.48,Cigna,Default,Percent of Total Billed Charges,76.36,,,,76.36,105.61
DEXTRAN 40 10%-NACL 0.9% 500ML,258,RC,,,,both,129.42,116.48,United Healthcare,Default,Fee Schedule,105.61,,,,76.36,105.61
WARFARIN 4MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
WARFARIN 4MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
WARFARIN 4MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
METHYLPREDNISOLONE 4MG DOSEPAK (MEDROL,J7509,HCPCS,636,RC,,both,56.69,51.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.68,,,,33.45,46.26
METHYLPREDNISOLONE 4MG DOSEPAK (MEDROL,J7509,HCPCS,636,RC,,both,56.69,51.02,Cigna,Default,Percent of Total Billed Charges,33.45,,,,33.45,46.26
METHYLPREDNISOLONE 4MG DOSEPAK (MEDROL,J7509,HCPCS,636,RC,,both,56.69,51.02,United Healthcare,Default,Fee Schedule,46.26,,,,33.45,46.26
PENICILLIN V POTASSIUM 250MG TAB(PEN-VK),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
PENICILLIN V POTASSIUM 250MG TAB(PEN-VK),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
PENICILLIN V POTASSIUM 250MG TAB(PEN-VK),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
PENICILLIN V POTASSIUM 500MG TAB (PEN-VK,637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
PENICILLIN V POTASSIUM 500MG TAB (PEN-VK,637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
PENICILLIN V POTASSIUM 500MG TAB (PEN-VK,637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DIPYRIDAMOLE 25MG TAB (PERSANTINE),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DIPYRIDAMOLE 25MG TAB (PERSANTINE),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DIPYRIDAMOLE 25MG TAB (PERSANTINE),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
DIPYRIDAMOLE 50MG TAB (PERSANTINE),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DIPYRIDAMOLE 50MG TAB (PERSANTINE),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DIPYRIDAMOLE 50MG TAB (PERSANTINE),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
BELLADON/PHENOBARB 5ML LIQ (DONNATAL),637,RC,,,,both,43.41,39.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.39,,,,25.61,35.42
BELLADON/PHENOBARB 5ML LIQ (DONNATAL),637,RC,,,,both,43.41,39.07,Cigna,Default,Percent of Total Billed Charges,25.61,,,,25.61,35.42
BELLADON/PHENOBARB 5ML LIQ (DONNATAL),637,RC,,,,both,43.41,39.07,United Healthcare,Default,Fee Schedule,35.42,,,,25.61,35.42
PROMETHAZINE 12.5MG SUPPS (PHENERGAN),250,RC,,,,both,15.39,13.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.77,,,,9.08,12.56
PROMETHAZINE 12.5MG SUPPS (PHENERGAN),250,RC,,,,both,15.39,13.85,Cigna,Default,Percent of Total Billed Charges,9.08,,,,9.08,12.56
PROMETHAZINE 12.5MG SUPPS (PHENERGAN),250,RC,,,,both,15.39,13.85,United Healthcare,Default,Fee Schedule,12.56,,,,9.08,12.56
PHENOBARBITAL 32.4 MG TAB,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PHENOBARBITAL 32.4 MG TAB,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PHENOBARBITAL 32.4 MG TAB,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
PREDNISONE 20MG TAB,J7512,HCPCS,636,RC,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PREDNISONE 20MG TAB,J7512,HCPCS,636,RC,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PREDNISONE 20MG TAB,J7512,HCPCS,636,RC,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MORPHINE SULFATE PCA 30MG/30ML,J2270,HCPCS,636,RC,,both,73.56,66.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.49,,,,43.4,60.02
MORPHINE SULFATE PCA 30MG/30ML,J2270,HCPCS,636,RC,,both,73.56,66.2,Cigna,Default,Percent of Total Billed Charges,43.4,,,,43.4,60.02
MORPHINE SULFATE PCA 30MG/30ML,J2270,HCPCS,636,RC,,both,73.56,66.2,United Healthcare,Default,Fee Schedule,60.02,,,,43.4,60.02
PREDNISONE 10MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PREDNISONE 10MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PREDNISONE 10MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MEPERIDINE PCA 300MG (DEMEROL),J2175,HCPCS,636,RC,,both,83.09,74.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.16,,,,49.02,67.8
MEPERIDINE PCA 300MG (DEMEROL),J2175,HCPCS,636,RC,,both,83.09,74.78,Cigna,Default,Percent of Total Billed Charges,49.02,,,,49.02,67.8
MEPERIDINE PCA 300MG (DEMEROL),J2175,HCPCS,636,RC,,both,83.09,74.78,United Healthcare,Default,Fee Schedule,67.8,,,,49.02,67.8
PREDNISONE 5MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PREDNISONE 5MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PREDNISONE 5MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ATROPINE 0.5 MG 5ML SYR,J0461,HCPCS,636,RC,,both,29.35,26.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.54,,,,17.32,23.95
ATROPINE 0.5 MG 5ML SYR,J0461,HCPCS,636,RC,,both,29.35,26.42,Cigna,Default,Percent of Total Billed Charges,17.32,,,,17.32,23.95
ATROPINE 0.5 MG 5ML SYR,J0461,HCPCS,636,RC,,both,29.35,26.42,United Healthcare,Default,Fee Schedule,23.95,,,,17.32,23.95
NITROGLYCERIN 0.4MG (1/150 GR)  #25 (NIT,637,RC,,,,both,26.45,23.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.52,,,,15.61,21.58
NITROGLYCERIN 0.4MG (1/150 GR)  #25 (NIT,637,RC,,,,both,26.45,23.81,Cigna,Default,Percent of Total Billed Charges,15.61,,,,15.61,21.58
NITROGLYCERIN 0.4MG (1/150 GR)  #25 (NIT,637,RC,,,,both,26.45,23.81,United Healthcare,Default,Fee Schedule,21.58,,,,15.61,21.58
CONJUGATED ESTROGENS 0.625MG TAB (PREMAR,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CONJUGATED ESTROGENS 0.625MG TAB (PREMAR,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CONJUGATED ESTROGENS 0.625MG TAB (PREMAR,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CONJUGATED ESTROGENS 0.3MG TAB (PREMARIN,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CONJUGATED ESTROGENS 0.3MG TAB (PREMARIN,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CONJUGATED ESTROGENS 0.3MG TAB (PREMARIN,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
EYE WASH 120ML SOL (PURIFIED WATER),250,RC,,,,both,26.27,23.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.39,,,,15.5,21.44
EYE WASH 120ML SOL (PURIFIED WATER),250,RC,,,,both,26.27,23.64,Cigna,Default,Percent of Total Billed Charges,15.5,,,,15.5,21.44
EYE WASH 120ML SOL (PURIFIED WATER),250,RC,,,,both,26.27,23.64,United Healthcare,Default,Fee Schedule,21.44,,,,15.5,21.44
METHADONE HCL 10MG TAB (DOLOPHINE),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
METHADONE HCL 10MG TAB (DOLOPHINE),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
METHADONE HCL 10MG TAB (DOLOPHINE),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
VITAMIN C 500MG TAB (ASCORBIC ACID),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
VITAMIN C 500MG TAB (ASCORBIC ACID),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
VITAMIN C 500MG TAB (ASCORBIC ACID),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
TETANUS/DIPH VACC (DECAVAC),90714,HCPCS,636,RC,,both,97.91,88.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.54,,,,57.77,79.89
TETANUS/DIPH VACC (DECAVAC),90714,HCPCS,636,RC,,both,97.91,88.12,Cigna,Default,Percent of Total Billed Charges,57.77,,,,57.77,79.89
TETANUS/DIPH VACC (DECAVAC),90714,HCPCS,636,RC,,both,97.91,88.12,United Healthcare,Default,Fee Schedule,79.89,,,,57.77,79.89
PHENYLEPHRINE 10MG/1ML INJ (NEO),J2371,HCPCS,636,RC,,both,39.23,35.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.46,,,,23.15,32.01
PHENYLEPHRINE 10MG/1ML INJ (NEO),J2371,HCPCS,636,RC,,both,39.23,35.31,Cigna,Default,Percent of Total Billed Charges,23.15,,,,23.15,32.01
PHENYLEPHRINE 10MG/1ML INJ (NEO),J2371,HCPCS,636,RC,,both,39.23,35.31,United Healthcare,Default,Fee Schedule,32.01,,,,23.15,32.01
BETHANECHOL 10MG TAB (URECHOLINE),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
BETHANECHOL 10MG TAB (URECHOLINE),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
BETHANECHOL 10MG TAB (URECHOLINE),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
AMPICILLIN & SULBACTAM 1500MG INJ(UNASYN,J0295,HCPCS,636,RC,,both,43.58,39.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.51,,,,25.71,35.56
AMPICILLIN & SULBACTAM 1500MG INJ(UNASYN,J0295,HCPCS,636,RC,,both,43.58,39.22,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.56
AMPICILLIN & SULBACTAM 1500MG INJ(UNASYN,J0295,HCPCS,636,RC,,both,43.58,39.22,United Healthcare,Default,Fee Schedule,35.56,,,,25.71,35.56
PHENYTOIN INJ 50MG/ML 5ML VIAL (DILANTIN,J1165,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
PHENYTOIN INJ 50MG/ML 5ML VIAL (DILANTIN,J1165,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
PHENYTOIN INJ 50MG/ML 5ML VIAL (DILANTIN,J1165,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
PHENYTOIN 125MG/5ML 237ML SUSP (DILANTIN,250,RC,,,,both,158.53,142.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.97,,,,93.53,129.36
PHENYTOIN 125MG/5ML 237ML SUSP (DILANTIN,250,RC,,,,both,158.53,142.68,Cigna,Default,Percent of Total Billed Charges,93.53,,,,93.53,129.36
PHENYTOIN 125MG/5ML 237ML SUSP (DILANTIN,250,RC,,,,both,158.53,142.68,United Healthcare,Default,Fee Schedule,129.36,,,,93.53,129.36
PHENAZOPYRIDINE 100MG TAB (PYRIDIUM),637,RC,,,,both,11.61,10.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.13,,,,6.85,9.47
PHENAZOPYRIDINE 100MG TAB (PYRIDIUM),637,RC,,,,both,11.61,10.45,Cigna,Default,Percent of Total Billed Charges,6.85,,,,6.85,9.47
PHENAZOPYRIDINE 100MG TAB (PYRIDIUM),637,RC,,,,both,11.61,10.45,United Healthcare,Default,Fee Schedule,9.47,,,,6.85,9.47
VERAPAMIL HCL 80MG TAB (CALAN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
VERAPAMIL HCL 80MG TAB (CALAN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
VERAPAMIL HCL 80MG TAB (CALAN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
METRONIDAZOLE 250MG TAB (FLAGYL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
METRONIDAZOLE 250MG TAB (FLAGYL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
METRONIDAZOLE 250MG TAB (FLAGYL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CHOLESTYRAMINE PWD PKT (QUESTRAN),637,RC,,,,both,15.68,14.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.98,,,,9.25,12.79
CHOLESTYRAMINE PWD PKT (QUESTRAN),637,RC,,,,both,15.68,14.11,Cigna,Default,Percent of Total Billed Charges,9.25,,,,9.25,12.79
CHOLESTYRAMINE PWD PKT (QUESTRAN),637,RC,,,,both,15.68,14.11,United Healthcare,Default,Fee Schedule,12.79,,,,9.25,12.79
TRAMADOL 50MG TAB (ULTRAM),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
TRAMADOL 50MG TAB (ULTRAM),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
TRAMADOL 50MG TAB (ULTRAM),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
TOBRAMYCIN OPTH  0.3% 5ML SOL,637,RC,,,,both,158.05,142.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.64,,,,93.25,128.97
TOBRAMYCIN OPTH  0.3% 5ML SOL,637,RC,,,,both,158.05,142.25,Cigna,Default,Percent of Total Billed Charges,93.25,,,,93.25,128.97
TOBRAMYCIN OPTH  0.3% 5ML SOL,637,RC,,,,both,158.05,142.25,United Healthcare,Default,Fee Schedule,128.97,,,,93.25,128.97
BISACODYL SUPP 10MG,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
BISACODYL SUPP 10MG,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
BISACODYL SUPP 10MG,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
AMPICILLIN & SULBACTAM 3000MG INJ(UNASYN,J0295,HCPCS,636,RC,,both,75.14,67.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.6,,,,44.33,61.31
AMPICILLIN & SULBACTAM 3000MG INJ(UNASYN,J0295,HCPCS,636,RC,,both,75.14,67.63,Cigna,Default,Percent of Total Billed Charges,44.33,,,,44.33,61.31
AMPICILLIN & SULBACTAM 3000MG INJ(UNASYN,J0295,HCPCS,636,RC,,both,75.14,67.63,United Healthcare,Default,Fee Schedule,61.31,,,,44.33,61.31
METOCLOPRAMIDE 10MG TAB (REGLAN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
METOCLOPRAMIDE 10MG TAB (REGLAN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
METOCLOPRAMIDE 10MG TAB (REGLAN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MORPHINE 10MG/10ML AMP (ASTRAMORPH),J2270,HCPCS,636,RC,,both,75.5,67.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.85,,,,44.54,61.61
MORPHINE 10MG/10ML AMP (ASTRAMORPH),J2270,HCPCS,636,RC,,both,75.5,67.95,Cigna,Default,Percent of Total Billed Charges,44.54,,,,44.54,61.61
MORPHINE 10MG/10ML AMP (ASTRAMORPH),J2270,HCPCS,636,RC,,both,75.5,67.95,United Healthcare,Default,Fee Schedule,61.61,,,,44.54,61.61
TEMAZEPAM 15MG CAP (RESTORIL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
TEMAZEPAM 15MG CAP (RESTORIL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
TEMAZEPAM 15MG CAP (RESTORIL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
ALBUTEROL SOL 0.5%-0.5ML DOSE,J7611,HCPCS,250,RC,,both,4.06,3.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.84,,,,2.4,3.31
ALBUTEROL SOL 0.5%-0.5ML DOSE,J7611,HCPCS,250,RC,,both,4.06,3.65,Cigna,Default,Percent of Total Billed Charges,2.4,,,,2.4,3.31
ALBUTEROL SOL 0.5%-0.5ML DOSE,J7611,HCPCS,250,RC,,both,4.06,3.65,United Healthcare,Default,Fee Schedule,3.31,,,,2.4,3.31
ACETAMINOPHEN 120MG SUPP (TYLENOL),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
ACETAMINOPHEN 120MG SUPP (TYLENOL),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
ACETAMINOPHEN 120MG SUPP (TYLENOL),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
ERTHROMYCIN 200MG/5ML SUSP (E.E.S.),250,RC,,,,both,1287.98,1159.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,901.59,,,,759.91,1050.99
ERTHROMYCIN 200MG/5ML SUSP (E.E.S.),250,RC,,,,both,1287.98,1159.18,Cigna,Default,Percent of Total Billed Charges,759.91,,,,759.91,1050.99
ERTHROMYCIN 200MG/5ML SUSP (E.E.S.),250,RC,,,,both,1287.98,1159.18,United Healthcare,Default,Fee Schedule,1050.99,,,,759.91,1050.99
RITALIN TABS 10MG,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
RITALIN TABS 10MG,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
RITALIN TABS 10MG,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
ERYTHROMYCIN 500MG INJ (ERYTHROCIN),250,RC,,,,both,422.11,379.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,295.48,,,,249.04,344.44
ERYTHROMYCIN 500MG INJ (ERYTHROCIN),250,RC,,,,both,422.11,379.9,Cigna,Default,Percent of Total Billed Charges,249.04,,,,249.04,344.44
ERYTHROMYCIN 500MG INJ (ERYTHROCIN),250,RC,,,,both,422.11,379.9,United Healthcare,Default,Fee Schedule,344.44,,,,249.04,344.44
METHYLPHENIDATE 5MG TAB (RITALIN),637,RC,,,,both,9.45,8.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.62,,,,5.58,7.71
METHYLPHENIDATE 5MG TAB (RITALIN),637,RC,,,,both,9.45,8.51,Cigna,Default,Percent of Total Billed Charges,5.58,,,,5.58,7.71
METHYLPHENIDATE 5MG TAB (RITALIN),637,RC,,,,both,9.45,8.51,United Healthcare,Default,Fee Schedule,7.71,,,,5.58,7.71
DAKINS 1/4 STR  0.125%  473ML,250,RC,,,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
DAKINS 1/4 STR  0.125%  473ML,250,RC,,,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
DAKINS 1/4 STR  0.125%  473ML,250,RC,,,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
NARCAN INJ 0.4MG/ML,J2310,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
NARCAN INJ 0.4MG/ML,J2310,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
NARCAN INJ 0.4MG/ML,J2310,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
ROCALTROL CAPS 0.25MCG,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
ROCALTROL CAPS 0.25MCG,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
ROCALTROL CAPS 0.25MCG,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
EPHEDRINE SULFATE INJ 50MG,250,RC,,,,both,263.81,237.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.67,,,,155.65,215.27
EPHEDRINE SULFATE INJ 50MG,250,RC,,,,both,263.81,237.43,Cigna,Default,Percent of Total Billed Charges,155.65,,,,155.65,215.27
EPHEDRINE SULFATE INJ 50MG,250,RC,,,,both,263.81,237.43,United Healthcare,Default,Fee Schedule,215.27,,,,155.65,215.27
EPINEPHRINE 1MG/ML AMP,250,RC,,,,both,81.35,73.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.94,,,,48,66.38
EPINEPHRINE 1MG/ML AMP,250,RC,,,,both,81.35,73.22,Cigna,Default,Percent of Total Billed Charges,48,,,,48,66.38
EPINEPHRINE 1MG/ML AMP,250,RC,,,,both,81.35,73.22,United Healthcare,Default,Fee Schedule,66.38,,,,48,66.38
TUBERSOL INJ 5TU/0.1ML,250,RC,,,,both,17.15,15.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12,,,,10.12,13.99
TUBERSOL INJ 5TU/0.1ML,250,RC,,,,both,17.15,15.44,Cigna,Default,Percent of Total Billed Charges,10.12,,,,10.12,13.99
TUBERSOL INJ 5TU/0.1ML,250,RC,,,,both,17.15,15.44,United Healthcare,Default,Fee Schedule,13.99,,,,10.12,13.99
TRIAMCINOLONE 0.1% 15GM CRM (KENALOG),637,RC,,,,both,27.9,25.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.53,,,,16.46,22.77
TRIAMCINOLONE 0.1% 15GM CRM (KENALOG),637,RC,,,,both,27.9,25.11,Cigna,Default,Percent of Total Billed Charges,16.46,,,,16.46,22.77
TRIAMCINOLONE 0.1% 15GM CRM (KENALOG),637,RC,,,,both,27.9,25.11,United Healthcare,Default,Fee Schedule,22.77,,,,16.46,22.77
SULFAMETHOXAZOLE/TMP DS 800/160MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
SULFAMETHOXAZOLE/TMP DS 800/160MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
SULFAMETHOXAZOLE/TMP DS 800/160MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
KETORALAC 30MG/1ML INJ (TORADOL),J1885,HCPCS,636,RC,,both,45.63,41.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.94,,,,26.92,37.23
KETORALAC 30MG/1ML INJ (TORADOL),J1885,HCPCS,636,RC,,both,45.63,41.07,Cigna,Default,Percent of Total Billed Charges,26.92,,,,26.92,37.23
KETORALAC 30MG/1ML INJ (TORADOL),J1885,HCPCS,636,RC,,both,45.63,41.07,United Healthcare,Default,Fee Schedule,37.23,,,,26.92,37.23
KETOROLAC 60MG/2ML 2ML VIAL (TORADOL),250,RC,,,,both,47.94,43.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.56,,,,28.28,39.12
KETOROLAC 60MG/2ML 2ML VIAL (TORADOL),250,RC,,,,both,47.94,43.15,Cigna,Default,Percent of Total Billed Charges,28.28,,,,28.28,39.12
KETOROLAC 60MG/2ML 2ML VIAL (TORADOL),250,RC,,,,both,47.94,43.15,United Healthcare,Default,Fee Schedule,39.12,,,,28.28,39.12
BUPIVACAINE 0.5% W/ EPI 30ML VIAL (MARCA,250,RC,,,,both,84.32,75.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.02,,,,49.75,68.81
BUPIVACAINE 0.5% W/ EPI 30ML VIAL (MARCA,250,RC,,,,both,84.32,75.89,Cigna,Default,Percent of Total Billed Charges,49.75,,,,49.75,68.81
BUPIVACAINE 0.5% W/ EPI 30ML VIAL (MARCA,250,RC,,,,both,84.32,75.89,United Healthcare,Default,Fee Schedule,68.81,,,,49.75,68.81
CARB/LEVO 10/100MG TAB (SINEMET),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CARB/LEVO 10/100MG TAB (SINEMET),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CARB/LEVO 10/100MG TAB (SINEMET),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CARB/LEVO 25/100MG TAB (SINEMET),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CARB/LEVO 25/100MG TAB (SINEMET),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CARB/LEVO 25/100MG TAB (SINEMET),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DOXEPIN HCL 50MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DOXEPIN HCL 50MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DOXEPIN HCL 50MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DOXEPIN HCL 10MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DOXEPIN HCL 10MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DOXEPIN HCL 10MG CAP (SINEQUAN),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
VERAPAMIL HCL 5MG/2ML INJ,250,RC,,,,both,162.71,146.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.9,,,,96,132.77
VERAPAMIL HCL 5MG/2ML INJ,250,RC,,,,both,162.71,146.44,Cigna,Default,Percent of Total Billed Charges,96,,,,96,132.77
VERAPAMIL HCL 5MG/2ML INJ,250,RC,,,,both,162.71,146.44,United Healthcare,Default,Fee Schedule,132.77,,,,96,132.77
DOXEPIN HCL 25MG CAP (SINEQUAN),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DOXEPIN HCL 25MG CAP (SINEQUAN),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DOXEPIN HCL 25MG CAP (SINEQUAN),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
NATURE'S TEAR DROPS,250,RC,,,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
NATURE'S TEAR DROPS,250,RC,,,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
NATURE'S TEAR DROPS,250,RC,,,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
ISOSORBIDE MONONITRATE 20MG TAB (ISMO),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
ISOSORBIDE MONONITRATE 20MG TAB (ISMO),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
ISOSORBIDE MONONITRATE 20MG TAB (ISMO),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
KETOROLAC 10MG TAB (TORADOL),250,RC,,,,both,6.25,5.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.38,,,,3.69,5.1
KETOROLAC 10MG TAB (TORADOL),250,RC,,,,both,6.25,5.63,Cigna,Default,Percent of Total Billed Charges,3.69,,,,3.69,5.1
KETOROLAC 10MG TAB (TORADOL),250,RC,,,,both,6.25,5.63,United Healthcare,Default,Fee Schedule,5.1,,,,3.69,5.1
POTASSIUM CHLORIDE  8MEQ TAB (KLOR-CON),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
POTASSIUM CHLORIDE  8MEQ TAB (KLOR-CON),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
POTASSIUM CHLORIDE  8MEQ TAB (KLOR-CON),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CLONIDINE TTS -2 PATCH (CATAPRES),637,RC,,,,both,106.34,95.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.44,,,,62.74,86.77
CLONIDINE TTS -2 PATCH (CATAPRES),637,RC,,,,both,106.34,95.71,Cigna,Default,Percent of Total Billed Charges,62.74,,,,62.74,86.77
CLONIDINE TTS -2 PATCH (CATAPRES),637,RC,,,,both,106.34,95.71,United Healthcare,Default,Fee Schedule,86.77,,,,62.74,86.77
LABETALOL 100MG TAB (TRANDATE),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
LABETALOL 100MG TAB (TRANDATE),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
LABETALOL 100MG TAB (TRANDATE),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
BUPIVACAINE 0.25% 10ML INJ (MARCAINE),250,RC,,,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
BUPIVACAINE 0.25% 10ML INJ (MARCAINE),250,RC,,,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
BUPIVACAINE 0.25% 10ML INJ (MARCAINE),250,RC,,,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
MAGNESIUM SULFATE 50% ORAL LIQ 60ML,250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
MAGNESIUM SULFATE 50% ORAL LIQ 60ML,250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
MAGNESIUM SULFATE 50% ORAL LIQ 60ML,250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
EPINEPH 1:10000 INJ ABBOJECT,250,RC,,,,both,58.4,52.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.88,,,,34.46,47.65
EPINEPH 1:10000 INJ ABBOJECT,250,RC,,,,both,58.4,52.56,Cigna,Default,Percent of Total Billed Charges,34.46,,,,34.46,47.65
EPINEPH 1:10000 INJ ABBOJECT,250,RC,,,,both,58.4,52.56,United Healthcare,Default,Fee Schedule,47.65,,,,34.46,47.65
ATENOLOL 50MG TAB (TENORMIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
ATENOLOL 50MG TAB (TENORMIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
ATENOLOL 50MG TAB (TENORMIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
DOBUTAMINE 250MG/20ML INJ,J1250,HCPCS,636,RC,,both,28.76,25.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.13,,,,16.97,23.47
DOBUTAMINE 250MG/20ML INJ,J1250,HCPCS,636,RC,,both,28.76,25.88,Cigna,Default,Percent of Total Billed Charges,16.97,,,,16.97,23.47
DOBUTAMINE 250MG/20ML INJ,J1250,HCPCS,636,RC,,both,28.76,25.88,United Healthcare,Default,Fee Schedule,23.47,,,,16.97,23.47
TETRACYCLINE HCL 250MG CAP,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
TETRACYCLINE HCL 250MG CAP,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
TETRACYCLINE HCL 250MG CAP,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MINERAL OIL LIGHT 10ML (MURI-LUBE),250,RC,,,,both,73.89,66.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.72,,,,43.6,60.29
MINERAL OIL LIGHT 10ML (MURI-LUBE),250,RC,,,,both,73.89,66.5,Cigna,Default,Percent of Total Billed Charges,43.6,,,,43.6,60.29
MINERAL OIL LIGHT 10ML (MURI-LUBE),250,RC,,,,both,73.89,66.5,United Healthcare,Default,Fee Schedule,60.29,,,,43.6,60.29
THEOPHYLLINE CR 300MG TAB (THEO-DUR),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
THEOPHYLLINE CR 300MG TAB (THEO-DUR),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
THEOPHYLLINE CR 300MG TAB (THEO-DUR),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
THEOPHYLLINE ER 400MG TAB (THEO-DUR),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
THEOPHYLLINE ER 400MG TAB (THEO-DUR),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
THEOPHYLLINE ER 400MG TAB (THEO-DUR),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
LIDOCAINE 0.5% W/EPI 50ML (XYLOCAINE MPF,250,RC,,,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
LIDOCAINE 0.5% W/EPI 50ML (XYLOCAINE MPF,250,RC,,,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
LIDOCAINE 0.5% W/EPI 50ML (XYLOCAINE MPF,250,RC,,,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
XYLO 1%EPI 1:100000 INJ,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
XYLO 1%EPI 1:100000 INJ,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
XYLO 1%EPI 1:100000 INJ,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
AMITRIPTYLINE 10MG TAB (ELAVIL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
AMITRIPTYLINE 10MG TAB (ELAVIL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
AMITRIPTYLINE 10MG TAB (ELAVIL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
MULTI VIT W/ MINERAL TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
MULTI VIT W/ MINERAL TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
MULTI VIT W/ MINERAL TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
THIAMINE 100MG TAB (VITAMIN B1),637,RC,,,,both,55.5,49.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.85,,,,32.74,45.29
THIAMINE 100MG TAB (VITAMIN B1),637,RC,,,,both,55.5,49.95,Cigna,Default,Percent of Total Billed Charges,32.74,,,,32.74,45.29
THIAMINE 100MG TAB (VITAMIN B1),637,RC,,,,both,55.5,49.95,United Healthcare,Default,Fee Schedule,45.29,,,,32.74,45.29
DOPAMINE 400MG/250ML PREMIX,J1265,HCPCS,636,RC,,both,151.27,136.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.89,,,,89.25,123.44
DOPAMINE 400MG/250ML PREMIX,J1265,HCPCS,636,RC,,both,151.27,136.14,Cigna,Default,Percent of Total Billed Charges,89.25,,,,89.25,123.44
DOPAMINE 400MG/250ML PREMIX,J1265,HCPCS,636,RC,,both,151.27,136.14,United Healthcare,Default,Fee Schedule,123.44,,,,89.25,123.44
TRIP ANTIBIOTIC OPHTH OI,250,RC,,,,both,20.04,18.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.03,,,,11.82,16.35
TRIP ANTIBIOTIC OPHTH OI,250,RC,,,,both,20.04,18.04,Cigna,Default,Percent of Total Billed Charges,11.82,,,,11.82,16.35
TRIP ANTIBIOTIC OPHTH OI,250,RC,,,,both,20.04,18.04,United Healthcare,Default,Fee Schedule,16.35,,,,11.82,16.35
IMIPRAMINE HCL 25MG TAB (TOFRANIL),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
IMIPRAMINE HCL 25MG TAB (TOFRANIL),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
IMIPRAMINE HCL 25MG TAB (TOFRANIL),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
PROPOFOL 200MG/20ML INJ,J2704,HCPCS,250,RC,,both,31.08,27.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.76,,,,18.34,25.36
PROPOFOL 200MG/20ML INJ,J2704,HCPCS,250,RC,,both,31.08,27.97,Cigna,Default,Percent of Total Billed Charges,18.34,,,,18.34,25.36
PROPOFOL 200MG/20ML INJ,J2704,HCPCS,250,RC,,both,31.08,27.97,United Healthcare,Default,Fee Schedule,25.36,,,,18.34,25.36
CEPHALEXIN 250MG/5ML 100ML SUSP (KELFEX),637,RC,,,,both,73.21,65.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.25,,,,43.19,59.74
CEPHALEXIN 250MG/5ML 100ML SUSP (KELFEX),637,RC,,,,both,73.21,65.89,Cigna,Default,Percent of Total Billed Charges,43.19,,,,43.19,59.74
CEPHALEXIN 250MG/5ML 100ML SUSP (KELFEX),637,RC,,,,both,73.21,65.89,United Healthcare,Default,Fee Schedule,59.74,,,,43.19,59.74
MANNITOL 25% 50ML VIAL (ARIDOL),J2150,HCPCS,636,RC,,both,101.2,91.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.84,,,,59.71,82.58
MANNITOL 25% 50ML VIAL (ARIDOL),J2150,HCPCS,636,RC,,both,101.2,91.08,Cigna,Default,Percent of Total Billed Charges,59.71,,,,59.71,82.58
MANNITOL 25% 50ML VIAL (ARIDOL),J2150,HCPCS,636,RC,,both,101.2,91.08,United Healthcare,Default,Fee Schedule,82.58,,,,59.71,82.58
XYLOCAINE INJ 1% 50CC,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
XYLOCAINE INJ 1% 50CC,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
XYLOCAINE INJ 1% 50CC,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
LIDOCAINE 2% W/EPI SDV 10ML (XYLOCAINE M,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
LIDOCAINE 2% W/EPI SDV 10ML (XYLOCAINE M,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
LIDOCAINE 2% W/EPI SDV 10ML (XYLOCAINE M,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
CLOTRIMAZOLE 10MG LOZENGE (MYCELEX),250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
CLOTRIMAZOLE 10MG LOZENGE (MYCELEX),250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
CLOTRIMAZOLE 10MG LOZENGE (MYCELEX),250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
NEO/POLY/DEX OPHTH OINT(MAXITROL OINT),250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
NEO/POLY/DEX OPHTH OINT(MAXITROL OINT),250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
NEO/POLY/DEX OPHTH OINT(MAXITROL OINT),250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
LIDOCAINE TOPICAL 4% 50ML  SOL (XYLOCAIN,250,RC,,,,both,300.49,270.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.34,,,,177.29,245.2
LIDOCAINE TOPICAL 4% 50ML  SOL (XYLOCAIN,250,RC,,,,both,300.49,270.44,Cigna,Default,Percent of Total Billed Charges,177.29,,,,177.29,245.2
LIDOCAINE TOPICAL 4% 50ML  SOL (XYLOCAIN,250,RC,,,,both,300.49,270.44,United Healthcare,Default,Fee Schedule,245.2,,,,177.29,245.2
CIPROFLOXACIN 250MG TAB (CIPRO),637,RC,,,,both,15.98,14.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.19,,,,9.43,13.04
CIPROFLOXACIN 250MG TAB (CIPRO),637,RC,,,,both,15.98,14.38,Cigna,Default,Percent of Total Billed Charges,9.43,,,,9.43,13.04
CIPROFLOXACIN 250MG TAB (CIPRO),637,RC,,,,both,15.98,14.38,United Healthcare,Default,Fee Schedule,13.04,,,,9.43,13.04
ACETAMINOPHEN XS 500MG CAPLET (TYLENOL X,637,RC,,,,both,6.76,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.73,,,,3.99,5.52
ACETAMINOPHEN XS 500MG CAPLET (TYLENOL X,637,RC,,,,both,6.76,6.08,Cigna,Default,Percent of Total Billed Charges,3.99,,,,3.99,5.52
ACETAMINOPHEN XS 500MG CAPLET (TYLENOL X,637,RC,,,,both,6.76,6.08,United Healthcare,Default,Fee Schedule,5.52,,,,3.99,5.52
ACETAMINOPHEN W/CODEINE #3 TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ACETAMINOPHEN W/CODEINE #3 TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ACETAMINOPHEN W/CODEINE #3 TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
LIDOCAINE W/EPI INJ 1.5% 5ML (XYLOCAINE),250,RC,,,,both,25.45,22.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.82,,,,15.02,20.77
LIDOCAINE W/EPI INJ 1.5% 5ML (XYLOCAINE),250,RC,,,,both,25.45,22.91,Cigna,Default,Percent of Total Billed Charges,15.02,,,,15.02,20.77
LIDOCAINE W/EPI INJ 1.5% 5ML (XYLOCAINE),250,RC,,,,both,25.45,22.91,United Healthcare,Default,Fee Schedule,20.77,,,,15.02,20.77
NEO/POLY/GRAM OPHTH SOLN (NEOSPORIN),250,RC,,,,both,287.93,259.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,201.55,,,,169.88,234.95
NEO/POLY/GRAM OPHTH SOLN (NEOSPORIN),250,RC,,,,both,287.93,259.14,Cigna,Default,Percent of Total Billed Charges,169.88,,,,169.88,234.95
NEO/POLY/GRAM OPHTH SOLN (NEOSPORIN),250,RC,,,,both,287.93,259.14,United Healthcare,Default,Fee Schedule,234.95,,,,169.88,234.95
ACETAMINOPHEN 325MG TAB (TYLENOL),637,RC,,,,both,7.3,6.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.11,,,,4.31,5.96
ACETAMINOPHEN 325MG TAB (TYLENOL),637,RC,,,,both,7.3,6.57,Cigna,Default,Percent of Total Billed Charges,4.31,,,,4.31,5.96
ACETAMINOPHEN 325MG TAB (TYLENOL),637,RC,,,,both,7.3,6.57,United Healthcare,Default,Fee Schedule,5.96,,,,4.31,5.96
LIDOCAINE JELLY 2% 30ML (XYLOCAINE),250,RC,,,,both,567.92,511.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,397.54,,,,335.07,463.42
LIDOCAINE JELLY 2% 30ML (XYLOCAINE),250,RC,,,,both,567.92,511.13,Cigna,Default,Percent of Total Billed Charges,335.07,,,,335.07,463.42
LIDOCAINE JELLY 2% 30ML (XYLOCAINE),250,RC,,,,both,567.92,511.13,United Healthcare,Default,Fee Schedule,463.42,,,,335.07,463.42
AMOXICILLIN 500MG CAP,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
AMOXICILLIN 500MG CAP,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
AMOXICILLIN 500MG CAP,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DIAZEPAM 5MG TAB (VALIUM),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DIAZEPAM 5MG TAB (VALIUM),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DIAZEPAM 5MG TAB (VALIUM),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
BUPROPION 100MG TAB (WELLBUTRIN),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
BUPROPION 100MG TAB (WELLBUTRIN),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
BUPROPION 100MG TAB (WELLBUTRIN),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
WARFARIN 5MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
WARFARIN 5MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
WARFARIN 5MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
DIAZEPAM 2MG TAB (VALIUM),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DIAZEPAM 2MG TAB (VALIUM),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DIAZEPAM 2MG TAB (VALIUM),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
NITROLINGUAL 0.4MG SPRAY (NITROSTAT),250,RC,,,,both,76.41,68.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.49,,,,45.08,62.35
NITROLINGUAL 0.4MG SPRAY (NITROSTAT),250,RC,,,,both,76.41,68.77,Cigna,Default,Percent of Total Billed Charges,45.08,,,,45.08,62.35
NITROLINGUAL 0.4MG SPRAY (NITROSTAT),250,RC,,,,both,76.41,68.77,United Healthcare,Default,Fee Schedule,62.35,,,,45.08,62.35
AMIODARONE 200MG TAB (PACERONE),637,RC,,,,both,17.72,15.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.4,,,,10.45,14.46
AMIODARONE 200MG TAB (PACERONE),637,RC,,,,both,17.72,15.95,Cigna,Default,Percent of Total Billed Charges,10.45,,,,10.45,14.46
AMIODARONE 200MG TAB (PACERONE),637,RC,,,,both,17.72,15.95,United Healthcare,Default,Fee Schedule,14.46,,,,10.45,14.46
ENALAPRIL 10MG TAB (VASOTEC),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
ENALAPRIL 10MG TAB (VASOTEC),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
ENALAPRIL 10MG TAB (VASOTEC),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
ENALAPRIL 5MG TAB (VASOTEC),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
ENALAPRIL 5MG TAB (VASOTEC),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
ENALAPRIL 5MG TAB (VASOTEC),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
DIPHENHYDRAMINE 25MG CAP(BENADRYL),Q0163,HCPCS,636,RC,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
DIPHENHYDRAMINE 25MG CAP(BENADRYL),Q0163,HCPCS,636,RC,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
DIPHENHYDRAMINE 25MG CAP(BENADRYL),Q0163,HCPCS,636,RC,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
HYDROXYZINE PAM 50MG CAP (VISTARIL),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
HYDROXYZINE PAM 50MG CAP (VISTARIL),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
HYDROXYZINE PAM 50MG CAP (VISTARIL),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
HYDROXYZINE PAM 100MG CAP (VISTARIL),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
HYDROXYZINE PAM 100MG CAP (VISTARIL),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
HYDROXYZINE PAM 100MG CAP (VISTARIL),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
NICOTINE PATCH 21MG/DAY,250,RC,,,,both,26.45,23.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.52,,,,15.61,21.58
NICOTINE PATCH 21MG/DAY,250,RC,,,,both,26.45,23.81,Cigna,Default,Percent of Total Billed Charges,15.61,,,,15.61,21.58
NICOTINE PATCH 21MG/DAY,250,RC,,,,both,26.45,23.81,United Healthcare,Default,Fee Schedule,21.58,,,,15.61,21.58
NICOTINE PATCH 14MG/DAY,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
NICOTINE PATCH 14MG/DAY,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
NICOTINE PATCH 14MG/DAY,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
BELLADONNA /PHENOBARB TAB (DONNATAL),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
BELLADONNA /PHENOBARB TAB (DONNATAL),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
BELLADONNA /PHENOBARB TAB (DONNATAL),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
Nitroglycerin/D5W : 50MG/250ML PREMIX,250,RC,,,,both,96.17,86.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.32,,,,56.74,78.47
Nitroglycerin/D5W : 50MG/250ML PREMIX,250,RC,,,,both,96.17,86.55,Cigna,Default,Percent of Total Billed Charges,56.74,,,,56.74,78.47
Nitroglycerin/D5W : 50MG/250ML PREMIX,250,RC,,,,both,96.17,86.55,United Healthcare,Default,Fee Schedule,78.47,,,,56.74,78.47
FERROUS SULFATE 220MG ELIXIR,250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
FERROUS SULFATE 220MG ELIXIR,250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
FERROUS SULFATE 220MG ELIXIR,250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ALPRAZOLAM 0.5MG TAB (XANAX),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ALPRAZOLAM 0.5MG TAB (XANAX),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ALPRAZOLAM 0.5MG TAB (XANAX),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
FENTANYL 250MCG/5ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
FENTANYL 250MCG/5ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
FENTANYL 250MCG/5ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
FML OPHTH SUSP 0.1%,250,RC,,,,both,95.01,85.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.51,,,,56.06,77.53
FML OPHTH SUSP 0.1%,250,RC,,,,both,95.01,85.51,Cigna,Default,Percent of Total Billed Charges,56.06,,,,56.06,77.53
FML OPHTH SUSP 0.1%,250,RC,,,,both,95.01,85.51,United Healthcare,Default,Fee Schedule,77.53,,,,56.06,77.53
TRIPLE ANTIBIOTIC OINT PKT (NEOSPORIN),637,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
TRIPLE ANTIBIOTIC OINT PKT (NEOSPORIN),637,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
TRIPLE ANTIBIOTIC OINT PKT (NEOSPORIN),637,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
CEPHALEXIN SUSP 250MG/5ML,250,RC,,,,both,62.76,56.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.93,,,,37.03,51.21
CEPHALEXIN SUSP 250MG/5ML,250,RC,,,,both,62.76,56.48,Cigna,Default,Percent of Total Billed Charges,37.03,,,,37.03,51.21
CEPHALEXIN SUSP 250MG/5ML,250,RC,,,,both,62.76,56.48,United Healthcare,Default,Fee Schedule,51.21,,,,37.03,51.21
NYSTATIN CREAM 30GM,250,RC,,,,both,27.9,25.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.53,,,,16.46,22.77
NYSTATIN CREAM 30GM,250,RC,,,,both,27.9,25.11,Cigna,Default,Percent of Total Billed Charges,16.46,,,,16.46,22.77
NYSTATIN CREAM 30GM,250,RC,,,,both,27.9,25.11,United Healthcare,Default,Fee Schedule,22.77,,,,16.46,22.77
CEFACLOR 125MG/5ML 75ML SUSP,250,RC,,,,both,74.96,67.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.47,,,,44.23,61.17
CEFACLOR 125MG/5ML 75ML SUSP,250,RC,,,,both,74.96,67.46,Cigna,Default,Percent of Total Billed Charges,44.23,,,,44.23,61.17
CEFACLOR 125MG/5ML 75ML SUSP,250,RC,,,,both,74.96,67.46,United Healthcare,Default,Fee Schedule,61.17,,,,44.23,61.17
BUTALBITAL/ACETAMINOPHEN/CAFFEINE TAB,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
BUTALBITAL/ACETAMINOPHEN/CAFFEINE TAB,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
BUTALBITAL/ACETAMINOPHEN/CAFFEINE TAB,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
CEFUROXIME 250MG TAB (CEFTIN),250,RC,,,,both,18.3,16.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.81,,,,10.8,14.93
CEFUROXIME 250MG TAB (CEFTIN),250,RC,,,,both,18.3,16.47,Cigna,Default,Percent of Total Billed Charges,10.8,,,,10.8,14.93
CEFUROXIME 250MG TAB (CEFTIN),250,RC,,,,both,18.3,16.47,United Healthcare,Default,Fee Schedule,14.93,,,,10.8,14.93
DEXAMETHASONE 2MG TAB,J8540,HCPCS,636,RC,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
DEXAMETHASONE 2MG TAB,J8540,HCPCS,636,RC,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
DEXAMETHASONE 2MG TAB,J8540,HCPCS,636,RC,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
DESIPRAMINE HCL 25MG TAB (NORPRAMIN),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
DESIPRAMINE HCL 25MG TAB (NORPRAMIN),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
DESIPRAMINE HCL 25MG TAB (NORPRAMIN),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
ORPHENADRINE 60MG/2ML  2ML INJ (NORFLEX),250,RC,,,,both,109.51,98.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.66,,,,64.61,89.36
ORPHENADRINE 60MG/2ML  2ML INJ (NORFLEX),250,RC,,,,both,109.51,98.56,Cigna,Default,Percent of Total Billed Charges,64.61,,,,64.61,89.36
ORPHENADRINE 60MG/2ML  2ML INJ (NORFLEX),250,RC,,,,both,109.51,98.56,United Healthcare,Default,Fee Schedule,89.36,,,,64.61,89.36
IRON COMPLEX 150MG CAP (FERREX),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
IRON COMPLEX 150MG CAP (FERREX),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
IRON COMPLEX 150MG CAP (FERREX),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
CECLOR SUSP 125MG/5ML,250,RC,,,,both,83.97,75.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.78,,,,49.54,68.52
CECLOR SUSP 125MG/5ML,250,RC,,,,both,83.97,75.57,Cigna,Default,Percent of Total Billed Charges,49.54,,,,49.54,68.52
CECLOR SUSP 125MG/5ML,250,RC,,,,both,83.97,75.57,United Healthcare,Default,Fee Schedule,68.52,,,,49.54,68.52
CIPROFLOXACIN INJ 400MG/40ML (CIPRO),J0744,HCPCS,636,RC,,both,30.22,27.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.15,,,,17.83,24.66
CIPROFLOXACIN INJ 400MG/40ML (CIPRO),J0744,HCPCS,636,RC,,both,30.22,27.2,Cigna,Default,Percent of Total Billed Charges,17.83,,,,17.83,24.66
CIPROFLOXACIN INJ 400MG/40ML (CIPRO),J0744,HCPCS,636,RC,,both,30.22,27.2,United Healthcare,Default,Fee Schedule,24.66,,,,17.83,24.66
COSYNTROPIN 0.25MG INJ (CORTROSYN),J0834,HCPCS,636,RC,,both,549.95,494.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,384.96,,,,324.47,448.76
COSYNTROPIN 0.25MG INJ (CORTROSYN),J0834,HCPCS,636,RC,,both,549.95,494.96,Cigna,Default,Percent of Total Billed Charges,324.47,,,,324.47,448.76
COSYNTROPIN 0.25MG INJ (CORTROSYN),J0834,HCPCS,636,RC,,both,549.95,494.96,United Healthcare,Default,Fee Schedule,448.76,,,,324.47,448.76
METHYLENE BLUE 0.5% 10ML,Q9968,HCPCS,636,RC,,both,1872.09,1684.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1310.46,,,,1104.53,1527.63
METHYLENE BLUE 0.5% 10ML,Q9968,HCPCS,636,RC,,both,1872.09,1684.88,Cigna,Default,Percent of Total Billed Charges,1104.53,,,,1104.53,1527.63
METHYLENE BLUE 0.5% 10ML,Q9968,HCPCS,636,RC,,both,1872.09,1684.88,United Healthcare,Default,Fee Schedule,1527.63,,,,1104.53,1527.63
ALLOPURINOL 300MG TAB (ZYLOPRIM),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
ALLOPURINOL 300MG TAB (ZYLOPRIM),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
ALLOPURINOL 300MG TAB (ZYLOPRIM),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
EUCERIN 40Z CRM,250,RC,,,,both,39.93,35.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.95,,,,23.56,32.58
EUCERIN 40Z CRM,250,RC,,,,both,39.93,35.94,Cigna,Default,Percent of Total Billed Charges,23.56,,,,23.56,32.58
EUCERIN 40Z CRM,250,RC,,,,both,39.93,35.94,United Healthcare,Default,Fee Schedule,32.58,,,,23.56,32.58
FLUOROURACIL 500MG/10ML INJ (ADRUCIL),J9190,HCPCS,636,RC,,both,33.46,30.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.42,,,,19.74,27.3
FLUOROURACIL 500MG/10ML INJ (ADRUCIL),J9190,HCPCS,636,RC,,both,33.46,30.11,Cigna,Default,Percent of Total Billed Charges,19.74,,,,19.74,27.3
FLUOROURACIL 500MG/10ML INJ (ADRUCIL),J9190,HCPCS,636,RC,,both,33.46,30.11,United Healthcare,Default,Fee Schedule,27.3,,,,19.74,27.3
CYCLOPHOSPHAMIDE 1000MG INJ (CYTOXAN),J9073,HCPCS,636,RC,,both,3002.33,2702.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2101.63,,,,1771.37,2449.9
CYCLOPHOSPHAMIDE 1000MG INJ (CYTOXAN),J9073,HCPCS,636,RC,,both,3002.33,2702.1,Cigna,Default,Percent of Total Billed Charges,1771.37,,,,1771.37,2449.9
CYCLOPHOSPHAMIDE 1000MG INJ (CYTOXAN),J9073,HCPCS,636,RC,,both,3002.33,2702.1,United Healthcare,Default,Fee Schedule,2449.9,,,,1771.37,2449.9
DURAGESIC SYSTEM 75MCG,250,RC,,,,both,149.91,134.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.94,,,,88.45,122.33
DURAGESIC SYSTEM 75MCG,250,RC,,,,both,149.91,134.92,Cigna,Default,Percent of Total Billed Charges,88.45,,,,88.45,122.33
DURAGESIC SYSTEM 75MCG,250,RC,,,,both,149.91,134.92,United Healthcare,Default,Fee Schedule,122.33,,,,88.45,122.33
DROPERIDOL INJ 2.5MG/ML 2ML AMP,J1790,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
DROPERIDOL INJ 2.5MG/ML 2ML AMP,J1790,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
DROPERIDOL INJ 2.5MG/ML 2ML AMP,J1790,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
ALCOHOL DEHYDRATED 1ML AMP INJ,250,RC,,,,both,51,45.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.7,,,,30.09,41.62
ALCOHOL DEHYDRATED 1ML AMP INJ,250,RC,,,,both,51,45.9,Cigna,Default,Percent of Total Billed Charges,30.09,,,,30.09,41.62
ALCOHOL DEHYDRATED 1ML AMP INJ,250,RC,,,,both,51,45.9,United Healthcare,Default,Fee Schedule,41.62,,,,30.09,41.62
AMLODIPINE 10MG TAB,637,RC,,,,both,11.06,9.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.74,,,,6.53,9.02
AMLODIPINE 10MG TAB,637,RC,,,,both,11.06,9.95,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.02
AMLODIPINE 10MG TAB,637,RC,,,,both,11.06,9.95,United Healthcare,Default,Fee Schedule,9.02,,,,6.53,9.02
AMLODIPINE 5 MG TAB,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
AMLODIPINE 5 MG TAB,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
AMLODIPINE 5 MG TAB,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
LISINOPRIL 20MG TAB (ZESTRIL),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
LISINOPRIL 20MG TAB (ZESTRIL),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
LISINOPRIL 20MG TAB (ZESTRIL),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
CALCIUM 500MG TAB (OSCAL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CALCIUM 500MG TAB (OSCAL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CALCIUM 500MG TAB (OSCAL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
METOLAZONE 5 MG TAB (ZAROXOLYN),250,RC,,,,both,14.65,13.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.26,,,,8.64,11.95
METOLAZONE 5 MG TAB (ZAROXOLYN),250,RC,,,,both,14.65,13.19,Cigna,Default,Percent of Total Billed Charges,8.64,,,,8.64,11.95
METOLAZONE 5 MG TAB (ZAROXOLYN),250,RC,,,,both,14.65,13.19,United Healthcare,Default,Fee Schedule,11.95,,,,8.64,11.95
BUPIVACAINE 0.5% INJ 10ML (MARCAINE),250,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
BUPIVACAINE 0.5% INJ 10ML (MARCAINE),250,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
BUPIVACAINE 0.5% INJ 10ML (MARCAINE),250,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ACYCLOVIR INJ 500MG,J0133,HCPCS,250,RC,,both,144.75,130.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.32,,,,85.4,118.12
ACYCLOVIR INJ 500MG,J0133,HCPCS,250,RC,,both,144.75,130.28,Cigna,Default,Percent of Total Billed Charges,85.4,,,,85.4,118.12
ACYCLOVIR INJ 500MG,J0133,HCPCS,250,RC,,both,144.75,130.28,United Healthcare,Default,Fee Schedule,118.12,,,,85.4,118.12
D 50W 50% VIAL 50ML,250,RC,,,,both,33.46,30.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.42,,,,19.74,27.3
D 50W 50% VIAL 50ML,250,RC,,,,both,33.46,30.11,Cigna,Default,Percent of Total Billed Charges,19.74,,,,19.74,27.3
D 50W 50% VIAL 50ML,250,RC,,,,both,33.46,30.11,United Healthcare,Default,Fee Schedule,27.3,,,,19.74,27.3
AZITHROMYCIN 250MG TAB (ZITHROMAX),Q0144,HCPCS,636,RC,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
AZITHROMYCIN 250MG TAB (ZITHROMAX),Q0144,HCPCS,636,RC,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
AZITHROMYCIN 250MG TAB (ZITHROMAX),Q0144,HCPCS,636,RC,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
BISACODYL 5MG EC TAB (DULCOLAX),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
BISACODYL 5MG EC TAB (DULCOLAX),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
BISACODYL 5MG EC TAB (DULCOLAX),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
ERYTHROMYCIN 250MG CAP (ERY-TAB),250,RC,,,,both,26.69,24.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.68,,,,15.75,21.78
ERYTHROMYCIN 250MG CAP (ERY-TAB),250,RC,,,,both,26.69,24.02,Cigna,Default,Percent of Total Billed Charges,15.75,,,,15.75,21.78
ERYTHROMYCIN 250MG CAP (ERY-TAB),250,RC,,,,both,26.69,24.02,United Healthcare,Default,Fee Schedule,21.78,,,,15.75,21.78
METHOTREXATE 2.5MG TAB,J8610,HCPCS,636,RC,,both,15.21,13.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.65,,,,8.97,12.41
METHOTREXATE 2.5MG TAB,J8610,HCPCS,636,RC,,both,15.21,13.69,Cigna,Default,Percent of Total Billed Charges,8.97,,,,8.97,12.41
METHOTREXATE 2.5MG TAB,J8610,HCPCS,636,RC,,both,15.21,13.69,United Healthcare,Default,Fee Schedule,12.41,,,,8.97,12.41
SALINE NASAL SPRAY (OCEAN),637,RC,,,,both,16.28,14.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.4,,,,9.61,13.28
SALINE NASAL SPRAY (OCEAN),637,RC,,,,both,16.28,14.65,Cigna,Default,Percent of Total Billed Charges,9.61,,,,9.61,13.28
SALINE NASAL SPRAY (OCEAN),637,RC,,,,both,16.28,14.65,United Healthcare,Default,Fee Schedule,13.28,,,,9.61,13.28
CLONIDINE TTS -1 PATCH (CATAPRES),637,RC,,,,both,46.78,42.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.75,,,,27.6,38.17
CLONIDINE TTS -1 PATCH (CATAPRES),637,RC,,,,both,46.78,42.1,Cigna,Default,Percent of Total Billed Charges,27.6,,,,27.6,38.17
CLONIDINE TTS -1 PATCH (CATAPRES),637,RC,,,,both,46.78,42.1,United Healthcare,Default,Fee Schedule,38.17,,,,27.6,38.17
DEXAMETHASONE 4MG/ML 5ML INJ SDV,J1100,HCPCS,636,RC,,both,33.5,30.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.45,,,,19.76,27.34
DEXAMETHASONE 4MG/ML 5ML INJ SDV,J1100,HCPCS,636,RC,,both,33.5,30.15,Cigna,Default,Percent of Total Billed Charges,19.76,,,,19.76,27.34
DEXAMETHASONE 4MG/ML 5ML INJ SDV,J1100,HCPCS,636,RC,,both,33.5,30.15,United Healthcare,Default,Fee Schedule,27.34,,,,19.76,27.34
MEPIVACAINE 1% 20ML INJ (CARBOCAINE),250,RC,,,,both,75.78,68.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.05,,,,44.71,61.84
MEPIVACAINE 1% 20ML INJ (CARBOCAINE),250,RC,,,,both,75.78,68.2,Cigna,Default,Percent of Total Billed Charges,44.71,,,,44.71,61.84
MEPIVACAINE 1% 20ML INJ (CARBOCAINE),250,RC,,,,both,75.78,68.2,United Healthcare,Default,Fee Schedule,61.84,,,,44.71,61.84
BETAMETHASONE 6MG/ML 5ML INJ (CELESTONE),J0702,HCPCS,636,RC,,both,115.05,103.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.54,,,,67.88,93.88
BETAMETHASONE 6MG/ML 5ML INJ (CELESTONE),J0702,HCPCS,636,RC,,both,115.05,103.55,Cigna,Default,Percent of Total Billed Charges,67.88,,,,67.88,93.88
BETAMETHASONE 6MG/ML 5ML INJ (CELESTONE),J0702,HCPCS,636,RC,,both,115.05,103.55,United Healthcare,Default,Fee Schedule,93.88,,,,67.88,93.88
DICYCLOMINE 10MG CAP (BENTYL),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DICYCLOMINE 10MG CAP (BENTYL),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DICYCLOMINE 10MG CAP (BENTYL),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DILTIAZEM 300MG CAP (CARDIZEM CD),250,RC,,,,both,13,11.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.1,,,,7.67,10.61
DILTIAZEM 300MG CAP (CARDIZEM CD),250,RC,,,,both,13,11.7,Cigna,Default,Percent of Total Billed Charges,7.67,,,,7.67,10.61
DILTIAZEM 300MG CAP (CARDIZEM CD),250,RC,,,,both,13,11.7,United Healthcare,Default,Fee Schedule,10.61,,,,7.67,10.61
DILTIAZEM ER 90MG CAP (CARDIZEM),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
DILTIAZEM ER 90MG CAP (CARDIZEM),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
DILTIAZEM ER 90MG CAP (CARDIZEM),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DOXAZOSIN 1MG TAB (CARDURA),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
DOXAZOSIN 1MG TAB (CARDURA),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
DOXAZOSIN 1MG TAB (CARDURA),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
DOXYCYCLINE 100MG INJ (VIBRAMYCIN),250,RC,,,,both,129.86,116.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.9,,,,76.62,105.97
DOXYCYCLINE 100MG INJ (VIBRAMYCIN),250,RC,,,,both,129.86,116.87,Cigna,Default,Percent of Total Billed Charges,76.62,,,,76.62,105.97
DOXYCYCLINE 100MG INJ (VIBRAMYCIN),250,RC,,,,both,129.86,116.87,United Healthcare,Default,Fee Schedule,105.97,,,,76.62,105.97
DOCUSATE SODIUM 100MG CAP (COLACE),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DOCUSATE SODIUM 100MG CAP (COLACE),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DOCUSATE SODIUM 100MG CAP (COLACE),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
VECURONIUM 10MG INJ (NORCURON),250,RC,,,,both,104.81,94.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.37,,,,61.84,85.52
VECURONIUM 10MG INJ (NORCURON),250,RC,,,,both,104.81,94.33,Cigna,Default,Percent of Total Billed Charges,61.84,,,,61.84,85.52
VECURONIUM 10MG INJ (NORCURON),250,RC,,,,both,104.81,94.33,United Healthcare,Default,Fee Schedule,85.52,,,,61.84,85.52
LABETALOL 100MG/20ML INJ (TRANDATE),250,RC,,,,both,69.72,62.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.8,,,,41.13,56.89
LABETALOL 100MG/20ML INJ (TRANDATE),250,RC,,,,both,69.72,62.75,Cigna,Default,Percent of Total Billed Charges,41.13,,,,41.13,56.89
LABETALOL 100MG/20ML INJ (TRANDATE),250,RC,,,,both,69.72,62.75,United Healthcare,Default,Fee Schedule,56.89,,,,41.13,56.89
NALBUPHINE 10MG/ML  1ML INJ (NUBAIN),J2300,HCPCS,636,RC,,both,136.56,122.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.59,,,,80.57,111.43
NALBUPHINE 10MG/ML  1ML INJ (NUBAIN),J2300,HCPCS,636,RC,,both,136.56,122.9,Cigna,Default,Percent of Total Billed Charges,80.57,,,,80.57,111.43
NALBUPHINE 10MG/ML  1ML INJ (NUBAIN),J2300,HCPCS,636,RC,,both,136.56,122.9,United Healthcare,Default,Fee Schedule,111.43,,,,80.57,111.43
DOCUSATE CALCIUM 240MG CAP (SURFAK),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
DOCUSATE CALCIUM 240MG CAP (SURFAK),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
DOCUSATE CALCIUM 240MG CAP (SURFAK),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PROSIGHT TAB (OCUVITE) I CAPS,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PROSIGHT TAB (OCUVITE) I CAPS,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PROSIGHT TAB (OCUVITE) I CAPS,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
GAVISCON SUSP,250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
GAVISCON SUSP,250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
GAVISCON SUSP,250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
GLIPIZIDE 10MG TAB (GLUCOTROL),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
GLIPIZIDE 10MG TAB (GLUCOTROL),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
GLIPIZIDE 10MG TAB (GLUCOTROL),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
GENTAMYCIN OPTH SOL,250,RC,,,,both,38.36,34.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.85,,,,22.63,31.3
GENTAMYCIN OPTH SOL,250,RC,,,,both,38.36,34.52,Cigna,Default,Percent of Total Billed Charges,22.63,,,,22.63,31.3
GENTAMYCIN OPTH SOL,250,RC,,,,both,38.36,34.52,United Healthcare,Default,Fee Schedule,31.3,,,,22.63,31.3
POLYETHYLENE GLYCOL-ELECTROLYTE SOL (GOL,637,RC,,,,both,81.35,73.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.94,,,,48,66.38
POLYETHYLENE GLYCOL-ELECTROLYTE SOL (GOL,637,RC,,,,both,81.35,73.22,Cigna,Default,Percent of Total Billed Charges,48,,,,48,66.38
POLYETHYLENE GLYCOL-ELECTROLYTE SOL (GOL,637,RC,,,,both,81.35,73.22,United Healthcare,Default,Fee Schedule,66.38,,,,48,66.38
GRANULEX AEROSOL 4OZ,250,RC,,,,both,97.91,88.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,68.54,,,,57.77,79.89
GRANULEX AEROSOL 4OZ,250,RC,,,,both,97.91,88.12,Cigna,Default,Percent of Total Billed Charges,57.77,,,,57.77,79.89
GRANULEX AEROSOL 4OZ,250,RC,,,,both,97.91,88.12,United Healthcare,Default,Fee Schedule,79.89,,,,57.77,79.89
GLYCERIN ADULT SUPP,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
GLYCERIN ADULT SUPP,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
GLYCERIN ADULT SUPP,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
GLUCAGON 1MG HYPOKIT INJ (GLUCAGEN),J1610,HCPCS,636,RC,,both,310.01,279.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,217.01,,,,182.91,252.97
GLUCAGON 1MG HYPOKIT INJ (GLUCAGEN),J1610,HCPCS,636,RC,,both,310.01,279.01,Cigna,Default,Percent of Total Billed Charges,182.91,,,,182.91,252.97
GLUCAGON 1MG HYPOKIT INJ (GLUCAGEN),J1610,HCPCS,636,RC,,both,310.01,279.01,United Healthcare,Default,Fee Schedule,252.97,,,,182.91,252.97
METRONIDAZOLE 500MG TAB (FLAGYL),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
METRONIDAZOLE 500MG TAB (FLAGYL),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
METRONIDAZOLE 500MG TAB (FLAGYL),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
GENTAMICIN SULFATE CRM,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
GENTAMICIN SULFATE CRM,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
GENTAMICIN SULFATE CRM,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
GENTAMICIN SULFATE 0.1%OINT  15GM,250,RC,,,,both,229.55,206.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,160.68,,,,135.43,187.31
GENTAMICIN SULFATE 0.1%OINT  15GM,250,RC,,,,both,229.55,206.6,Cigna,Default,Percent of Total Billed Charges,135.43,,,,135.43,187.31
GENTAMICIN SULFATE 0.1%OINT  15GM,250,RC,,,,both,229.55,206.6,United Healthcare,Default,Fee Schedule,187.31,,,,135.43,187.31
GENTAMICIN OPHTH OINT 3.5GM(GENTAK),250,RC,,,,both,91.41,82.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.99,,,,53.93,74.59
GENTAMICIN OPHTH OINT 3.5GM(GENTAK),250,RC,,,,both,91.41,82.27,Cigna,Default,Percent of Total Billed Charges,53.93,,,,53.93,74.59
GENTAMICIN OPHTH OINT 3.5GM(GENTAK),250,RC,,,,both,91.41,82.27,United Healthcare,Default,Fee Schedule,74.59,,,,53.93,74.59
MORPHINE SULFATE 10MG/ML INJ,J2270,HCPCS,636,RC,,both,31.81,28.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.27,,,,18.77,25.96
MORPHINE SULFATE 10MG/ML INJ,J2270,HCPCS,636,RC,,both,31.81,28.63,Cigna,Default,Percent of Total Billed Charges,18.77,,,,18.77,25.96
MORPHINE SULFATE 10MG/ML INJ,J2270,HCPCS,636,RC,,both,31.81,28.63,United Healthcare,Default,Fee Schedule,25.96,,,,18.77,25.96
GLIPIZIDE 5MG TAB (GLUCOTROL),250,RC,,,,both,7.72,6.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.4,,,,4.55,6.3
GLIPIZIDE 5MG TAB (GLUCOTROL),250,RC,,,,both,7.72,6.95,Cigna,Default,Percent of Total Billed Charges,4.55,,,,4.55,6.3
GLIPIZIDE 5MG TAB (GLUCOTROL),250,RC,,,,both,7.72,6.95,United Healthcare,Default,Fee Schedule,6.3,,,,4.55,6.3
DIAZOXIDE 15MG/ML 20ML INJ (HYPERSTAT),250,RC,,,,both,524.72,472.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,367.3,,,,309.58,428.17
DIAZOXIDE 15MG/ML 20ML INJ (HYPERSTAT),250,RC,,,,both,524.72,472.25,Cigna,Default,Percent of Total Billed Charges,309.58,,,,309.58,428.17
DIAZOXIDE 15MG/ML 20ML INJ (HYPERSTAT),250,RC,,,,both,524.72,472.25,United Healthcare,Default,Fee Schedule,428.17,,,,309.58,428.17
TETRACAINE 0.5% EYE DROP,250,RC,,,,both,475.2,427.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,332.64,,,,280.37,387.76
TETRACAINE 0.5% EYE DROP,250,RC,,,,both,475.2,427.68,Cigna,Default,Percent of Total Billed Charges,280.37,,,,280.37,387.76
TETRACAINE 0.5% EYE DROP,250,RC,,,,both,475.2,427.68,United Healthcare,Default,Fee Schedule,387.76,,,,280.37,387.76
ERYTHROMYCIN EC 333MG (ERY-TAB),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
ERYTHROMYCIN EC 333MG (ERY-TAB),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
ERYTHROMYCIN EC 333MG (ERY-TAB),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
IBUPROFEN 200MG TAB (MOTRIN),637,RC,,,,both,1.44,1.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.01,,,,0.85,1.18
IBUPROFEN 200MG TAB (MOTRIN),637,RC,,,,both,1.44,1.3,Cigna,Default,Percent of Total Billed Charges,0.85,,,,0.85,1.18
IBUPROFEN 200MG TAB (MOTRIN),637,RC,,,,both,1.44,1.3,United Healthcare,Default,Fee Schedule,1.18,,,,0.85,1.18
LUPRON DEPOT INJ 7.5MG,J9217,HCPCS,636,RC,,both,2308.75,2077.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1616.12,,,,1362.16,1883.94
LUPRON DEPOT INJ 7.5MG,J9217,HCPCS,636,RC,,both,2308.75,2077.88,Cigna,Default,Percent of Total Billed Charges,1362.16,,,,1362.16,1883.94
LUPRON DEPOT INJ 7.5MG,J9217,HCPCS,636,RC,,both,2308.75,2077.88,United Healthcare,Default,Fee Schedule,1883.94,,,,1362.16,1883.94
CHLORPHENIRAMINE MAL 4MG TAB (CHLORPHEN),250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
CHLORPHENIRAMINE MAL 4MG TAB (CHLORPHEN),250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
CHLORPHENIRAMINE MAL 4MG TAB (CHLORPHEN),250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
DILTIAZEM 240MG CAP (CARDIZEM CD),250,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
DILTIAZEM 240MG CAP (CARDIZEM CD),250,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
DILTIAZEM 240MG CAP (CARDIZEM CD),250,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
DEXAMETHASONE SOD PHOS 10MG/ML 1ML INJ,J1100,HCPCS,636,RC,,both,33.74,30.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.62,,,,19.91,27.53
DEXAMETHASONE SOD PHOS 10MG/ML 1ML INJ,J1100,HCPCS,636,RC,,both,33.74,30.37,Cigna,Default,Percent of Total Billed Charges,19.91,,,,19.91,27.53
DEXAMETHASONE SOD PHOS 10MG/ML 1ML INJ,J1100,HCPCS,636,RC,,both,33.74,30.37,United Healthcare,Default,Fee Schedule,27.53,,,,19.91,27.53
OCTREOTIDE 100MCG/ML INJ (SANDOSTATIN),J2354,HCPCS,636,RC,,both,76.05,68.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.24,,,,44.87,62.06
OCTREOTIDE 100MCG/ML INJ (SANDOSTATIN),J2354,HCPCS,636,RC,,both,76.05,68.45,Cigna,Default,Percent of Total Billed Charges,44.87,,,,44.87,62.06
OCTREOTIDE 100MCG/ML INJ (SANDOSTATIN),J2354,HCPCS,636,RC,,both,76.05,68.45,United Healthcare,Default,Fee Schedule,62.06,,,,44.87,62.06
PNEUMOVAX 23 INJ 0.5ML,90732,HCPCS,636,RC,,both,586.82,528.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,410.77,,,,346.22,478.85
PNEUMOVAX 23 INJ 0.5ML,90732,HCPCS,636,RC,,both,586.82,528.14,Cigna,Default,Percent of Total Billed Charges,346.22,,,,346.22,478.85
PNEUMOVAX 23 INJ 0.5ML,90732,HCPCS,636,RC,,both,586.82,528.14,United Healthcare,Default,Fee Schedule,478.85,,,,346.22,478.85
CEFUROXIME 500MG TAB (CEFTIN),637,RC,,,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
CEFUROXIME 500MG TAB (CEFTIN),637,RC,,,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
CEFUROXIME 500MG TAB (CEFTIN),637,RC,,,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
CEFOXITIN 500MG TAB,250,RC,,,,both,33.41,30.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.39,,,,19.71,27.26
CEFOXITIN 500MG TAB,250,RC,,,,both,33.41,30.07,Cigna,Default,Percent of Total Billed Charges,19.71,,,,19.71,27.26
CEFOXITIN 500MG TAB,250,RC,,,,both,33.41,30.07,United Healthcare,Default,Fee Schedule,27.26,,,,19.71,27.26
CEFPROZIL 250MG/5ML SUSP 50ML (CEFZIL),250,RC,,,,both,147.31,132.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.12,,,,86.91,120.2
CEFPROZIL 250MG/5ML SUSP 50ML (CEFZIL),250,RC,,,,both,147.31,132.58,Cigna,Default,Percent of Total Billed Charges,86.91,,,,86.91,120.2
CEFPROZIL 250MG/5ML SUSP 50ML (CEFZIL),250,RC,,,,both,147.31,132.58,United Healthcare,Default,Fee Schedule,120.2,,,,86.91,120.2
CEFOXITIN 250MG TAB (CEFZIL),250,RC,,,,both,17.15,15.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12,,,,10.12,13.99
CEFOXITIN 250MG TAB (CEFZIL),250,RC,,,,both,17.15,15.44,Cigna,Default,Percent of Total Billed Charges,10.12,,,,10.12,13.99
CEFOXITIN 250MG TAB (CEFZIL),250,RC,,,,both,17.15,15.44,United Healthcare,Default,Fee Schedule,13.99,,,,10.12,13.99
FAMOTIDINE 20MG TAB (PEPCID),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
FAMOTIDINE 20MG TAB (PEPCID),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
FAMOTIDINE 20MG TAB (PEPCID),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
LIDOCAINE VISCOUS 2% 100ML (XYLOCAINE),250,RC,,,,both,58.41,52.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.89,,,,34.46,47.66
LIDOCAINE VISCOUS 2% 100ML (XYLOCAINE),250,RC,,,,both,58.41,52.57,Cigna,Default,Percent of Total Billed Charges,34.46,,,,34.46,47.66
LIDOCAINE VISCOUS 2% 100ML (XYLOCAINE),250,RC,,,,both,58.41,52.57,United Healthcare,Default,Fee Schedule,47.66,,,,34.46,47.66
DICLOXACILLIN 250MG CAP,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
DICLOXACILLIN 250MG CAP,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
DICLOXACILLIN 250MG CAP,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
FLUOXETINE 20MG CAP,637,RC,,,,both,12.44,11.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.71,,,,7.34,10.15
FLUOXETINE 20MG CAP,637,RC,,,,both,12.44,11.2,Cigna,Default,Percent of Total Billed Charges,7.34,,,,7.34,10.15
FLUOXETINE 20MG CAP,637,RC,,,,both,12.44,11.2,United Healthcare,Default,Fee Schedule,10.15,,,,7.34,10.15
BACITRACIN OPHTH OINT 3.5GM TUBE,250,RC,,,,both,332.09,298.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,232.46,,,,195.93,270.99
BACITRACIN OPHTH OINT 3.5GM TUBE,250,RC,,,,both,332.09,298.88,Cigna,Default,Percent of Total Billed Charges,195.93,,,,195.93,270.99
BACITRACIN OPHTH OINT 3.5GM TUBE,250,RC,,,,both,332.09,298.88,United Healthcare,Default,Fee Schedule,270.99,,,,195.93,270.99
PENICILLIN V POTASSIUM 250MG/5ML SUSP (P,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
PENICILLIN V POTASSIUM 250MG/5ML SUSP (P,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
PENICILLIN V POTASSIUM 250MG/5ML SUSP (P,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
PENICILLIN G POTASSIUM 5MU INJ,250,RC,,,,both,195.53,175.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.87,,,,115.36,159.55
PENICILLIN G POTASSIUM 5MU INJ,250,RC,,,,both,195.53,175.98,Cigna,Default,Percent of Total Billed Charges,115.36,,,,115.36,159.55
PENICILLIN G POTASSIUM 5MU INJ,250,RC,,,,both,195.53,175.98,United Healthcare,Default,Fee Schedule,159.55,,,,115.36,159.55
CORTISPORIN OPTH OINT,250,RC,,,,both,134.22,120.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.95,,,,79.19,109.52
CORTISPORIN OPTH OINT,250,RC,,,,both,134.22,120.8,Cigna,Default,Percent of Total Billed Charges,79.19,,,,79.19,109.52
CORTISPORIN OPTH OINT,250,RC,,,,both,134.22,120.8,United Healthcare,Default,Fee Schedule,109.52,,,,79.19,109.52
ERYTHROMYCIN OPHTH OINT 0.5% (ILOTYCIN),250,RC,,,,both,81.7,73.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.19,,,,48.2,66.67
ERYTHROMYCIN OPHTH OINT 0.5% (ILOTYCIN),250,RC,,,,both,81.7,73.53,Cigna,Default,Percent of Total Billed Charges,48.2,,,,48.2,66.67
ERYTHROMYCIN OPHTH OINT 0.5% (ILOTYCIN),250,RC,,,,both,81.7,73.53,United Healthcare,Default,Fee Schedule,66.67,,,,48.2,66.67
DOXYCYCLINE 100MG CAP (VIBRAMYCIN),250,RC,,,,both,24.61,22.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.23,,,,14.52,20.08
DOXYCYCLINE 100MG CAP (VIBRAMYCIN),250,RC,,,,both,24.61,22.15,Cigna,Default,Percent of Total Billed Charges,14.52,,,,14.52,20.08
DOXYCYCLINE 100MG CAP (VIBRAMYCIN),250,RC,,,,both,24.61,22.15,United Healthcare,Default,Fee Schedule,20.08,,,,14.52,20.08
TUBERSOL  5TU/0.1ML INJ,86580,HCPCS,300,RC,,both,46.29,41.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.4,,,,27.31,37.77
TUBERSOL  5TU/0.1ML INJ,86580,HCPCS,300,RC,,both,46.29,41.66,Cigna,Default,Percent of Total Billed Charges,27.31,,,,27.31,37.77
TUBERSOL  5TU/0.1ML INJ,86580,HCPCS,300,RC,,both,46.29,41.66,United Healthcare,Default,Fee Schedule,37.77,,,,27.31,37.77
FLUCONAZOLE PREMIX 200MG (DIFLUCAN),J1450,HCPCS,636,RC,,both,364.35,327.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.04,,,,214.97,297.31
FLUCONAZOLE PREMIX 200MG (DIFLUCAN),J1450,HCPCS,636,RC,,both,364.35,327.92,Cigna,Default,Percent of Total Billed Charges,214.97,,,,214.97,297.31
FLUCONAZOLE PREMIX 200MG (DIFLUCAN),J1450,HCPCS,636,RC,,both,364.35,327.92,United Healthcare,Default,Fee Schedule,297.31,,,,214.97,297.31
FLUCONAZOLE 100MG TAB (DIFLUCAN),637,RC,,,,both,40.99,36.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.69,,,,24.18,33.45
FLUCONAZOLE 100MG TAB (DIFLUCAN),637,RC,,,,both,40.99,36.89,Cigna,Default,Percent of Total Billed Charges,24.18,,,,24.18,33.45
FLUCONAZOLE 100MG TAB (DIFLUCAN),637,RC,,,,both,40.99,36.89,United Healthcare,Default,Fee Schedule,33.45,,,,24.18,33.45
FLUCONAZOLE 200MG TAB (DIFLUCAN),250,RC,,,,both,61.02,54.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.71,,,,36,49.79
FLUCONAZOLE 200MG TAB (DIFLUCAN),250,RC,,,,both,61.02,54.92,Cigna,Default,Percent of Total Billed Charges,36,,,,36,49.79
FLUCONAZOLE 200MG TAB (DIFLUCAN),250,RC,,,,both,61.02,54.92,United Healthcare,Default,Fee Schedule,49.79,,,,36,49.79
CONJUGATED ESTROGENS 25MG INJ (PREMARIN),J1410,HCPCS,636,RC,,both,1755.99,1580.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1229.19,,,,1036.03,1432.89
CONJUGATED ESTROGENS 25MG INJ (PREMARIN),J1410,HCPCS,636,RC,,both,1755.99,1580.39,Cigna,Default,Percent of Total Billed Charges,1036.03,,,,1036.03,1432.89
CONJUGATED ESTROGENS 25MG INJ (PREMARIN),J1410,HCPCS,636,RC,,both,1755.99,1580.39,United Healthcare,Default,Fee Schedule,1432.89,,,,1036.03,1432.89
CONJUGATED ESTROGENS 0.625MG/GM 42.5GM C,637,RC,,,,both,210.93,189.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.65,,,,124.45,172.12
CONJUGATED ESTROGENS 0.625MG/GM 42.5GM C,637,RC,,,,both,210.93,189.84,Cigna,Default,Percent of Total Billed Charges,124.45,,,,124.45,172.12
CONJUGATED ESTROGENS 0.625MG/GM 42.5GM C,637,RC,,,,both,210.93,189.84,United Healthcare,Default,Fee Schedule,172.12,,,,124.45,172.12
HYDROXYZINE PAM 25MG CAP (VISTARIL),Q0177,HCPCS,636,RC,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
HYDROXYZINE PAM 25MG CAP (VISTARIL),Q0177,HCPCS,636,RC,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
HYDROXYZINE PAM 25MG CAP (VISTARIL),Q0177,HCPCS,636,RC,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
ALBUTEROL HFA 90MCG (VENTOLIN HFA),J3535,HCPCS,636,RC,,both,378.23,340.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,264.76,,,,223.16,308.64
ALBUTEROL HFA 90MCG (VENTOLIN HFA),J3535,HCPCS,636,RC,,both,378.23,340.41,Cigna,Default,Percent of Total Billed Charges,223.16,,,,223.16,308.64
ALBUTEROL HFA 90MCG (VENTOLIN HFA),J3535,HCPCS,636,RC,,both,378.23,340.41,United Healthcare,Default,Fee Schedule,308.64,,,,223.16,308.64
OXYTOCIN 10U/1ML INJ (PITOCIN),J2590,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
OXYTOCIN 10U/1ML INJ (PITOCIN),J2590,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
OXYTOCIN 10U/1ML INJ (PITOCIN),J2590,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
HALOPERIDOL LACT 5MG/1ML INJ,J1630,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
HALOPERIDOL LACT 5MG/1ML INJ,J1630,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
HALOPERIDOL LACT 5MG/1ML INJ,J1630,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
VASOPRESSIN INJ 10U/0.5,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
VASOPRESSIN INJ 10U/0.5,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
VASOPRESSIN INJ 10U/0.5,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
HYDRALAZINE HCL 20MG/ML INJ,J0360,HCPCS,636,RC,,both,84.26,75.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.98,,,,49.71,68.76
HYDRALAZINE HCL 20MG/ML INJ,J0360,HCPCS,636,RC,,both,84.26,75.83,Cigna,Default,Percent of Total Billed Charges,49.71,,,,49.71,68.76
HYDRALAZINE HCL 20MG/ML INJ,J0360,HCPCS,636,RC,,both,84.26,75.83,United Healthcare,Default,Fee Schedule,68.76,,,,49.71,68.76
HYDROXYZINE HCL 50MG/1ML INJ (VISTARIL),250,RC,,,,both,152.43,137.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.7,,,,89.93,124.38
HYDROXYZINE HCL 50MG/1ML INJ (VISTARIL),250,RC,,,,both,152.43,137.19,Cigna,Default,Percent of Total Billed Charges,89.93,,,,89.93,124.38
HYDROXYZINE HCL 50MG/1ML INJ (VISTARIL),250,RC,,,,both,152.43,137.19,United Healthcare,Default,Fee Schedule,124.38,,,,89.93,124.38
PREDNISONE OPTH 1% 5ML SUSP (PRED-FORTE),637,RC,,,,both,237.88,214.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,166.52,,,,140.35,194.11
PREDNISONE OPTH 1% 5ML SUSP (PRED-FORTE),637,RC,,,,both,237.88,214.09,Cigna,Default,Percent of Total Billed Charges,140.35,,,,140.35,194.11
PREDNISONE OPTH 1% 5ML SUSP (PRED-FORTE),637,RC,,,,both,237.88,214.09,United Healthcare,Default,Fee Schedule,194.11,,,,140.35,194.11
HYDROCORTISONE 2.5% OINT (CORTIZONE),250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
HYDROCORTISONE 2.5% OINT (CORTIZONE),250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
HYDROCORTISONE 2.5% OINT (CORTIZONE),250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
"HEPARIN 10,000units/ML  INJ",J1644,HCPCS,636,RC,,both,38.36,34.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.85,,,,22.63,31.3
"HEPARIN 10,000units/ML  INJ",J1644,HCPCS,636,RC,,both,38.36,34.52,Cigna,Default,Percent of Total Billed Charges,22.63,,,,22.63,31.3
"HEPARIN 10,000units/ML  INJ",J1644,HCPCS,636,RC,,both,38.36,34.52,United Healthcare,Default,Fee Schedule,31.3,,,,22.63,31.3
IMIPENEM & CILASTATIN 500MG ADV INJ (PRI,250,RC,,,,both,134,120.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.8,,,,79.06,109.34
IMIPENEM & CILASTATIN 500MG ADV INJ (PRI,250,RC,,,,both,134,120.6,Cigna,Default,Percent of Total Billed Charges,79.06,,,,79.06,109.34
IMIPENEM & CILASTATIN 500MG ADV INJ (PRI,250,RC,,,,both,134,120.6,United Healthcare,Default,Fee Schedule,109.34,,,,79.06,109.34
PROMETHAZINE 25MG SUPP (PHENERGAN),250,RC,,,,both,76.13,68.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.29,,,,44.92,62.12
PROMETHAZINE 25MG SUPP (PHENERGAN),250,RC,,,,both,76.13,68.52,Cigna,Default,Percent of Total Billed Charges,44.92,,,,44.92,62.12
PROMETHAZINE 25MG SUPP (PHENERGAN),250,RC,,,,both,76.13,68.52,United Healthcare,Default,Fee Schedule,62.12,,,,44.92,62.12
HEPARIN LOCK 500UNIT/5ML  FLUSH,J1642,HCPCS,250,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
HEPARIN LOCK 500UNIT/5ML  FLUSH,J1642,HCPCS,250,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
HEPARIN LOCK 500UNIT/5ML  FLUSH,J1642,HCPCS,250,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
HYDROCORTISONE 1% CRM (CORTIZONE),637,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
HYDROCORTISONE 1% CRM (CORTIZONE),637,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
HYDROCORTISONE 1% CRM (CORTIZONE),637,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
PAPAVERINE HCL 60MG/2ML 2ML INJ,250,RC,,,,both,219.15,197.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,153.4,,,,129.3,178.83
PAPAVERINE HCL 60MG/2ML 2ML INJ,250,RC,,,,both,219.15,197.24,Cigna,Default,Percent of Total Billed Charges,129.3,,,,129.3,178.83
PAPAVERINE HCL 60MG/2ML 2ML INJ,250,RC,,,,both,219.15,197.24,United Healthcare,Default,Fee Schedule,178.83,,,,129.3,178.83
HYDROCHLOROTHIAZIDE 25MG TAB,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
HYDROCHLOROTHIAZIDE 25MG TAB,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
HYDROCHLOROTHIAZIDE 25MG TAB,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PAREGORIC LIQUID 5ML,250,RC,,,,both,14.65,13.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.26,,,,8.64,11.95
PAREGORIC LIQUID 5ML,250,RC,,,,both,14.65,13.19,Cigna,Default,Percent of Total Billed Charges,8.64,,,,8.64,11.95
PAREGORIC LIQUID 5ML,250,RC,,,,both,14.65,13.19,United Healthcare,Default,Fee Schedule,11.95,,,,8.64,11.95
PROTAMINE SULFATE 50MG/5ML INJ,J2720,HCPCS,636,RC,,both,57.53,51.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.27,,,,33.94,46.94
PROTAMINE SULFATE 50MG/5ML INJ,J2720,HCPCS,636,RC,,both,57.53,51.78,Cigna,Default,Percent of Total Billed Charges,33.94,,,,33.94,46.94
PROTAMINE SULFATE 50MG/5ML INJ,J2720,HCPCS,636,RC,,both,57.53,51.78,United Healthcare,Default,Fee Schedule,46.94,,,,33.94,46.94
PREDNISONE 1MG TAB,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PREDNISONE 1MG TAB,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PREDNISONE 1MG TAB,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
IBUPROFEN 800MG TAB (MOTRIN),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
IBUPROFEN 800MG TAB (MOTRIN),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
IBUPROFEN 800MG TAB (MOTRIN),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
NITROGLYCERIN 0.2MG/HR PATCH (NITRO-DUR),637,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NITROGLYCERIN 0.2MG/HR PATCH (NITRO-DUR),637,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NITROGLYCERIN 0.2MG/HR PATCH (NITRO-DUR),637,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
IMIPENEM/CILASTATIN 500MG INJ (PRIMAXIN),J0743,HCPCS,636,RC,,both,171.23,154.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,119.86,,,,101.03,139.72
IMIPENEM/CILASTATIN 500MG INJ (PRIMAXIN),J0743,HCPCS,636,RC,,both,171.23,154.11,Cigna,Default,Percent of Total Billed Charges,101.03,,,,101.03,139.72
IMIPENEM/CILASTATIN 500MG INJ (PRIMAXIN),J0743,HCPCS,636,RC,,both,171.23,154.11,United Healthcare,Default,Fee Schedule,139.72,,,,101.03,139.72
PROPYLTHIOURACIL 50MG TAB,637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
PROPYLTHIOURACIL 50MG TAB,637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
PROPYLTHIOURACIL 50MG TAB,637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
FERROGEL FORTE CAP,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
FERROGEL FORTE CAP,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
FERROGEL FORTE CAP,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
NICOTINE PATCH  7MG/DAY,250,RC,,,,both,23.75,21.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.62,,,,14.01,19.38
NICOTINE PATCH  7MG/DAY,250,RC,,,,both,23.75,21.38,Cigna,Default,Percent of Total Billed Charges,14.01,,,,14.01,19.38
NICOTINE PATCH  7MG/DAY,250,RC,,,,both,23.75,21.38,United Healthcare,Default,Fee Schedule,19.38,,,,14.01,19.38
HYPOTEARS OPTH SOL,250,RC,,,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
HYPOTEARS OPTH SOL,250,RC,,,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
HYPOTEARS OPTH SOL,250,RC,,,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
"HEPARIN 1,000units/ML 1ML INJ",J1644,HCPCS,636,RC,,both,42.71,38.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.9,,,,25.2,34.85
"HEPARIN 1,000units/ML 1ML INJ",J1644,HCPCS,636,RC,,both,42.71,38.44,Cigna,Default,Percent of Total Billed Charges,25.2,,,,25.2,34.85
"HEPARIN 1,000units/ML 1ML INJ",J1644,HCPCS,636,RC,,both,42.71,38.44,United Healthcare,Default,Fee Schedule,34.85,,,,25.2,34.85
HEPARIN SODIUM INJ( 1MU/,J1644,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
HEPARIN SODIUM INJ( 1MU/,J1644,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
HEPARIN SODIUM INJ( 1MU/,J1644,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
HYDROMET 5ML DOSE (HYCODAN),250,RC,,,,both,6.08,5.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.96
HYDROMET 5ML DOSE (HYCODAN),250,RC,,,,both,6.08,5.47,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.96
HYDROMET 5ML DOSE (HYCODAN),250,RC,,,,both,6.08,5.47,United Healthcare,Default,Fee Schedule,4.96,,,,3.59,4.96
PROCHLORPERAZINE 10MG/2ML INJ (COMPAZINE,J0780,HCPCS,636,RC,,both,95.46,85.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.82,,,,56.32,77.9
PROCHLORPERAZINE 10MG/2ML INJ (COMPAZINE,J0780,HCPCS,636,RC,,both,95.46,85.91,Cigna,Default,Percent of Total Billed Charges,56.32,,,,56.32,77.9
PROCHLORPERAZINE 10MG/2ML INJ (COMPAZINE,J0780,HCPCS,636,RC,,both,95.46,85.91,United Healthcare,Default,Fee Schedule,77.9,,,,56.32,77.9
PROCARDIA XL 90 MG,250,RC,,,,both,13,11.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.1,,,,7.67,10.61
PROCARDIA XL 90 MG,250,RC,,,,both,13,11.7,Cigna,Default,Percent of Total Billed Charges,7.67,,,,7.67,10.61
PROCARDIA XL 90 MG,250,RC,,,,both,13,11.7,United Healthcare,Default,Fee Schedule,10.61,,,,7.67,10.61
PHENOBARB SOD INJ 130MG,250,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
PHENOBARB SOD INJ 130MG,250,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
PHENOBARB SOD INJ 130MG,250,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
NIFEDIPINE XL 30 MG TAB (PROCARDIA XL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
NIFEDIPINE XL 30 MG TAB (PROCARDIA XL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
NIFEDIPINE XL 30 MG TAB (PROCARDIA XL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
TETANUS INJ 250U (BAY-TET),J1670,HCPCS,636,RC,,both,536.63,482.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,375.64,,,,316.61,437.89
TETANUS INJ 250U (BAY-TET),J1670,HCPCS,636,RC,,both,536.63,482.97,Cigna,Default,Percent of Total Billed Charges,316.61,,,,316.61,437.89
TETANUS INJ 250U (BAY-TET),J1670,HCPCS,636,RC,,both,536.63,482.97,United Healthcare,Default,Fee Schedule,437.89,,,,316.61,437.89
AMOXICILLIN 250MG CAP,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
AMOXICILLIN 250MG CAP,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
AMOXICILLIN 250MG CAP,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
AZATHIOPRINE 50MG TAB (IMURAN),J7500,HCPCS,636,RC,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
AZATHIOPRINE 50MG TAB (IMURAN),J7500,HCPCS,636,RC,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
AZATHIOPRINE 50MG TAB (IMURAN),J7500,HCPCS,636,RC,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
ISOPROTERENOL HCL INJ 0,250,RC,,,,both,54,48.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.8,,,,31.86,44.06
ISOPROTERENOL HCL INJ 0,250,RC,,,,both,54,48.6,Cigna,Default,Percent of Total Billed Charges,31.86,,,,31.86,44.06
ISOPROTERENOL HCL INJ 0,250,RC,,,,both,54,48.6,United Healthcare,Default,Fee Schedule,44.06,,,,31.86,44.06
ISUPREL HCL INJ 0.2MG/M,250,RC,,,,both,80.25,72.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.18,,,,47.35,65.48
ISUPREL HCL INJ 0.2MG/M,250,RC,,,,both,80.25,72.23,Cigna,Default,Percent of Total Billed Charges,47.35,,,,47.35,65.48
ISUPREL HCL INJ 0.2MG/M,250,RC,,,,both,80.25,72.23,United Healthcare,Default,Fee Schedule,65.48,,,,47.35,65.48
METOCLOPRAMIDE 10MG/2ML INJ (REGLAN),J2765,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
METOCLOPRAMIDE 10MG/2ML INJ (REGLAN),J2765,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
METOCLOPRAMIDE 10MG/2ML INJ (REGLAN),J2765,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
ISOPROTERENOL 1MG/5ML AMP (ISUPREL),250,RC,,,,both,1217.78,1096,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,852.45,,,,718.49,993.71
ISOPROTERENOL 1MG/5ML AMP (ISUPREL),250,RC,,,,both,1217.78,1096,Cigna,Default,Percent of Total Billed Charges,718.49,,,,718.49,993.71
ISOPROTERENOL 1MG/5ML AMP (ISUPREL),250,RC,,,,both,1217.78,1096,United Healthcare,Default,Fee Schedule,993.71,,,,718.49,993.71
REFRESH PM LUB OPTH,250,RC,,,,both,50.4,45.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.28,,,,29.74,41.13
REFRESH PM LUB OPTH,250,RC,,,,both,50.4,45.36,Cigna,Default,Percent of Total Billed Charges,29.74,,,,29.74,41.13
REFRESH PM LUB OPTH,250,RC,,,,both,50.4,45.36,United Healthcare,Default,Fee Schedule,41.13,,,,29.74,41.13
LEVOTHYROXINE  0.025MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
LEVOTHYROXINE  0.025MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
LEVOTHYROXINE  0.025MG TAB (SYNTHROID),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CEFTRIAXONE 1000MG ADV VIAL (ROCEPHIN),J0696,HCPCS,636,RC,,both,41.84,37.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.29,,,,24.69,34.14
CEFTRIAXONE 1000MG ADV VIAL (ROCEPHIN),J0696,HCPCS,636,RC,,both,41.84,37.66,Cigna,Default,Percent of Total Billed Charges,24.69,,,,24.69,34.14
CEFTRIAXONE 1000MG ADV VIAL (ROCEPHIN),J0696,HCPCS,636,RC,,both,41.84,37.66,United Healthcare,Default,Fee Schedule,34.14,,,,24.69,34.14
ASPIRIN 81MG CHEW TAB,637,RC,,,,both,6.95,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.1,5.67
ASPIRIN 81MG CHEW TAB,637,RC,,,,both,6.95,6.26,Cigna,Default,Percent of Total Billed Charges,4.1,,,,4.1,5.67
ASPIRIN 81MG CHEW TAB,637,RC,,,,both,6.95,6.26,United Healthcare,Default,Fee Schedule,5.67,,,,4.1,5.67
WARFARIN 1MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
WARFARIN 1MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
WARFARIN 1MG TAB (COUMADIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
AMINOCAPROIC ACID 250MG/ML 20ML INJ (AMI,S0017,HCPCS,636,RC,,both,65.96,59.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.17,,,,38.92,53.82
AMINOCAPROIC ACID 250MG/ML 20ML INJ (AMI,S0017,HCPCS,636,RC,,both,65.96,59.36,Cigna,Default,Percent of Total Billed Charges,38.92,,,,38.92,53.82
AMINOCAPROIC ACID 250MG/ML 20ML INJ (AMI,S0017,HCPCS,636,RC,,both,65.96,59.36,United Healthcare,Default,Fee Schedule,53.82,,,,38.92,53.82
VERAPAMIL SR 240MG TAB (ISOPTIN SR),637,RC,,,,both,11.23,10.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.86,,,,6.63,9.16
VERAPAMIL SR 240MG TAB (ISOPTIN SR),637,RC,,,,both,11.23,10.11,Cigna,Default,Percent of Total Billed Charges,6.63,,,,6.63,9.16
VERAPAMIL SR 240MG TAB (ISOPTIN SR),637,RC,,,,both,11.23,10.11,United Healthcare,Default,Fee Schedule,9.16,,,,6.63,9.16
PROPRANOLOL 1MG/1ML INJ (INDERAL),J1800,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
PROPRANOLOL 1MG/1ML INJ (INDERAL),J1800,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
PROPRANOLOL 1MG/1ML INJ (INDERAL),J1800,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
IBUPROFEN 400 MG TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
IBUPROFEN 400 MG TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
IBUPROFEN 400 MG TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
IPECAC SYRUP 1.4MG/ML,250,RC,,,,both,6.25,5.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.38,,,,3.69,5.1
IPECAC SYRUP 1.4MG/ML,250,RC,,,,both,6.25,5.63,Cigna,Default,Percent of Total Billed Charges,3.69,,,,3.69,5.1
IPECAC SYRUP 1.4MG/ML,250,RC,,,,both,6.25,5.63,United Healthcare,Default,Fee Schedule,5.1,,,,3.69,5.1
ISOSORBIDE DIN 40MG TAB (ISORDIL TITRADO,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
ISOSORBIDE DIN 40MG TAB (ISORDIL TITRADO,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
ISOSORBIDE DIN 40MG TAB (ISORDIL TITRADO,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
POLYMYXIN B/TRIMETHOPRIM OPHTH DROPS,250,RC,,,,both,74.91,67.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.44,,,,44.2,61.13
POLYMYXIN B/TRIMETHOPRIM OPHTH DROPS,250,RC,,,,both,74.91,67.42,Cigna,Default,Percent of Total Billed Charges,44.2,,,,44.2,61.13
POLYMYXIN B/TRIMETHOPRIM OPHTH DROPS,250,RC,,,,both,74.91,67.42,United Healthcare,Default,Fee Schedule,61.13,,,,44.2,61.13
AMPICILLIN & SULBACTAM 1.5GM ADV INJ,250,RC,,,,both,37.5,33.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.25,,,,22.12,30.6
AMPICILLIN & SULBACTAM 1.5GM ADV INJ,250,RC,,,,both,37.5,33.75,Cigna,Default,Percent of Total Billed Charges,22.12,,,,22.12,30.6
AMPICILLIN & SULBACTAM 1.5GM ADV INJ,250,RC,,,,both,37.5,33.75,United Healthcare,Default,Fee Schedule,30.6,,,,22.12,30.6
AMPICILLIN & SULBACTAM 3GM ADV INJ (UNAS,250,RC,,,,both,65.25,58.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.68,,,,38.5,53.24
AMPICILLIN & SULBACTAM 3GM ADV INJ (UNAS,250,RC,,,,both,65.25,58.73,Cigna,Default,Percent of Total Billed Charges,38.5,,,,38.5,53.24
AMPICILLIN & SULBACTAM 3GM ADV INJ (UNAS,250,RC,,,,both,65.25,58.73,United Healthcare,Default,Fee Schedule,53.24,,,,38.5,53.24
MAGNESIUM SULFATE 1000MG/2ML INJ,J3475,HCPCS,636,RC,,both,59.56,53.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.69,,,,35.14,48.6
MAGNESIUM SULFATE 1000MG/2ML INJ,J3475,HCPCS,636,RC,,both,59.56,53.6,Cigna,Default,Percent of Total Billed Charges,35.14,,,,35.14,48.6
MAGNESIUM SULFATE 1000MG/2ML INJ,J3475,HCPCS,636,RC,,both,59.56,53.6,United Healthcare,Default,Fee Schedule,48.6,,,,35.14,48.6
HEPARIN INJ 1000U/ML 30ML,J1644,HCPCS,636,RC,,both,35.15,31.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.6,,,,20.74,28.68
HEPARIN INJ 1000U/ML 30ML,J1644,HCPCS,636,RC,,both,35.15,31.64,Cigna,Default,Percent of Total Billed Charges,20.74,,,,20.74,28.68
HEPARIN INJ 1000U/ML 30ML,J1644,HCPCS,636,RC,,both,35.15,31.64,United Healthcare,Default,Fee Schedule,28.68,,,,20.74,28.68
SOD BICARB INJ:50MEQ 50ML,258,RC,,,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
SOD BICARB INJ:50MEQ 50ML,258,RC,,,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
SOD BICARB INJ:50MEQ 50ML,258,RC,,,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
MELATONIN 5MG TAB,637,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
MELATONIN 5MG TAB,637,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
MELATONIN 5MG TAB,637,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.17,,,,43.13,59.65
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,Cigna,Default,Percent of Total Billed Charges,43.13,,,,43.13,59.65
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,United Healthcare,Default,Fee Schedule,59.65,,,,43.13,59.65
IV TEMPLATE,636,RC,,,,both,395.14,355.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.6,,,,233.13,322.43
IV TEMPLATE,636,RC,,,,both,395.14,355.63,Cigna,Default,Percent of Total Billed Charges,233.13,,,,233.13,322.43
IV TEMPLATE,636,RC,,,,both,395.14,355.63,United Healthcare,Default,Fee Schedule,322.43,,,,233.13,322.43
RANITIDINE 50MG/2ML IV (ZANTAC),J2780,HCPCS,636,RC,,both,35.45,31.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.82,,,,20.92,28.93
RANITIDINE 50MG/2ML IV (ZANTAC),J2780,HCPCS,636,RC,,both,35.45,31.91,Cigna,Default,Percent of Total Billed Charges,20.92,,,,20.92,28.93
RANITIDINE 50MG/2ML IV (ZANTAC),J2780,HCPCS,636,RC,,both,35.45,31.91,United Healthcare,Default,Fee Schedule,28.93,,,,20.92,28.93
CARBAMAZEPINE 200MG TAB (TEGRETOL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CARBAMAZEPINE 200MG TAB (TEGRETOL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CARBAMAZEPINE 200MG TAB (TEGRETOL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
GEMCITABINE 1GM VIAL (GEMZAR),J9201,HCPCS,636,RC,,both,1897,1707.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1327.9,,,,1119.23,1547.95
GEMCITABINE 1GM VIAL (GEMZAR),J9201,HCPCS,636,RC,,both,1897,1707.3,Cigna,Default,Percent of Total Billed Charges,1119.23,,,,1119.23,1547.95
GEMCITABINE 1GM VIAL (GEMZAR),J9201,HCPCS,636,RC,,both,1897,1707.3,United Healthcare,Default,Fee Schedule,1547.95,,,,1119.23,1547.95
ALBUMIN 25% (12.5GM/50ML) INJ,P9047,HCPCS,636,RC,,both,502.06,451.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,351.44,,,,296.22,409.68
ALBUMIN 25% (12.5GM/50ML) INJ,P9047,HCPCS,636,RC,,both,502.06,451.85,Cigna,Default,Percent of Total Billed Charges,296.22,,,,296.22,409.68
ALBUMIN 25% (12.5GM/50ML) INJ,P9047,HCPCS,636,RC,,both,502.06,451.85,United Healthcare,Default,Fee Schedule,409.68,,,,296.22,409.68
CYCLOPHOSPHAMIDE 500MG INJ (CYTOXAN),J9073,HCPCS,636,RC,,both,116.42,104.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,81.49,,,,68.69,95
CYCLOPHOSPHAMIDE 500MG INJ (CYTOXAN),J9073,HCPCS,636,RC,,both,116.42,104.78,Cigna,Default,Percent of Total Billed Charges,68.69,,,,68.69,95
CYCLOPHOSPHAMIDE 500MG INJ (CYTOXAN),J9073,HCPCS,636,RC,,both,116.42,104.78,United Healthcare,Default,Fee Schedule,95,,,,68.69,95
DOXORUBICIN 20MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,339.05,305.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,237.34,,,,200.04,276.66
DOXORUBICIN 20MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,339.05,305.15,Cigna,Default,Percent of Total Billed Charges,200.04,,,,200.04,276.66
DOXORUBICIN 20MG VIAL (ADRIAMYCIN),J9000,HCPCS,636,RC,,both,339.05,305.15,United Healthcare,Default,Fee Schedule,276.66,,,,200.04,276.66
CIPRO HC EAR DROP 10ML BOTTLE,250,RC,,,,both,313.2,281.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,219.24,,,,184.79,255.57
CIPRO HC EAR DROP 10ML BOTTLE,250,RC,,,,both,313.2,281.88,Cigna,Default,Percent of Total Billed Charges,184.79,,,,184.79,255.57
CIPRO HC EAR DROP 10ML BOTTLE,250,RC,,,,both,313.2,281.88,United Healthcare,Default,Fee Schedule,255.57,,,,184.79,255.57
OXYCODONE SR 20MG TAB (OXYCONTIN),637,RC,,,,both,11.62,10.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.13,,,,6.86,9.48
OXYCODONE SR 20MG TAB (OXYCONTIN),637,RC,,,,both,11.62,10.46,Cigna,Default,Percent of Total Billed Charges,6.86,,,,6.86,9.48
OXYCODONE SR 20MG TAB (OXYCONTIN),637,RC,,,,both,11.62,10.46,United Healthcare,Default,Fee Schedule,9.48,,,,6.86,9.48
FILGRASTIM 480MCG/0.8 ML INJ (NEUPOGEN),J1442,HCPCS,636,RC,,both,2821.72,2539.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1975.2,,,,1664.81,2302.52
FILGRASTIM 480MCG/0.8 ML INJ (NEUPOGEN),J1442,HCPCS,636,RC,,both,2821.72,2539.55,Cigna,Default,Percent of Total Billed Charges,1664.81,,,,1664.81,2302.52
FILGRASTIM 480MCG/0.8 ML INJ (NEUPOGEN),J1442,HCPCS,636,RC,,both,2821.72,2539.55,United Healthcare,Default,Fee Schedule,2302.52,,,,1664.81,2302.52
RETEPLASE 10 UNIT HALFKIT (RETAVASE),J2993,HCPCS,636,RC,,both,4546.14,4091.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3182.3,,,,2682.22,3709.65
RETEPLASE 10 UNIT HALFKIT (RETAVASE),J2993,HCPCS,636,RC,,both,4546.14,4091.53,Cigna,Default,Percent of Total Billed Charges,2682.22,,,,2682.22,3709.65
RETEPLASE 10 UNIT HALFKIT (RETAVASE),J2993,HCPCS,636,RC,,both,4546.14,4091.53,United Healthcare,Default,Fee Schedule,3709.65,,,,2682.22,3709.65
EPTIFIBATIDE 2MG/ML 100ML VIAL (INTEG,J1327,HCPCS,636,RC,,both,2086.68,1878.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1460.68,,,,1231.14,1702.73
EPTIFIBATIDE 2MG/ML 100ML VIAL (INTEG,J1327,HCPCS,636,RC,,both,2086.68,1878.01,Cigna,Default,Percent of Total Billed Charges,1231.14,,,,1231.14,1702.73
EPTIFIBATIDE 2MG/ML 100ML VIAL (INTEG,J1327,HCPCS,636,RC,,both,2086.68,1878.01,United Healthcare,Default,Fee Schedule,1702.73,,,,1231.14,1702.73
OCTREOTIDE LAR DEP 30MG (SANDOSTATIN),J2353,HCPCS,250,RC,,both,6971.75,6274.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4880.22,,,,4113.33,5688.95
OCTREOTIDE LAR DEP 30MG (SANDOSTATIN),J2353,HCPCS,250,RC,,both,6971.75,6274.58,Cigna,Default,Percent of Total Billed Charges,4113.33,,,,4113.33,5688.95
OCTREOTIDE LAR DEP 30MG (SANDOSTATIN),J2353,HCPCS,250,RC,,both,6971.75,6274.58,United Healthcare,Default,Fee Schedule,5688.95,,,,4113.33,5688.95
OSMOLITE 8OZ LIQ,250,RC,,,,both,8.75,7.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.12,,,,5.16,7.14
OSMOLITE 8OZ LIQ,250,RC,,,,both,8.75,7.88,Cigna,Default,Percent of Total Billed Charges,5.16,,,,5.16,7.14
OSMOLITE 8OZ LIQ,250,RC,,,,both,8.75,7.88,United Healthcare,Default,Fee Schedule,7.14,,,,5.16,7.14
FENTANYL 1000MCG/20ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,144.11,129.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.88,,,,85.02,117.59
FENTANYL 1000MCG/20ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,144.11,129.7,Cigna,Default,Percent of Total Billed Charges,85.02,,,,85.02,117.59
FENTANYL 1000MCG/20ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,144.11,129.7,United Healthcare,Default,Fee Schedule,117.59,,,,85.02,117.59
TIZANIDINE 4MG TAB (ZANAFLEX),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
TIZANIDINE 4MG TAB (ZANAFLEX),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
TIZANIDINE 4MG TAB (ZANAFLEX),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
FACTOR 8 REC. 1127 U/VIAL,J7192,HCPCS,636,RC,,both,7359.77,6623.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5151.84,,,,4342.26,6005.57
FACTOR 8 REC. 1127 U/VIAL,J7192,HCPCS,636,RC,,both,7359.77,6623.79,Cigna,Default,Percent of Total Billed Charges,4342.26,,,,4342.26,6005.57
FACTOR 8 REC. 1127 U/VIAL,J7192,HCPCS,636,RC,,both,7359.77,6623.79,United Healthcare,Default,Fee Schedule,6005.57,,,,4342.26,6005.57
LETROZOLE 2.5MG TAB (FEMARA),250,RC,,,,both,30.5,27.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.35,,,,18,24.89
LETROZOLE 2.5MG TAB (FEMARA),250,RC,,,,both,30.5,27.45,Cigna,Default,Percent of Total Billed Charges,18,,,,18,24.89
LETROZOLE 2.5MG TAB (FEMARA),250,RC,,,,both,30.5,27.45,United Healthcare,Default,Fee Schedule,24.89,,,,18,24.89
CALCIUM CHLORIDE 10% INJ 1000MG/10ML,250,RC,,,,both,112.78,101.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.95,,,,66.54,92.03
CALCIUM CHLORIDE 10% INJ 1000MG/10ML,250,RC,,,,both,112.78,101.5,Cigna,Default,Percent of Total Billed Charges,66.54,,,,66.54,92.03
CALCIUM CHLORIDE 10% INJ 1000MG/10ML,250,RC,,,,both,112.78,101.5,United Healthcare,Default,Fee Schedule,92.03,,,,66.54,92.03
LYMPHAZURIN 1% INJ 5ML(ISOSULFAN BLUE),Q9968,HCPCS,636,RC,,both,6569.03,5912.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4598.32,,,,3875.73,5360.33
LYMPHAZURIN 1% INJ 5ML(ISOSULFAN BLUE),Q9968,HCPCS,636,RC,,both,6569.03,5912.13,Cigna,Default,Percent of Total Billed Charges,3875.73,,,,3875.73,5360.33
LYMPHAZURIN 1% INJ 5ML(ISOSULFAN BLUE),Q9968,HCPCS,636,RC,,both,6569.03,5912.13,United Healthcare,Default,Fee Schedule,5360.33,,,,3875.73,5360.33
DILTIAZEM INJ 125MG/25ML,250,RC,,,,both,113.31,101.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.32,,,,66.85,92.46
DILTIAZEM INJ 125MG/25ML,250,RC,,,,both,113.31,101.98,Cigna,Default,Percent of Total Billed Charges,66.85,,,,66.85,92.46
DILTIAZEM INJ 125MG/25ML,250,RC,,,,both,113.31,101.98,United Healthcare,Default,Fee Schedule,92.46,,,,66.85,92.46
CILOSTAZOL 100MG TAB (PLETAL),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
CILOSTAZOL 100MG TAB (PLETAL),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
CILOSTAZOL 100MG TAB (PLETAL),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
TOPIRAMATE 25MG TAB (TOPAMAX),637,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
TOPIRAMATE 25MG TAB (TOPAMAX),637,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
TOPIRAMATE 25MG TAB (TOPAMAX),637,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
LEVOTHYROXINE 0.137MCG TAB (SYNTHROID),637,RC,,,,both,6.39,5.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.77,5.21
LEVOTHYROXINE 0.137MCG TAB (SYNTHROID),637,RC,,,,both,6.39,5.75,Cigna,Default,Percent of Total Billed Charges,3.77,,,,3.77,5.21
LEVOTHYROXINE 0.137MCG TAB (SYNTHROID),637,RC,,,,both,6.39,5.75,United Healthcare,Default,Fee Schedule,5.21,,,,3.77,5.21
HEP B IMM GLOB 5ML,J1573,HCPCS,250,RC,,both,2690,2421,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1883,,,,1587.1,2195.04
HEP B IMM GLOB 5ML,J1573,HCPCS,250,RC,,both,2690,2421,Cigna,Default,Percent of Total Billed Charges,1587.1,,,,1587.1,2195.04
HEP B IMM GLOB 5ML,J1573,HCPCS,250,RC,,both,2690,2421,United Healthcare,Default,Fee Schedule,2195.04,,,,1587.1,2195.04
HEP B VAC RECOMB 20MCG/ML 1ML INJ,90746,HCPCS,636,RC,,both,302.54,272.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,211.78,,,,178.5,246.87
HEP B VAC RECOMB 20MCG/ML 1ML INJ,90746,HCPCS,636,RC,,both,302.54,272.29,Cigna,Default,Percent of Total Billed Charges,178.5,,,,178.5,246.87
HEP B VAC RECOMB 20MCG/ML 1ML INJ,90746,HCPCS,636,RC,,both,302.54,272.29,United Healthcare,Default,Fee Schedule,246.87,,,,178.5,246.87
HYDROCORTISONE 2.5% CRM (RECTAL USE),637,RC,,,,both,375.52,337.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,262.86,,,,221.56,306.42
HYDROCORTISONE 2.5% CRM (RECTAL USE),637,RC,,,,both,375.52,337.97,Cigna,Default,Percent of Total Billed Charges,221.56,,,,221.56,306.42
HYDROCORTISONE 2.5% CRM (RECTAL USE),637,RC,,,,both,375.52,337.97,United Healthcare,Default,Fee Schedule,306.42,,,,221.56,306.42
VITAMIN A 50MG/ML 2ML VIAL (AQUASOL),250,RC,,,,both,98.72,88.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.1,,,,58.24,80.56
VITAMIN A 50MG/ML 2ML VIAL (AQUASOL),250,RC,,,,both,98.72,88.85,Cigna,Default,Percent of Total Billed Charges,58.24,,,,58.24,80.56
VITAMIN A 50MG/ML 2ML VIAL (AQUASOL),250,RC,,,,both,98.72,88.85,United Healthcare,Default,Fee Schedule,80.56,,,,58.24,80.56
LIOTHYRONINE 5MCG TAB,637,RC,,,,both,6.39,5.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.77,5.21
LIOTHYRONINE 5MCG TAB,637,RC,,,,both,6.39,5.75,Cigna,Default,Percent of Total Billed Charges,3.77,,,,3.77,5.21
LIOTHYRONINE 5MCG TAB,637,RC,,,,both,6.39,5.75,United Healthcare,Default,Fee Schedule,5.21,,,,3.77,5.21
CALCIUM CARBONATE 500MG TAB (TUMS),637,RC,,,,both,1.38,1.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.97,,,,0.81,1.13
CALCIUM CARBONATE 500MG TAB (TUMS),637,RC,,,,both,1.38,1.24,Cigna,Default,Percent of Total Billed Charges,0.81,,,,0.81,1.13
CALCIUM CARBONATE 500MG TAB (TUMS),637,RC,,,,both,1.38,1.24,United Healthcare,Default,Fee Schedule,1.13,,,,0.81,1.13
CYCLOPHOSPHAMIDE 25MG TAB (CYTOXAN),J8530,HCPCS,636,RC,,both,6.08,5.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.96
CYCLOPHOSPHAMIDE 25MG TAB (CYTOXAN),J8530,HCPCS,636,RC,,both,6.08,5.47,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.96
CYCLOPHOSPHAMIDE 25MG TAB (CYTOXAN),J8530,HCPCS,636,RC,,both,6.08,5.47,United Healthcare,Default,Fee Schedule,4.96,,,,3.59,4.96
METOPROLOL XL SUCC 100MG (TOPROL XL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
METOPROLOL XL SUCC 100MG (TOPROL XL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
METOPROLOL XL SUCC 100MG (TOPROL XL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
SARGRAMOSTIM 500MCG VIAL (LEUKINE),J2820,HCPCS,636,RC,,both,1176,1058.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,823.2,,,,693.84,959.62
SARGRAMOSTIM 500MCG VIAL (LEUKINE),J2820,HCPCS,636,RC,,both,1176,1058.4,Cigna,Default,Percent of Total Billed Charges,693.84,,,,693.84,959.62
SARGRAMOSTIM 500MCG VIAL (LEUKINE),J2820,HCPCS,636,RC,,both,1176,1058.4,United Healthcare,Default,Fee Schedule,959.62,,,,693.84,959.62
NACL 3% 500ML HYPERTONIC SALINE IVF,J7131,HCPCS,636,RC,,both,31.96,28.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.37,,,,18.86,26.08
NACL 3% 500ML HYPERTONIC SALINE IVF,J7131,HCPCS,636,RC,,both,31.96,28.76,Cigna,Default,Percent of Total Billed Charges,18.86,,,,18.86,26.08
NACL 3% 500ML HYPERTONIC SALINE IVF,J7131,HCPCS,636,RC,,both,31.96,28.76,United Healthcare,Default,Fee Schedule,26.08,,,,18.86,26.08
PHENOL 10ML TOPICAL,250,RC,,,,both,31.81,28.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.27,,,,18.77,25.96
PHENOL 10ML TOPICAL,250,RC,,,,both,31.81,28.63,Cigna,Default,Percent of Total Billed Charges,18.77,,,,18.77,25.96
PHENOL 10ML TOPICAL,250,RC,,,,both,31.81,28.63,United Healthcare,Default,Fee Schedule,25.96,,,,18.77,25.96
NESIRITIDE 1.5MG INJ (NATRECOR),J2325,HCPCS,636,RC,,both,2168.38,1951.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1517.87,,,,1279.34,1769.4
NESIRITIDE 1.5MG INJ (NATRECOR),J2325,HCPCS,636,RC,,both,2168.38,1951.54,Cigna,Default,Percent of Total Billed Charges,1279.34,,,,1279.34,1769.4
NESIRITIDE 1.5MG INJ (NATRECOR),J2325,HCPCS,636,RC,,both,2168.38,1951.54,United Healthcare,Default,Fee Schedule,1769.4,,,,1279.34,1769.4
"HEPARIN 10,000units/10ML INJ",J1644,HCPCS,636,RC,,both,31.96,28.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.37,,,,18.86,26.08
"HEPARIN 10,000units/10ML INJ",J1644,HCPCS,636,RC,,both,31.96,28.76,Cigna,Default,Percent of Total Billed Charges,18.86,,,,18.86,26.08
"HEPARIN 10,000units/10ML INJ",J1644,HCPCS,636,RC,,both,31.96,28.76,United Healthcare,Default,Fee Schedule,26.08,,,,18.86,26.08
MOXIFLOXACIN 400MG TAB (AVELOX),637,RC,,,,both,126.42,113.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,88.49,,,,74.59,103.16
MOXIFLOXACIN 400MG TAB (AVELOX),637,RC,,,,both,126.42,113.78,Cigna,Default,Percent of Total Billed Charges,74.59,,,,74.59,103.16
MOXIFLOXACIN 400MG TAB (AVELOX),637,RC,,,,both,126.42,113.78,United Healthcare,Default,Fee Schedule,103.16,,,,74.59,103.16
ZIPRASIDONE 20MG CAP (GEODON),637,RC,,,,both,39.15,35.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.4,,,,23.1,31.95
ZIPRASIDONE 20MG CAP (GEODON),637,RC,,,,both,39.15,35.24,Cigna,Default,Percent of Total Billed Charges,23.1,,,,23.1,31.95
ZIPRASIDONE 20MG CAP (GEODON),637,RC,,,,both,39.15,35.24,United Healthcare,Default,Fee Schedule,31.95,,,,23.1,31.95
PANCURONIUM 10MG/5ML AMP,250,RC,,,,both,59.56,53.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.69,,,,35.14,48.6
PANCURONIUM 10MG/5ML AMP,250,RC,,,,both,59.56,53.6,Cigna,Default,Percent of Total Billed Charges,35.14,,,,35.14,48.6
PANCURONIUM 10MG/5ML AMP,250,RC,,,,both,59.56,53.6,United Healthcare,Default,Fee Schedule,48.6,,,,35.14,48.6
LINEZOLID 600MG TAB (ZYVOX),637,RC,,,,both,789.75,710.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,552.82,,,,465.95,644.44
LINEZOLID 600MG TAB (ZYVOX),637,RC,,,,both,789.75,710.78,Cigna,Default,Percent of Total Billed Charges,465.95,,,,465.95,644.44
LINEZOLID 600MG TAB (ZYVOX),637,RC,,,,both,789.75,710.78,United Healthcare,Default,Fee Schedule,644.44,,,,465.95,644.44
Linezolid PREMIX  600MG/300ML IVPB  (ZYV,J2020,HCPCS,636,RC,,both,454.12,408.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,317.88,,,,267.93,370.56
Linezolid PREMIX  600MG/300ML IVPB  (ZYV,J2020,HCPCS,636,RC,,both,454.12,408.71,Cigna,Default,Percent of Total Billed Charges,267.93,,,,267.93,370.56
Linezolid PREMIX  600MG/300ML IVPB  (ZYV,J2020,HCPCS,636,RC,,both,454.12,408.71,United Healthcare,Default,Fee Schedule,370.56,,,,267.93,370.56
QUINUPRISTIN & DALFOPRISTIN 500MG VIAL,J2770,HCPCS,250,RC,,both,363,326.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,254.1,,,,214.17,296.21
QUINUPRISTIN & DALFOPRISTIN 500MG VIAL,J2770,HCPCS,250,RC,,both,363,326.7,Cigna,Default,Percent of Total Billed Charges,214.17,,,,214.17,296.21
QUINUPRISTIN & DALFOPRISTIN 500MG VIAL,J2770,HCPCS,250,RC,,both,363,326.7,United Healthcare,Default,Fee Schedule,296.21,,,,214.17,296.21
TRAMADOL/APAP 37.5/325MG TAB (ULTRACET),637,RC,,,,both,4.06,3.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.84,,,,2.4,3.31
TRAMADOL/APAP 37.5/325MG TAB (ULTRACET),637,RC,,,,both,4.06,3.65,Cigna,Default,Percent of Total Billed Charges,2.4,,,,2.4,3.31
TRAMADOL/APAP 37.5/325MG TAB (ULTRACET),637,RC,,,,both,4.06,3.65,United Healthcare,Default,Fee Schedule,3.31,,,,2.4,3.31
BALSALAZIDE 750MG TAB (COLAZAL),250,RC,,,,both,6.08,5.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.96
BALSALAZIDE 750MG TAB (COLAZAL),250,RC,,,,both,6.08,5.47,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.96
BALSALAZIDE 750MG TAB (COLAZAL),250,RC,,,,both,6.08,5.47,United Healthcare,Default,Fee Schedule,4.96,,,,3.59,4.96
EPINEPH 1:1000 30MG/30ML INJ,250,RC,,,,both,37.77,33.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.44,,,,22.28,30.82
EPINEPH 1:1000 30MG/30ML INJ,250,RC,,,,both,37.77,33.99,Cigna,Default,Percent of Total Billed Charges,22.28,,,,22.28,30.82
EPINEPH 1:1000 30MG/30ML INJ,250,RC,,,,both,37.77,33.99,United Healthcare,Default,Fee Schedule,30.82,,,,22.28,30.82
ACETAMINOPHEN ELIXIR 5ML DOSE,637,RC,,,,both,4.06,3.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.84,,,,2.4,3.31
ACETAMINOPHEN ELIXIR 5ML DOSE,637,RC,,,,both,4.06,3.65,Cigna,Default,Percent of Total Billed Charges,2.4,,,,2.4,3.31
ACETAMINOPHEN ELIXIR 5ML DOSE,637,RC,,,,both,4.06,3.65,United Healthcare,Default,Fee Schedule,3.31,,,,2.4,3.31
ONDANSETRON ODT 4MG TAB (ZOFRAN ODT),Q0162,HCPCS,636,RC,,both,107.45,96.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.22,,,,63.4,87.68
ONDANSETRON ODT 4MG TAB (ZOFRAN ODT),Q0162,HCPCS,636,RC,,both,107.45,96.71,Cigna,Default,Percent of Total Billed Charges,63.4,,,,63.4,87.68
ONDANSETRON ODT 4MG TAB (ZOFRAN ODT),Q0162,HCPCS,636,RC,,both,107.45,96.71,United Healthcare,Default,Fee Schedule,87.68,,,,63.4,87.68
FOLBEE TAB (FOLTX),250,RC,,,,both,6.09,5.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.97
FOLBEE TAB (FOLTX),250,RC,,,,both,6.09,5.48,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.97
FOLBEE TAB (FOLTX),250,RC,,,,both,6.09,5.48,United Healthcare,Default,Fee Schedule,4.97,,,,3.59,4.97
PODOPHYLLUM RESIN (PODOCON-25),250,RC,,,,both,526.75,474.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,368.72,,,,310.78,429.83
PODOPHYLLUM RESIN (PODOCON-25),250,RC,,,,both,526.75,474.08,Cigna,Default,Percent of Total Billed Charges,310.78,,,,310.78,429.83
PODOPHYLLUM RESIN (PODOCON-25),250,RC,,,,both,526.75,474.08,United Healthcare,Default,Fee Schedule,429.83,,,,310.78,429.83
PRAMIPEXOLE  0.25MG TAB (MIRAPEX),637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PRAMIPEXOLE  0.25MG TAB (MIRAPEX),637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PRAMIPEXOLE  0.25MG TAB (MIRAPEX),637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
VANICREAM 16OZ JAR,250,RC,,,,both,48.46,43.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.92,,,,28.59,39.54
VANICREAM 16OZ JAR,250,RC,,,,both,48.46,43.61,Cigna,Default,Percent of Total Billed Charges,28.59,,,,28.59,39.54
VANICREAM 16OZ JAR,250,RC,,,,both,48.46,43.61,United Healthcare,Default,Fee Schedule,39.54,,,,28.59,39.54
TOLTERODINE ER 4MG CAP (DETROL),637,RC,,,,both,15.98,14.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.19,,,,9.43,13.04
TOLTERODINE ER 4MG CAP (DETROL),637,RC,,,,both,15.98,14.38,Cigna,Default,Percent of Total Billed Charges,9.43,,,,9.43,13.04
TOLTERODINE ER 4MG CAP (DETROL),637,RC,,,,both,15.98,14.38,United Healthcare,Default,Fee Schedule,13.04,,,,9.43,13.04
PSEUDOEPHEDRINE 120MG 12 HR TAB (SUDAFED,637,RC,,,,both,4.15,3.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.9,,,,2.45,3.39
PSEUDOEPHEDRINE 120MG 12 HR TAB (SUDAFED,637,RC,,,,both,4.15,3.74,Cigna,Default,Percent of Total Billed Charges,2.45,,,,2.45,3.39
PSEUDOEPHEDRINE 120MG 12 HR TAB (SUDAFED,637,RC,,,,both,4.15,3.74,United Healthcare,Default,Fee Schedule,3.39,,,,2.45,3.39
DEPOTESTOSTERONE CYP 200MG INJ 1ML,J1071,HCPCS,636,RC,,both,105.77,95.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.04,,,,62.4,86.31
DEPOTESTOSTERONE CYP 200MG INJ 1ML,J1071,HCPCS,636,RC,,both,105.77,95.19,Cigna,Default,Percent of Total Billed Charges,62.4,,,,62.4,86.31
DEPOTESTOSTERONE CYP 200MG INJ 1ML,J1071,HCPCS,636,RC,,both,105.77,95.19,United Healthcare,Default,Fee Schedule,86.31,,,,62.4,86.31
CEFAZOLIN 1000MG INJ (ANCEF),J0689,HCPCS,636,RC,,both,35.95,32.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.16,,,,21.21,29.34
CEFAZOLIN 1000MG INJ (ANCEF),J0689,HCPCS,636,RC,,both,35.95,32.36,Cigna,Default,Percent of Total Billed Charges,21.21,,,,21.21,29.34
CEFAZOLIN 1000MG INJ (ANCEF),J0689,HCPCS,636,RC,,both,35.95,32.36,United Healthcare,Default,Fee Schedule,29.34,,,,21.21,29.34
ZINC SULFATE 220MG CAP (EQUIV 50MG),637,RC,,,,both,6.39,5.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.77,5.21
ZINC SULFATE 220MG CAP (EQUIV 50MG),637,RC,,,,both,6.39,5.75,Cigna,Default,Percent of Total Billed Charges,3.77,,,,3.77,5.21
ZINC SULFATE 220MG CAP (EQUIV 50MG),637,RC,,,,both,6.39,5.75,United Healthcare,Default,Fee Schedule,5.21,,,,3.77,5.21
PROMETHAZINE 25MG TAB (PHENERGAN),Q0169,HCPCS,636,RC,,both,6.08,5.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.96
PROMETHAZINE 25MG TAB (PHENERGAN),Q0169,HCPCS,636,RC,,both,6.08,5.47,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.96
PROMETHAZINE 25MG TAB (PHENERGAN),Q0169,HCPCS,636,RC,,both,6.08,5.47,United Healthcare,Default,Fee Schedule,4.96,,,,3.59,4.96
SALINE NASAL GEL  AYR,637,RC,,,,both,16.28,14.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.4,,,,9.61,13.28
SALINE NASAL GEL  AYR,637,RC,,,,both,16.28,14.65,Cigna,Default,Percent of Total Billed Charges,9.61,,,,9.61,13.28
SALINE NASAL GEL  AYR,637,RC,,,,both,16.28,14.65,United Healthcare,Default,Fee Schedule,13.28,,,,9.61,13.28
ENSURE HIGH PROTEIN SUPPLEMENT 240ML,637,RC,,,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
ENSURE HIGH PROTEIN SUPPLEMENT 240ML,637,RC,,,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
ENSURE HIGH PROTEIN SUPPLEMENT 240ML,637,RC,,,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
HALOPERIDOL 2MG/ML SOL (HALDOL),250,RC,,,,both,157.77,141.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,110.44,,,,93.08,128.74
HALOPERIDOL 2MG/ML SOL (HALDOL),250,RC,,,,both,157.77,141.99,Cigna,Default,Percent of Total Billed Charges,93.08,,,,93.08,128.74
HALOPERIDOL 2MG/ML SOL (HALDOL),250,RC,,,,both,157.77,141.99,United Healthcare,Default,Fee Schedule,128.74,,,,93.08,128.74
OLANZAPINE 10MG TAB (ZYPREXA),637,RC,,,,both,45.9,41.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.13,,,,27.08,37.45
OLANZAPINE 10MG TAB (ZYPREXA),637,RC,,,,both,45.9,41.31,Cigna,Default,Percent of Total Billed Charges,27.08,,,,27.08,37.45
OLANZAPINE 10MG TAB (ZYPREXA),637,RC,,,,both,45.9,41.31,United Healthcare,Default,Fee Schedule,37.45,,,,27.08,37.45
COCAINE 4% SOL,250,RC,,,,both,160.5,144.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,112.35,,,,94.7,130.97
COCAINE 4% SOL,250,RC,,,,both,160.5,144.45,Cigna,Default,Percent of Total Billed Charges,94.7,,,,94.7,130.97
COCAINE 4% SOL,250,RC,,,,both,160.5,144.45,United Healthcare,Default,Fee Schedule,130.97,,,,94.7,130.97
TRIMETHOBENZAMIDE 300MG CAP (TIGAN),Q0173,HCPCS,636,RC,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
TRIMETHOBENZAMIDE 300MG CAP (TIGAN),Q0173,HCPCS,636,RC,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
TRIMETHOBENZAMIDE 300MG CAP (TIGAN),Q0173,HCPCS,636,RC,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PRIMIDONE 50MG TAB (MYSOLINE),637,RC,,,,both,6.31,5.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.42,,,,3.72,5.15
PRIMIDONE 50MG TAB (MYSOLINE),637,RC,,,,both,6.31,5.68,Cigna,Default,Percent of Total Billed Charges,3.72,,,,3.72,5.15
PRIMIDONE 50MG TAB (MYSOLINE),637,RC,,,,both,6.31,5.68,United Healthcare,Default,Fee Schedule,5.15,,,,3.72,5.15
DEXAMETHASONE 10MG INJ SDV,J1100,HCPCS,636,RC,,both,35.95,32.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.16,,,,21.21,29.34
DEXAMETHASONE 10MG INJ SDV,J1100,HCPCS,636,RC,,both,35.95,32.36,Cigna,Default,Percent of Total Billed Charges,21.21,,,,21.21,29.34
DEXAMETHASONE 10MG INJ SDV,J1100,HCPCS,636,RC,,both,35.95,32.36,United Healthcare,Default,Fee Schedule,29.34,,,,21.21,29.34
ALTEPLASE 2MG (CATHFLO ACTIVASE),J2997,HCPCS,636,RC,,both,312.77,281.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,218.94,,,,184.53,255.22
ALTEPLASE 2MG (CATHFLO ACTIVASE),J2997,HCPCS,636,RC,,both,312.77,281.49,Cigna,Default,Percent of Total Billed Charges,184.53,,,,184.53,255.22
ALTEPLASE 2MG (CATHFLO ACTIVASE),J2997,HCPCS,636,RC,,both,312.77,281.49,United Healthcare,Default,Fee Schedule,255.22,,,,184.53,255.22
LUGOL'S SOLUTION,250,RC,,,,both,68.85,61.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.2,,,,40.62,56.18
LUGOL'S SOLUTION,250,RC,,,,both,68.85,61.97,Cigna,Default,Percent of Total Billed Charges,40.62,,,,40.62,56.18
LUGOL'S SOLUTION,250,RC,,,,both,68.85,61.97,United Healthcare,Default,Fee Schedule,56.18,,,,40.62,56.18
ZOLEDRONIC ACID 4MG INJ (ZOMETA),J3489,HCPCS,636,RC,,both,3960.12,3564.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2772.08,,,,2336.47,3231.46
ZOLEDRONIC ACID 4MG INJ (ZOMETA),J3489,HCPCS,636,RC,,both,3960.12,3564.11,Cigna,Default,Percent of Total Billed Charges,2336.47,,,,2336.47,3231.46
ZOLEDRONIC ACID 4MG INJ (ZOMETA),J3489,HCPCS,636,RC,,both,3960.12,3564.11,United Healthcare,Default,Fee Schedule,3231.46,,,,2336.47,3231.46
HIB VACCINE (W/TET),90648,HCPCS,636,RC,,both,124.93,112.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87.45,,,,73.71,101.94
HIB VACCINE (W/TET),90648,HCPCS,636,RC,,both,124.93,112.44,Cigna,Default,Percent of Total Billed Charges,73.71,,,,73.71,101.94
HIB VACCINE (W/TET),90648,HCPCS,636,RC,,both,124.93,112.44,United Healthcare,Default,Fee Schedule,101.94,,,,73.71,101.94
DESMOPRESSIN 4MCG/ML 1ML AMP (DDAVP),250,RC,,,,both,1058.88,952.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,741.22,,,,624.74,864.05
DESMOPRESSIN 4MCG/ML 1ML AMP (DDAVP),250,RC,,,,both,1058.88,952.99,Cigna,Default,Percent of Total Billed Charges,624.74,,,,624.74,864.05
DESMOPRESSIN 4MCG/ML 1ML AMP (DDAVP),250,RC,,,,both,1058.88,952.99,United Healthcare,Default,Fee Schedule,864.05,,,,624.74,864.05
NACL 7% 5ML NEB,J7131,HCPCS,636,RC,,both,9.29,8.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.5,,,,5.48,7.58
NACL 7% 5ML NEB,J7131,HCPCS,636,RC,,both,9.29,8.36,Cigna,Default,Percent of Total Billed Charges,5.48,,,,5.48,7.58
NACL 7% 5ML NEB,J7131,HCPCS,636,RC,,both,9.29,8.36,United Healthcare,Default,Fee Schedule,7.58,,,,5.48,7.58
FLORANEX TAB,637,RC,,,,both,30.8,27.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.56,,,,18.17,25.13
FLORANEX TAB,637,RC,,,,both,30.8,27.72,Cigna,Default,Percent of Total Billed Charges,18.17,,,,18.17,25.13
FLORANEX TAB,637,RC,,,,both,30.8,27.72,United Healthcare,Default,Fee Schedule,25.13,,,,18.17,25.13
DOCUSATE SODIUM 10MG/ML LIQ 120ML,250,RC,,,,both,15.98,14.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.19,,,,9.43,13.04
DOCUSATE SODIUM 10MG/ML LIQ 120ML,250,RC,,,,both,15.98,14.38,Cigna,Default,Percent of Total Billed Charges,9.43,,,,9.43,13.04
DOCUSATE SODIUM 10MG/ML LIQ 120ML,250,RC,,,,both,15.98,14.38,United Healthcare,Default,Fee Schedule,13.04,,,,9.43,13.04
CALCIUM GLUCONATE 1000MG/10ML,J0612,HCPCS,250,RC,,both,167.86,151.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.5,,,,99.04,136.97
CALCIUM GLUCONATE 1000MG/10ML,J0612,HCPCS,250,RC,,both,167.86,151.07,Cigna,Default,Percent of Total Billed Charges,99.04,,,,99.04,136.97
CALCIUM GLUCONATE 1000MG/10ML,J0612,HCPCS,250,RC,,both,167.86,151.07,United Healthcare,Default,Fee Schedule,136.97,,,,99.04,136.97
BOOST DIABETIC SUPPLEMENT,250,RC,,,,both,11.5,10.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.05,,,,6.78,9.38
BOOST DIABETIC SUPPLEMENT,250,RC,,,,both,11.5,10.35,Cigna,Default,Percent of Total Billed Charges,6.78,,,,6.78,9.38
BOOST DIABETIC SUPPLEMENT,250,RC,,,,both,11.5,10.35,United Healthcare,Default,Fee Schedule,9.38,,,,6.78,9.38
DOLASETRON 12.5MG INJ (ANZEMET),J1260,HCPCS,636,RC,,both,71.46,64.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.02,,,,42.16,58.31
DOLASETRON 12.5MG INJ (ANZEMET),J1260,HCPCS,636,RC,,both,71.46,64.31,Cigna,Default,Percent of Total Billed Charges,42.16,,,,42.16,58.31
DOLASETRON 12.5MG INJ (ANZEMET),J1260,HCPCS,636,RC,,both,71.46,64.31,United Healthcare,Default,Fee Schedule,58.31,,,,42.16,58.31
EMPTY IV CONTAINER 250ML,250,RC,,,,both,18.8,16.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.16,,,,11.09,15.34
EMPTY IV CONTAINER 250ML,250,RC,,,,both,18.8,16.92,Cigna,Default,Percent of Total Billed Charges,11.09,,,,11.09,15.34
EMPTY IV CONTAINER 250ML,250,RC,,,,both,18.8,16.92,United Healthcare,Default,Fee Schedule,15.34,,,,11.09,15.34
MULTIVITAMIN LIQ (CENTAMIN),250,RC,,,,both,25,22.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.5,,,,14.75,20.4
MULTIVITAMIN LIQ (CENTAMIN),250,RC,,,,both,25,22.5,Cigna,Default,Percent of Total Billed Charges,14.75,,,,14.75,20.4
MULTIVITAMIN LIQ (CENTAMIN),250,RC,,,,both,25,22.5,United Healthcare,Default,Fee Schedule,20.4,,,,14.75,20.4
PERUVIAN BALSAM,250,RC,,,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
PERUVIAN BALSAM,250,RC,,,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
PERUVIAN BALSAM,250,RC,,,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
FENTANYL 100MCG/HR PATCH (DURAGESIC),250,RC,,,,both,201.06,180.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,140.74,,,,118.63,164.06
FENTANYL 100MCG/HR PATCH (DURAGESIC),250,RC,,,,both,201.06,180.95,Cigna,Default,Percent of Total Billed Charges,118.63,,,,118.63,164.06
FENTANYL 100MCG/HR PATCH (DURAGESIC),250,RC,,,,both,201.06,180.95,United Healthcare,Default,Fee Schedule,164.06,,,,118.63,164.06
FENTANYL 75MCG/HR PATCH (DURAGESIC),250,RC,,,,both,196.69,177.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.68,,,,116.05,160.5
FENTANYL 75MCG/HR PATCH (DURAGESIC),250,RC,,,,both,196.69,177.02,Cigna,Default,Percent of Total Billed Charges,116.05,,,,116.05,160.5
FENTANYL 75MCG/HR PATCH (DURAGESIC),250,RC,,,,both,196.69,177.02,United Healthcare,Default,Fee Schedule,160.5,,,,116.05,160.5
CHARCOAL ACTIDOSE WITH SORBITOL (80Z),250,RC,,,,both,89.48,80.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.64,,,,52.79,73.02
CHARCOAL ACTIDOSE WITH SORBITOL (80Z),250,RC,,,,both,89.48,80.53,Cigna,Default,Percent of Total Billed Charges,52.79,,,,52.79,73.02
CHARCOAL ACTIDOSE WITH SORBITOL (80Z),250,RC,,,,both,89.48,80.53,United Healthcare,Default,Fee Schedule,73.02,,,,52.79,73.02
EMPTY STERILIZED VIAL 30ML,250,RC,,,,both,4.15,3.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.9,,,,2.45,3.39
EMPTY STERILIZED VIAL 30ML,250,RC,,,,both,4.15,3.74,Cigna,Default,Percent of Total Billed Charges,2.45,,,,2.45,3.39
EMPTY STERILIZED VIAL 30ML,250,RC,,,,both,4.15,3.74,United Healthcare,Default,Fee Schedule,3.39,,,,2.45,3.39
GLIMEPIRIDE 4MG TAB (AMARYL),250,RC,,,,both,5.8,5.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.06,,,,3.42,4.73
GLIMEPIRIDE 4MG TAB (AMARYL),250,RC,,,,both,5.8,5.22,Cigna,Default,Percent of Total Billed Charges,3.42,,,,3.42,4.73
GLIMEPIRIDE 4MG TAB (AMARYL),250,RC,,,,both,5.8,5.22,United Healthcare,Default,Fee Schedule,4.73,,,,3.42,4.73
EPINEPHRINE 0.3MG/0.3ML AUTO PEN,J0171,HCPCS,250,RC,,both,1074.72,967.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,752.3,,,,634.08,876.97
EPINEPHRINE 0.3MG/0.3ML AUTO PEN,J0171,HCPCS,250,RC,,both,1074.72,967.25,Cigna,Default,Percent of Total Billed Charges,634.08,,,,634.08,876.97
EPINEPHRINE 0.3MG/0.3ML AUTO PEN,J0171,HCPCS,250,RC,,both,1074.72,967.25,United Healthcare,Default,Fee Schedule,876.97,,,,634.08,876.97
LIDOCAINE VISCOUS 15ML U/D (XYLOCAINE),637,RC,,,,both,28.93,26.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.25,,,,17.07,23.61
LIDOCAINE VISCOUS 15ML U/D (XYLOCAINE),637,RC,,,,both,28.93,26.04,Cigna,Default,Percent of Total Billed Charges,17.07,,,,17.07,23.61
LIDOCAINE VISCOUS 15ML U/D (XYLOCAINE),637,RC,,,,both,28.93,26.04,United Healthcare,Default,Fee Schedule,23.61,,,,17.07,23.61
DAPTOMYCIN 500MG VIAL (CUBICIN),J0878,HCPCS,636,RC,,both,567.73,510.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,397.41,,,,334.96,463.27
DAPTOMYCIN 500MG VIAL (CUBICIN),J0878,HCPCS,636,RC,,both,567.73,510.96,Cigna,Default,Percent of Total Billed Charges,334.96,,,,334.96,463.27
DAPTOMYCIN 500MG VIAL (CUBICIN),J0878,HCPCS,636,RC,,both,567.73,510.96,United Healthcare,Default,Fee Schedule,463.27,,,,334.96,463.27
VANCOMYCIN 250MG (VANCOCIN),637,RC,,,,both,70.6,63.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.42,,,,41.65,57.61
VANCOMYCIN 250MG (VANCOCIN),637,RC,,,,both,70.6,63.54,Cigna,Default,Percent of Total Billed Charges,41.65,,,,41.65,57.61
VANCOMYCIN 250MG (VANCOCIN),637,RC,,,,both,70.6,63.54,United Healthcare,Default,Fee Schedule,57.61,,,,41.65,57.61
ESMOLOL 2500MG/250ML  PREMIX (BREVIBLOC),250,RC,,,,both,2608.97,2348.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1826.28,,,,1539.29,2128.92
ESMOLOL 2500MG/250ML  PREMIX (BREVIBLOC),250,RC,,,,both,2608.97,2348.07,Cigna,Default,Percent of Total Billed Charges,1539.29,,,,1539.29,2128.92
ESMOLOL 2500MG/250ML  PREMIX (BREVIBLOC),250,RC,,,,both,2608.97,2348.07,United Healthcare,Default,Fee Schedule,2128.92,,,,1539.29,2128.92
LEVALBUTEROL 1.25MG NEB (XOPENEX),J7614,HCPCS,250,RC,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
LEVALBUTEROL 1.25MG NEB (XOPENEX),J7614,HCPCS,250,RC,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
LEVALBUTEROL 1.25MG NEB (XOPENEX),J7614,HCPCS,250,RC,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
CHLORHEXIDINE ORAL RINSE (PERIDEX),250,RC,,,,both,42.43,38.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.7,,,,25.03,34.62
CHLORHEXIDINE ORAL RINSE (PERIDEX),250,RC,,,,both,42.43,38.19,Cigna,Default,Percent of Total Billed Charges,25.03,,,,25.03,34.62
CHLORHEXIDINE ORAL RINSE (PERIDEX),250,RC,,,,both,42.43,38.19,United Healthcare,Default,Fee Schedule,34.62,,,,25.03,34.62
GALANTAMINE 4MG TAB (RAZADYNE),637,RC,,,,both,12.44,11.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.71,,,,7.34,10.15
GALANTAMINE 4MG TAB (RAZADYNE),637,RC,,,,both,12.44,11.2,Cigna,Default,Percent of Total Billed Charges,7.34,,,,7.34,10.15
GALANTAMINE 4MG TAB (RAZADYNE),637,RC,,,,both,12.44,11.2,United Healthcare,Default,Fee Schedule,10.15,,,,7.34,10.15
ERTAPENEM 1000MG INJ (INVANZ),J1335,HCPCS,636,RC,,both,653.05,587.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,457.14,,,,385.3,532.89
ERTAPENEM 1000MG INJ (INVANZ),J1335,HCPCS,636,RC,,both,653.05,587.75,Cigna,Default,Percent of Total Billed Charges,385.3,,,,385.3,532.89
ERTAPENEM 1000MG INJ (INVANZ),J1335,HCPCS,636,RC,,both,653.05,587.75,United Healthcare,Default,Fee Schedule,532.89,,,,385.3,532.89
ALENDRONATE 70MG WEEKLY TAB (FOSAMAX),637,RC,,,,both,84.63,76.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.24,,,,49.93,69.06
ALENDRONATE 70MG WEEKLY TAB (FOSAMAX),637,RC,,,,both,84.63,76.17,Cigna,Default,Percent of Total Billed Charges,49.93,,,,49.93,69.06
ALENDRONATE 70MG WEEKLY TAB (FOSAMAX),637,RC,,,,both,84.63,76.17,United Healthcare,Default,Fee Schedule,69.06,,,,49.93,69.06
GABAPENTIN 300MG CAP (NEURONTIN),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
GABAPENTIN 300MG CAP (NEURONTIN),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
GABAPENTIN 300MG CAP (NEURONTIN),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
TIOTROPIUM HANDIHALER (SPIRIVA),637,RC,,,,both,523.27,470.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,366.29,,,,308.73,426.99
TIOTROPIUM HANDIHALER (SPIRIVA),637,RC,,,,both,523.27,470.94,Cigna,Default,Percent of Total Billed Charges,308.73,,,,308.73,426.99
TIOTROPIUM HANDIHALER (SPIRIVA),637,RC,,,,both,523.27,470.94,United Healthcare,Default,Fee Schedule,426.99,,,,308.73,426.99
VANICREAM 4OZ TUBE,250,RC,,,,both,18.3,16.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.81,,,,10.8,14.93
VANICREAM 4OZ TUBE,250,RC,,,,both,18.3,16.47,Cigna,Default,Percent of Total Billed Charges,10.8,,,,10.8,14.93
VANICREAM 4OZ TUBE,250,RC,,,,both,18.3,16.47,United Healthcare,Default,Fee Schedule,14.93,,,,10.8,14.93
QUETIAPINE 25MG TAB (SEROQUEL),637,RC,,,,both,8.29,7.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.8,,,,4.89,6.76
QUETIAPINE 25MG TAB (SEROQUEL),637,RC,,,,both,8.29,7.46,Cigna,Default,Percent of Total Billed Charges,4.89,,,,4.89,6.76
QUETIAPINE 25MG TAB (SEROQUEL),637,RC,,,,both,8.29,7.46,United Healthcare,Default,Fee Schedule,6.76,,,,4.89,6.76
INFLUENZA ADULT VACCINE,90658,HCPCS,636,RC,,both,76.19,68.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.33,,,,44.95,62.17
INFLUENZA ADULT VACCINE,90658,HCPCS,636,RC,,both,76.19,68.57,Cigna,Default,Percent of Total Billed Charges,44.95,,,,44.95,62.17
INFLUENZA ADULT VACCINE,90658,HCPCS,636,RC,,both,76.19,68.57,United Healthcare,Default,Fee Schedule,62.17,,,,44.95,62.17
HYDROCORTISONE 2.5% LOT,637,RC,,,,both,115.05,103.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.54,,,,67.88,93.88
HYDROCORTISONE 2.5% LOT,637,RC,,,,both,115.05,103.55,Cigna,Default,Percent of Total Billed Charges,67.88,,,,67.88,93.88
HYDROCORTISONE 2.5% LOT,637,RC,,,,both,115.05,103.55,United Healthcare,Default,Fee Schedule,93.88,,,,67.88,93.88
ACYCLOVIR 400MG TAB (ZOVIRAX),637,RC,,,,both,16.11,14.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.28,,,,9.5,13.15
ACYCLOVIR 400MG TAB (ZOVIRAX),637,RC,,,,both,16.11,14.5,Cigna,Default,Percent of Total Billed Charges,9.5,,,,9.5,13.15
ACYCLOVIR 400MG TAB (ZOVIRAX),637,RC,,,,both,16.11,14.5,United Healthcare,Default,Fee Schedule,13.15,,,,9.5,13.15
CLONIDINE 100MCG/ML 10ML VIAL (DURACLON),J0735,HCPCS,636,RC,,both,265.76,239.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,186.03,,,,156.8,216.86
CLONIDINE 100MCG/ML 10ML VIAL (DURACLON),J0735,HCPCS,636,RC,,both,265.76,239.18,Cigna,Default,Percent of Total Billed Charges,156.8,,,,156.8,216.86
CLONIDINE 100MCG/ML 10ML VIAL (DURACLON),J0735,HCPCS,636,RC,,both,265.76,239.18,United Healthcare,Default,Fee Schedule,216.86,,,,156.8,216.86
AMOXICILLIN/CLAVULANATE 400MG SUSP (AUGM,637,RC,,,,both,316.41,284.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.49,,,,186.68,258.19
AMOXICILLIN/CLAVULANATE 400MG SUSP (AUGM,637,RC,,,,both,316.41,284.77,Cigna,Default,Percent of Total Billed Charges,186.68,,,,186.68,258.19
AMOXICILLIN/CLAVULANATE 400MG SUSP (AUGM,637,RC,,,,both,316.41,284.77,United Healthcare,Default,Fee Schedule,258.19,,,,186.68,258.19
METOPROLOL 5MG/5ML INJ (LOPRESSOR),J3490,HCPCS,636,RC,,both,29.64,26.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.75,,,,17.49,24.19
METOPROLOL 5MG/5ML INJ (LOPRESSOR),J3490,HCPCS,636,RC,,both,29.64,26.68,Cigna,Default,Percent of Total Billed Charges,17.49,,,,17.49,24.19
METOPROLOL 5MG/5ML INJ (LOPRESSOR),J3490,HCPCS,636,RC,,both,29.64,26.68,United Healthcare,Default,Fee Schedule,24.19,,,,17.49,24.19
CULTURELLE W/LACTOBACILLUS CAP,250,RC,,,,both,5.25,4.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.68,,,,3.1,4.28
CULTURELLE W/LACTOBACILLUS CAP,250,RC,,,,both,5.25,4.73,Cigna,Default,Percent of Total Billed Charges,3.1,,,,3.1,4.28
CULTURELLE W/LACTOBACILLUS CAP,250,RC,,,,both,5.25,4.73,United Healthcare,Default,Fee Schedule,4.28,,,,3.1,4.28
INSULIN GLARGINE PEN (LANTUS SOLOSTAR,J1815,HCPCS,636,RC,,both,451.63,406.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,316.14,,,,266.46,368.53
INSULIN GLARGINE PEN (LANTUS SOLOSTAR,J1815,HCPCS,636,RC,,both,451.63,406.47,Cigna,Default,Percent of Total Billed Charges,266.46,,,,266.46,368.53
INSULIN GLARGINE PEN (LANTUS SOLOSTAR,J1815,HCPCS,636,RC,,both,451.63,406.47,United Healthcare,Default,Fee Schedule,368.53,,,,266.46,368.53
DIPHTHERIA/TETANUS TOX PEDIATRIC,250,RC,,,,both,55.21,49.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.65,,,,32.57,45.05
DIPHTHERIA/TETANUS TOX PEDIATRIC,250,RC,,,,both,55.21,49.69,Cigna,Default,Percent of Total Billed Charges,32.57,,,,32.57,45.05
DIPHTHERIA/TETANUS TOX PEDIATRIC,250,RC,,,,both,55.21,49.69,United Healthcare,Default,Fee Schedule,45.05,,,,32.57,45.05
VALPROATE SODIUM 500MG/5ML INJ,250,RC,,,,both,34.28,30.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24,,,,20.23,27.97
VALPROATE SODIUM 500MG/5ML INJ,250,RC,,,,both,34.28,30.85,Cigna,Default,Percent of Total Billed Charges,20.23,,,,20.23,27.97
VALPROATE SODIUM 500MG/5ML INJ,250,RC,,,,both,34.28,30.85,United Healthcare,Default,Fee Schedule,27.97,,,,20.23,27.97
Fluconazole/PREMIX IVPB: 200MG/100ML,J1450,HCPCS,636,RC,,both,99.09,89.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,69.36,,,,58.46,80.86
Fluconazole/PREMIX IVPB: 200MG/100ML,J1450,HCPCS,636,RC,,both,99.09,89.18,Cigna,Default,Percent of Total Billed Charges,58.46,,,,58.46,80.86
Fluconazole/PREMIX IVPB: 200MG/100ML,J1450,HCPCS,636,RC,,both,99.09,89.18,United Healthcare,Default,Fee Schedule,80.86,,,,58.46,80.86
OXYBUTYNIN XL 5MG TAB (DITROPAN XL),637,RC,,,,both,19.08,17.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.36,,,,11.26,15.57
OXYBUTYNIN XL 5MG TAB (DITROPAN XL),637,RC,,,,both,19.08,17.17,Cigna,Default,Percent of Total Billed Charges,11.26,,,,11.26,15.57
OXYBUTYNIN XL 5MG TAB (DITROPAN XL),637,RC,,,,both,19.08,17.17,United Healthcare,Default,Fee Schedule,15.57,,,,11.26,15.57
SUCRALFATE 1000MG/10ML (CARAFATE),250,RC,,,,both,56.59,50.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.61,,,,33.39,46.18
SUCRALFATE 1000MG/10ML (CARAFATE),250,RC,,,,both,56.59,50.93,Cigna,Default,Percent of Total Billed Charges,33.39,,,,33.39,46.18
SUCRALFATE 1000MG/10ML (CARAFATE),250,RC,,,,both,56.59,50.93,United Healthcare,Default,Fee Schedule,46.18,,,,33.39,46.18
LIDOCAINE 5% PATCH (LIDODERM),250,RC,,,,both,41.25,37.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.88,,,,24.34,33.66
LIDOCAINE 5% PATCH (LIDODERM),250,RC,,,,both,41.25,37.13,Cigna,Default,Percent of Total Billed Charges,24.34,,,,24.34,33.66
LIDOCAINE 5% PATCH (LIDODERM),250,RC,,,,both,41.25,37.13,United Healthcare,Default,Fee Schedule,33.66,,,,24.34,33.66
DEXMEDETOMIDINE 200MCG/2ML INJ,250,RC,,,,both,330.93,297.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,231.65,,,,195.25,270.04
DEXMEDETOMIDINE 200MCG/2ML INJ,250,RC,,,,both,330.93,297.84,Cigna,Default,Percent of Total Billed Charges,195.25,,,,195.25,270.04
DEXMEDETOMIDINE 200MCG/2ML INJ,250,RC,,,,both,330.93,297.84,United Healthcare,Default,Fee Schedule,270.04,,,,195.25,270.04
OXYCODONE CR 10MG TAB (OXYCONTIN),637,RC,,,,both,8.29,7.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.8,,,,4.89,6.76
OXYCODONE CR 10MG TAB (OXYCONTIN),637,RC,,,,both,8.29,7.46,Cigna,Default,Percent of Total Billed Charges,4.89,,,,4.89,6.76
OXYCODONE CR 10MG TAB (OXYCONTIN),637,RC,,,,both,8.29,7.46,United Healthcare,Default,Fee Schedule,6.76,,,,4.89,6.76
OXYCODONE 5MG TAB,637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
OXYCODONE 5MG TAB,637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
OXYCODONE 5MG TAB,637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
"VITAMIN A 10,000U CAP",637,RC,,,,both,4.06,3.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.84,,,,2.4,3.31
"VITAMIN A 10,000U CAP",637,RC,,,,both,4.06,3.65,Cigna,Default,Percent of Total Billed Charges,2.4,,,,2.4,3.31
"VITAMIN A 10,000U CAP",637,RC,,,,both,4.06,3.65,United Healthcare,Default,Fee Schedule,3.31,,,,2.4,3.31
POTASSIUM CHLORIDE 10MEQ TAB (KLOR CON),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
POTASSIUM CHLORIDE 10MEQ TAB (KLOR CON),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
POTASSIUM CHLORIDE 10MEQ TAB (KLOR CON),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ATROPINE 1MG/10ML INJ ABBOJECT,J0461,HCPCS,636,RC,,both,70.02,63.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.01,,,,41.31,57.14
ATROPINE 1MG/10ML INJ ABBOJECT,J0461,HCPCS,636,RC,,both,70.02,63.02,Cigna,Default,Percent of Total Billed Charges,41.31,,,,41.31,57.14
ATROPINE 1MG/10ML INJ ABBOJECT,J0461,HCPCS,636,RC,,both,70.02,63.02,United Healthcare,Default,Fee Schedule,57.14,,,,41.31,57.14
ENSURE,637,RC,,,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
ENSURE,637,RC,,,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
ENSURE,637,RC,,,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
DOCUSATE SODIUM 50MG/5ML LIQ (DSS),250,RC,,,,both,22.75,20.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.92,,,,13.42,18.56
DOCUSATE SODIUM 50MG/5ML LIQ (DSS),250,RC,,,,both,22.75,20.48,Cigna,Default,Percent of Total Billed Charges,13.42,,,,13.42,18.56
DOCUSATE SODIUM 50MG/5ML LIQ (DSS),250,RC,,,,both,22.75,20.48,United Healthcare,Default,Fee Schedule,18.56,,,,13.42,18.56
DANTROLENE 50MG CAP  (DANTRIUM),250,RC,,,,both,7.74,6.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.42,,,,4.57,6.32
DANTROLENE 50MG CAP  (DANTRIUM),250,RC,,,,both,7.74,6.97,Cigna,Default,Percent of Total Billed Charges,4.57,,,,4.57,6.32
DANTROLENE 50MG CAP  (DANTRIUM),250,RC,,,,both,7.74,6.97,United Healthcare,Default,Fee Schedule,6.32,,,,4.57,6.32
MULTIVITAMIN LIQUID 240ML,250,RC,,,,both,25.44,22.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.81,,,,15.01,20.76
MULTIVITAMIN LIQUID 240ML,250,RC,,,,both,25.44,22.9,Cigna,Default,Percent of Total Billed Charges,15.01,,,,15.01,20.76
MULTIVITAMIN LIQUID 240ML,250,RC,,,,both,25.44,22.9,United Healthcare,Default,Fee Schedule,20.76,,,,15.01,20.76
MICONAZOLE 2% 30GM CRM (LOTRIMIN AF),637,RC,,,,both,55.78,50.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.05,,,,32.91,45.52
MICONAZOLE 2% 30GM CRM (LOTRIMIN AF),637,RC,,,,both,55.78,50.2,Cigna,Default,Percent of Total Billed Charges,32.91,,,,32.91,45.52
MICONAZOLE 2% 30GM CRM (LOTRIMIN AF),637,RC,,,,both,55.78,50.2,United Healthcare,Default,Fee Schedule,45.52,,,,32.91,45.52
POLYETHYLENE GLYCOL 3350 17GM PKT (MIRAL,637,RC,,,,both,13.96,12.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.77,,,,8.24,11.39
POLYETHYLENE GLYCOL 3350 17GM PKT (MIRAL,637,RC,,,,both,13.96,12.56,Cigna,Default,Percent of Total Billed Charges,8.24,,,,8.24,11.39
POLYETHYLENE GLYCOL 3350 17GM PKT (MIRAL,637,RC,,,,both,13.96,12.56,United Healthcare,Default,Fee Schedule,11.39,,,,8.24,11.39
VANCOMYCIN 125MG CAP (VANCOCIN),637,RC,,,,both,134.61,121.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,94.23,,,,79.42,109.84
VANCOMYCIN 125MG CAP (VANCOCIN),637,RC,,,,both,134.61,121.15,Cigna,Default,Percent of Total Billed Charges,79.42,,,,79.42,109.84
VANCOMYCIN 125MG CAP (VANCOCIN),637,RC,,,,both,134.61,121.15,United Healthcare,Default,Fee Schedule,109.84,,,,79.42,109.84
PERMETHRIN 1% CRM RINSE,A9180,HCPCS,250,RC,,both,31,27.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.7,,,,18.29,25.3
PERMETHRIN 1% CRM RINSE,A9180,HCPCS,250,RC,,both,31,27.9,Cigna,Default,Percent of Total Billed Charges,18.29,,,,18.29,25.3
PERMETHRIN 1% CRM RINSE,A9180,HCPCS,250,RC,,both,31,27.9,United Healthcare,Default,Fee Schedule,25.3,,,,18.29,25.3
PHENYLEPHRINE 0.25% NASAL SPRAY (NEO-SYN,250,RC,,,,both,15.39,13.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.77,,,,9.08,12.56
PHENYLEPHRINE 0.25% NASAL SPRAY (NEO-SYN,250,RC,,,,both,15.39,13.85,Cigna,Default,Percent of Total Billed Charges,9.08,,,,9.08,12.56
PHENYLEPHRINE 0.25% NASAL SPRAY (NEO-SYN,250,RC,,,,both,15.39,13.85,United Healthcare,Default,Fee Schedule,12.56,,,,9.08,12.56
LOLLIPOPS FENTANYL (ACTIQ),250,RC,,,,both,65,58.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.5,,,,38.35,53.04
LOLLIPOPS FENTANYL (ACTIQ),250,RC,,,,both,65,58.5,Cigna,Default,Percent of Total Billed Charges,38.35,,,,38.35,53.04
LOLLIPOPS FENTANYL (ACTIQ),250,RC,,,,both,65,58.5,United Healthcare,Default,Fee Schedule,53.04,,,,38.35,53.04
ACETAMINOPHEN W/CODEINE ORAL SOLN 5ML,637,RC,,,,both,2.61,2.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.83,,,,1.54,2.13
ACETAMINOPHEN W/CODEINE ORAL SOLN 5ML,637,RC,,,,both,2.61,2.35,Cigna,Default,Percent of Total Billed Charges,1.54,,,,1.54,2.13
ACETAMINOPHEN W/CODEINE ORAL SOLN 5ML,637,RC,,,,both,2.61,2.35,United Healthcare,Default,Fee Schedule,2.13,,,,1.54,2.13
TRAVOPROST 0.004% EYE DROP 2.5ML (TRAVAT,637,RC,,,,both,406.47,365.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,284.53,,,,239.82,331.68
TRAVOPROST 0.004% EYE DROP 2.5ML (TRAVAT,637,RC,,,,both,406.47,365.82,Cigna,Default,Percent of Total Billed Charges,239.82,,,,239.82,331.68
TRAVOPROST 0.004% EYE DROP 2.5ML (TRAVAT,637,RC,,,,both,406.47,365.82,United Healthcare,Default,Fee Schedule,331.68,,,,239.82,331.68
IRON DEXTRAN COMPLEX 50MG/ML 1ML SDV (DE,J1750,HCPCS,636,RC,,both,147.31,132.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,103.12,,,,86.91,120.2
IRON DEXTRAN COMPLEX 50MG/ML 1ML SDV (DE,J1750,HCPCS,636,RC,,both,147.31,132.58,Cigna,Default,Percent of Total Billed Charges,86.91,,,,86.91,120.2
IRON DEXTRAN COMPLEX 50MG/ML 1ML SDV (DE,J1750,HCPCS,636,RC,,both,147.31,132.58,United Healthcare,Default,Fee Schedule,120.2,,,,86.91,120.2
TOLTERODINE 2MG CAP (DETROL),250,RC,,,,both,14.93,13.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.45,,,,8.81,12.18
TOLTERODINE 2MG CAP (DETROL),250,RC,,,,both,14.93,13.44,Cigna,Default,Percent of Total Billed Charges,8.81,,,,8.81,12.18
TOLTERODINE 2MG CAP (DETROL),250,RC,,,,both,14.93,13.44,United Healthcare,Default,Fee Schedule,12.18,,,,8.81,12.18
PREGABALIN 25MG CAP (LYRICA),250,RC,,,,both,37.3,33.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.11,,,,22.01,30.44
PREGABALIN 25MG CAP (LYRICA),250,RC,,,,both,37.3,33.57,Cigna,Default,Percent of Total Billed Charges,22.01,,,,22.01,30.44
PREGABALIN 25MG CAP (LYRICA),250,RC,,,,both,37.3,33.57,United Healthcare,Default,Fee Schedule,30.44,,,,22.01,30.44
GUAIFENESIN 600MG TAB (MUCINEX),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
GUAIFENESIN 600MG TAB (MUCINEX),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
GUAIFENESIN 600MG TAB (MUCINEX),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PENTOXIFYLLINE 400MG TAB ER (TRENTAL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PENTOXIFYLLINE 400MG TAB ER (TRENTAL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PENTOXIFYLLINE 400MG TAB ER (TRENTAL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
BUPIVACAINE 0.5% 30ML INJ (MARCAINE),250,RC,,,,both,28.48,25.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.94,,,,16.8,23.24
BUPIVACAINE 0.5% 30ML INJ (MARCAINE),250,RC,,,,both,28.48,25.63,Cigna,Default,Percent of Total Billed Charges,16.8,,,,16.8,23.24
BUPIVACAINE 0.5% 30ML INJ (MARCAINE),250,RC,,,,both,28.48,25.63,United Healthcare,Default,Fee Schedule,23.24,,,,16.8,23.24
PREGABALIN 150MG CAP (LYRICA),250,RC,,,,both,9.95,8.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.96,,,,5.87,8.12
PREGABALIN 150MG CAP (LYRICA),250,RC,,,,both,9.95,8.96,Cigna,Default,Percent of Total Billed Charges,5.87,,,,5.87,8.12
PREGABALIN 150MG CAP (LYRICA),250,RC,,,,both,9.95,8.96,United Healthcare,Default,Fee Schedule,8.12,,,,5.87,8.12
METRONIDAZOLE 500MG/100ML IVPB PREMIX,250,RC,,,,both,36.61,32.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.63,,,,21.6,29.87
METRONIDAZOLE 500MG/100ML IVPB PREMIX,250,RC,,,,both,36.61,32.95,Cigna,Default,Percent of Total Billed Charges,21.6,,,,21.6,29.87
METRONIDAZOLE 500MG/100ML IVPB PREMIX,250,RC,,,,both,36.61,32.95,United Healthcare,Default,Fee Schedule,29.87,,,,21.6,29.87
CINNAMON 1000MG CAP,250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CINNAMON 1000MG CAP,250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CINNAMON 1000MG CAP,250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
LEVOFLOXACIN 750MG/150ML IVPB PREMIX,J1956,HCPCS,636,RC,,both,247.26,222.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.08,,,,145.88,201.76
LEVOFLOXACIN 750MG/150ML IVPB PREMIX,J1956,HCPCS,636,RC,,both,247.26,222.53,Cigna,Default,Percent of Total Billed Charges,145.88,,,,145.88,201.76
LEVOFLOXACIN 750MG/150ML IVPB PREMIX,J1956,HCPCS,636,RC,,both,247.26,222.53,United Healthcare,Default,Fee Schedule,201.76,,,,145.88,201.76
SLOW FE IRON,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
SLOW FE IRON,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
SLOW FE IRON,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CHLORASEPTIC MUCOUS MEMBRANE SPRAY 1.4%,250,RC,,,,both,24.04,21.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.83,,,,14.18,19.62
CHLORASEPTIC MUCOUS MEMBRANE SPRAY 1.4%,250,RC,,,,both,24.04,21.64,Cigna,Default,Percent of Total Billed Charges,14.18,,,,14.18,19.62
CHLORASEPTIC MUCOUS MEMBRANE SPRAY 1.4%,250,RC,,,,both,24.04,21.64,United Healthcare,Default,Fee Schedule,19.62,,,,14.18,19.62
MEPHYTON 5MG TAB (VITAMIN K),250,RC,,,,both,118.97,107.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.28,,,,70.19,97.08
MEPHYTON 5MG TAB (VITAMIN K),250,RC,,,,both,118.97,107.07,Cigna,Default,Percent of Total Billed Charges,70.19,,,,70.19,97.08
MEPHYTON 5MG TAB (VITAMIN K),250,RC,,,,both,118.97,107.07,United Healthcare,Default,Fee Schedule,97.08,,,,70.19,97.08
BOOST LIQ 240 ML CAN,250,RC,,,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
BOOST LIQ 240 ML CAN,250,RC,,,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
BOOST LIQ 240 ML CAN,250,RC,,,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
EZETIMIBE 10MG TAB (ZETIA),637,RC,,,,both,53.28,47.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.3,,,,31.44,43.48
EZETIMIBE 10MG TAB (ZETIA),637,RC,,,,both,53.28,47.95,Cigna,Default,Percent of Total Billed Charges,31.44,,,,31.44,43.48
EZETIMIBE 10MG TAB (ZETIA),637,RC,,,,both,53.28,47.95,United Healthcare,Default,Fee Schedule,43.48,,,,31.44,43.48
ZIPRASIDONE 20MG/ML IM INJ (GEODON),J3486,HCPCS,636,RC,,both,54.34,48.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.04,,,,32.06,44.34
ZIPRASIDONE 20MG/ML IM INJ (GEODON),J3486,HCPCS,636,RC,,both,54.34,48.91,Cigna,Default,Percent of Total Billed Charges,32.06,,,,32.06,44.34
ZIPRASIDONE 20MG/ML IM INJ (GEODON),J3486,HCPCS,636,RC,,both,54.34,48.91,United Healthcare,Default,Fee Schedule,44.34,,,,32.06,44.34
BISMUTH 262MG CHEWABLE TAB,637,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
BISMUTH 262MG CHEWABLE TAB,637,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
BISMUTH 262MG CHEWABLE TAB,637,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
HYDRALAZINE HCL 10MG TAB,637,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
HYDRALAZINE HCL 10MG TAB,637,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
HYDRALAZINE HCL 10MG TAB,637,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
CALCITRIOL 0.5MCG CAP (ROCALTROL),637,RC,,,,both,9.59,8.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.71,,,,5.66,7.83
CALCITRIOL 0.5MCG CAP (ROCALTROL),637,RC,,,,both,9.59,8.63,Cigna,Default,Percent of Total Billed Charges,5.66,,,,5.66,7.83
CALCITRIOL 0.5MCG CAP (ROCALTROL),637,RC,,,,both,9.59,8.63,United Healthcare,Default,Fee Schedule,7.83,,,,5.66,7.83
TRIPLE ANTIBIOTIC OINT 30GM TUBE (NEOSPO,637,RC,,,,both,13.37,12.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.36,,,,7.89,10.91
TRIPLE ANTIBIOTIC OINT 30GM TUBE (NEOSPO,637,RC,,,,both,13.37,12.03,Cigna,Default,Percent of Total Billed Charges,7.89,,,,7.89,10.91
TRIPLE ANTIBIOTIC OINT 30GM TUBE (NEOSPO,637,RC,,,,both,13.37,12.03,United Healthcare,Default,Fee Schedule,10.91,,,,7.89,10.91
ESTRIDIOL VAG CRM 42.5GM TUBE (ESTRACE),250,RC,,,,both,223.71,201.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,156.6,,,,131.99,182.55
ESTRIDIOL VAG CRM 42.5GM TUBE (ESTRACE),250,RC,,,,both,223.71,201.34,Cigna,Default,Percent of Total Billed Charges,131.99,,,,131.99,182.55
ESTRIDIOL VAG CRM 42.5GM TUBE (ESTRACE),250,RC,,,,both,223.71,201.34,United Healthcare,Default,Fee Schedule,182.55,,,,131.99,182.55
FLUOROURACIL 1 GM VIAL (50MG/1ML; 20ML),J9190,HCPCS,636,RC,,both,30.7,27.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.49,,,,18.11,25.05
FLUOROURACIL 1 GM VIAL (50MG/1ML; 20ML),J9190,HCPCS,636,RC,,both,30.7,27.63,Cigna,Default,Percent of Total Billed Charges,18.11,,,,18.11,25.05
FLUOROURACIL 1 GM VIAL (50MG/1ML; 20ML),J9190,HCPCS,636,RC,,both,30.7,27.63,United Healthcare,Default,Fee Schedule,25.05,,,,18.11,25.05
SENNA 8.6MG TAB (SENOKOT),250,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
SENNA 8.6MG TAB (SENOKOT),250,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
SENNA 8.6MG TAB (SENOKOT),250,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
DULOXETINE 30MG CAP (CYMBALTA),250,RC,,,,both,34.07,30.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.85,,,,20.1,27.8
DULOXETINE 30MG CAP (CYMBALTA),250,RC,,,,both,34.07,30.66,Cigna,Default,Percent of Total Billed Charges,20.1,,,,20.1,27.8
DULOXETINE 30MG CAP (CYMBALTA),250,RC,,,,both,34.07,30.66,United Healthcare,Default,Fee Schedule,27.8,,,,20.1,27.8
WARFARIN 5MG INJ (COUMADIN),250,RC,,,,both,86.84,78.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.79,,,,51.24,70.86
WARFARIN 5MG INJ (COUMADIN),250,RC,,,,both,86.84,78.16,Cigna,Default,Percent of Total Billed Charges,51.24,,,,51.24,70.86
WARFARIN 5MG INJ (COUMADIN),250,RC,,,,both,86.84,78.16,United Healthcare,Default,Fee Schedule,70.86,,,,51.24,70.86
FONDAPARINUX 2.5MG/0.5ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,173.15,155.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.2,,,,102.16,141.29
FONDAPARINUX 2.5MG/0.5ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,173.15,155.84,Cigna,Default,Percent of Total Billed Charges,102.16,,,,102.16,141.29
FONDAPARINUX 2.5MG/0.5ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,173.15,155.84,United Healthcare,Default,Fee Schedule,141.29,,,,102.16,141.29
MORPHINE SULFATE CONC 20MG/ML 30ML,637,RC,,,,both,96.45,86.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.52,,,,56.91,78.7
MORPHINE SULFATE CONC 20MG/ML 30ML,637,RC,,,,both,96.45,86.81,Cigna,Default,Percent of Total Billed Charges,56.91,,,,56.91,78.7
MORPHINE SULFATE CONC 20MG/ML 30ML,637,RC,,,,both,96.45,86.81,United Healthcare,Default,Fee Schedule,78.7,,,,56.91,78.7
FENOFIBRATE 145MG TAB (TRICOR),637,RC,,,,both,15.21,13.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.65,,,,8.97,12.41
FENOFIBRATE 145MG TAB (TRICOR),637,RC,,,,both,15.21,13.69,Cigna,Default,Percent of Total Billed Charges,8.97,,,,8.97,12.41
FENOFIBRATE 145MG TAB (TRICOR),637,RC,,,,both,15.21,13.69,United Healthcare,Default,Fee Schedule,12.41,,,,8.97,12.41
FLUTICASONE & SALMETEROL 100/50 INHALER,637,RC,,,,both,235.05,211.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,164.54,,,,138.68,191.8
FLUTICASONE & SALMETEROL 100/50 INHALER,637,RC,,,,both,235.05,211.55,Cigna,Default,Percent of Total Billed Charges,138.68,,,,138.68,191.8
FLUTICASONE & SALMETEROL 100/50 INHALER,637,RC,,,,both,235.05,211.55,United Healthcare,Default,Fee Schedule,191.8,,,,138.68,191.8
ZINC OXIDE 454GM OINT TUB,637,RC,,,,both,62.46,56.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.72,,,,36.85,50.97
ZINC OXIDE 454GM OINT TUB,637,RC,,,,both,62.46,56.21,Cigna,Default,Percent of Total Billed Charges,36.85,,,,36.85,50.97
ZINC OXIDE 454GM OINT TUB,637,RC,,,,both,62.46,56.21,United Healthcare,Default,Fee Schedule,50.97,,,,36.85,50.97
FLUTICASONE & SALMETEROL 250/50 DISKUS,637,RC,,,,both,665.74,599.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,466.02,,,,392.79,543.24
FLUTICASONE & SALMETEROL 250/50 DISKUS,637,RC,,,,both,665.74,599.17,Cigna,Default,Percent of Total Billed Charges,392.79,,,,392.79,543.24
FLUTICASONE & SALMETEROL 250/50 DISKUS,637,RC,,,,both,665.74,599.17,United Healthcare,Default,Fee Schedule,543.24,,,,392.79,543.24
BUMETANIDE 2MG TAB (BUMEX),250,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
BUMETANIDE 2MG TAB (BUMEX),250,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
BUMETANIDE 2MG TAB (BUMEX),250,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
INSULIN ASPART PREFILLED PEN (NOVOLOG),250,RC,,,,both,623.49,561.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,436.44,,,,367.86,508.77
INSULIN ASPART PREFILLED PEN (NOVOLOG),250,RC,,,,both,623.49,561.14,Cigna,Default,Percent of Total Billed Charges,367.86,,,,367.86,508.77
INSULIN ASPART PREFILLED PEN (NOVOLOG),250,RC,,,,both,623.49,561.14,United Healthcare,Default,Fee Schedule,508.77,,,,367.86,508.77
INSULIN ASPART PROTAMINE/ASPART 70/30 PE,J1815,HCPCS,636,RC,,both,593.44,534.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,415.41,,,,350.13,484.25
INSULIN ASPART PROTAMINE/ASPART 70/30 PE,J1815,HCPCS,636,RC,,both,593.44,534.1,Cigna,Default,Percent of Total Billed Charges,350.13,,,,350.13,484.25
INSULIN ASPART PROTAMINE/ASPART 70/30 PE,J1815,HCPCS,636,RC,,both,593.44,534.1,United Healthcare,Default,Fee Schedule,484.25,,,,350.13,484.25
INSULIN DETEMIR PREFILLED PEN (LEVEMIR),J1815,HCPCS,636,RC,,both,490.82,441.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,343.57,,,,289.58,400.51
INSULIN DETEMIR PREFILLED PEN (LEVEMIR),J1815,HCPCS,636,RC,,both,490.82,441.74,Cigna,Default,Percent of Total Billed Charges,289.58,,,,289.58,400.51
INSULIN DETEMIR PREFILLED PEN (LEVEMIR),J1815,HCPCS,636,RC,,both,490.82,441.74,United Healthcare,Default,Fee Schedule,400.51,,,,289.58,400.51
CALCITRIOL 0.25 MCG LIQ CAP (ROCALTROL),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CALCITRIOL 0.25 MCG LIQ CAP (ROCALTROL),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CALCITRIOL 0.25 MCG LIQ CAP (ROCALTROL),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ESOMEPRAZOLE 40MG INJ (NEXIUM),250,RC,,,,both,237.07,213.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,165.95,,,,139.87,193.45
ESOMEPRAZOLE 40MG INJ (NEXIUM),250,RC,,,,both,237.07,213.36,Cigna,Default,Percent of Total Billed Charges,139.87,,,,139.87,193.45
ESOMEPRAZOLE 40MG INJ (NEXIUM),250,RC,,,,both,237.07,213.36,United Healthcare,Default,Fee Schedule,193.45,,,,139.87,193.45
STERILE WATER FOR INJECTION 1000 ML,250,RC,,,,both,5.54,4.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.88,,,,3.27,4.52
STERILE WATER FOR INJECTION 1000 ML,250,RC,,,,both,5.54,4.99,Cigna,Default,Percent of Total Billed Charges,3.27,,,,3.27,4.52
STERILE WATER FOR INJECTION 1000 ML,250,RC,,,,both,5.54,4.99,United Healthcare,Default,Fee Schedule,4.52,,,,3.27,4.52
AMOX/CLAVULANATE 200MG/28.5MG 50ML,637,RC,,,,both,71.91,64.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.34,,,,42.43,58.68
AMOX/CLAVULANATE 200MG/28.5MG 50ML,637,RC,,,,both,71.91,64.72,Cigna,Default,Percent of Total Billed Charges,42.43,,,,42.43,58.68
AMOX/CLAVULANATE 200MG/28.5MG 50ML,637,RC,,,,both,71.91,64.72,United Healthcare,Default,Fee Schedule,58.68,,,,42.43,58.68
PEDIALYTE 1000ML BOTTLE,637,RC,,,,both,22.66,20.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.86,,,,13.37,18.49
PEDIALYTE 1000ML BOTTLE,637,RC,,,,both,22.66,20.39,Cigna,Default,Percent of Total Billed Charges,13.37,,,,13.37,18.49
PEDIALYTE 1000ML BOTTLE,637,RC,,,,both,22.66,20.39,United Healthcare,Default,Fee Schedule,18.49,,,,13.37,18.49
FLUTICASONE & SALMETEROL 500/50 DISKUS,637,RC,,,,both,1085.05,976.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,759.54,,,,640.18,885.4
FLUTICASONE & SALMETEROL 500/50 DISKUS,637,RC,,,,both,1085.05,976.55,Cigna,Default,Percent of Total Billed Charges,640.18,,,,640.18,885.4
FLUTICASONE & SALMETEROL 500/50 DISKUS,637,RC,,,,both,1085.05,976.55,United Healthcare,Default,Fee Schedule,885.4,,,,640.18,885.4
OCTREOTIDE LAR DEPOT 20MG (SANDOSTATIN),J2353,HCPCS,250,RC,,both,13088.5,11779.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9161.95,,,,7722.22,10680.22
OCTREOTIDE LAR DEPOT 20MG (SANDOSTATIN),J2353,HCPCS,250,RC,,both,13088.5,11779.65,Cigna,Default,Percent of Total Billed Charges,7722.22,,,,7722.22,10680.22
OCTREOTIDE LAR DEPOT 20MG (SANDOSTATIN),J2353,HCPCS,250,RC,,both,13088.5,11779.65,United Healthcare,Default,Fee Schedule,10680.22,,,,7722.22,10680.22
"EPOETIN ALPHA  20,000U (PROCRIT)",J0885,HCPCS,636,RC,,both,2603.84,2343.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1822.69,,,,1536.27,2124.73
"EPOETIN ALPHA  20,000U (PROCRIT)",J0885,HCPCS,636,RC,,both,2603.84,2343.46,Cigna,Default,Percent of Total Billed Charges,1536.27,,,,1536.27,2124.73
"EPOETIN ALPHA  20,000U (PROCRIT)",J0885,HCPCS,636,RC,,both,2603.84,2343.46,United Healthcare,Default,Fee Schedule,2124.73,,,,1536.27,2124.73
"EPOETIN ALPHA 10,000 U (PROCRIT)",J0885,HCPCS,636,RC,,both,1702.8,1532.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1191.96,,,,1004.65,1389.48
"EPOETIN ALPHA 10,000 U (PROCRIT)",J0885,HCPCS,636,RC,,both,1702.8,1532.52,Cigna,Default,Percent of Total Billed Charges,1004.65,,,,1004.65,1389.48
"EPOETIN ALPHA 10,000 U (PROCRIT)",J0885,HCPCS,636,RC,,both,1702.8,1532.52,United Healthcare,Default,Fee Schedule,1389.48,,,,1004.65,1389.48
CLOTRIMAZOLE 1% 30GM CRM (LOTRIMIN),250,RC,,,,both,29.35,26.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.54,,,,17.32,23.95
CLOTRIMAZOLE 1% 30GM CRM (LOTRIMIN),250,RC,,,,both,29.35,26.42,Cigna,Default,Percent of Total Billed Charges,17.32,,,,17.32,23.95
CLOTRIMAZOLE 1% 30GM CRM (LOTRIMIN),250,RC,,,,both,29.35,26.42,United Healthcare,Default,Fee Schedule,23.95,,,,17.32,23.95
B TOTAL LIQ 30 ML DROPPER BOTTLE,250,RC,,,,both,31.25,28.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.88,,,,18.44,25.5
B TOTAL LIQ 30 ML DROPPER BOTTLE,250,RC,,,,both,31.25,28.13,Cigna,Default,Percent of Total Billed Charges,18.44,,,,18.44,25.5
B TOTAL LIQ 30 ML DROPPER BOTTLE,250,RC,,,,both,31.25,28.13,United Healthcare,Default,Fee Schedule,25.5,,,,18.44,25.5
MOXIFLOXACIN 400MG/250ML PREMIX IVPB (AV,J2280,HCPCS,636,RC,,both,140.91,126.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,98.64,,,,83.14,114.98
MOXIFLOXACIN 400MG/250ML PREMIX IVPB (AV,J2280,HCPCS,636,RC,,both,140.91,126.82,Cigna,Default,Percent of Total Billed Charges,83.14,,,,83.14,114.98
MOXIFLOXACIN 400MG/250ML PREMIX IVPB (AV,J2280,HCPCS,636,RC,,both,140.91,126.82,United Healthcare,Default,Fee Schedule,114.98,,,,83.14,114.98
ACETAMINOPHEN 160MG/5ML U/D CUPS (TYLENO,637,RC,,,,both,6.95,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.1,5.67
ACETAMINOPHEN 160MG/5ML U/D CUPS (TYLENO,637,RC,,,,both,6.95,6.26,Cigna,Default,Percent of Total Billed Charges,4.1,,,,4.1,5.67
ACETAMINOPHEN 160MG/5ML U/D CUPS (TYLENO,637,RC,,,,both,6.95,6.26,United Healthcare,Default,Fee Schedule,5.67,,,,4.1,5.67
QUETIAPINE 100MG TAB (SEROQUEL),637,RC,,,,both,15.76,14.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.03,,,,9.3,12.86
QUETIAPINE 100MG TAB (SEROQUEL),637,RC,,,,both,15.76,14.18,Cigna,Default,Percent of Total Billed Charges,9.3,,,,9.3,12.86
QUETIAPINE 100MG TAB (SEROQUEL),637,RC,,,,both,15.76,14.18,United Healthcare,Default,Fee Schedule,12.86,,,,9.3,12.86
RIVASTIGIMINE 3MG CAP (EXELON),250,RC,,,,both,13.55,12.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.48,,,,7.99,11.06
RIVASTIGIMINE 3MG CAP (EXELON),250,RC,,,,both,13.55,12.2,Cigna,Default,Percent of Total Billed Charges,7.99,,,,7.99,11.06
RIVASTIGIMINE 3MG CAP (EXELON),250,RC,,,,both,13.55,12.2,United Healthcare,Default,Fee Schedule,11.06,,,,7.99,11.06
RIVASTIGMINE 1.5MG CAP (EXELON),250,RC,,,,both,14.24,12.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.97,,,,8.4,11.62
RIVASTIGMINE 1.5MG CAP (EXELON),250,RC,,,,both,14.24,12.82,Cigna,Default,Percent of Total Billed Charges,8.4,,,,8.4,11.62
RIVASTIGMINE 1.5MG CAP (EXELON),250,RC,,,,both,14.24,12.82,United Healthcare,Default,Fee Schedule,11.62,,,,8.4,11.62
MEMANTINE 5MG TAB (NAMENDA),637,RC,,,,both,10.78,9.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.55,,,,6.36,8.8
MEMANTINE 5MG TAB (NAMENDA),637,RC,,,,both,10.78,9.7,Cigna,Default,Percent of Total Billed Charges,6.36,,,,6.36,8.8
MEMANTINE 5MG TAB (NAMENDA),637,RC,,,,both,10.78,9.7,United Healthcare,Default,Fee Schedule,8.8,,,,6.36,8.8
MENOMUNE-A/C/Y/W-135  INJ 0.05MG,250,RC,,,,both,625.71,563.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,438,,,,369.17,510.58
MENOMUNE-A/C/Y/W-135  INJ 0.05MG,250,RC,,,,both,625.71,563.14,Cigna,Default,Percent of Total Billed Charges,369.17,,,,369.17,510.58
MENOMUNE-A/C/Y/W-135  INJ 0.05MG,250,RC,,,,both,625.71,563.14,United Healthcare,Default,Fee Schedule,510.58,,,,369.17,510.58
PREGABALIN 50MG CAP (LYRICA),250,RC,,,,both,42.39,38.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.67,,,,25.01,34.59
PREGABALIN 50MG CAP (LYRICA),250,RC,,,,both,42.39,38.15,Cigna,Default,Percent of Total Billed Charges,25.01,,,,25.01,34.59
PREGABALIN 50MG CAP (LYRICA),250,RC,,,,both,42.39,38.15,United Healthcare,Default,Fee Schedule,34.59,,,,25.01,34.59
MEGESTROL 20MG TAB (MEGACE),J3475,HCPCS,636,RC,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
MEGESTROL 20MG TAB (MEGACE),J3475,HCPCS,636,RC,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
MEGESTROL 20MG TAB (MEGACE),J3475,HCPCS,636,RC,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CARBOXYMETHYLCELLULOSE OPHTH DROP 15ML,637,RC,,,,both,32.25,29.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.58,,,,19.03,26.32
CARBOXYMETHYLCELLULOSE OPHTH DROP 15ML,637,RC,,,,both,32.25,29.03,Cigna,Default,Percent of Total Billed Charges,19.03,,,,19.03,26.32
CARBOXYMETHYLCELLULOSE OPHTH DROP 15ML,637,RC,,,,both,32.25,29.03,United Healthcare,Default,Fee Schedule,26.32,,,,19.03,26.32
PREGABALIN 75MG CAP (LYRICA),637,RC,,,,both,30.68,27.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.48,,,,18.1,25.03
PREGABALIN 75MG CAP (LYRICA),637,RC,,,,both,30.68,27.61,Cigna,Default,Percent of Total Billed Charges,18.1,,,,18.1,25.03
PREGABALIN 75MG CAP (LYRICA),637,RC,,,,both,30.68,27.61,United Healthcare,Default,Fee Schedule,25.03,,,,18.1,25.03
RANOLAZINE 500MG TAB (RANEXA),637,RC,,,,both,16.57,14.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.6,,,,9.78,13.52
RANOLAZINE 500MG TAB (RANEXA),637,RC,,,,both,16.57,14.91,Cigna,Default,Percent of Total Billed Charges,9.78,,,,9.78,13.52
RANOLAZINE 500MG TAB (RANEXA),637,RC,,,,both,16.57,14.91,United Healthcare,Default,Fee Schedule,13.52,,,,9.78,13.52
BIVALIRUDIN 250MG INJ (ANGIOMAX),J0583,HCPCS,636,RC,,both,1988.35,1789.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1391.84,,,,1173.13,1622.49
BIVALIRUDIN 250MG INJ (ANGIOMAX),J0583,HCPCS,636,RC,,both,1988.35,1789.52,Cigna,Default,Percent of Total Billed Charges,1173.13,,,,1173.13,1622.49
BIVALIRUDIN 250MG INJ (ANGIOMAX),J0583,HCPCS,636,RC,,both,1988.35,1789.52,United Healthcare,Default,Fee Schedule,1622.49,,,,1173.13,1622.49
SOLIFENACIN 5MG TAB (VESICARE),637,RC,,,,both,39.15,35.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.4,,,,23.1,31.95
SOLIFENACIN 5MG TAB (VESICARE),637,RC,,,,both,39.15,35.24,Cigna,Default,Percent of Total Billed Charges,23.1,,,,23.1,31.95
SOLIFENACIN 5MG TAB (VESICARE),637,RC,,,,both,39.15,35.24,United Healthcare,Default,Fee Schedule,31.95,,,,23.1,31.95
DICLOFENAC&MISOPROSTOL 50MG TAB (ARTHROT,637,RC,,,,both,9.41,8.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.59,,,,5.55,7.68
DICLOFENAC&MISOPROSTOL 50MG TAB (ARTHROT,637,RC,,,,both,9.41,8.47,Cigna,Default,Percent of Total Billed Charges,5.55,,,,5.55,7.68
DICLOFENAC&MISOPROSTOL 50MG TAB (ARTHROT,637,RC,,,,both,9.41,8.47,United Healthcare,Default,Fee Schedule,7.68,,,,5.55,7.68
MILRINONE 20MG/100ML PREMIX (PRIMACOR),J2260,HCPCS,250,RC,,both,82,73.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.4,,,,48.38,66.91
MILRINONE 20MG/100ML PREMIX (PRIMACOR),J2260,HCPCS,250,RC,,both,82,73.8,Cigna,Default,Percent of Total Billed Charges,48.38,,,,48.38,66.91
MILRINONE 20MG/100ML PREMIX (PRIMACOR),J2260,HCPCS,250,RC,,both,82,73.8,United Healthcare,Default,Fee Schedule,66.91,,,,48.38,66.91
PIOGLITAZONE 30MG TAB (ACTOS),637,RC,,,,both,26.83,24.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.78,,,,15.83,21.89
PIOGLITAZONE 30MG TAB (ACTOS),637,RC,,,,both,26.83,24.15,Cigna,Default,Percent of Total Billed Charges,15.83,,,,15.83,21.89
PIOGLITAZONE 30MG TAB (ACTOS),637,RC,,,,both,26.83,24.15,United Healthcare,Default,Fee Schedule,21.89,,,,15.83,21.89
JUZO COMPRESSION STOCKINGS,250,RC,,,,both,90.94,81.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.66,,,,53.65,74.21
JUZO COMPRESSION STOCKINGS,250,RC,,,,both,90.94,81.85,Cigna,Default,Percent of Total Billed Charges,53.65,,,,53.65,74.21
JUZO COMPRESSION STOCKINGS,250,RC,,,,both,90.94,81.85,United Healthcare,Default,Fee Schedule,74.21,,,,53.65,74.21
CEPASTAT LOZENGE,250,RC,,,,both,13.37,12.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.36,,,,7.89,10.91
CEPASTAT LOZENGE,250,RC,,,,both,13.37,12.03,Cigna,Default,Percent of Total Billed Charges,7.89,,,,7.89,10.91
CEPASTAT LOZENGE,250,RC,,,,both,13.37,12.03,United Healthcare,Default,Fee Schedule,10.91,,,,7.89,10.91
GLIPIZIDE XL 2.5MG TAB (GLUCOTROL XL),250,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
GLIPIZIDE XL 2.5MG TAB (GLUCOTROL XL),250,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
GLIPIZIDE XL 2.5MG TAB (GLUCOTROL XL),250,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
VARENICLINE 0.5MG TAB(1 CARD OF 11 TABS),250,RC,,,,both,65.75,59.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.02,,,,38.79,53.65
VARENICLINE 0.5MG TAB(1 CARD OF 11 TABS),250,RC,,,,both,65.75,59.18,Cigna,Default,Percent of Total Billed Charges,38.79,,,,38.79,53.65
VARENICLINE 0.5MG TAB(1 CARD OF 11 TABS),250,RC,,,,both,65.75,59.18,United Healthcare,Default,Fee Schedule,53.65,,,,38.79,53.65
VARENICLINE 1MG TAB (1 CARD OF 28 TAB),250,RC,,,,both,174.25,156.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,121.98,,,,102.81,142.19
VARENICLINE 1MG TAB (1 CARD OF 28 TAB),250,RC,,,,both,174.25,156.83,Cigna,Default,Percent of Total Billed Charges,102.81,,,,102.81,142.19
VARENICLINE 1MG TAB (1 CARD OF 28 TAB),250,RC,,,,both,174.25,156.83,United Healthcare,Default,Fee Schedule,142.19,,,,102.81,142.19
HYDROCODONE/APAP 7.5/325MG 15 ML ELIXIR,637,RC,,,,both,14.93,13.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.45,,,,8.81,12.18
HYDROCODONE/APAP 7.5/325MG 15 ML ELIXIR,637,RC,,,,both,14.93,13.44,Cigna,Default,Percent of Total Billed Charges,8.81,,,,8.81,12.18
HYDROCODONE/APAP 7.5/325MG 15 ML ELIXIR,637,RC,,,,both,14.93,13.44,United Healthcare,Default,Fee Schedule,12.18,,,,8.81,12.18
HYDROMORPHONE 2MG TAB (DILAUDID),250,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
HYDROMORPHONE 2MG TAB (DILAUDID),250,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
HYDROMORPHONE 2MG TAB (DILAUDID),250,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
RIFAXIMIN 200MG TAB (XIFAXIN),250,RC,,,,both,70.55,63.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.38,,,,41.62,57.57
RIFAXIMIN 200MG TAB (XIFAXIN),250,RC,,,,both,70.55,63.5,Cigna,Default,Percent of Total Billed Charges,41.62,,,,41.62,57.57
RIFAXIMIN 200MG TAB (XIFAXIN),250,RC,,,,both,70.55,63.5,United Healthcare,Default,Fee Schedule,57.57,,,,41.62,57.57
OXYCODONE/APAP 5/325MG TAB (PERCOCET),637,RC,,,,both,11.68,10.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.18,,,,6.89,9.53
OXYCODONE/APAP 5/325MG TAB (PERCOCET),637,RC,,,,both,11.68,10.51,Cigna,Default,Percent of Total Billed Charges,6.89,,,,6.89,9.53
OXYCODONE/APAP 5/325MG TAB (PERCOCET),637,RC,,,,both,11.68,10.51,United Healthcare,Default,Fee Schedule,9.53,,,,6.89,9.53
OSELTAMIVIR 75MG CAP (TAMIFLU),637,RC,,,,both,71.86,64.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.3,,,,42.4,58.64
OSELTAMIVIR 75MG CAP (TAMIFLU),637,RC,,,,both,71.86,64.67,Cigna,Default,Percent of Total Billed Charges,42.4,,,,42.4,58.64
OSELTAMIVIR 75MG CAP (TAMIFLU),637,RC,,,,both,71.86,64.67,United Healthcare,Default,Fee Schedule,58.64,,,,42.4,58.64
DEMECLOCYCLINE 150MG TAB,250,RC,,,,both,47.04,42.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.93,,,,27.75,38.38
DEMECLOCYCLINE 150MG TAB,250,RC,,,,both,47.04,42.34,Cigna,Default,Percent of Total Billed Charges,27.75,,,,27.75,38.38
DEMECLOCYCLINE 150MG TAB,250,RC,,,,both,47.04,42.34,United Healthcare,Default,Fee Schedule,38.38,,,,27.75,38.38
FIBERSOURCE (TUBE FEED),250,RC,,,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
FIBERSOURCE (TUBE FEED),250,RC,,,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
FIBERSOURCE (TUBE FEED),250,RC,,,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
BOOST HIGH PROTEIN,250,RC,,,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
BOOST HIGH PROTEIN,250,RC,,,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
BOOST HIGH PROTEIN,250,RC,,,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
LEVETIRACETAM 500MG TAB (KEPPRA),637,RC,,,,both,15.39,13.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.77,,,,9.08,12.56
LEVETIRACETAM 500MG TAB (KEPPRA),637,RC,,,,both,15.39,13.85,Cigna,Default,Percent of Total Billed Charges,9.08,,,,9.08,12.56
LEVETIRACETAM 500MG TAB (KEPPRA),637,RC,,,,both,15.39,13.85,United Healthcare,Default,Fee Schedule,12.56,,,,9.08,12.56
IBUPROFEN 100MG/5ML U/D CUP,637,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
IBUPROFEN 100MG/5ML U/D CUP,637,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
IBUPROFEN 100MG/5ML U/D CUP,637,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
ALTEPLASE 100MG INJ  (ACTIVASE),J2997,HCPCS,636,RC,,both,45509.85,40958.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31856.9,,,,26850.81,37136.04
ALTEPLASE 100MG INJ  (ACTIVASE),J2997,HCPCS,636,RC,,both,45509.85,40958.87,Cigna,Default,Percent of Total Billed Charges,26850.81,,,,26850.81,37136.04
ALTEPLASE 100MG INJ  (ACTIVASE),J2997,HCPCS,636,RC,,both,45509.85,40958.87,United Healthcare,Default,Fee Schedule,37136.04,,,,26850.81,37136.04
MORPHINE 0.5MG/ML 10 ML VIAL (DURAMORPH),J2274,HCPCS,636,RC,,both,476.76,429.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,333.73,,,,281.29,389.04
MORPHINE 0.5MG/ML 10 ML VIAL (DURAMORPH),J2274,HCPCS,636,RC,,both,476.76,429.08,Cigna,Default,Percent of Total Billed Charges,281.29,,,,281.29,389.04
MORPHINE 0.5MG/ML 10 ML VIAL (DURAMORPH),J2274,HCPCS,636,RC,,both,476.76,429.08,United Healthcare,Default,Fee Schedule,389.04,,,,281.29,389.04
MISOPROSTOL 200MCG TAB (CYTOTEC),637,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
MISOPROSTOL 200MCG TAB (CYTOTEC),637,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
MISOPROSTOL 200MCG TAB (CYTOTEC),637,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
FENTANYL 2500MCG/50ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,34,30.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.8,,,,20.06,27.74
FENTANYL 2500MCG/50ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,34,30.6,Cigna,Default,Percent of Total Billed Charges,20.06,,,,20.06,27.74
FENTANYL 2500MCG/50ML INJ (SUBLIMAZE),J3010,HCPCS,636,RC,,both,34,30.6,United Healthcare,Default,Fee Schedule,27.74,,,,20.06,27.74
AMMONIA INHALANTS,250,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
AMMONIA INHALANTS,250,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
AMMONIA INHALANTS,250,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
AMMONIUM LACTATE 12% CRM (LAC-HYDRIN),250,RC,,,,both,54.34,48.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.04,,,,32.06,44.34
AMMONIUM LACTATE 12% CRM (LAC-HYDRIN),250,RC,,,,both,54.34,48.91,Cigna,Default,Percent of Total Billed Charges,32.06,,,,32.06,44.34
AMMONIUM LACTATE 12% CRM (LAC-HYDRIN),250,RC,,,,both,54.34,48.91,United Healthcare,Default,Fee Schedule,44.34,,,,32.06,44.34
CYANIDE ANTIDOTE KIT,250,RC,,,,both,738.5,664.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,516.95,,,,435.72,602.62
CYANIDE ANTIDOTE KIT,250,RC,,,,both,738.5,664.65,Cigna,Default,Percent of Total Billed Charges,435.72,,,,435.72,602.62
CYANIDE ANTIDOTE KIT,250,RC,,,,both,738.5,664.65,United Healthcare,Default,Fee Schedule,602.62,,,,435.72,602.62
CLIDINIUM/CPZ 5MG/2.5MG CAP (LIBRAX),250,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
CLIDINIUM/CPZ 5MG/2.5MG CAP (LIBRAX),250,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
CLIDINIUM/CPZ 5MG/2.5MG CAP (LIBRAX),250,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
COLLODION FLEXIBLE 5 ML,250,RC,,,,both,445.57,401.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,311.9,,,,262.89,363.59
COLLODION FLEXIBLE 5 ML,250,RC,,,,both,445.57,401.01,Cigna,Default,Percent of Total Billed Charges,262.89,,,,262.89,363.59
COLLODION FLEXIBLE 5 ML,250,RC,,,,both,445.57,401.01,United Healthcare,Default,Fee Schedule,363.59,,,,262.89,363.59
HEPATITIS A VACCINE INACTIVATED (HAVRIX),250,RC,,,,both,305.64,275.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,213.95,,,,180.33,249.4
HEPATITIS A VACCINE INACTIVATED (HAVRIX),250,RC,,,,both,305.64,275.08,Cigna,Default,Percent of Total Billed Charges,180.33,,,,180.33,249.4
HEPATITIS A VACCINE INACTIVATED (HAVRIX),250,RC,,,,both,305.64,275.08,United Healthcare,Default,Fee Schedule,249.4,,,,180.33,249.4
GLUCAGON 1MG INJ (GLUCAGEN),J1610,HCPCS,636,RC,,both,1444.8,1300.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1011.36,,,,852.43,1178.96
GLUCAGON 1MG INJ (GLUCAGEN),J1610,HCPCS,636,RC,,both,1444.8,1300.32,Cigna,Default,Percent of Total Billed Charges,852.43,,,,852.43,1178.96
GLUCAGON 1MG INJ (GLUCAGEN),J1610,HCPCS,636,RC,,both,1444.8,1300.32,United Healthcare,Default,Fee Schedule,1178.96,,,,852.43,1178.96
GLUCOSE TAB,250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
GLUCOSE TAB,250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
GLUCOSE TAB,250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
HYDROCORTISONE 500MG/4ML INJ (SOLU-CORTE,J1720,HCPCS,636,RC,,both,61.59,55.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.11,,,,36.34,50.26
HYDROCORTISONE 500MG/4ML INJ (SOLU-CORTE,J1720,HCPCS,636,RC,,both,61.59,55.43,Cigna,Default,Percent of Total Billed Charges,36.34,,,,36.34,50.26
HYDROCORTISONE 500MG/4ML INJ (SOLU-CORTE,J1720,HCPCS,636,RC,,both,61.59,55.43,United Healthcare,Default,Fee Schedule,50.26,,,,36.34,50.26
ADENOSINE 90MG/30ML VIAL (ADENOCARD),J0153,HCPCS,636,RC,,both,977.11,879.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,683.98,,,,576.49,797.32
ADENOSINE 90MG/30ML VIAL (ADENOCARD),J0153,HCPCS,636,RC,,both,977.11,879.4,Cigna,Default,Percent of Total Billed Charges,576.49,,,,576.49,797.32
ADENOSINE 90MG/30ML VIAL (ADENOCARD),J0153,HCPCS,636,RC,,both,977.11,879.4,United Healthcare,Default,Fee Schedule,797.32,,,,576.49,797.32
ZOLEDRONIC ACID 5MG/100ML PREMIX (RECLAS,J3489,HCPCS,636,RC,,both,4669.25,4202.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3268.48,,,,2754.86,3810.11
ZOLEDRONIC ACID 5MG/100ML PREMIX (RECLAS,J3489,HCPCS,636,RC,,both,4669.25,4202.33,Cigna,Default,Percent of Total Billed Charges,2754.86,,,,2754.86,3810.11
ZOLEDRONIC ACID 5MG/100ML PREMIX (RECLAS,J3489,HCPCS,636,RC,,both,4669.25,4202.33,United Healthcare,Default,Fee Schedule,3810.11,,,,2754.86,3810.11
LIDOCAINE-MPF 2% VIAL 5ML (XYLOCAINE-MPF,250,RC,,,,both,27.93,25.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.55,,,,16.48,22.79
LIDOCAINE-MPF 2% VIAL 5ML (XYLOCAINE-MPF,250,RC,,,,both,27.93,25.14,Cigna,Default,Percent of Total Billed Charges,16.48,,,,16.48,22.79
LIDOCAINE-MPF 2% VIAL 5ML (XYLOCAINE-MPF,250,RC,,,,both,27.93,25.14,United Healthcare,Default,Fee Schedule,22.79,,,,16.48,22.79
NEO/POLY/BACT OPHTH OINT (NESPORIN OPHTH,250,RC,,,,both,25.57,23.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.9,,,,15.09,20.87
NEO/POLY/BACT OPHTH OINT (NESPORIN OPHTH,250,RC,,,,both,25.57,23.01,Cigna,Default,Percent of Total Billed Charges,15.09,,,,15.09,20.87
NEO/POLY/BACT OPHTH OINT (NESPORIN OPHTH,250,RC,,,,both,25.57,23.01,United Healthcare,Default,Fee Schedule,20.87,,,,15.09,20.87
MOMETASONE FUROATE 0.1% 15GM CRM (ELOCON,637,RC,,,,both,109.25,98.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,76.48,,,,64.46,89.15
MOMETASONE FUROATE 0.1% 15GM CRM (ELOCON,637,RC,,,,both,109.25,98.33,Cigna,Default,Percent of Total Billed Charges,64.46,,,,64.46,89.15
MOMETASONE FUROATE 0.1% 15GM CRM (ELOCON,637,RC,,,,both,109.25,98.33,United Healthcare,Default,Fee Schedule,89.15,,,,64.46,89.15
LUBIPROSTONE 24MCG CAP (AMITIZA),637,RC,,,,both,16.28,14.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.4,,,,9.61,13.28
LUBIPROSTONE 24MCG CAP (AMITIZA),637,RC,,,,both,16.28,14.65,Cigna,Default,Percent of Total Billed Charges,9.61,,,,9.61,13.28
LUBIPROSTONE 24MCG CAP (AMITIZA),637,RC,,,,both,16.28,14.65,United Healthcare,Default,Fee Schedule,13.28,,,,9.61,13.28
HYDROCODONE/APAP TAB 10/325 MG (NORCO),637,RC,,,,both,7.19,6.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.03,,,,4.24,5.87
HYDROCODONE/APAP TAB 10/325 MG (NORCO),637,RC,,,,both,7.19,6.47,Cigna,Default,Percent of Total Billed Charges,4.24,,,,4.24,5.87
HYDROCODONE/APAP TAB 10/325 MG (NORCO),637,RC,,,,both,7.19,6.47,United Healthcare,Default,Fee Schedule,5.87,,,,4.24,5.87
SEVOFLURANE INHALATION ANESTHETIC (ULTAN,250,RC,,,,both,930.9,837.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,651.63,,,,549.23,759.61
SEVOFLURANE INHALATION ANESTHETIC (ULTAN,250,RC,,,,both,930.9,837.81,Cigna,Default,Percent of Total Billed Charges,549.23,,,,549.23,759.61
SEVOFLURANE INHALATION ANESTHETIC (ULTAN,250,RC,,,,both,930.9,837.81,United Healthcare,Default,Fee Schedule,759.61,,,,549.23,759.61
VASELINE 2.5OZ TUBE,250,RC,,,,both,8.13,7.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.69,,,,4.8,6.63
VASELINE 2.5OZ TUBE,250,RC,,,,both,8.13,7.32,Cigna,Default,Percent of Total Billed Charges,4.8,,,,4.8,6.63
VASELINE 2.5OZ TUBE,250,RC,,,,both,8.13,7.32,United Healthcare,Default,Fee Schedule,6.63,,,,4.8,6.63
ETOMIDATE 20MG/10ML AMP (AMIDATE),250,RC,,,,both,95.59,86.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.91,,,,56.4,78
ETOMIDATE 20MG/10ML AMP (AMIDATE),250,RC,,,,both,95.59,86.03,Cigna,Default,Percent of Total Billed Charges,56.4,,,,56.4,78
ETOMIDATE 20MG/10ML AMP (AMIDATE),250,RC,,,,both,95.59,86.03,United Healthcare,Default,Fee Schedule,78,,,,56.4,78
PROBIOTIC CAP,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
PROBIOTIC CAP,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
PROBIOTIC CAP,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
FENTANYL 12 MCG/HR PATCH (DURAGESIC),250,RC,,,,both,94.37,84.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.06,,,,55.68,77.01
FENTANYL 12 MCG/HR PATCH (DURAGESIC),250,RC,,,,both,94.37,84.93,Cigna,Default,Percent of Total Billed Charges,55.68,,,,55.68,77.01
FENTANYL 12 MCG/HR PATCH (DURAGESIC),250,RC,,,,both,94.37,84.93,United Healthcare,Default,Fee Schedule,77.01,,,,55.68,77.01
DICLOFENAC 1% 100GM TOPICAL GEL  (VOLTAR,637,RC,,,,both,268.23,241.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.76,,,,158.26,218.88
DICLOFENAC 1% 100GM TOPICAL GEL  (VOLTAR,637,RC,,,,both,268.23,241.41,Cigna,Default,Percent of Total Billed Charges,158.26,,,,158.26,218.88
DICLOFENAC 1% 100GM TOPICAL GEL  (VOLTAR,637,RC,,,,both,268.23,241.41,United Healthcare,Default,Fee Schedule,218.88,,,,158.26,218.88
ASPIRIN & DIPYRIDAMOL 200MG CAP (AGGRENO,637,RC,,,,both,10.78,9.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.55,,,,6.36,8.8
ASPIRIN & DIPYRIDAMOL 200MG CAP (AGGRENO,637,RC,,,,both,10.78,9.7,Cigna,Default,Percent of Total Billed Charges,6.36,,,,6.36,8.8
ASPIRIN & DIPYRIDAMOL 200MG CAP (AGGRENO,637,RC,,,,both,10.78,9.7,United Healthcare,Default,Fee Schedule,8.8,,,,6.36,8.8
OXCARBAZEPINE 150MG TAB (TRILEPTAL),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
OXCARBAZEPINE 150MG TAB (TRILEPTAL),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
OXCARBAZEPINE 150MG TAB (TRILEPTAL),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
MAGIC MOUTHWASH 120 ML,250,RC,,,,both,609.78,548.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,426.85,,,,359.77,497.58
MAGIC MOUTHWASH 120 ML,250,RC,,,,both,609.78,548.8,Cigna,Default,Percent of Total Billed Charges,359.77,,,,359.77,497.58
MAGIC MOUTHWASH 120 ML,250,RC,,,,both,609.78,548.8,United Healthcare,Default,Fee Schedule,497.58,,,,359.77,497.58
ABELCET B LIPOSOMAL 100MG VIAL,J0287,HCPCS,250,RC,,both,794.5,715.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,556.15,,,,468.76,648.31
ABELCET B LIPOSOMAL 100MG VIAL,J0287,HCPCS,250,RC,,both,794.5,715.05,Cigna,Default,Percent of Total Billed Charges,468.76,,,,468.76,648.31
ABELCET B LIPOSOMAL 100MG VIAL,J0287,HCPCS,250,RC,,both,794.5,715.05,United Healthcare,Default,Fee Schedule,648.31,,,,468.76,648.31
URSODIOL 300MG CAP (ACTIGALL),637,RC,,,,both,9.41,8.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.59,,,,5.55,7.68
URSODIOL 300MG CAP (ACTIGALL),637,RC,,,,both,9.41,8.47,Cigna,Default,Percent of Total Billed Charges,5.55,,,,5.55,7.68
URSODIOL 300MG CAP (ACTIGALL),637,RC,,,,both,9.41,8.47,United Healthcare,Default,Fee Schedule,7.68,,,,5.55,7.68
GANCICLOVIR 500MG INJ (CYTOVENE),J1570,HCPCS,636,RC,,both,257.13,231.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,179.99,,,,151.71,209.82
GANCICLOVIR 500MG INJ (CYTOVENE),J1570,HCPCS,636,RC,,both,257.13,231.42,Cigna,Default,Percent of Total Billed Charges,151.71,,,,151.71,209.82
GANCICLOVIR 500MG INJ (CYTOVENE),J1570,HCPCS,636,RC,,both,257.13,231.42,United Healthcare,Default,Fee Schedule,209.82,,,,151.71,209.82
CYCLOSPORINE 25MG MICRO (NEORAL),637,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
CYCLOSPORINE 25MG MICRO (NEORAL),637,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
CYCLOSPORINE 25MG MICRO (NEORAL),637,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
VENLAFAXINE XR 75MG CAP (EFFEXOR),250,RC,,,,both,17.14,15.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12,,,,10.11,13.99
VENLAFAXINE XR 75MG CAP (EFFEXOR),250,RC,,,,both,17.14,15.43,Cigna,Default,Percent of Total Billed Charges,10.11,,,,10.11,13.99
VENLAFAXINE XR 75MG CAP (EFFEXOR),250,RC,,,,both,17.14,15.43,United Healthcare,Default,Fee Schedule,13.99,,,,10.11,13.99
DIVALPROEX ER 250MG TAB (DEPAKOTE),250,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
DIVALPROEX ER 250MG TAB (DEPAKOTE),250,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
DIVALPROEX ER 250MG TAB (DEPAKOTE),250,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
AZITHROMYCIN 500MG INJ (ZITHROMAX),J0456,HCPCS,636,RC,,both,79.32,71.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.52,,,,46.8,64.73
AZITHROMYCIN 500MG INJ (ZITHROMAX),J0456,HCPCS,636,RC,,both,79.32,71.39,Cigna,Default,Percent of Total Billed Charges,46.8,,,,46.8,64.73
AZITHROMYCIN 500MG INJ (ZITHROMAX),J0456,HCPCS,636,RC,,both,79.32,71.39,United Healthcare,Default,Fee Schedule,64.73,,,,46.8,64.73
PEPTINEX 240 ML ORAL FEED,250,RC,,,,both,43.5,39.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.45,,,,25.66,35.5
PEPTINEX 240 ML ORAL FEED,250,RC,,,,both,43.5,39.15,Cigna,Default,Percent of Total Billed Charges,25.66,,,,25.66,35.5
PEPTINEX 240 ML ORAL FEED,250,RC,,,,both,43.5,39.15,United Healthcare,Default,Fee Schedule,35.5,,,,25.66,35.5
MEROPENEM 1GM IV (MERREM),J2185,HCPCS,250,RC,,both,261.5,235.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.05,,,,154.28,213.38
MEROPENEM 1GM IV (MERREM),J2185,HCPCS,250,RC,,both,261.5,235.35,Cigna,Default,Percent of Total Billed Charges,154.28,,,,154.28,213.38
MEROPENEM 1GM IV (MERREM),J2185,HCPCS,250,RC,,both,261.5,235.35,United Healthcare,Default,Fee Schedule,213.38,,,,154.28,213.38
IMMUNE GLOBULIN 5GM VIAL (GAMMAGARD S/D),250,RC,,,,both,1711.89,1540.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1198.32,,,,1010.02,1396.9
IMMUNE GLOBULIN 5GM VIAL (GAMMAGARD S/D),250,RC,,,,both,1711.89,1540.7,Cigna,Default,Percent of Total Billed Charges,1010.02,,,,1010.02,1396.9
IMMUNE GLOBULIN 5GM VIAL (GAMMAGARD S/D),250,RC,,,,both,1711.89,1540.7,United Healthcare,Default,Fee Schedule,1396.9,,,,1010.02,1396.9
"VIT D 50,000IU CAP (ERGOCALCIFEROL)",637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
"VIT D 50,000IU CAP (ERGOCALCIFEROL)",637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
"VIT D 50,000IU CAP (ERGOCALCIFEROL)",637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ESCITALOPAM 10 MG TAB (LEXAPRO),250,RC,,,,both,11.9,10.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.33,,,,7.02,9.71
ESCITALOPAM 10 MG TAB (LEXAPRO),250,RC,,,,both,11.9,10.71,Cigna,Default,Percent of Total Billed Charges,7.02,,,,7.02,9.71
ESCITALOPAM 10 MG TAB (LEXAPRO),250,RC,,,,both,11.9,10.71,United Healthcare,Default,Fee Schedule,9.71,,,,7.02,9.71
NAFCILLIN 2000MG INJ,250,RC,,,,both,72.75,65.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.92,,,,42.92,59.36
NAFCILLIN 2000MG INJ,250,RC,,,,both,72.75,65.48,Cigna,Default,Percent of Total Billed Charges,42.92,,,,42.92,59.36
NAFCILLIN 2000MG INJ,250,RC,,,,both,72.75,65.48,United Healthcare,Default,Fee Schedule,59.36,,,,42.92,59.36
OXACILLIN 2GM ADV INJ,250,RC,,,,both,87.25,78.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.08,,,,51.48,71.2
OXACILLIN 2GM ADV INJ,250,RC,,,,both,87.25,78.53,Cigna,Default,Percent of Total Billed Charges,51.48,,,,51.48,71.2
OXACILLIN 2GM ADV INJ,250,RC,,,,both,87.25,78.53,United Healthcare,Default,Fee Schedule,71.2,,,,51.48,71.2
CHLORTHALIDONE 50MG TAB (THALITONE),250,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CHLORTHALIDONE 50MG TAB (THALITONE),250,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CHLORTHALIDONE 50MG TAB (THALITONE),250,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
PYRIDOXINE  B6 25MG,637,RC,,,,both,7.85,7.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.5,,,,4.63,6.41
PYRIDOXINE  B6 25MG,637,RC,,,,both,7.85,7.07,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.41
PYRIDOXINE  B6 25MG,637,RC,,,,both,7.85,7.07,United Healthcare,Default,Fee Schedule,6.41,,,,4.63,6.41
HALFLYTELY BOWEL PREP W/BISAC TAB,250,RC,,,,both,222.56,200.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,155.79,,,,131.31,181.61
HALFLYTELY BOWEL PREP W/BISAC TAB,250,RC,,,,both,222.56,200.3,Cigna,Default,Percent of Total Billed Charges,131.31,,,,131.31,181.61
HALFLYTELY BOWEL PREP W/BISAC TAB,250,RC,,,,both,222.56,200.3,United Healthcare,Default,Fee Schedule,181.61,,,,131.31,181.61
PROPOFOL 500MG/50ML INJ,250,RC,,,,both,96.75,87.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.72,,,,57.08,78.95
PROPOFOL 500MG/50ML INJ,250,RC,,,,both,96.75,87.08,Cigna,Default,Percent of Total Billed Charges,57.08,,,,57.08,78.95
PROPOFOL 500MG/50ML INJ,250,RC,,,,both,96.75,87.08,United Healthcare,Default,Fee Schedule,78.95,,,,57.08,78.95
VITAMIN B-12 500MCG TAB,637,RC,,,,both,6.63,5.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.64,,,,3.91,5.41
VITAMIN B-12 500MCG TAB,637,RC,,,,both,6.63,5.97,Cigna,Default,Percent of Total Billed Charges,3.91,,,,3.91,5.41
VITAMIN B-12 500MCG TAB,637,RC,,,,both,6.63,5.97,United Healthcare,Default,Fee Schedule,5.41,,,,3.91,5.41
MORPHINE SULFATE 4MG/ML INJ,J2270,HCPCS,636,RC,,both,29.86,26.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.9,,,,17.62,24.37
MORPHINE SULFATE 4MG/ML INJ,J2270,HCPCS,636,RC,,both,29.86,26.87,Cigna,Default,Percent of Total Billed Charges,17.62,,,,17.62,24.37
MORPHINE SULFATE 4MG/ML INJ,J2270,HCPCS,636,RC,,both,29.86,26.87,United Healthcare,Default,Fee Schedule,24.37,,,,17.62,24.37
PREDNISOLONE 15MG/5ML ELIXIR (PEDIAPRED),J7510,HCPCS,636,RC,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
PREDNISOLONE 15MG/5ML ELIXIR (PEDIAPRED),J7510,HCPCS,636,RC,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
PREDNISOLONE 15MG/5ML ELIXIR (PEDIAPRED),J7510,HCPCS,636,RC,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
METRONIDAZOLE 20MG/ML SUSP,250,RC,,,,both,12.78,11.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.95,,,,7.54,10.43
METRONIDAZOLE 20MG/ML SUSP,250,RC,,,,both,12.78,11.5,Cigna,Default,Percent of Total Billed Charges,7.54,,,,7.54,10.43
METRONIDAZOLE 20MG/ML SUSP,250,RC,,,,both,12.78,11.5,United Healthcare,Default,Fee Schedule,10.43,,,,7.54,10.43
VITAMIN D3 1000U (25MCG) TAB,637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
VITAMIN D3 1000U (25MCG) TAB,637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
VITAMIN D3 1000U (25MCG) TAB,637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
INSULIN GLARGINE 100U/ML 10 ML VIAL (LA,J1815,HCPCS,636,RC,,both,393.24,353.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,275.27,,,,232.01,320.88
INSULIN GLARGINE 100U/ML 10 ML VIAL (LA,J1815,HCPCS,636,RC,,both,393.24,353.92,Cigna,Default,Percent of Total Billed Charges,232.01,,,,232.01,320.88
INSULIN GLARGINE 100U/ML 10 ML VIAL (LA,J1815,HCPCS,636,RC,,both,393.24,353.92,United Healthcare,Default,Fee Schedule,320.88,,,,232.01,320.88
ROPINIROLE 0.5MG TAB (REQUIP),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
ROPINIROLE 0.5MG TAB (REQUIP),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
ROPINIROLE 0.5MG TAB (REQUIP),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
NULYTELY 4000ML BOWEL PREP,637,RC,,,,both,102.32,92.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.62,,,,60.37,83.49
NULYTELY 4000ML BOWEL PREP,637,RC,,,,both,102.32,92.09,Cigna,Default,Percent of Total Billed Charges,60.37,,,,60.37,83.49
NULYTELY 4000ML BOWEL PREP,637,RC,,,,both,102.32,92.09,United Healthcare,Default,Fee Schedule,83.49,,,,60.37,83.49
DULOXETINE 20MG CAP (CYMBALTA),250,RC,,,,both,15.49,13.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.84,,,,9.14,12.64
DULOXETINE 20MG CAP (CYMBALTA),250,RC,,,,both,15.49,13.94,Cigna,Default,Percent of Total Billed Charges,9.14,,,,9.14,12.64
DULOXETINE 20MG CAP (CYMBALTA),250,RC,,,,both,15.49,13.94,United Healthcare,Default,Fee Schedule,12.64,,,,9.14,12.64
ENTACAPONE 200MG TAB (COMTAN),250,RC,,,,both,13,11.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.1,,,,7.67,10.61
ENTACAPONE 200MG TAB (COMTAN),250,RC,,,,both,13,11.7,Cigna,Default,Percent of Total Billed Charges,7.67,,,,7.67,10.61
ENTACAPONE 200MG TAB (COMTAN),250,RC,,,,both,13,11.7,United Healthcare,Default,Fee Schedule,10.61,,,,7.67,10.61
FISH OIL 500MG CAP,250,RC,,,,both,6.95,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.1,5.67
FISH OIL 500MG CAP,250,RC,,,,both,6.95,6.26,Cigna,Default,Percent of Total Billed Charges,4.1,,,,4.1,5.67
FISH OIL 500MG CAP,250,RC,,,,both,6.95,6.26,United Healthcare,Default,Fee Schedule,5.67,,,,4.1,5.67
METFORMIN ER 500MG TAB (GLUCOPHAGE XR),637,RC,,,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
METFORMIN ER 500MG TAB (GLUCOPHAGE XR),637,RC,,,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
METFORMIN ER 500MG TAB (GLUCOPHAGE XR),637,RC,,,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
CEFOTETAN 1000MG VIAL (CEFOTAN),S0074,HCPCS,636,RC,,both,54.61,49.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.23,,,,32.22,44.56
CEFOTETAN 1000MG VIAL (CEFOTAN),S0074,HCPCS,636,RC,,both,54.61,49.15,Cigna,Default,Percent of Total Billed Charges,32.22,,,,32.22,44.56
CEFOTETAN 1000MG VIAL (CEFOTAN),S0074,HCPCS,636,RC,,both,54.61,49.15,United Healthcare,Default,Fee Schedule,44.56,,,,32.22,44.56
VENLAFAXINE 75MG TAB (EFFEXOR),637,RC,,,,both,9.68,8.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.78,,,,5.71,7.9
VENLAFAXINE 75MG TAB (EFFEXOR),637,RC,,,,both,9.68,8.71,Cigna,Default,Percent of Total Billed Charges,5.71,,,,5.71,7.9
VENLAFAXINE 75MG TAB (EFFEXOR),637,RC,,,,both,9.68,8.71,United Healthcare,Default,Fee Schedule,7.9,,,,5.71,7.9
BUDESONIDE & FORMOTEROL 160/4.5 INHALER,637,RC,,,,both,1532.49,1379.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1072.74,,,,904.17,1250.51
BUDESONIDE & FORMOTEROL 160/4.5 INHALER,637,RC,,,,both,1532.49,1379.24,Cigna,Default,Percent of Total Billed Charges,904.17,,,,904.17,1250.51
BUDESONIDE & FORMOTEROL 160/4.5 INHALER,637,RC,,,,both,1532.49,1379.24,United Healthcare,Default,Fee Schedule,1250.51,,,,904.17,1250.51
HEMORRHOIDAL GEL (PREPARATION H),637,RC,,,,both,16.28,14.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.4,,,,9.61,13.28
HEMORRHOIDAL GEL (PREPARATION H),637,RC,,,,both,16.28,14.65,Cigna,Default,Percent of Total Billed Charges,9.61,,,,9.61,13.28
HEMORRHOIDAL GEL (PREPARATION H),637,RC,,,,both,16.28,14.65,United Healthcare,Default,Fee Schedule,13.28,,,,9.61,13.28
DIPHENHYDRAMINE 12.5MG/5ML ORAL SYR,Q0163,HCPCS,636,RC,,both,6.08,5.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.96
DIPHENHYDRAMINE 12.5MG/5ML ORAL SYR,Q0163,HCPCS,636,RC,,both,6.08,5.47,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.96
DIPHENHYDRAMINE 12.5MG/5ML ORAL SYR,Q0163,HCPCS,636,RC,,both,6.08,5.47,United Healthcare,Default,Fee Schedule,4.96,,,,3.59,4.96
FLUPHENAZINE DECANOATE 25MG/ML INJ,J2680,HCPCS,250,RC,,both,165,148.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,115.5,,,,97.35,134.64
FLUPHENAZINE DECANOATE 25MG/ML INJ,J2680,HCPCS,250,RC,,both,165,148.5,Cigna,Default,Percent of Total Billed Charges,97.35,,,,97.35,134.64
FLUPHENAZINE DECANOATE 25MG/ML INJ,J2680,HCPCS,250,RC,,both,165,148.5,United Healthcare,Default,Fee Schedule,134.64,,,,97.35,134.64
GLYCERIN PEDIATRIC SUPPS,637,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
GLYCERIN PEDIATRIC SUPPS,637,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
GLYCERIN PEDIATRIC SUPPS,637,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
CHLORHEXIDINE GLUCONATE 4% SCRUB 8 OZ,250,RC,,,,both,25.27,22.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.69,,,,14.91,20.62
CHLORHEXIDINE GLUCONATE 4% SCRUB 8 OZ,250,RC,,,,both,25.27,22.74,Cigna,Default,Percent of Total Billed Charges,14.91,,,,14.91,20.62
CHLORHEXIDINE GLUCONATE 4% SCRUB 8 OZ,250,RC,,,,both,25.27,22.74,United Healthcare,Default,Fee Schedule,20.62,,,,14.91,20.62
CHLORHEXIDINE GLUCONATE 4% SCRUB 32 OZ,250,RC,,,,both,50.55,45.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.38,,,,29.82,41.25
CHLORHEXIDINE GLUCONATE 4% SCRUB 32 OZ,250,RC,,,,both,50.55,45.5,Cigna,Default,Percent of Total Billed Charges,29.82,,,,29.82,41.25
CHLORHEXIDINE GLUCONATE 4% SCRUB 32 OZ,250,RC,,,,both,50.55,45.5,United Healthcare,Default,Fee Schedule,41.25,,,,29.82,41.25
KETOROLAC 15MG/1ML INJ (TORADOL),J1885,HCPCS,636,RC,,both,29.86,26.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.9,,,,17.62,24.37
KETOROLAC 15MG/1ML INJ (TORADOL),J1885,HCPCS,636,RC,,both,29.86,26.87,Cigna,Default,Percent of Total Billed Charges,17.62,,,,17.62,24.37
KETOROLAC 15MG/1ML INJ (TORADOL),J1885,HCPCS,636,RC,,both,29.86,26.87,United Healthcare,Default,Fee Schedule,24.37,,,,17.62,24.37
BETAXOLOL 0.5% OPTH SUSP (BETOPTIC),637,RC,,,,both,149.91,134.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.94,,,,88.45,122.33
BETAXOLOL 0.5% OPTH SUSP (BETOPTIC),637,RC,,,,both,149.91,134.92,Cigna,Default,Percent of Total Billed Charges,88.45,,,,88.45,122.33
BETAXOLOL 0.5% OPTH SUSP (BETOPTIC),637,RC,,,,both,149.91,134.92,United Healthcare,Default,Fee Schedule,122.33,,,,88.45,122.33
PULMOCARE 240ML TUBE FEEDING,637,RC,,,,both,8.5,7.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.95,,,,5.02,6.94
PULMOCARE 240ML TUBE FEEDING,637,RC,,,,both,8.5,7.65,Cigna,Default,Percent of Total Billed Charges,5.02,,,,5.02,6.94
PULMOCARE 240ML TUBE FEEDING,637,RC,,,,both,8.5,7.65,United Healthcare,Default,Fee Schedule,6.94,,,,5.02,6.94
IPRATROPIUM/ALBUTEROL 3ML NEB (DUONEB),J7620,HCPCS,250,RC,,both,10.27,9.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.19,,,,6.06,8.38
IPRATROPIUM/ALBUTEROL 3ML NEB (DUONEB),J7620,HCPCS,250,RC,,both,10.27,9.24,Cigna,Default,Percent of Total Billed Charges,6.06,,,,6.06,8.38
IPRATROPIUM/ALBUTEROL 3ML NEB (DUONEB),J7620,HCPCS,250,RC,,both,10.27,9.24,United Healthcare,Default,Fee Schedule,8.38,,,,6.06,8.38
"HEPARIN 10,000U/ML  5 ML INJ",J1644,HCPCS,636,RC,,both,72.34,65.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.64,,,,42.68,59.03
"HEPARIN 10,000U/ML  5 ML INJ",J1644,HCPCS,636,RC,,both,72.34,65.11,Cigna,Default,Percent of Total Billed Charges,42.68,,,,42.68,59.03
"HEPARIN 10,000U/ML  5 ML INJ",J1644,HCPCS,636,RC,,both,72.34,65.11,United Healthcare,Default,Fee Schedule,59.03,,,,42.68,59.03
NALOXONE 2MG/2ML SYR (NARCAN),J2310,HCPCS,250,RC,,both,180.15,162.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,126.1,,,,106.29,147
NALOXONE 2MG/2ML SYR (NARCAN),J2310,HCPCS,250,RC,,both,180.15,162.14,Cigna,Default,Percent of Total Billed Charges,106.29,,,,106.29,147
NALOXONE 2MG/2ML SYR (NARCAN),J2310,HCPCS,250,RC,,both,180.15,162.14,United Healthcare,Default,Fee Schedule,147,,,,106.29,147
LAMOTRIGINE 100MG TAB (LAMICTAL),637,RC,,,,both,9.41,8.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.59,,,,5.55,7.68
LAMOTRIGINE 100MG TAB (LAMICTAL),637,RC,,,,both,9.41,8.47,Cigna,Default,Percent of Total Billed Charges,5.55,,,,5.55,7.68
LAMOTRIGINE 100MG TAB (LAMICTAL),637,RC,,,,both,9.41,8.47,United Healthcare,Default,Fee Schedule,7.68,,,,5.55,7.68
IRON SUCROSE 100MG/5ML INJ (VENOFER),J1756,HCPCS,636,RC,,both,283.8,255.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.66,,,,167.44,231.58
IRON SUCROSE 100MG/5ML INJ (VENOFER),J1756,HCPCS,636,RC,,both,283.8,255.42,Cigna,Default,Percent of Total Billed Charges,167.44,,,,167.44,231.58
IRON SUCROSE 100MG/5ML INJ (VENOFER),J1756,HCPCS,636,RC,,both,283.8,255.42,United Healthcare,Default,Fee Schedule,231.58,,,,167.44,231.58
VITAMIN D3 400U TAB,637,RC,,,,both,1.16,1.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.81,,,,0.68,0.95
VITAMIN D3 400U TAB,637,RC,,,,both,1.16,1.04,Cigna,Default,Percent of Total Billed Charges,0.68,,,,0.68,0.95
VITAMIN D3 400U TAB,637,RC,,,,both,1.16,1.04,United Healthcare,Default,Fee Schedule,0.95,,,,0.68,0.95
LET SOLUTION,250,RC,,,,both,35,31.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.5,,,,20.65,28.56
LET SOLUTION,250,RC,,,,both,35,31.5,Cigna,Default,Percent of Total Billed Charges,20.65,,,,20.65,28.56
LET SOLUTION,250,RC,,,,both,35,31.5,United Healthcare,Default,Fee Schedule,28.56,,,,20.65,28.56
LIDOCAINE 2% W/EPI 20ML VIAL (XYLOCAINE,250,RC,,,,both,81.12,73.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.78,,,,47.86,66.19
LIDOCAINE 2% W/EPI 20ML VIAL (XYLOCAINE,250,RC,,,,both,81.12,73.01,Cigna,Default,Percent of Total Billed Charges,47.86,,,,47.86,66.19
LIDOCAINE 2% W/EPI 20ML VIAL (XYLOCAINE,250,RC,,,,both,81.12,73.01,United Healthcare,Default,Fee Schedule,66.19,,,,47.86,66.19
HALLS SF COUGH DROP,637,RC,,,,both,6.09,5.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.26,,,,3.59,4.97
HALLS SF COUGH DROP,637,RC,,,,both,6.09,5.48,Cigna,Default,Percent of Total Billed Charges,3.59,,,,3.59,4.97
HALLS SF COUGH DROP,637,RC,,,,both,6.09,5.48,United Healthcare,Default,Fee Schedule,4.97,,,,3.59,4.97
DEXTROMETHORPHAN COUGH SYRUP 3 OZ (DELSY,637,RC,,,,both,42.13,37.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.49,,,,24.86,34.38
DEXTROMETHORPHAN COUGH SYRUP 3 OZ (DELSY,637,RC,,,,both,42.13,37.92,Cigna,Default,Percent of Total Billed Charges,24.86,,,,24.86,34.38
DEXTROMETHORPHAN COUGH SYRUP 3 OZ (DELSY,637,RC,,,,both,42.13,37.92,United Healthcare,Default,Fee Schedule,34.38,,,,24.86,34.38
METOPROLOL TART 25MG TAB (LOPRESSOR),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
METOPROLOL TART 25MG TAB (LOPRESSOR),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
METOPROLOL TART 25MG TAB (LOPRESSOR),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
ESOMEPRAZOLE 40MG TAB (NEXIUM),637,RC,,,,both,24.06,21.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.84,,,,14.2,19.63
ESOMEPRAZOLE 40MG TAB (NEXIUM),637,RC,,,,both,24.06,21.65,Cigna,Default,Percent of Total Billed Charges,14.2,,,,14.2,19.63
ESOMEPRAZOLE 40MG TAB (NEXIUM),637,RC,,,,both,24.06,21.65,United Healthcare,Default,Fee Schedule,19.63,,,,14.2,19.63
CHLORPROMAZINE 10MG TAB (THORAZINE),Q0161,HCPCS,636,RC,,both,7.26,6.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.08,,,,4.28,5.92
CHLORPROMAZINE 10MG TAB (THORAZINE),Q0161,HCPCS,636,RC,,both,7.26,6.53,Cigna,Default,Percent of Total Billed Charges,4.28,,,,4.28,5.92
CHLORPROMAZINE 10MG TAB (THORAZINE),Q0161,HCPCS,636,RC,,both,7.26,6.53,United Healthcare,Default,Fee Schedule,5.92,,,,4.28,5.92
ALTEPLASE 2MG (CATHFLO ACTIVASE),J2997,HCPCS,636,RC,,both,909.97,818.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,636.98,,,,536.88,742.54
ALTEPLASE 2MG (CATHFLO ACTIVASE),J2997,HCPCS,636,RC,,both,909.97,818.97,Cigna,Default,Percent of Total Billed Charges,536.88,,,,536.88,742.54
ALTEPLASE 2MG (CATHFLO ACTIVASE),J2997,HCPCS,636,RC,,both,909.97,818.97,United Healthcare,Default,Fee Schedule,742.54,,,,536.88,742.54
VALACYCLOVIR 1000MG TAB (VALTREX),637,RC,,,,both,45.9,41.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.13,,,,27.08,37.45
VALACYCLOVIR 1000MG TAB (VALTREX),637,RC,,,,both,45.9,41.31,Cigna,Default,Percent of Total Billed Charges,27.08,,,,27.08,37.45
VALACYCLOVIR 1000MG TAB (VALTREX),637,RC,,,,both,45.9,41.31,United Healthcare,Default,Fee Schedule,37.45,,,,27.08,37.45
OSMOPREP TAB,637,RC,,,,both,11.25,10.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.88,,,,6.64,9.18
OSMOPREP TAB,637,RC,,,,both,11.25,10.13,Cigna,Default,Percent of Total Billed Charges,6.64,,,,6.64,9.18
OSMOPREP TAB,637,RC,,,,both,11.25,10.13,United Healthcare,Default,Fee Schedule,9.18,,,,6.64,9.18
ACETAMINOPHEN 325MG/10.15ML ELIXIR (TYLE,637,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
ACETAMINOPHEN 325MG/10.15ML ELIXIR (TYLE,637,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
ACETAMINOPHEN 325MG/10.15ML ELIXIR (TYLE,637,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
CARB/LEVO/ENTAC 100MG TAB (STALEVO),637,RC,,,,both,16.32,14.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.42,,,,9.63,13.32
CARB/LEVO/ENTAC 100MG TAB (STALEVO),637,RC,,,,both,16.32,14.69,Cigna,Default,Percent of Total Billed Charges,9.63,,,,9.63,13.32
CARB/LEVO/ENTAC 100MG TAB (STALEVO),637,RC,,,,both,16.32,14.69,United Healthcare,Default,Fee Schedule,13.32,,,,9.63,13.32
IRBESARTAN/HYDROCHLOROTHIAZIDE 300/25MG,637,RC,,,,both,17.25,15.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.08,,,,10.18,14.08
IRBESARTAN/HYDROCHLOROTHIAZIDE 300/25MG,637,RC,,,,both,17.25,15.53,Cigna,Default,Percent of Total Billed Charges,10.18,,,,10.18,14.08
IRBESARTAN/HYDROCHLOROTHIAZIDE 300/25MG,637,RC,,,,both,17.25,15.53,United Healthcare,Default,Fee Schedule,14.08,,,,10.18,14.08
PRESERVISION W/ LUTEIN SOFTGEL,637,RC,,,,both,6.39,5.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.77,5.21
PRESERVISION W/ LUTEIN SOFTGEL,637,RC,,,,both,6.39,5.75,Cigna,Default,Percent of Total Billed Charges,3.77,,,,3.77,5.21
PRESERVISION W/ LUTEIN SOFTGEL,637,RC,,,,both,6.39,5.75,United Healthcare,Default,Fee Schedule,5.21,,,,3.77,5.21
INFLUENZA HIGH DOSE VACCINE,90653,HCPCS,636,RC,,both,248.97,224.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,174.28,,,,146.89,203.16
INFLUENZA HIGH DOSE VACCINE,90653,HCPCS,636,RC,,both,248.97,224.07,Cigna,Default,Percent of Total Billed Charges,146.89,,,,146.89,203.16
INFLUENZA HIGH DOSE VACCINE,90653,HCPCS,636,RC,,both,248.97,224.07,United Healthcare,Default,Fee Schedule,203.16,,,,146.89,203.16
ROPINIROLE 1MG TAB (REQUIP),637,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
ROPINIROLE 1MG TAB (REQUIP),637,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
ROPINIROLE 1MG TAB (REQUIP),637,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
CHLORTHALIDONE 25MG TAB (THALITONE),637,RC,,,,both,6.91,6.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.84,,,,4.08,5.64
CHLORTHALIDONE 25MG TAB (THALITONE),637,RC,,,,both,6.91,6.22,Cigna,Default,Percent of Total Billed Charges,4.08,,,,4.08,5.64
CHLORTHALIDONE 25MG TAB (THALITONE),637,RC,,,,both,6.91,6.22,United Healthcare,Default,Fee Schedule,5.64,,,,4.08,5.64
"EPOETIN ALPHA 40,000 U (PROCRIT)",J0885,HCPCS,636,RC,,both,4517.45,4065.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3162.22,,,,2665.3,3686.24
"EPOETIN ALPHA 40,000 U (PROCRIT)",J0885,HCPCS,636,RC,,both,4517.45,4065.71,Cigna,Default,Percent of Total Billed Charges,2665.3,,,,2665.3,3686.24
"EPOETIN ALPHA 40,000 U (PROCRIT)",J0885,HCPCS,636,RC,,both,4517.45,4065.71,United Healthcare,Default,Fee Schedule,3686.24,,,,2665.3,3686.24
DNU METOPROLOL XL TAB: 25MG (TOPROL),637,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
DNU METOPROLOL XL TAB: 25MG (TOPROL),637,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
DNU METOPROLOL XL TAB: 25MG (TOPROL),637,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
NYSTATIN 100MU/ML SUSP 5ML U/D CUP,637,RC,,,,both,12.87,11.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.01,,,,7.59,10.5
NYSTATIN 100MU/ML SUSP 5ML U/D CUP,637,RC,,,,both,12.87,11.58,Cigna,Default,Percent of Total Billed Charges,7.59,,,,7.59,10.5
NYSTATIN 100MU/ML SUSP 5ML U/D CUP,637,RC,,,,both,12.87,11.58,United Healthcare,Default,Fee Schedule,10.5,,,,7.59,10.5
MUPIROCIN 15 GM CRM (BACTROBAN),637,RC,,,,both,280.37,252.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,196.26,,,,165.42,228.78
MUPIROCIN 15 GM CRM (BACTROBAN),637,RC,,,,both,280.37,252.33,Cigna,Default,Percent of Total Billed Charges,165.42,,,,165.42,228.78
MUPIROCIN 15 GM CRM (BACTROBAN),637,RC,,,,both,280.37,252.33,United Healthcare,Default,Fee Schedule,228.78,,,,165.42,228.78
CRANBERRY TABLETS 450MG,250,RC,,,,both,6.95,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.1,5.67
CRANBERRY TABLETS 450MG,250,RC,,,,both,6.95,6.26,Cigna,Default,Percent of Total Billed Charges,4.1,,,,4.1,5.67
CRANBERRY TABLETS 450MG,250,RC,,,,both,6.95,6.26,United Healthcare,Default,Fee Schedule,5.67,,,,4.1,5.67
ACETAMINOPHEN PREMIX IVPB: 1000MG/100ML,J0131,HCPCS,636,RC,,both,264.25,237.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,184.98,,,,155.91,215.63
ACETAMINOPHEN PREMIX IVPB: 1000MG/100ML,J0131,HCPCS,636,RC,,both,264.25,237.83,Cigna,Default,Percent of Total Billed Charges,155.91,,,,155.91,215.63
ACETAMINOPHEN PREMIX IVPB: 1000MG/100ML,J0131,HCPCS,636,RC,,both,264.25,237.83,United Healthcare,Default,Fee Schedule,215.63,,,,155.91,215.63
HEPARIN 100 U /ML 5ML SYR,J1642,HCPCS,636,RC,,both,18.02,16.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.61,,,,10.63,14.7
HEPARIN 100 U /ML 5ML SYR,J1642,HCPCS,636,RC,,both,18.02,16.22,Cigna,Default,Percent of Total Billed Charges,10.63,,,,10.63,14.7
HEPARIN 100 U /ML 5ML SYR,J1642,HCPCS,636,RC,,both,18.02,16.22,United Healthcare,Default,Fee Schedule,14.7,,,,10.63,14.7
ARIPIPRAZOLE 5MG TAB (ABILIFY),637,RC,,,,both,148.76,133.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.13,,,,87.77,121.39
ARIPIPRAZOLE 5MG TAB (ABILIFY),637,RC,,,,both,148.76,133.88,Cigna,Default,Percent of Total Billed Charges,87.77,,,,87.77,121.39
ARIPIPRAZOLE 5MG TAB (ABILIFY),637,RC,,,,both,148.76,133.88,United Healthcare,Default,Fee Schedule,121.39,,,,87.77,121.39
MEPIVICAINE 2% 20ML INJ (CARBOCAINE),250,RC,,,,both,31.81,28.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.27,,,,18.77,25.96
MEPIVICAINE 2% 20ML INJ (CARBOCAINE),250,RC,,,,both,31.81,28.63,Cigna,Default,Percent of Total Billed Charges,18.77,,,,18.77,25.96
MEPIVICAINE 2% 20ML INJ (CARBOCAINE),250,RC,,,,both,31.81,28.63,United Healthcare,Default,Fee Schedule,25.96,,,,18.77,25.96
SPIRONOLACTONE 50MG TAB (ALDACTONE),637,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
SPIRONOLACTONE 50MG TAB (ALDACTONE),637,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
SPIRONOLACTONE 50MG TAB (ALDACTONE),637,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
FERRIC GLUCONATE 62.5 MG/5ML VIAL (FERRL,J2916,HCPCS,636,RC,,both,188.27,169.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.79,,,,111.08,153.63
FERRIC GLUCONATE 62.5 MG/5ML VIAL (FERRL,J2916,HCPCS,636,RC,,both,188.27,169.44,Cigna,Default,Percent of Total Billed Charges,111.08,,,,111.08,153.63
FERRIC GLUCONATE 62.5 MG/5ML VIAL (FERRL,J2916,HCPCS,636,RC,,both,188.27,169.44,United Healthcare,Default,Fee Schedule,153.63,,,,111.08,153.63
HYDROCODONE/APAP TAB 5/325MG (NORCO),637,RC,,,,both,11.68,10.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.18,,,,6.89,9.53
HYDROCODONE/APAP TAB 5/325MG (NORCO),637,RC,,,,both,11.68,10.51,Cigna,Default,Percent of Total Billed Charges,6.89,,,,6.89,9.53
HYDROCODONE/APAP TAB 5/325MG (NORCO),637,RC,,,,both,11.68,10.51,United Healthcare,Default,Fee Schedule,9.53,,,,6.89,9.53
ACETYLCYSTEINE 10% 30ML VIAL (MUCOMYST),250,RC,,,,both,79.5,71.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.65,,,,46.9,64.87
ACETYLCYSTEINE 10% 30ML VIAL (MUCOMYST),250,RC,,,,both,79.5,71.55,Cigna,Default,Percent of Total Billed Charges,46.9,,,,46.9,64.87
ACETYLCYSTEINE 10% 30ML VIAL (MUCOMYST),250,RC,,,,both,79.5,71.55,United Healthcare,Default,Fee Schedule,64.87,,,,46.9,64.87
FLEBOGAMMA 10GM/100ML,J1572,HCPCS,250,RC,,both,1086,977.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,760.2,,,,640.74,886.18
FLEBOGAMMA 10GM/100ML,J1572,HCPCS,250,RC,,both,1086,977.4,Cigna,Default,Percent of Total Billed Charges,640.74,,,,640.74,886.18
FLEBOGAMMA 10GM/100ML,J1572,HCPCS,250,RC,,both,1086,977.4,United Healthcare,Default,Fee Schedule,886.18,,,,640.74,886.18
FLEBOGAMMA 20GM/400ML,J1572,HCPCS,250,RC,,both,2171.75,1954.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1520.22,,,,1281.33,1772.15
FLEBOGAMMA 20GM/400ML,J1572,HCPCS,250,RC,,both,2171.75,1954.58,Cigna,Default,Percent of Total Billed Charges,1281.33,,,,1281.33,1772.15
FLEBOGAMMA 20GM/400ML,J1572,HCPCS,250,RC,,both,2171.75,1954.58,United Healthcare,Default,Fee Schedule,1772.15,,,,1281.33,1772.15
NF-MELOXICAM ORAL TABLET 7.5MG,250,RC,,,,both,11.63,10.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.14,,,,6.86,9.49
NF-MELOXICAM ORAL TABLET 7.5MG,250,RC,,,,both,11.63,10.47,Cigna,Default,Percent of Total Billed Charges,6.86,,,,6.86,9.49
NF-MELOXICAM ORAL TABLET 7.5MG,250,RC,,,,both,11.63,10.47,United Healthcare,Default,Fee Schedule,9.49,,,,6.86,9.49
ALCOHOL DEHYDRATED 5ML AMP INJ,250,RC,,,,both,208.52,187.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,145.96,,,,123.03,170.15
ALCOHOL DEHYDRATED 5ML AMP INJ,250,RC,,,,both,208.52,187.67,Cigna,Default,Percent of Total Billed Charges,123.03,,,,123.03,170.15
ALCOHOL DEHYDRATED 5ML AMP INJ,250,RC,,,,both,208.52,187.67,United Healthcare,Default,Fee Schedule,170.15,,,,123.03,170.15
DUTASTERIDE 0.5 MG CAP (AVODART),637,RC,,,,both,18.25,16.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.78,,,,10.77,14.89
DUTASTERIDE 0.5 MG CAP (AVODART),637,RC,,,,both,18.25,16.43,Cigna,Default,Percent of Total Billed Charges,10.77,,,,10.77,14.89
DUTASTERIDE 0.5 MG CAP (AVODART),637,RC,,,,both,18.25,16.43,United Healthcare,Default,Fee Schedule,14.89,,,,10.77,14.89
ERYTHROMYCIN 400MG/5ML SUSP (E.E.S),637,RC,,,,both,122.76,110.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.93,,,,72.43,100.17
ERYTHROMYCIN 400MG/5ML SUSP (E.E.S),637,RC,,,,both,122.76,110.48,Cigna,Default,Percent of Total Billed Charges,72.43,,,,72.43,100.17
ERYTHROMYCIN 400MG/5ML SUSP (E.E.S),637,RC,,,,both,122.76,110.48,United Healthcare,Default,Fee Schedule,100.17,,,,72.43,100.17
PHENYTOIN 100MG/2ML INJ (DILANTIN),J1165,HCPCS,636,RC,,both,30.22,27.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.15,,,,17.83,24.66
PHENYTOIN 100MG/2ML INJ (DILANTIN),J1165,HCPCS,636,RC,,both,30.22,27.2,Cigna,Default,Percent of Total Billed Charges,17.83,,,,17.83,24.66
PHENYTOIN 100MG/2ML INJ (DILANTIN),J1165,HCPCS,636,RC,,both,30.22,27.2,United Healthcare,Default,Fee Schedule,24.66,,,,17.83,24.66
MAGNESIUM SULFATE 5000MG/10ML INJ,J3475,HCPCS,636,RC,,both,96.75,87.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.72,,,,57.08,78.95
MAGNESIUM SULFATE 5000MG/10ML INJ,J3475,HCPCS,636,RC,,both,96.75,87.08,Cigna,Default,Percent of Total Billed Charges,57.08,,,,57.08,78.95
MAGNESIUM SULFATE 5000MG/10ML INJ,J3475,HCPCS,636,RC,,both,96.75,87.08,United Healthcare,Default,Fee Schedule,78.95,,,,57.08,78.95
MULTITRACE-4 MDV 10ML,250,RC,,,,both,94.03,84.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.82,,,,55.48,76.73
MULTITRACE-4 MDV 10ML,250,RC,,,,both,94.03,84.63,Cigna,Default,Percent of Total Billed Charges,55.48,,,,55.48,76.73
MULTITRACE-4 MDV 10ML,250,RC,,,,both,94.03,84.63,United Healthcare,Default,Fee Schedule,76.73,,,,55.48,76.73
CARVEDILOL 12.5 MG TAB (COREG),637,RC,,,,both,9.95,8.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.96,,,,5.87,8.12
CARVEDILOL 12.5 MG TAB (COREG),637,RC,,,,both,9.95,8.96,Cigna,Default,Percent of Total Billed Charges,5.87,,,,5.87,8.12
CARVEDILOL 12.5 MG TAB (COREG),637,RC,,,,both,9.95,8.96,United Healthcare,Default,Fee Schedule,8.12,,,,5.87,8.12
DIALYVITE RENAL MVI TAB,637,RC,,,,both,9.29,8.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.5,,,,5.48,7.58
DIALYVITE RENAL MVI TAB,637,RC,,,,both,9.29,8.36,Cigna,Default,Percent of Total Billed Charges,5.48,,,,5.48,7.58
DIALYVITE RENAL MVI TAB,637,RC,,,,both,9.29,8.36,United Healthcare,Default,Fee Schedule,7.58,,,,5.48,7.58
DABIGATRAN 150 MG CAP (PRADAXA),637,RC,,,,both,20.47,18.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.33,,,,12.08,16.7
DABIGATRAN 150 MG CAP (PRADAXA),637,RC,,,,both,20.47,18.42,Cigna,Default,Percent of Total Billed Charges,12.08,,,,12.08,16.7
DABIGATRAN 150 MG CAP (PRADAXA),637,RC,,,,both,20.47,18.42,United Healthcare,Default,Fee Schedule,16.7,,,,12.08,16.7
BIMATOPROST 0.03% OPHTH 2.5ML (LUMIGAN),637,RC,,,,both,477.37,429.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,334.16,,,,281.65,389.53
BIMATOPROST 0.03% OPHTH 2.5ML (LUMIGAN),637,RC,,,,both,477.37,429.63,Cigna,Default,Percent of Total Billed Charges,281.65,,,,281.65,389.53
BIMATOPROST 0.03% OPHTH 2.5ML (LUMIGAN),637,RC,,,,both,477.37,429.63,United Healthcare,Default,Fee Schedule,389.53,,,,281.65,389.53
POTASSIUM CITRATE TAB 10MEQ (UROCIT K),637,RC,,,,both,7.55,6.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.28,,,,4.45,6.16
POTASSIUM CITRATE TAB 10MEQ (UROCIT K),637,RC,,,,both,7.55,6.8,Cigna,Default,Percent of Total Billed Charges,4.45,,,,4.45,6.16
POTASSIUM CITRATE TAB 10MEQ (UROCIT K),637,RC,,,,both,7.55,6.8,United Healthcare,Default,Fee Schedule,6.16,,,,4.45,6.16
POLIDOCANOL 1% 2ML INJ (ASCLERA),250,RC,,,,both,387.44,348.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,271.21,,,,228.59,316.15
POLIDOCANOL 1% 2ML INJ (ASCLERA),250,RC,,,,both,387.44,348.7,Cigna,Default,Percent of Total Billed Charges,228.59,,,,228.59,316.15
POLIDOCANOL 1% 2ML INJ (ASCLERA),250,RC,,,,both,387.44,348.7,United Healthcare,Default,Fee Schedule,316.15,,,,228.59,316.15
INTRALIPID 20% 500ML,250,RC,,,,both,284.01,255.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,198.81,,,,167.57,231.75
INTRALIPID 20% 500ML,250,RC,,,,both,284.01,255.61,Cigna,Default,Percent of Total Billed Charges,167.57,,,,167.57,231.75
INTRALIPID 20% 500ML,250,RC,,,,both,284.01,255.61,United Healthcare,Default,Fee Schedule,231.75,,,,167.57,231.75
INSULIN REGULAR 100 U/ML 10 ML VIAL (HUM,J1815,HCPCS,636,RC,,both,335.17,301.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,234.62,,,,197.75,273.5
INSULIN REGULAR 100 U/ML 10 ML VIAL (HUM,J1815,HCPCS,636,RC,,both,335.17,301.65,Cigna,Default,Percent of Total Billed Charges,197.75,,,,197.75,273.5
INSULIN REGULAR 100 U/ML 10 ML VIAL (HUM,J1815,HCPCS,636,RC,,both,335.17,301.65,United Healthcare,Default,Fee Schedule,273.5,,,,197.75,273.5
METHAZOLAMIDE 25MG TAB (NEPTAZANE),637,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
METHAZOLAMIDE 25MG TAB (NEPTAZANE),637,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
METHAZOLAMIDE 25MG TAB (NEPTAZANE),637,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
VENLAFAXINE XR 150MG CAP (EFFEXOR XR),637,RC,,,,both,24.06,21.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.84,,,,14.2,19.63
VENLAFAXINE XR 150MG CAP (EFFEXOR XR),637,RC,,,,both,24.06,21.65,Cigna,Default,Percent of Total Billed Charges,14.2,,,,14.2,19.63
VENLAFAXINE XR 150MG CAP (EFFEXOR XR),637,RC,,,,both,24.06,21.65,United Healthcare,Default,Fee Schedule,19.63,,,,14.2,19.63
NACL 0.9% BACTERIOSTATIC 20ML VIAL,250,RC,,,,both,28.76,25.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.13,,,,16.97,23.47
NACL 0.9% BACTERIOSTATIC 20ML VIAL,250,RC,,,,both,28.76,25.88,Cigna,Default,Percent of Total Billed Charges,16.97,,,,16.97,23.47
NACL 0.9% BACTERIOSTATIC 20ML VIAL,250,RC,,,,both,28.76,25.88,United Healthcare,Default,Fee Schedule,23.47,,,,16.97,23.47
NUTRIHEP (HEPATIC FORM) SUPP 250ML,637,RC,,,,both,76.05,68.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.24,,,,44.87,62.06
NUTRIHEP (HEPATIC FORM) SUPP 250ML,637,RC,,,,both,76.05,68.45,Cigna,Default,Percent of Total Billed Charges,44.87,,,,44.87,62.06
NUTRIHEP (HEPATIC FORM) SUPP 250ML,637,RC,,,,both,76.05,68.45,United Healthcare,Default,Fee Schedule,62.06,,,,44.87,62.06
PREFILLED SYR 0.5ML TDaP (ADACEL),250,RC,,,,both,216.46,194.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.52,,,,127.71,176.63
PREFILLED SYR 0.5ML TDaP (ADACEL),250,RC,,,,both,216.46,194.81,Cigna,Default,Percent of Total Billed Charges,127.71,,,,127.71,176.63
PREFILLED SYR 0.5ML TDaP (ADACEL),250,RC,,,,both,216.46,194.81,United Healthcare,Default,Fee Schedule,176.63,,,,127.71,176.63
ACETYLCYSTEINE 6000MG/30ML INJ,J0132,HCPCS,636,RC,,both,1032.6,929.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,722.82,,,,609.23,842.6
ACETYLCYSTEINE 6000MG/30ML INJ,J0132,HCPCS,636,RC,,both,1032.6,929.34,Cigna,Default,Percent of Total Billed Charges,609.23,,,,609.23,842.6
ACETYLCYSTEINE 6000MG/30ML INJ,J0132,HCPCS,636,RC,,both,1032.6,929.34,United Healthcare,Default,Fee Schedule,842.6,,,,609.23,842.6
VASOLEX 60GM OINT,637,RC,,,,both,269.92,242.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,188.94,,,,159.25,220.25
VASOLEX 60GM OINT,637,RC,,,,both,269.92,242.93,Cigna,Default,Percent of Total Billed Charges,159.25,,,,159.25,220.25
VASOLEX 60GM OINT,637,RC,,,,both,269.92,242.93,United Healthcare,Default,Fee Schedule,220.25,,,,159.25,220.25
ONDANSETRON ODT 8MG TAB (ZOFRAN ODT),Q0162,HCPCS,636,RC,,both,178.97,161.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,125.28,,,,105.59,146.04
ONDANSETRON ODT 8MG TAB (ZOFRAN ODT),Q0162,HCPCS,636,RC,,both,178.97,161.07,Cigna,Default,Percent of Total Billed Charges,105.59,,,,105.59,146.04
ONDANSETRON ODT 8MG TAB (ZOFRAN ODT),Q0162,HCPCS,636,RC,,both,178.97,161.07,United Healthcare,Default,Fee Schedule,146.04,,,,105.59,146.04
FONDAPARINUX 5MG/0.4ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,587.48,528.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,411.24,,,,346.61,479.38
FONDAPARINUX 5MG/0.4ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,587.48,528.73,Cigna,Default,Percent of Total Billed Charges,346.61,,,,346.61,479.38
FONDAPARINUX 5MG/0.4ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,587.48,528.73,United Healthcare,Default,Fee Schedule,479.38,,,,346.61,479.38
FONDAPARINUX 7.5MG/0.6ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,587.48,528.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,411.24,,,,346.61,479.38
FONDAPARINUX 7.5MG/0.6ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,587.48,528.73,Cigna,Default,Percent of Total Billed Charges,346.61,,,,346.61,479.38
FONDAPARINUX 7.5MG/0.6ML INJ (ARIXTRA),J1652,HCPCS,636,RC,,both,587.48,528.73,United Healthcare,Default,Fee Schedule,479.38,,,,346.61,479.38
LEVOTHRYOXINE 100MCG INJ,250,RC,,,,both,487.62,438.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,341.33,,,,287.7,397.9
LEVOTHRYOXINE 100MCG INJ,250,RC,,,,both,487.62,438.86,Cigna,Default,Percent of Total Billed Charges,287.7,,,,287.7,397.9
LEVOTHRYOXINE 100MCG INJ,250,RC,,,,both,487.62,438.86,United Healthcare,Default,Fee Schedule,397.9,,,,287.7,397.9
VITAMIN A & D OINT 56.7GM TUBE,637,RC,,,,both,10.74,9.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.52,,,,6.34,8.76
VITAMIN A & D OINT 56.7GM TUBE,637,RC,,,,both,10.74,9.67,Cigna,Default,Percent of Total Billed Charges,6.34,,,,6.34,8.76
VITAMIN A & D OINT 56.7GM TUBE,637,RC,,,,both,10.74,9.67,United Healthcare,Default,Fee Schedule,8.76,,,,6.34,8.76
NACL 0.45% 250ML IV FLUID,250,RC,,,,both,28.76,25.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.13,,,,16.97,23.47
NACL 0.45% 250ML IV FLUID,250,RC,,,,both,28.76,25.88,Cigna,Default,Percent of Total Billed Charges,16.97,,,,16.97,23.47
NACL 0.45% 250ML IV FLUID,250,RC,,,,both,28.76,25.88,United Healthcare,Default,Fee Schedule,23.47,,,,16.97,23.47
ATORVASTATIN 40MG TAB (LIPITOR),637,RC,,,,both,25.99,23.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.19,,,,15.33,21.21
ATORVASTATIN 40MG TAB (LIPITOR),637,RC,,,,both,25.99,23.39,Cigna,Default,Percent of Total Billed Charges,15.33,,,,15.33,21.21
ATORVASTATIN 40MG TAB (LIPITOR),637,RC,,,,both,25.99,23.39,United Healthcare,Default,Fee Schedule,21.21,,,,15.33,21.21
ATORVASTATIN 10MG TAB (LIPITOR),637,RC,,,,both,17.98,16.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.59,,,,10.61,14.67
ATORVASTATIN 10MG TAB (LIPITOR),637,RC,,,,both,17.98,16.18,Cigna,Default,Percent of Total Billed Charges,10.61,,,,10.61,14.67
ATORVASTATIN 10MG TAB (LIPITOR),637,RC,,,,both,17.98,16.18,United Healthcare,Default,Fee Schedule,14.67,,,,10.61,14.67
NEOSTIGMINE 15MG TAB (PROSTIGMIN),637,RC,,,,both,8.85,7.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.2,,,,5.22,7.22
NEOSTIGMINE 15MG TAB (PROSTIGMIN),637,RC,,,,both,8.85,7.97,Cigna,Default,Percent of Total Billed Charges,5.22,,,,5.22,7.22
NEOSTIGMINE 15MG TAB (PROSTIGMIN),637,RC,,,,both,8.85,7.97,United Healthcare,Default,Fee Schedule,7.22,,,,5.22,7.22
VITAMIN B-12 250 MCG TAB,637,RC,,,,both,7.03,6.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.92,,,,4.15,5.74
VITAMIN B-12 250 MCG TAB,637,RC,,,,both,7.03,6.33,Cigna,Default,Percent of Total Billed Charges,4.15,,,,4.15,5.74
VITAMIN B-12 250 MCG TAB,637,RC,,,,both,7.03,6.33,United Healthcare,Default,Fee Schedule,5.74,,,,4.15,5.74
IBUPROFEN 800MG/200ML IVPB (CALDOLOR),J1741,HCPCS,636,RC,,both,121.15,109.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,84.8,,,,71.48,98.86
IBUPROFEN 800MG/200ML IVPB (CALDOLOR),J1741,HCPCS,636,RC,,both,121.15,109.04,Cigna,Default,Percent of Total Billed Charges,71.48,,,,71.48,98.86
IBUPROFEN 800MG/200ML IVPB (CALDOLOR),J1741,HCPCS,636,RC,,both,121.15,109.04,United Healthcare,Default,Fee Schedule,98.86,,,,71.48,98.86
HYDROCORTISONE 5MG TAB (CORTEF),637,RC,,,,both,6.68,6.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.68,,,,3.94,5.45
HYDROCORTISONE 5MG TAB (CORTEF),637,RC,,,,both,6.68,6.01,Cigna,Default,Percent of Total Billed Charges,3.94,,,,3.94,5.45
HYDROCORTISONE 5MG TAB (CORTEF),637,RC,,,,both,6.68,6.01,United Healthcare,Default,Fee Schedule,5.45,,,,3.94,5.45
SEVELAMER HCL 800MG TAB (RENAGEL),637,RC,,,,both,16.56,14.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.59,,,,9.77,13.51
SEVELAMER HCL 800MG TAB (RENAGEL),637,RC,,,,both,16.56,14.9,Cigna,Default,Percent of Total Billed Charges,9.77,,,,9.77,13.51
SEVELAMER HCL 800MG TAB (RENAGEL),637,RC,,,,both,16.56,14.9,United Healthcare,Default,Fee Schedule,13.51,,,,9.77,13.51
RIVAROXABAN 10MG (XARELTO),637,RC,,,,both,84.71,76.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.3,,,,49.98,69.12
RIVAROXABAN 10MG (XARELTO),637,RC,,,,both,84.71,76.24,Cigna,Default,Percent of Total Billed Charges,49.98,,,,49.98,69.12
RIVAROXABAN 10MG (XARELTO),637,RC,,,,both,84.71,76.24,United Healthcare,Default,Fee Schedule,69.12,,,,49.98,69.12
ENOXAPARIN SQ 40MG/0.4ML (LOVENOX),250,RC,,,,both,155.43,139.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.8,,,,91.7,126.83
ENOXAPARIN SQ 40MG/0.4ML (LOVENOX),250,RC,,,,both,155.43,139.89,Cigna,Default,Percent of Total Billed Charges,91.7,,,,91.7,126.83
ENOXAPARIN SQ 40MG/0.4ML (LOVENOX),250,RC,,,,both,155.43,139.89,United Healthcare,Default,Fee Schedule,126.83,,,,91.7,126.83
DIVALPROEX  ER 500MG TAB,637,RC,,,,both,22.26,20.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.58,,,,13.13,18.16
DIVALPROEX  ER 500MG TAB,637,RC,,,,both,22.26,20.03,Cigna,Default,Percent of Total Billed Charges,13.13,,,,13.13,18.16
DIVALPROEX  ER 500MG TAB,637,RC,,,,both,22.26,20.03,United Healthcare,Default,Fee Schedule,18.16,,,,13.13,18.16
LUPRON DEPOT 22.5MG 3 MONTH KIT,J1950,HCPCS,250,RC,,both,9679.75,8711.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6775.82,,,,5711.05,7898.68
LUPRON DEPOT 22.5MG 3 MONTH KIT,J1950,HCPCS,250,RC,,both,9679.75,8711.78,Cigna,Default,Percent of Total Billed Charges,5711.05,,,,5711.05,7898.68
LUPRON DEPOT 22.5MG 3 MONTH KIT,J1950,HCPCS,250,RC,,both,9679.75,8711.78,United Healthcare,Default,Fee Schedule,7898.68,,,,5711.05,7898.68
INSULIN DETEMIR 10ML VIAL (LEVEMIR),J1815,HCPCS,636,RC,,both,622.5,560.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,435.75,,,,367.28,507.96
INSULIN DETEMIR 10ML VIAL (LEVEMIR),J1815,HCPCS,636,RC,,both,622.5,560.25,Cigna,Default,Percent of Total Billed Charges,367.28,,,,367.28,507.96
INSULIN DETEMIR 10ML VIAL (LEVEMIR),J1815,HCPCS,636,RC,,both,622.5,560.25,United Healthcare,Default,Fee Schedule,507.96,,,,367.28,507.96
MELOXICAM 7.5MG TAB (MOBIC),637,RC,,,,both,15.11,13.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.58,,,,8.91,12.33
MELOXICAM 7.5MG TAB (MOBIC),637,RC,,,,both,15.11,13.6,Cigna,Default,Percent of Total Billed Charges,8.91,,,,8.91,12.33
MELOXICAM 7.5MG TAB (MOBIC),637,RC,,,,both,15.11,13.6,United Healthcare,Default,Fee Schedule,12.33,,,,8.91,12.33
TRIMETHOPRIM 100MG TAB (PRIMSOL),637,RC,,,,both,6.64,5.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.65,,,,3.92,5.42
TRIMETHOPRIM 100MG TAB (PRIMSOL),637,RC,,,,both,6.64,5.98,Cigna,Default,Percent of Total Billed Charges,3.92,,,,3.92,5.42
TRIMETHOPRIM 100MG TAB (PRIMSOL),637,RC,,,,both,6.64,5.98,United Healthcare,Default,Fee Schedule,5.42,,,,3.92,5.42
GENTAMICIN 40MG/ML 20ML VIAL,J1580,HCPCS,636,RC,,both,150.78,135.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,105.55,,,,88.96,123.04
GENTAMICIN 40MG/ML 20ML VIAL,J1580,HCPCS,636,RC,,both,150.78,135.7,Cigna,Default,Percent of Total Billed Charges,88.96,,,,88.96,123.04
GENTAMICIN 40MG/ML 20ML VIAL,J1580,HCPCS,636,RC,,both,150.78,135.7,United Healthcare,Default,Fee Schedule,123.04,,,,88.96,123.04
CARBOXYMETHYLCELLULOSE EYE OINT 3.5GM,637,RC,,,,both,40.68,36.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.48,,,,24,33.19
CARBOXYMETHYLCELLULOSE EYE OINT 3.5GM,637,RC,,,,both,40.68,36.61,Cigna,Default,Percent of Total Billed Charges,24,,,,24,33.19
CARBOXYMETHYLCELLULOSE EYE OINT 3.5GM,637,RC,,,,both,40.68,36.61,United Healthcare,Default,Fee Schedule,33.19,,,,24,33.19
ENOXAPARIN SQ 30MG/0.3ML (LOVENOX),250,RC,,,,both,129.58,116.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,90.71,,,,76.45,105.74
ENOXAPARIN SQ 30MG/0.3ML (LOVENOX),250,RC,,,,both,129.58,116.62,Cigna,Default,Percent of Total Billed Charges,76.45,,,,76.45,105.74
ENOXAPARIN SQ 30MG/0.3ML (LOVENOX),250,RC,,,,both,129.58,116.62,United Healthcare,Default,Fee Schedule,105.74,,,,76.45,105.74
NM RENAL DOSE (TC MAG3),A9562,HCPCS,343,RC,,both,1700.26,1530.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1190.18,,,,1003.15,1387.41
NM RENAL DOSE (TC MAG3),A9562,HCPCS,343,RC,,both,1700.26,1530.23,Cigna,Default,Percent of Total Billed Charges,1003.15,,,,1003.15,1387.41
NM RENAL DOSE (TC MAG3),A9562,HCPCS,343,RC,,both,1700.26,1530.23,United Healthcare,Default,Fee Schedule,1387.41,,,,1003.15,1387.41
NM HEPATOBILIARY DOSE- CHO,A9537,HCPCS,343,RC,,both,205.66,185.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,143.96,,,,121.34,167.82
NM HEPATOBILIARY DOSE- CHO,A9537,HCPCS,343,RC,,both,205.66,185.09,Cigna,Default,Percent of Total Billed Charges,121.34,,,,121.34,167.82
NM HEPATOBILIARY DOSE- CHO,A9537,HCPCS,343,RC,,both,205.66,185.09,United Healthcare,Default,Fee Schedule,167.82,,,,121.34,167.82
ROFLUMILAST 500MG TAB (DALIRESP),637,RC,,,,both,31.53,28.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.07,,,,18.6,25.73
ROFLUMILAST 500MG TAB (DALIRESP),637,RC,,,,both,31.53,28.38,Cigna,Default,Percent of Total Billed Charges,18.6,,,,18.6,25.73
ROFLUMILAST 500MG TAB (DALIRESP),637,RC,,,,both,31.53,28.38,United Healthcare,Default,Fee Schedule,25.73,,,,18.6,25.73
NM MUGA DOSE (PYP),A9560,HCPCS,343,RC,,both,149.91,134.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.94,,,,88.45,122.33
NM MUGA DOSE (PYP),A9560,HCPCS,343,RC,,both,149.91,134.92,Cigna,Default,Percent of Total Billed Charges,88.45,,,,88.45,122.33
NM MUGA DOSE (PYP),A9560,HCPCS,343,RC,,both,149.91,134.92,United Healthcare,Default,Fee Schedule,122.33,,,,88.45,122.33
NM CARDIOLITE DOSE (TC),A9500,HCPCS,343,RC,,both,332,298.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,232.4,,,,195.88,270.91
NM CARDIOLITE DOSE (TC),A9500,HCPCS,343,RC,,both,332,298.8,Cigna,Default,Percent of Total Billed Charges,195.88,,,,195.88,270.91
NM CARDIOLITE DOSE (TC),A9500,HCPCS,343,RC,,both,332,298.8,United Healthcare,Default,Fee Schedule,270.91,,,,195.88,270.91
NM BONE DOSE (TCMDP),A9503,HCPCS,343,RC,,both,123.65,111.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.56,,,,72.95,100.9
NM BONE DOSE (TCMDP),A9503,HCPCS,343,RC,,both,123.65,111.29,Cigna,Default,Percent of Total Billed Charges,72.95,,,,72.95,100.9
NM BONE DOSE (TCMDP),A9503,HCPCS,343,RC,,both,123.65,111.29,United Healthcare,Default,Fee Schedule,100.9,,,,72.95,100.9
NM TC99 FILTERED,A9520,HCPCS,343,RC,,both,864.37,777.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,605.06,,,,509.98,705.33
NM TC99 FILTERED,A9520,HCPCS,343,RC,,both,864.37,777.93,Cigna,Default,Percent of Total Billed Charges,509.98,,,,509.98,705.33
NM TC99 FILTERED,A9520,HCPCS,343,RC,,both,864.37,777.93,United Healthcare,Default,Fee Schedule,705.33,,,,509.98,705.33
NM Tc99m CERETEC,A9521,HCPCS,343,RC,,both,2154.67,1939.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1508.27,,,,1271.26,1758.21
NM Tc99m CERETEC,A9521,HCPCS,343,RC,,both,2154.67,1939.2,Cigna,Default,Percent of Total Billed Charges,1271.26,,,,1271.26,1758.21
NM Tc99m CERETEC,A9521,HCPCS,343,RC,,both,2154.67,1939.2,United Healthcare,Default,Fee Schedule,1758.21,,,,1271.26,1758.21
SYSTANE BALANCE EYE DROP 10ML,637,RC,,,,both,39.82,35.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.87,,,,23.49,32.49
SYSTANE BALANCE EYE DROP 10ML,637,RC,,,,both,39.82,35.84,Cigna,Default,Percent of Total Billed Charges,23.49,,,,23.49,32.49
SYSTANE BALANCE EYE DROP 10ML,637,RC,,,,both,39.82,35.84,United Healthcare,Default,Fee Schedule,32.49,,,,23.49,32.49
DARIFENACIN 7.5MG TAB (ENABLEX),637,RC,,,,both,23.82,21.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.67,,,,14.05,19.44
DARIFENACIN 7.5MG TAB (ENABLEX),637,RC,,,,both,23.82,21.44,Cigna,Default,Percent of Total Billed Charges,14.05,,,,14.05,19.44
DARIFENACIN 7.5MG TAB (ENABLEX),637,RC,,,,both,23.82,21.44,United Healthcare,Default,Fee Schedule,19.44,,,,14.05,19.44
RIFAMPIN 600MG VIAL (RIFADIN),250,RC,,,,both,355.35,319.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,248.74,,,,209.66,289.97
RIFAMPIN 600MG VIAL (RIFADIN),250,RC,,,,both,355.35,319.82,Cigna,Default,Percent of Total Billed Charges,209.66,,,,209.66,289.97
RIFAMPIN 600MG VIAL (RIFADIN),250,RC,,,,both,355.35,319.82,United Healthcare,Default,Fee Schedule,289.97,,,,209.66,289.97
MITOMYCIN 40MG VIAL,J9280,HCPCS,250,RC,,both,5662.56,5096.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3963.79,,,,3340.91,4620.65
MITOMYCIN 40MG VIAL,J9280,HCPCS,250,RC,,both,5662.56,5096.3,Cigna,Default,Percent of Total Billed Charges,3340.91,,,,3340.91,4620.65
MITOMYCIN 40MG VIAL,J9280,HCPCS,250,RC,,both,5662.56,5096.3,United Healthcare,Default,Fee Schedule,4620.65,,,,3340.91,4620.65
MITOMYCIN 5MG VIAL,250,RC,,,,both,210.5,189.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,147.35,,,,124.2,171.77
MITOMYCIN 5MG VIAL,250,RC,,,,both,210.5,189.45,Cigna,Default,Percent of Total Billed Charges,124.2,,,,124.2,171.77
MITOMYCIN 5MG VIAL,250,RC,,,,both,210.5,189.45,United Healthcare,Default,Fee Schedule,171.77,,,,124.2,171.77
RAMIPRIL 10MG CAP (ALTACE),637,RC,,,,both,6,5.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.2,,,,3.54,4.9
RAMIPRIL 10MG CAP (ALTACE),637,RC,,,,both,6,5.4,Cigna,Default,Percent of Total Billed Charges,3.54,,,,3.54,4.9
RAMIPRIL 10MG CAP (ALTACE),637,RC,,,,both,6,5.4,United Healthcare,Default,Fee Schedule,4.9,,,,3.54,4.9
ENOXAPARIN SQ 100MG/ML  (LOVENOX),250,RC,,,,both,316.11,284.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,221.28,,,,186.5,257.95
ENOXAPARIN SQ 100MG/ML  (LOVENOX),250,RC,,,,both,316.11,284.5,Cigna,Default,Percent of Total Billed Charges,186.5,,,,186.5,257.95
ENOXAPARIN SQ 100MG/ML  (LOVENOX),250,RC,,,,both,316.11,284.5,United Healthcare,Default,Fee Schedule,257.95,,,,186.5,257.95
CORICIDIN HBP COUGH & CONGESTION,637,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
CORICIDIN HBP COUGH & CONGESTION,637,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
CORICIDIN HBP COUGH & CONGESTION,637,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
NM IODINE 123,A9516,HCPCS,343,RC,,both,326.56,293.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.59,,,,192.67,266.47
NM IODINE 123,A9516,HCPCS,343,RC,,both,326.56,293.9,Cigna,Default,Percent of Total Billed Charges,192.67,,,,192.67,266.47
NM IODINE 123,A9516,HCPCS,343,RC,,both,326.56,293.9,United Healthcare,Default,Fee Schedule,266.47,,,,192.67,266.47
VALRUBICIN 800MG/20ML (VALSTAR),J9357,HCPCS,636,RC,,both,21593.65,19434.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15115.56,,,,12740.25,17620.42
VALRUBICIN 800MG/20ML (VALSTAR),J9357,HCPCS,636,RC,,both,21593.65,19434.29,Cigna,Default,Percent of Total Billed Charges,12740.25,,,,12740.25,17620.42
VALRUBICIN 800MG/20ML (VALSTAR),J9357,HCPCS,636,RC,,both,21593.65,19434.29,United Healthcare,Default,Fee Schedule,17620.42,,,,12740.25,17620.42
TECHNETIUM Tc 99 PENTELATE DIAGNOSTIC,A9567,HCPCS,343,RC,,both,448.89,404,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.22,,,,264.85,366.29
TECHNETIUM Tc 99 PENTELATE DIAGNOSTIC,A9567,HCPCS,343,RC,,both,448.89,404,Cigna,Default,Percent of Total Billed Charges,264.85,,,,264.85,366.29
TECHNETIUM Tc 99 PENTELATE DIAGNOSTIC,A9567,HCPCS,343,RC,,both,448.89,404,United Healthcare,Default,Fee Schedule,366.29,,,,264.85,366.29
ARGATROBAN 125MG/125ML PREMIX,J0883,HCPCS,636,RC,,both,3396.17,3056.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2377.32,,,,2003.74,2771.27
ARGATROBAN 125MG/125ML PREMIX,J0883,HCPCS,636,RC,,both,3396.17,3056.55,Cigna,Default,Percent of Total Billed Charges,2003.74,,,,2003.74,2771.27
ARGATROBAN 125MG/125ML PREMIX,J0883,HCPCS,636,RC,,both,3396.17,3056.55,United Healthcare,Default,Fee Schedule,2771.27,,,,2003.74,2771.27
ACYCLOVIR 5% 15GM OINT (ZOVIRAX),250,RC,,,,both,652.56,587.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,456.79,,,,385.01,532.49
ACYCLOVIR 5% 15GM OINT (ZOVIRAX),250,RC,,,,both,652.56,587.3,Cigna,Default,Percent of Total Billed Charges,385.01,,,,385.01,532.49
ACYCLOVIR 5% 15GM OINT (ZOVIRAX),250,RC,,,,both,652.56,587.3,United Healthcare,Default,Fee Schedule,532.49,,,,385.01,532.49
ROPIVACAINE 1% 20ML INJ (NAROPIN),J2795,HCPCS,636,RC,,both,58.08,52.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.66,,,,34.27,47.39
ROPIVACAINE 1% 20ML INJ (NAROPIN),J2795,HCPCS,636,RC,,both,58.08,52.27,Cigna,Default,Percent of Total Billed Charges,34.27,,,,34.27,47.39
ROPIVACAINE 1% 20ML INJ (NAROPIN),J2795,HCPCS,636,RC,,both,58.08,52.27,United Healthcare,Default,Fee Schedule,47.39,,,,34.27,47.39
ENOXAPARIN SQ 60MG/0.6ML  (LOVENOX),J1650,HCPCS,636,RC,,both,138.3,124.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.81,,,,81.6,112.85
ENOXAPARIN SQ 60MG/0.6ML  (LOVENOX),J1650,HCPCS,636,RC,,both,138.3,124.47,Cigna,Default,Percent of Total Billed Charges,81.6,,,,81.6,112.85
ENOXAPARIN SQ 60MG/0.6ML  (LOVENOX),J1650,HCPCS,636,RC,,both,138.3,124.47,United Healthcare,Default,Fee Schedule,112.85,,,,81.6,112.85
AMIKACIN 1000MG/4ML INJ,J0278,HCPCS,636,RC,,both,130.14,117.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.1,,,,76.78,106.19
AMIKACIN 1000MG/4ML INJ,J0278,HCPCS,636,RC,,both,130.14,117.13,Cigna,Default,Percent of Total Billed Charges,76.78,,,,76.78,106.19
AMIKACIN 1000MG/4ML INJ,J0278,HCPCS,636,RC,,both,130.14,117.13,United Healthcare,Default,Fee Schedule,106.19,,,,76.78,106.19
NF-VIIBRYD ORAL TABLET 10MG,250,RC,,,,both,20.97,18.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.68,,,,12.37,17.11
NF-VIIBRYD ORAL TABLET 10MG,250,RC,,,,both,20.97,18.87,Cigna,Default,Percent of Total Billed Charges,12.37,,,,12.37,17.11
NF-VIIBRYD ORAL TABLET 10MG,250,RC,,,,both,20.97,18.87,United Healthcare,Default,Fee Schedule,17.11,,,,12.37,17.11
NIACIN ER 500MG TAB,250,RC,,,,both,25.38,22.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.77,,,,14.97,20.71
NIACIN ER 500MG TAB,250,RC,,,,both,25.38,22.84,Cigna,Default,Percent of Total Billed Charges,14.97,,,,14.97,20.71
NIACIN ER 500MG TAB,250,RC,,,,both,25.38,22.84,United Healthcare,Default,Fee Schedule,20.71,,,,14.97,20.71
NF- FELODIPINE TABLET ER 5MG,250,RC,,,,both,8.54,7.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.98,,,,5.04,6.97
NF- FELODIPINE TABLET ER 5MG,250,RC,,,,both,8.54,7.69,Cigna,Default,Percent of Total Billed Charges,5.04,,,,5.04,6.97
NF- FELODIPINE TABLET ER 5MG,250,RC,,,,both,8.54,7.69,United Healthcare,Default,Fee Schedule,6.97,,,,5.04,6.97
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,24.33,21.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.03,,,,14.35,19.85
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,24.33,21.9,Cigna,Default,Percent of Total Billed Charges,14.35,,,,14.35,19.85
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,24.33,21.9,United Healthcare,Default,Fee Schedule,19.85,,,,14.35,19.85
NF-CLONAZEPAM ORAL TABLET 1MG,250,RC,,,,both,7.52,6.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.26,,,,4.44,6.14
NF-CLONAZEPAM ORAL TABLET 1MG,250,RC,,,,both,7.52,6.77,Cigna,Default,Percent of Total Billed Charges,4.44,,,,4.44,6.14
NF-CLONAZEPAM ORAL TABLET 1MG,250,RC,,,,both,7.52,6.77,United Healthcare,Default,Fee Schedule,6.14,,,,4.44,6.14
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,20.96,18.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.67,,,,12.37,17.1
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,20.96,18.86,Cigna,Default,Percent of Total Billed Charges,12.37,,,,12.37,17.1
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,20.96,18.86,United Healthcare,Default,Fee Schedule,17.1,,,,12.37,17.1
NF-MECLICOT TAB 12.5MG,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-MECLICOT TAB 12.5MG,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-MECLICOT TAB 12.5MG,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-MECLIZINE HCL ORAL TABLET 12.5MG,250,RC,,,,both,3.29,2.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.3,,,,1.94,2.68
NF-MECLIZINE HCL ORAL TABLET 12.5MG,250,RC,,,,both,3.29,2.96,Cigna,Default,Percent of Total Billed Charges,1.94,,,,1.94,2.68
NF-MECLIZINE HCL ORAL TABLET 12.5MG,250,RC,,,,both,3.29,2.96,United Healthcare,Default,Fee Schedule,2.68,,,,1.94,2.68
NF-BIOBRANE GLOVES,250,RC,,,,both,986.16,887.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,690.31,,,,581.83,804.71
NF-BIOBRANE GLOVES,250,RC,,,,both,986.16,887.54,Cigna,Default,Percent of Total Billed Charges,581.83,,,,581.83,804.71
NF-BIOBRANE GLOVES,250,RC,,,,both,986.16,887.54,United Healthcare,Default,Fee Schedule,804.71,,,,581.83,804.71
NF-CORDRAN SP TOPICAL CREAM 0.05%,250,RC,,,,both,9.12,8.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.38,,,,5.38,7.44
NF-CORDRAN SP TOPICAL CREAM 0.05%,250,RC,,,,both,9.12,8.21,Cigna,Default,Percent of Total Billed Charges,5.38,,,,5.38,7.44
NF-CORDRAN SP TOPICAL CREAM 0.05%,250,RC,,,,both,9.12,8.21,United Healthcare,Default,Fee Schedule,7.44,,,,5.38,7.44
NF-MEMANTINE HCL TAB 10MG,250,RC,,,,both,20.89,18.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.62,,,,12.33,17.05
NF-MEMANTINE HCL TAB 10MG,250,RC,,,,both,20.89,18.8,Cigna,Default,Percent of Total Billed Charges,12.33,,,,12.33,17.05
NF-MEMANTINE HCL TAB 10MG,250,RC,,,,both,20.89,18.8,United Healthcare,Default,Fee Schedule,17.05,,,,12.33,17.05
NF-NEO AC ORAL SYRUP 10MG-30MG-15MG/5ML,250,RC,,,,both,0.79,0.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.55,,,,0.47,0.64
NF-NEO AC ORAL SYRUP 10MG-30MG-15MG/5ML,250,RC,,,,both,0.79,0.71,Cigna,Default,Percent of Total Billed Charges,0.47,,,,0.47,0.64
NF-NEO AC ORAL SYRUP 10MG-30MG-15MG/5ML,250,RC,,,,both,0.79,0.71,United Healthcare,Default,Fee Schedule,0.64,,,,0.47,0.64
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,34.1,30.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.87,,,,20.12,27.83
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,34.1,30.69,Cigna,Default,Percent of Total Billed Charges,20.12,,,,20.12,27.83
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,34.1,30.69,United Healthcare,Default,Fee Schedule,27.83,,,,20.12,27.83
NM Tc99m Pertechnetate Dose,A9512,HCPCS,343,RC,,both,115.33,103.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,80.73,,,,68.04,94.11
NM Tc99m Pertechnetate Dose,A9512,HCPCS,343,RC,,both,115.33,103.8,Cigna,Default,Percent of Total Billed Charges,68.04,,,,68.04,94.11
NM Tc99m Pertechnetate Dose,A9512,HCPCS,343,RC,,both,115.33,103.8,United Healthcare,Default,Fee Schedule,94.11,,,,68.04,94.11
PACLITAXEL 6MG/ML INJ,J9267,HCPCS,636,RC,,both,590.56,531.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,413.39,,,,348.43,481.9
PACLITAXEL 6MG/ML INJ,J9267,HCPCS,636,RC,,both,590.56,531.5,Cigna,Default,Percent of Total Billed Charges,348.43,,,,348.43,481.9
PACLITAXEL 6MG/ML INJ,J9267,HCPCS,636,RC,,both,590.56,531.5,United Healthcare,Default,Fee Schedule,481.9,,,,348.43,481.9
CARBOPLATIN 150 MG/15ML INJ,J9045,HCPCS,636,RC,,both,672.55,605.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,470.78,,,,396.8,548.8
CARBOPLATIN 150 MG/15ML INJ,J9045,HCPCS,636,RC,,both,672.55,605.3,Cigna,Default,Percent of Total Billed Charges,396.8,,,,396.8,548.8
CARBOPLATIN 150 MG/15ML INJ,J9045,HCPCS,636,RC,,both,672.55,605.3,United Healthcare,Default,Fee Schedule,548.8,,,,396.8,548.8
REGADENOSON 0.4MG/5ML INJ,J2785,HCPCS,636,RC,,both,1355.34,1219.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,948.74,,,,799.65,1105.96
REGADENOSON 0.4MG/5ML INJ,J2785,HCPCS,636,RC,,both,1355.34,1219.81,Cigna,Default,Percent of Total Billed Charges,799.65,,,,799.65,1105.96
REGADENOSON 0.4MG/5ML INJ,J2785,HCPCS,636,RC,,both,1355.34,1219.81,United Healthcare,Default,Fee Schedule,1105.96,,,,799.65,1105.96
NF-CHERATUSSIN AC SYR 10MG-100MG/5ML,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-CHERATUSSIN AC SYR 10MG-100MG/5ML,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-CHERATUSSIN AC SYR 10MG-100MG/5ML,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-FEXOFENADINE HCL ORAL TABLET 180MG,250,RC,,,,both,30.38,27.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.27,,,,17.92,24.79
NF-FEXOFENADINE HCL ORAL TABLET 180MG,250,RC,,,,both,30.38,27.34,Cigna,Default,Percent of Total Billed Charges,17.92,,,,17.92,24.79
NF-FEXOFENADINE HCL ORAL TABLET 180MG,250,RC,,,,both,30.38,27.34,United Healthcare,Default,Fee Schedule,24.79,,,,17.92,24.79
NF-LEVOTHYROXINE IV PWD FOR SOLN 100MCG,250,RC,,,,both,306.81,276.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,214.77,,,,181.02,250.36
NF-LEVOTHYROXINE IV PWD FOR SOLN 100MCG,250,RC,,,,both,306.81,276.13,Cigna,Default,Percent of Total Billed Charges,181.02,,,,181.02,250.36
NF-LEVOTHYROXINE IV PWD FOR SOLN 100MCG,250,RC,,,,both,306.81,276.13,United Healthcare,Default,Fee Schedule,250.36,,,,181.02,250.36
NF-ATACAND HCT TAB 16MG-12.5MG,250,RC,,,,both,13.59,12.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.51,,,,8.02,11.09
NF-ATACAND HCT TAB 16MG-12.5MG,250,RC,,,,both,13.59,12.23,Cigna,Default,Percent of Total Billed Charges,8.02,,,,8.02,11.09
NF-ATACAND HCT TAB 16MG-12.5MG,250,RC,,,,both,13.59,12.23,United Healthcare,Default,Fee Schedule,11.09,,,,8.02,11.09
NF-RISPERDAL ORAL TABLET 0.5MG,250,RC,,,,both,21.23,19.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.86,,,,12.53,17.32
NF-RISPERDAL ORAL TABLET 0.5MG,250,RC,,,,both,21.23,19.11,Cigna,Default,Percent of Total Billed Charges,12.53,,,,12.53,17.32
NF-RISPERDAL ORAL TABLET 0.5MG,250,RC,,,,both,21.23,19.11,United Healthcare,Default,Fee Schedule,17.32,,,,12.53,17.32
NF-LYRICA CAP 100MG,250,RC,,,,both,16.24,14.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.37,,,,9.58,13.25
NF-LYRICA CAP 100MG,250,RC,,,,both,16.24,14.62,Cigna,Default,Percent of Total Billed Charges,9.58,,,,9.58,13.25
NF-LYRICA CAP 100MG,250,RC,,,,both,16.24,14.62,United Healthcare,Default,Fee Schedule,13.25,,,,9.58,13.25
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,12.33,11.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.63,,,,7.27,10.06
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,12.33,11.1,Cigna,Default,Percent of Total Billed Charges,7.27,,,,7.27,10.06
NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,250,RC,,,,both,12.33,11.1,United Healthcare,Default,Fee Schedule,10.06,,,,7.27,10.06
NF-ISOSORBIDE DINITRATE ORAL TABLET 30MG,250,RC,,,,both,5.57,5.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.9,,,,3.29,4.55
NF-ISOSORBIDE DINITRATE ORAL TABLET 30MG,250,RC,,,,both,5.57,5.01,Cigna,Default,Percent of Total Billed Charges,3.29,,,,3.29,4.55
NF-ISOSORBIDE DINITRATE ORAL TABLET 30MG,250,RC,,,,both,5.57,5.01,United Healthcare,Default,Fee Schedule,4.55,,,,3.29,4.55
NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,250,RC,,,,both,2.96,2.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.07,,,,1.75,2.42
NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,250,RC,,,,both,2.96,2.66,Cigna,Default,Percent of Total Billed Charges,1.75,,,,1.75,2.42
NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,250,RC,,,,both,2.96,2.66,United Healthcare,Default,Fee Schedule,2.42,,,,1.75,2.42
NF-PROTONIX ORAL TABLET 40MG,250,RC,,,,both,20.24,18.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.17,,,,11.94,16.52
NF-PROTONIX ORAL TABLET 40MG,250,RC,,,,both,20.24,18.22,Cigna,Default,Percent of Total Billed Charges,11.94,,,,11.94,16.52
NF-PROTONIX ORAL TABLET 40MG,250,RC,,,,both,20.24,18.22,United Healthcare,Default,Fee Schedule,16.52,,,,11.94,16.52
NF-ATORVASTATIN CALCIUM ORAL TAB 20MG,250,RC,,,,both,24.3,21.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.01,,,,14.34,19.83
NF-ATORVASTATIN CALCIUM ORAL TAB 20MG,250,RC,,,,both,24.3,21.87,Cigna,Default,Percent of Total Billed Charges,14.34,,,,14.34,19.83
NF-ATORVASTATIN CALCIUM ORAL TAB 20MG,250,RC,,,,both,24.3,21.87,United Healthcare,Default,Fee Schedule,19.83,,,,14.34,19.83
NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG,250,RC,,,,both,26.05,23.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.24,,,,15.37,21.26
NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG,250,RC,,,,both,26.05,23.45,Cigna,Default,Percent of Total Billed Charges,15.37,,,,15.37,21.26
NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG,250,RC,,,,both,26.05,23.45,United Healthcare,Default,Fee Schedule,21.26,,,,15.37,21.26
NF-RABEPRAZOLE SODIUM TAB EC 20MG,250,RC,,,,both,41.06,36.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.74,,,,24.23,33.5
NF-RABEPRAZOLE SODIUM TAB EC 20MG,250,RC,,,,both,41.06,36.95,Cigna,Default,Percent of Total Billed Charges,24.23,,,,24.23,33.5
NF-RABEPRAZOLE SODIUM TAB EC 20MG,250,RC,,,,both,41.06,36.95,United Healthcare,Default,Fee Schedule,33.5,,,,24.23,33.5
NF-CRESTOR TAB 10MG,250,RC,,,,both,26.99,24.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.89,,,,15.92,22.02
NF-CRESTOR TAB 10MG,250,RC,,,,both,26.99,24.29,Cigna,Default,Percent of Total Billed Charges,15.92,,,,15.92,22.02
NF-CRESTOR TAB 10MG,250,RC,,,,both,26.99,24.29,United Healthcare,Default,Fee Schedule,22.02,,,,15.92,22.02
NF-ZESTRIL TABLET 10MG,250,RC,,,,both,6.22,5.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.35,,,,3.67,5.08
NF-ZESTRIL TABLET 10MG,250,RC,,,,both,6.22,5.6,Cigna,Default,Percent of Total Billed Charges,3.67,,,,3.67,5.08
NF-ZESTRIL TABLET 10MG,250,RC,,,,both,6.22,5.6,United Healthcare,Default,Fee Schedule,5.08,,,,3.67,5.08
NF-ESCITALOPRAM ORAL TABLET 10MG,250,RC,,,,both,1.04,0.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.73,,,,0.61,0.85
NF-ESCITALOPRAM ORAL TABLET 10MG,250,RC,,,,both,1.04,0.94,Cigna,Default,Percent of Total Billed Charges,0.61,,,,0.61,0.85
NF-ESCITALOPRAM ORAL TABLET 10MG,250,RC,,,,both,1.04,0.94,United Healthcare,Default,Fee Schedule,0.85,,,,0.61,0.85
NF-ESCITALOPRAM ORAL TABLET 20MG,250,RC,,,,both,18.04,16.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.63,,,,10.64,14.72
NF-ESCITALOPRAM ORAL TABLET 20MG,250,RC,,,,both,18.04,16.24,Cigna,Default,Percent of Total Billed Charges,10.64,,,,10.64,14.72
NF-ESCITALOPRAM ORAL TABLET 20MG,250,RC,,,,both,18.04,16.24,United Healthcare,Default,Fee Schedule,14.72,,,,10.64,14.72
NF-CITALOPRAM HBR ORAL TAB 40MG,250,RC,,,,both,1.46,1.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.02,,,,0.86,1.19
NF-CITALOPRAM HBR ORAL TAB 40MG,250,RC,,,,both,1.46,1.31,Cigna,Default,Percent of Total Billed Charges,0.86,,,,0.86,1.19
NF-CITALOPRAM HBR ORAL TAB 40MG,250,RC,,,,both,1.46,1.31,United Healthcare,Default,Fee Schedule,1.19,,,,0.86,1.19
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,4.55,4.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.18,,,,2.68,3.71
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,4.55,4.1,Cigna,Default,Percent of Total Billed Charges,2.68,,,,2.68,3.71
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,4.55,4.1,United Healthcare,Default,Fee Schedule,3.71,,,,2.68,3.71
NF-LISINOPRIL ORAL TABLET 40MG,250,RC,,,,both,6.9,6.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.83,,,,4.07,5.63
NF-LISINOPRIL ORAL TABLET 40MG,250,RC,,,,both,6.9,6.21,Cigna,Default,Percent of Total Billed Charges,4.07,,,,4.07,5.63
NF-LISINOPRIL ORAL TABLET 40MG,250,RC,,,,both,6.9,6.21,United Healthcare,Default,Fee Schedule,5.63,,,,4.07,5.63
NF-MELOXICAM ORAL TAB 15MG,250,RC,,,,both,22.39,20.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.67,,,,13.21,18.27
NF-MELOXICAM ORAL TAB 15MG,250,RC,,,,both,22.39,20.15,Cigna,Default,Percent of Total Billed Charges,13.21,,,,13.21,18.27
NF-MELOXICAM ORAL TAB 15MG,250,RC,,,,both,22.39,20.15,United Healthcare,Default,Fee Schedule,18.27,,,,13.21,18.27
NF-TRAZODONE HCL ORAL TABLET 100MG,250,RC,,,,both,3.41,3.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.39,,,,2.01,2.78
NF-TRAZODONE HCL ORAL TABLET 100MG,250,RC,,,,both,3.41,3.07,Cigna,Default,Percent of Total Billed Charges,2.01,,,,2.01,2.78
NF-TRAZODONE HCL ORAL TABLET 100MG,250,RC,,,,both,3.41,3.07,United Healthcare,Default,Fee Schedule,2.78,,,,2.01,2.78
DOBUTAMINE 250MG/250ML PREMIX,J1250,HCPCS,636,RC,,both,79.09,71.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.36,,,,46.66,64.54
DOBUTAMINE 250MG/250ML PREMIX,J1250,HCPCS,636,RC,,both,79.09,71.18,Cigna,Default,Percent of Total Billed Charges,46.66,,,,46.66,64.54
DOBUTAMINE 250MG/250ML PREMIX,J1250,HCPCS,636,RC,,both,79.09,71.18,United Healthcare,Default,Fee Schedule,64.54,,,,46.66,64.54
NF-LEVOTHYROXINE ORAL TABLET 0.2MG,250,RC,,,,both,2.95,2.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.06,,,,1.74,2.41
NF-LEVOTHYROXINE ORAL TABLET 0.2MG,250,RC,,,,both,2.95,2.66,Cigna,Default,Percent of Total Billed Charges,1.74,,,,1.74,2.41
NF-LEVOTHYROXINE ORAL TABLET 0.2MG,250,RC,,,,both,2.95,2.66,United Healthcare,Default,Fee Schedule,2.41,,,,1.74,2.41
NF-MELATONIN 3MG,250,RC,,,,both,0.16,0.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.11,,,,0.09,0.13
NF-MELATONIN 3MG,250,RC,,,,both,0.16,0.14,Cigna,Default,Percent of Total Billed Charges,0.09,,,,0.09,0.13
NF-MELATONIN 3MG,250,RC,,,,both,0.16,0.14,United Healthcare,Default,Fee Schedule,0.13,,,,0.09,0.13
NF-LABETALOL HCL ORAL TABLET 200MG,250,RC,,,,both,3.52,3.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.46,,,,2.08,2.87
NF-LABETALOL HCL ORAL TABLET 200MG,250,RC,,,,both,3.52,3.17,Cigna,Default,Percent of Total Billed Charges,2.08,,,,2.08,2.87
NF-LABETALOL HCL ORAL TABLET 200MG,250,RC,,,,both,3.52,3.17,United Healthcare,Default,Fee Schedule,2.87,,,,2.08,2.87
NF-CLONAZEPAM DISINTEGRATING TAB 1MG,250,RC,,,,both,6.55,5.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.58,,,,3.86,5.34
NF-CLONAZEPAM DISINTEGRATING TAB 1MG,250,RC,,,,both,6.55,5.9,Cigna,Default,Percent of Total Billed Charges,3.86,,,,3.86,5.34
NF-CLONAZEPAM DISINTEGRATING TAB 1MG,250,RC,,,,both,6.55,5.9,United Healthcare,Default,Fee Schedule,5.34,,,,3.86,5.34
NF-DOXAZOSIN MESYLATE ORAL TABLET 8MG,250,RC,,,,both,4.8,4.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.36,,,,2.83,3.92
NF-DOXAZOSIN MESYLATE ORAL TABLET 8MG,250,RC,,,,both,4.8,4.32,Cigna,Default,Percent of Total Billed Charges,2.83,,,,2.83,3.92
NF-DOXAZOSIN MESYLATE ORAL TABLET 8MG,250,RC,,,,both,4.8,4.32,United Healthcare,Default,Fee Schedule,3.92,,,,2.83,3.92
NF-TERAZOSIN HCL CAP 2MG,250,RC,,,,both,7.46,6.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.22,,,,4.4,6.09
NF-TERAZOSIN HCL CAP 2MG,250,RC,,,,both,7.46,6.71,Cigna,Default,Percent of Total Billed Charges,4.4,,,,4.4,6.09
NF-TERAZOSIN HCL CAP 2MG,250,RC,,,,both,7.46,6.71,United Healthcare,Default,Fee Schedule,6.09,,,,4.4,6.09
PROMETHAZINE 25MG/ML 1ML INJ (PHENERGAN,J2550,HCPCS,636,RC,,both,28.48,25.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.94,,,,16.8,23.24
PROMETHAZINE 25MG/ML 1ML INJ (PHENERGAN,J2550,HCPCS,636,RC,,both,28.48,25.63,Cigna,Default,Percent of Total Billed Charges,16.8,,,,16.8,23.24
PROMETHAZINE 25MG/ML 1ML INJ (PHENERGAN,J2550,HCPCS,636,RC,,both,28.48,25.63,United Healthcare,Default,Fee Schedule,23.24,,,,16.8,23.24
NF-NIFEDIPINE ER TABLET 90MG,250,RC,,,,both,26.41,23.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.49,,,,15.58,21.55
NF-NIFEDIPINE ER TABLET 90MG,250,RC,,,,both,26.41,23.77,Cigna,Default,Percent of Total Billed Charges,15.58,,,,15.58,21.55
NF-NIFEDIPINE ER TABLET 90MG,250,RC,,,,both,26.41,23.77,United Healthcare,Default,Fee Schedule,21.55,,,,15.58,21.55
DIAZEPAM 5 MG/ML 10 ML INJ,J3360,HCPCS,636,RC,,both,88.12,79.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.68,,,,51.99,71.91
DIAZEPAM 5 MG/ML 10 ML INJ,J3360,HCPCS,636,RC,,both,88.12,79.31,Cigna,Default,Percent of Total Billed Charges,51.99,,,,51.99,71.91
DIAZEPAM 5 MG/ML 10 ML INJ,J3360,HCPCS,636,RC,,both,88.12,79.31,United Healthcare,Default,Fee Schedule,71.91,,,,51.99,71.91
TETANUS TOX/DIPHTH/PERTUS INJ (ADACEL),90715,HCPCS,636,RC,,both,268.5,241.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,187.95,,,,158.42,219.1
TETANUS TOX/DIPHTH/PERTUS INJ (ADACEL),90715,HCPCS,636,RC,,both,268.5,241.65,Cigna,Default,Percent of Total Billed Charges,158.42,,,,158.42,219.1
TETANUS TOX/DIPHTH/PERTUS INJ (ADACEL),90715,HCPCS,636,RC,,both,268.5,241.65,United Healthcare,Default,Fee Schedule,219.1,,,,158.42,219.1
NF-DEMECLOCYCLINE HCL TAB 300MG,250,RC,,,,both,79.34,71.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.54,,,,46.81,64.74
NF-DEMECLOCYCLINE HCL TAB 300MG,250,RC,,,,both,79.34,71.41,Cigna,Default,Percent of Total Billed Charges,46.81,,,,46.81,64.74
NF-DEMECLOCYCLINE HCL TAB 300MG,250,RC,,,,both,79.34,71.41,United Healthcare,Default,Fee Schedule,64.74,,,,46.81,64.74
NF-DEMECLOCYCLINE HCL ORAL TABLET 300MG,250,RC,,,,both,89.01,80.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,62.31,,,,52.52,72.63
NF-DEMECLOCYCLINE HCL ORAL TABLET 300MG,250,RC,,,,both,89.01,80.11,Cigna,Default,Percent of Total Billed Charges,52.52,,,,52.52,72.63
NF-DEMECLOCYCLINE HCL ORAL TABLET 300MG,250,RC,,,,both,89.01,80.11,United Healthcare,Default,Fee Schedule,72.63,,,,52.52,72.63
NF-BETAINE HYDROCHLORIDE POWDER,250,RC,,,,both,0.1,0.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.07,,,,0.06,0.08
NF-BETAINE HYDROCHLORIDE POWDER,250,RC,,,,both,0.1,0.09,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.08
NF-BETAINE HYDROCHLORIDE POWDER,250,RC,,,,both,0.1,0.09,United Healthcare,Default,Fee Schedule,0.08,,,,0.06,0.08
PROPARACAINE 0.5% OPHTH DROP,250,RC,,,,both,203.99,183.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.79,,,,120.35,166.46
PROPARACAINE 0.5% OPHTH DROP,250,RC,,,,both,203.99,183.59,Cigna,Default,Percent of Total Billed Charges,120.35,,,,120.35,166.46
PROPARACAINE 0.5% OPHTH DROP,250,RC,,,,both,203.99,183.59,United Healthcare,Default,Fee Schedule,166.46,,,,120.35,166.46
TERAZOSIN 1 MG CAP (HYTRIN),250,RC,,,,both,15.98,14.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.19,,,,9.43,13.04
TERAZOSIN 1 MG CAP (HYTRIN),250,RC,,,,both,15.98,14.38,Cigna,Default,Percent of Total Billed Charges,9.43,,,,9.43,13.04
TERAZOSIN 1 MG CAP (HYTRIN),250,RC,,,,both,15.98,14.38,United Healthcare,Default,Fee Schedule,13.04,,,,9.43,13.04
NF-TERAZOSIN HCL CAP 2MG,250,RC,,,,both,7.46,6.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.22,,,,4.4,6.09
NF-TERAZOSIN HCL CAP 2MG,250,RC,,,,both,7.46,6.71,Cigna,Default,Percent of Total Billed Charges,4.4,,,,4.4,6.09
NF-TERAZOSIN HCL CAP 2MG,250,RC,,,,both,7.46,6.71,United Healthcare,Default,Fee Schedule,6.09,,,,4.4,6.09
NF-PRADAXA ORAL CAPSULE 75MG,250,RC,,,,both,19.36,17.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.55,,,,11.42,15.8
NF-PRADAXA ORAL CAPSULE 75MG,250,RC,,,,both,19.36,17.42,Cigna,Default,Percent of Total Billed Charges,11.42,,,,11.42,15.8
NF-PRADAXA ORAL CAPSULE 75MG,250,RC,,,,both,19.36,17.42,United Healthcare,Default,Fee Schedule,15.8,,,,11.42,15.8
NF-ICAPS ORIGINAL ORAL TABLET,250,RC,,,,both,0.72,0.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.5,,,,0.42,0.59
NF-ICAPS ORIGINAL ORAL TABLET,250,RC,,,,both,0.72,0.65,Cigna,Default,Percent of Total Billed Charges,0.42,,,,0.42,0.59
NF-ICAPS ORIGINAL ORAL TABLET,250,RC,,,,both,0.72,0.65,United Healthcare,Default,Fee Schedule,0.59,,,,0.42,0.59
TROPICAMIDE 1% OPHTH SOLN 15ml,250,RC,,,,both,46.49,41.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.54,,,,27.43,37.94
TROPICAMIDE 1% OPHTH SOLN 15ml,250,RC,,,,both,46.49,41.84,Cigna,Default,Percent of Total Billed Charges,27.43,,,,27.43,37.94
TROPICAMIDE 1% OPHTH SOLN 15ml,250,RC,,,,both,46.49,41.84,United Healthcare,Default,Fee Schedule,37.94,,,,27.43,37.94
SUPREP BOWEL PREP KIT,250,RC,,,,both,579.51,521.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,405.66,,,,341.91,472.88
SUPREP BOWEL PREP KIT,250,RC,,,,both,579.51,521.56,Cigna,Default,Percent of Total Billed Charges,341.91,,,,341.91,472.88
SUPREP BOWEL PREP KIT,250,RC,,,,both,579.51,521.56,United Healthcare,Default,Fee Schedule,472.88,,,,341.91,472.88
BOWEL PREP KIT 16 OZ,250,RC,,,,both,399.75,359.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.82,,,,235.85,326.2
BOWEL PREP KIT 16 OZ,250,RC,,,,both,399.75,359.78,Cigna,Default,Percent of Total Billed Charges,235.85,,,,235.85,326.2
BOWEL PREP KIT 16 OZ,250,RC,,,,both,399.75,359.78,United Healthcare,Default,Fee Schedule,326.2,,,,235.85,326.2
"VITAMIN D 50,000IU CAP (ERGOCALIFEROL)",250,RC,,,,both,6.63,5.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.64,,,,3.91,5.41
"VITAMIN D 50,000IU CAP (ERGOCALIFEROL)",250,RC,,,,both,6.63,5.97,Cigna,Default,Percent of Total Billed Charges,3.91,,,,3.91,5.41
"VITAMIN D 50,000IU CAP (ERGOCALIFEROL)",250,RC,,,,both,6.63,5.97,United Healthcare,Default,Fee Schedule,5.41,,,,3.91,5.41
VITAMIN D3 5000U CAP,250,RC,,,,both,6.63,5.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.64,,,,3.91,5.41
VITAMIN D3 5000U CAP,250,RC,,,,both,6.63,5.97,Cigna,Default,Percent of Total Billed Charges,3.91,,,,3.91,5.41
VITAMIN D3 5000U CAP,250,RC,,,,both,6.63,5.97,United Healthcare,Default,Fee Schedule,5.41,,,,3.91,5.41
CALCIUM CITRATE 250 MG TAB,250,RC,,,,both,6.31,5.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.42,,,,3.72,5.15
CALCIUM CITRATE 250 MG TAB,250,RC,,,,both,6.31,5.68,Cigna,Default,Percent of Total Billed Charges,3.72,,,,3.72,5.15
CALCIUM CITRATE 250 MG TAB,250,RC,,,,both,6.31,5.68,United Healthcare,Default,Fee Schedule,5.15,,,,3.72,5.15
NF-DESMOPRESSIN ACETATE ORAL TABLET 0.2M,250,RC,,,,both,17.47,15.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.23,,,,10.31,14.26
NF-DESMOPRESSIN ACETATE ORAL TABLET 0.2M,250,RC,,,,both,17.47,15.72,Cigna,Default,Percent of Total Billed Charges,10.31,,,,10.31,14.26
NF-DESMOPRESSIN ACETATE ORAL TABLET 0.2M,250,RC,,,,both,17.47,15.72,United Healthcare,Default,Fee Schedule,14.26,,,,10.31,14.26
NF-EPLERENONE ORAL TABLET 25MG,250,RC,,,,both,16.41,14.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.49,,,,9.68,13.39
NF-EPLERENONE ORAL TABLET 25MG,250,RC,,,,both,16.41,14.77,Cigna,Default,Percent of Total Billed Charges,9.68,,,,9.68,13.39
NF-EPLERENONE ORAL TABLET 25MG,250,RC,,,,both,16.41,14.77,United Healthcare,Default,Fee Schedule,13.39,,,,9.68,13.39
"HEPLOCK 10,000units/10ML SYRINGE",250,RC,,,,both,18.89,17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.22,,,,11.15,15.41
"HEPLOCK 10,000units/10ML SYRINGE",250,RC,,,,both,18.89,17,Cigna,Default,Percent of Total Billed Charges,11.15,,,,11.15,15.41
"HEPLOCK 10,000units/10ML SYRINGE",250,RC,,,,both,18.89,17,United Healthcare,Default,Fee Schedule,15.41,,,,11.15,15.41
DESMOPRESSIN ACETATE 0.1MG TAB,250,RC,,,,both,14.04,12.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.83,,,,8.28,11.46
DESMOPRESSIN ACETATE 0.1MG TAB,250,RC,,,,both,14.04,12.64,Cigna,Default,Percent of Total Billed Charges,8.28,,,,8.28,11.46
DESMOPRESSIN ACETATE 0.1MG TAB,250,RC,,,,both,14.04,12.64,United Healthcare,Default,Fee Schedule,11.46,,,,8.28,11.46
HYDROMORPHONE 1MG/ML SOLN 8 ML,250,RC,,,,both,576,518.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,403.2,,,,339.84,470.02
HYDROMORPHONE 1MG/ML SOLN 8 ML,250,RC,,,,both,576,518.4,Cigna,Default,Percent of Total Billed Charges,339.84,,,,339.84,470.02
HYDROMORPHONE 1MG/ML SOLN 8 ML,250,RC,,,,both,576,518.4,United Healthcare,Default,Fee Schedule,470.02,,,,339.84,470.02
NAPROXEN ORAL TABLET 220MG,250,RC,,,,both,6.31,5.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.42,,,,3.72,5.15
NAPROXEN ORAL TABLET 220MG,250,RC,,,,both,6.31,5.68,Cigna,Default,Percent of Total Billed Charges,3.72,,,,3.72,5.15
NAPROXEN ORAL TABLET 220MG,250,RC,,,,both,6.31,5.68,United Healthcare,Default,Fee Schedule,5.15,,,,3.72,5.15
FIBERCON TAB 625MG,250,RC,,,,both,7.47,6.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.23,,,,4.41,6.1
FIBERCON TAB 625MG,250,RC,,,,both,7.47,6.72,Cigna,Default,Percent of Total Billed Charges,4.41,,,,4.41,6.1
FIBERCON TAB 625MG,250,RC,,,,both,7.47,6.72,United Healthcare,Default,Fee Schedule,6.1,,,,4.41,6.1
NF-CYMBALTA CAP DR 30MG,250,RC,,,,both,20.89,18.8,United Healthcare,Default,Fee Schedule,17.05,,,,12.33,17.05
PRASUGREL 10MG TAB (EFFIENT),250,RC,,,,both,43.97,39.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.78,,,,25.94,35.88
PRASUGREL 10MG TAB (EFFIENT),250,RC,,,,both,43.97,39.57,Cigna,Default,Percent of Total Billed Charges,25.94,,,,25.94,35.88
PRASUGREL 10MG TAB (EFFIENT),250,RC,,,,both,43.97,39.57,United Healthcare,Default,Fee Schedule,35.88,,,,25.94,35.88
FENOFIBRATE 160MG TAB (TRICOR),637,RC,,,,both,31.55,28.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.08,,,,18.61,25.74
FENOFIBRATE 160MG TAB (TRICOR),637,RC,,,,both,31.55,28.4,Cigna,Default,Percent of Total Billed Charges,18.61,,,,18.61,25.74
FENOFIBRATE 160MG TAB (TRICOR),637,RC,,,,both,31.55,28.4,United Healthcare,Default,Fee Schedule,25.74,,,,18.61,25.74
BUDESONIDE NEB 0.5MG/2ML(PULMICORT),J7626,HCPCS,250,RC,,both,68.22,61.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.75,,,,40.25,55.67
BUDESONIDE NEB 0.5MG/2ML(PULMICORT),J7626,HCPCS,250,RC,,both,68.22,61.4,Cigna,Default,Percent of Total Billed Charges,40.25,,,,40.25,55.67
BUDESONIDE NEB 0.5MG/2ML(PULMICORT),J7626,HCPCS,250,RC,,both,68.22,61.4,United Healthcare,Default,Fee Schedule,55.67,,,,40.25,55.67
LEVETIRACETAM 1000MG IVPB PREMIX,J1953,HCPCS,636,RC,,both,254.4,228.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,178.08,,,,150.1,207.59
LEVETIRACETAM 1000MG IVPB PREMIX,J1953,HCPCS,636,RC,,both,254.4,228.96,Cigna,Default,Percent of Total Billed Charges,150.1,,,,150.1,207.59
LEVETIRACETAM 1000MG IVPB PREMIX,J1953,HCPCS,636,RC,,both,254.4,228.96,United Healthcare,Default,Fee Schedule,207.59,,,,150.1,207.59
LEVETIRACETAM 500MG/5ML  5ML INJ,J1953,HCPCS,636,RC,,both,166.12,149.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.28,,,,98.01,135.55
LEVETIRACETAM 500MG/5ML  5ML INJ,J1953,HCPCS,636,RC,,both,166.12,149.51,Cigna,Default,Percent of Total Billed Charges,98.01,,,,98.01,135.55
LEVETIRACETAM 500MG/5ML  5ML INJ,J1953,HCPCS,636,RC,,both,166.12,149.51,United Healthcare,Default,Fee Schedule,135.55,,,,98.01,135.55
HYDROCODONE/APAP TAB 7.5/325MG(NORCO),637,RC,,,,both,6.98,6.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.89,,,,4.12,5.7
HYDROCODONE/APAP TAB 7.5/325MG(NORCO),637,RC,,,,both,6.98,6.28,Cigna,Default,Percent of Total Billed Charges,4.12,,,,4.12,5.7
HYDROCODONE/APAP TAB 7.5/325MG(NORCO),637,RC,,,,both,6.98,6.28,United Healthcare,Default,Fee Schedule,5.7,,,,4.12,5.7
FERUMOXYTOL  510MG/17ML INJ(FERAHEME),Q0138,HCPCS,636,RC,,both,2857.84,2572.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2000.49,,,,1686.13,2332
FERUMOXYTOL  510MG/17ML INJ(FERAHEME),Q0138,HCPCS,636,RC,,both,2857.84,2572.06,Cigna,Default,Percent of Total Billed Charges,1686.13,,,,1686.13,2332
FERUMOXYTOL  510MG/17ML INJ(FERAHEME),Q0138,HCPCS,636,RC,,both,2857.84,2572.06,United Healthcare,Default,Fee Schedule,2332,,,,1686.13,2332
NF-GLIMEPIRIDE ORAL TABLET 2MG,250,RC,,,,both,3.9,3.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.73,,,,2.3,3.18
NF-GLIMEPIRIDE ORAL TABLET 2MG,250,RC,,,,both,3.9,3.51,Cigna,Default,Percent of Total Billed Charges,2.3,,,,2.3,3.18
NF-GLIMEPIRIDE ORAL TABLET 2MG,250,RC,,,,both,3.9,3.51,United Healthcare,Default,Fee Schedule,3.18,,,,2.3,3.18
GLIMEPERIDE 2MG TAB (AMARYL),250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
GLIMEPERIDE 2MG TAB (AMARYL),250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
GLIMEPERIDE 2MG TAB (AMARYL),250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
SITAGLIPTIN 50MG TAB (JANUVIA),637,RC,,,,both,88.45,79.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.92,,,,52.19,72.18
SITAGLIPTIN 50MG TAB (JANUVIA),637,RC,,,,both,88.45,79.61,Cigna,Default,Percent of Total Billed Charges,52.19,,,,52.19,72.18
SITAGLIPTIN 50MG TAB (JANUVIA),637,RC,,,,both,88.45,79.61,United Healthcare,Default,Fee Schedule,72.18,,,,52.19,72.18
NF-METOLAZONE ORAL TABLET 5MG,250,RC,,,,both,6.67,6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.67,,,,3.94,5.44
NF-METOLAZONE ORAL TABLET 5MG,250,RC,,,,both,6.67,6,Cigna,Default,Percent of Total Billed Charges,3.94,,,,3.94,5.44
NF-METOLAZONE ORAL TABLET 5MG,250,RC,,,,both,6.67,6,United Healthcare,Default,Fee Schedule,5.44,,,,3.94,5.44
LEVETIRACETAM 500MG PREMIX (KEPPRA),J1953,HCPCS,636,RC,,both,152.6,137.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.82,,,,90.03,124.52
LEVETIRACETAM 500MG PREMIX (KEPPRA),J1953,HCPCS,636,RC,,both,152.6,137.34,Cigna,Default,Percent of Total Billed Charges,90.03,,,,90.03,124.52
LEVETIRACETAM 500MG PREMIX (KEPPRA),J1953,HCPCS,636,RC,,both,152.6,137.34,United Healthcare,Default,Fee Schedule,124.52,,,,90.03,124.52
LEVETIRACETAM 100MG/ML ORAL SOLN 120ML,250,RC,,,,both,399.75,359.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,279.82,,,,235.85,326.2
LEVETIRACETAM 100MG/ML ORAL SOLN 120ML,250,RC,,,,both,399.75,359.78,Cigna,Default,Percent of Total Billed Charges,235.85,,,,235.85,326.2
LEVETIRACETAM 100MG/ML ORAL SOLN 120ML,250,RC,,,,both,399.75,359.78,United Healthcare,Default,Fee Schedule,326.2,,,,235.85,326.2
AMIODARONE 450MG/9ML (50MG/ML)CORDARONE,J0282,HCPCS,636,RC,,both,40.96,36.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.67,,,,24.17,33.42
AMIODARONE 450MG/9ML (50MG/ML)CORDARONE,J0282,HCPCS,636,RC,,both,40.96,36.86,Cigna,Default,Percent of Total Billed Charges,24.17,,,,24.17,33.42
AMIODARONE 450MG/9ML (50MG/ML)CORDARONE,J0282,HCPCS,636,RC,,both,40.96,36.86,United Healthcare,Default,Fee Schedule,33.42,,,,24.17,33.42
LEVETIRACETAM 500MG/5ML  5ML INJ,J1953,HCPCS,636,RC,,both,40.71,36.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.5,,,,24.02,33.22
LEVETIRACETAM 500MG/5ML  5ML INJ,J1953,HCPCS,636,RC,,both,40.71,36.64,Cigna,Default,Percent of Total Billed Charges,24.02,,,,24.02,33.22
LEVETIRACETAM 500MG/5ML  5ML INJ,J1953,HCPCS,636,RC,,both,40.71,36.64,United Healthcare,Default,Fee Schedule,33.22,,,,24.02,33.22
ATORVASTATIN 20MG TAB (LIPITOR),637,RC,,,,both,24.67,22.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.27,,,,14.56,20.13
ATORVASTATIN 20MG TAB (LIPITOR),637,RC,,,,both,24.67,22.2,Cigna,Default,Percent of Total Billed Charges,14.56,,,,14.56,20.13
ATORVASTATIN 20MG TAB (LIPITOR),637,RC,,,,both,24.67,22.2,United Healthcare,Default,Fee Schedule,20.13,,,,14.56,20.13
NEPHRO-VITE TAB,637,RC,,,,both,6.68,6.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.68,,,,3.94,5.45
NEPHRO-VITE TAB,637,RC,,,,both,6.68,6.01,Cigna,Default,Percent of Total Billed Charges,3.94,,,,3.94,5.45
NEPHRO-VITE TAB,637,RC,,,,both,6.68,6.01,United Healthcare,Default,Fee Schedule,5.45,,,,3.94,5.45
POTASSIUM CHLORIDE/NS IVPB: 20MEQ/100ML,250,RC,,,,both,28.48,25.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.94,,,,16.8,23.24
POTASSIUM CHLORIDE/NS IVPB: 20MEQ/100ML,250,RC,,,,both,28.48,25.63,Cigna,Default,Percent of Total Billed Charges,16.8,,,,16.8,23.24
POTASSIUM CHLORIDE/NS IVPB: 20MEQ/100ML,250,RC,,,,both,28.48,25.63,United Healthcare,Default,Fee Schedule,23.24,,,,16.8,23.24
ACETYLCYSTEINE 20% INH RESP SOLN 4ML(MUC,J7608,HCPCS,250,RC,,both,70.74,63.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.52,,,,41.74,57.72
ACETYLCYSTEINE 20% INH RESP SOLN 4ML(MUC,J7608,HCPCS,250,RC,,both,70.74,63.67,Cigna,Default,Percent of Total Billed Charges,41.74,,,,41.74,57.72
ACETYLCYSTEINE 20% INH RESP SOLN 4ML(MUC,J7608,HCPCS,250,RC,,both,70.74,63.67,United Healthcare,Default,Fee Schedule,57.72,,,,41.74,57.72
NITROGLYCERIN 2% OINT 1 GM PKT(NITROBID),637,RC,,,,both,14.59,13.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.21,,,,8.61,11.91
NITROGLYCERIN 2% OINT 1 GM PKT(NITROBID),637,RC,,,,both,14.59,13.13,Cigna,Default,Percent of Total Billed Charges,8.61,,,,8.61,11.91
NITROGLYCERIN 2% OINT 1 GM PKT(NITROBID),637,RC,,,,both,14.59,13.13,United Healthcare,Default,Fee Schedule,11.91,,,,8.61,11.91
TICAGRELOR 90MG TAB (BRILINTA),250,RC,,,,both,38.8,34.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.16,,,,22.89,31.66
TICAGRELOR 90MG TAB (BRILINTA),250,RC,,,,both,38.8,34.92,Cigna,Default,Percent of Total Billed Charges,22.89,,,,22.89,31.66
TICAGRELOR 90MG TAB (BRILINTA),250,RC,,,,both,38.8,34.92,United Healthcare,Default,Fee Schedule,31.66,,,,22.89,31.66
FERUMOXYTOL INJ 510MG/17ML,Q0138,HCPCS,636,RC,,both,2557.4,2301.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1790.18,,,,1508.87,2086.84
FERUMOXYTOL INJ 510MG/17ML,Q0138,HCPCS,636,RC,,both,2557.4,2301.66,Cigna,Default,Percent of Total Billed Charges,1508.87,,,,1508.87,2086.84
FERUMOXYTOL INJ 510MG/17ML,Q0138,HCPCS,636,RC,,both,2557.4,2301.66,United Healthcare,Default,Fee Schedule,2086.84,,,,1508.87,2086.84
TROPICAMIDE OPHTH SOLN 1% 2ML,250,RC,,,,both,40,36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28,,,,23.6,32.64
TROPICAMIDE OPHTH SOLN 1% 2ML,250,RC,,,,both,40,36,Cigna,Default,Percent of Total Billed Charges,23.6,,,,23.6,32.64
TROPICAMIDE OPHTH SOLN 1% 2ML,250,RC,,,,both,40,36,United Healthcare,Default,Fee Schedule,32.64,,,,23.6,32.64
CLARITHROMYCIN ORAL SUSP 250MG/5ML 50ML,250,RC,,,,both,247.82,223.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.47,,,,146.21,202.22
CLARITHROMYCIN ORAL SUSP 250MG/5ML 50ML,250,RC,,,,both,247.82,223.04,Cigna,Default,Percent of Total Billed Charges,146.21,,,,146.21,202.22
CLARITHROMYCIN ORAL SUSP 250MG/5ML 50ML,250,RC,,,,both,247.82,223.04,United Healthcare,Default,Fee Schedule,202.22,,,,146.21,202.22
APIXABAN 2.5MG TABLET,250,RC,,,,both,51.12,46.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.78,,,,30.16,41.71
APIXABAN 2.5MG TABLET,250,RC,,,,both,51.12,46.01,Cigna,Default,Percent of Total Billed Charges,30.16,,,,30.16,41.71
APIXABAN 2.5MG TABLET,250,RC,,,,both,51.12,46.01,United Healthcare,Default,Fee Schedule,41.71,,,,30.16,41.71
BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,14.79,13.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.35,,,,8.73,12.07
BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,14.79,13.31,Cigna,Default,Percent of Total Billed Charges,8.73,,,,8.73,12.07
BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,14.79,13.31,United Healthcare,Default,Fee Schedule,12.07,,,,8.73,12.07
LITHIUM CARBONATE CAP 300MG,250,RC,,,,both,6.31,5.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.42,,,,3.72,5.15
LITHIUM CARBONATE CAP 300MG,250,RC,,,,both,6.31,5.68,Cigna,Default,Percent of Total Billed Charges,3.72,,,,3.72,5.15
LITHIUM CARBONATE CAP 300MG,250,RC,,,,both,6.31,5.68,United Healthcare,Default,Fee Schedule,5.15,,,,3.72,5.15
DAPTOMYCIN 500MG IV,J0878,HCPCS,636,RC,,both,2485.16,2236.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1739.61,,,,1466.24,2027.89
DAPTOMYCIN 500MG IV,J0878,HCPCS,636,RC,,both,2485.16,2236.64,Cigna,Default,Percent of Total Billed Charges,1466.24,,,,1466.24,2027.89
DAPTOMYCIN 500MG IV,J0878,HCPCS,636,RC,,both,2485.16,2236.64,United Healthcare,Default,Fee Schedule,2027.89,,,,1466.24,2027.89
INJECTAFER IV SOLN 750MG/15ML,J1439,HCPCS,636,RC,,both,4904.38,4413.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3433.07,,,,2893.58,4001.97
INJECTAFER IV SOLN 750MG/15ML,J1439,HCPCS,636,RC,,both,4904.38,4413.94,Cigna,Default,Percent of Total Billed Charges,2893.58,,,,2893.58,4001.97
INJECTAFER IV SOLN 750MG/15ML,J1439,HCPCS,636,RC,,both,4904.38,4413.94,United Healthcare,Default,Fee Schedule,4001.97,,,,2893.58,4001.97
ESZOPICLONE 1MG TAB,250,RC,,,,both,19.66,17.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.76,,,,11.6,16.04
ESZOPICLONE 1MG TAB,250,RC,,,,both,19.66,17.69,Cigna,Default,Percent of Total Billed Charges,11.6,,,,11.6,16.04
ESZOPICLONE 1MG TAB,250,RC,,,,both,19.66,17.69,United Healthcare,Default,Fee Schedule,16.04,,,,11.6,16.04
SODIUM TETRADECYL 1% INJ 2ML,250,RC,,,,both,217.93,196.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,152.55,,,,128.58,177.83
SODIUM TETRADECYL 1% INJ 2ML,250,RC,,,,both,217.93,196.14,Cigna,Default,Percent of Total Billed Charges,128.58,,,,128.58,177.83
SODIUM TETRADECYL 1% INJ 2ML,250,RC,,,,both,217.93,196.14,United Healthcare,Default,Fee Schedule,177.83,,,,128.58,177.83
SODIUM PHOSPHATE 15MMOL/5ML INJ,250,RC,,,,both,108.42,97.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.89,,,,63.97,88.47
SODIUM PHOSPHATE 15MMOL/5ML INJ,250,RC,,,,both,108.42,97.58,Cigna,Default,Percent of Total Billed Charges,63.97,,,,63.97,88.47
SODIUM PHOSPHATE 15MMOL/5ML INJ,250,RC,,,,both,108.42,97.58,United Healthcare,Default,Fee Schedule,88.47,,,,63.97,88.47
TIGECYCLINE 50MG/10ML INJ,636,RC,,,,both,664.76,598.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,465.33,,,,392.21,542.44
TIGECYCLINE 50MG/10ML INJ,636,RC,,,,both,664.76,598.28,Cigna,Default,Percent of Total Billed Charges,392.21,,,,392.21,542.44
TIGECYCLINE 50MG/10ML INJ,636,RC,,,,both,664.76,598.28,United Healthcare,Default,Fee Schedule,542.44,,,,392.21,542.44
COLESTIPOL 1000mg TAB (COLESTID),250,RC,,,,both,21.52,19.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.06,,,,12.7,17.56
COLESTIPOL 1000mg TAB (COLESTID),250,RC,,,,both,21.52,19.37,Cigna,Default,Percent of Total Billed Charges,12.7,,,,12.7,17.56
COLESTIPOL 1000mg TAB (COLESTID),250,RC,,,,both,21.52,19.37,United Healthcare,Default,Fee Schedule,17.56,,,,12.7,17.56
ZADITOR OPHTH SOLN 0.025%,250,RC,,,,both,56.67,51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.67,,,,33.44,46.24
ZADITOR OPHTH SOLN 0.025%,250,RC,,,,both,56.67,51,Cigna,Default,Percent of Total Billed Charges,33.44,,,,33.44,46.24
ZADITOR OPHTH SOLN 0.025%,250,RC,,,,both,56.67,51,United Healthcare,Default,Fee Schedule,46.24,,,,33.44,46.24
PNEUMOCCAL VACCINE 13,90670,HCPCS,636,RC,,both,1204.26,1083.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,842.98,,,,710.51,982.68
PNEUMOCCAL VACCINE 13,90670,HCPCS,636,RC,,both,1204.26,1083.83,Cigna,Default,Percent of Total Billed Charges,710.51,,,,710.51,982.68
PNEUMOCCAL VACCINE 13,90670,HCPCS,636,RC,,both,1204.26,1083.83,United Healthcare,Default,Fee Schedule,982.68,,,,710.51,982.68
MANNITOL 20% 500 ML,J2150,HCPCS,250,RC,,both,101.2,91.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,70.84,,,,59.71,82.58
MANNITOL 20% 500 ML,J2150,HCPCS,250,RC,,both,101.2,91.08,Cigna,Default,Percent of Total Billed Charges,59.71,,,,59.71,82.58
MANNITOL 20% 500 ML,J2150,HCPCS,250,RC,,both,101.2,91.08,United Healthcare,Default,Fee Schedule,82.58,,,,59.71,82.58
BCG INJ,90586,HCPCS,636,RC,,both,770.72,693.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,539.5,,,,454.72,628.91
BCG INJ,90586,HCPCS,636,RC,,both,770.72,693.65,Cigna,Default,Percent of Total Billed Charges,454.72,,,,454.72,628.91
BCG INJ,90586,HCPCS,636,RC,,both,770.72,693.65,United Healthcare,Default,Fee Schedule,628.91,,,,454.72,628.91
CARB/LEVO ER TAB 50MG-200MG,250,RC,,,,both,8.4,7.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.88,,,,4.96,6.85
CARB/LEVO ER TAB 50MG-200MG,250,RC,,,,both,8.4,7.56,Cigna,Default,Percent of Total Billed Charges,4.96,,,,4.96,6.85
CARB/LEVO ER TAB 50MG-200MG,250,RC,,,,both,8.4,7.56,United Healthcare,Default,Fee Schedule,6.85,,,,4.96,6.85
TESTOSTERONE 200MG/ML INJ,J1071,HCPCS,250,RC,,both,133.09,119.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,93.16,,,,78.52,108.6
TESTOSTERONE 200MG/ML INJ,J1071,HCPCS,250,RC,,both,133.09,119.78,Cigna,Default,Percent of Total Billed Charges,78.52,,,,78.52,108.6
TESTOSTERONE 200MG/ML INJ,J1071,HCPCS,250,RC,,both,133.09,119.78,United Healthcare,Default,Fee Schedule,108.6,,,,78.52,108.6
SUGAMMADEX 200MG/2ML INJ (BRIDION),250,RC,,,,both,595.57,536.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,416.9,,,,351.39,485.99
SUGAMMADEX 200MG/2ML INJ (BRIDION),250,RC,,,,both,595.57,536.01,Cigna,Default,Percent of Total Billed Charges,351.39,,,,351.39,485.99
SUGAMMADEX 200MG/2ML INJ (BRIDION),250,RC,,,,both,595.57,536.01,United Healthcare,Default,Fee Schedule,485.99,,,,351.39,485.99
HUMALOG MIX 75/25 INJECTION,250,RC,,,,both,137.01,123.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.91,,,,80.84,111.8
HUMALOG MIX 75/25 INJECTION,250,RC,,,,both,137.01,123.31,Cigna,Default,Percent of Total Billed Charges,80.84,,,,80.84,111.8
HUMALOG MIX 75/25 INJECTION,250,RC,,,,both,137.01,123.31,United Healthcare,Default,Fee Schedule,111.8,,,,80.84,111.8
SULFAMETH/TMP SUSP 800/160/20ML,250,RC,,,,both,22.96,20.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.07,,,,13.55,18.74
SULFAMETH/TMP SUSP 800/160/20ML,250,RC,,,,both,22.96,20.66,Cigna,Default,Percent of Total Billed Charges,13.55,,,,13.55,18.74
SULFAMETH/TMP SUSP 800/160/20ML,250,RC,,,,both,22.96,20.66,United Healthcare,Default,Fee Schedule,18.74,,,,13.55,18.74
TRANEXAMIC ACID 1000MG/10ML  INJ,250,RC,,,,both,290.55,261.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,203.38,,,,171.42,237.09
TRANEXAMIC ACID 1000MG/10ML  INJ,250,RC,,,,both,290.55,261.5,Cigna,Default,Percent of Total Billed Charges,171.42,,,,171.42,237.09
TRANEXAMIC ACID 1000MG/10ML  INJ,250,RC,,,,both,290.55,261.5,United Healthcare,Default,Fee Schedule,237.09,,,,171.42,237.09
NF-PROVERA ORAL TABLET 2.5MG,250,RC,,,,both,6.48,5.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.54,,,,3.82,5.29
NF-PROVERA ORAL TABLET 2.5MG,250,RC,,,,both,6.48,5.83,Cigna,Default,Percent of Total Billed Charges,3.82,,,,3.82,5.29
NF-PROVERA ORAL TABLET 2.5MG,250,RC,,,,both,6.48,5.83,United Healthcare,Default,Fee Schedule,5.29,,,,3.82,5.29
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,57.24,51.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.07,,,,33.77,46.71
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,57.24,51.52,Cigna,Default,Percent of Total Billed Charges,33.77,,,,33.77,46.71
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,57.24,51.52,United Healthcare,Default,Fee Schedule,46.71,,,,33.77,46.71
NF-CYPROHEPTADINE HCL ORAL TABLET 4MG,250,RC,,,,both,2.95,2.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.06,,,,1.74,2.41
NF-CYPROHEPTADINE HCL ORAL TABLET 4MG,250,RC,,,,both,2.95,2.66,Cigna,Default,Percent of Total Billed Charges,1.74,,,,1.74,2.41
NF-CYPROHEPTADINE HCL ORAL TABLET 4MG,250,RC,,,,both,2.95,2.66,United Healthcare,Default,Fee Schedule,2.41,,,,1.74,2.41
NF-ESTERIFIED ESTROGENS-METHYLTESTOSTERO,250,RC,,,,both,3.74,3.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.62,,,,2.21,3.05
NF-ESTERIFIED ESTROGENS-METHYLTESTOSTERO,250,RC,,,,both,3.74,3.37,Cigna,Default,Percent of Total Billed Charges,2.21,,,,2.21,3.05
NF-ESTERIFIED ESTROGENS-METHYLTESTOSTERO,250,RC,,,,both,3.74,3.37,United Healthcare,Default,Fee Schedule,3.05,,,,2.21,3.05
NF-CO Q-10 CAPSULE 10MG,250,RC,,,,both,1.82,1.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.27,,,,1.07,1.49
NF-CO Q-10 CAPSULE 10MG,250,RC,,,,both,1.82,1.64,Cigna,Default,Percent of Total Billed Charges,1.07,,,,1.07,1.49
NF-CO Q-10 CAPSULE 10MG,250,RC,,,,both,1.82,1.64,United Healthcare,Default,Fee Schedule,1.49,,,,1.07,1.49
NF-EFUDEX CREAM 5%,250,RC,,,,both,50.77,45.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.54,,,,29.95,41.43
NF-EFUDEX CREAM 5%,250,RC,,,,both,50.77,45.69,Cigna,Default,Percent of Total Billed Charges,29.95,,,,29.95,41.43
NF-EFUDEX CREAM 5%,250,RC,,,,both,50.77,45.69,United Healthcare,Default,Fee Schedule,41.43,,,,29.95,41.43
NF-TRIAMCINOLONE  OIN  0.1%,250,RC,,,,both,0.31,0.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.18,0.25
NF-TRIAMCINOLONE  OIN  0.1%,250,RC,,,,both,0.31,0.28,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.25
NF-TRIAMCINOLONE  OIN  0.1%,250,RC,,,,both,0.31,0.28,United Healthcare,Default,Fee Schedule,0.25,,,,0.18,0.25
NF-PROBIOTIC DIGESTIVE CARE CAP 20 BILLI,250,RC,,,,both,2.48,2.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.74,,,,1.46,2.02
NF-PROBIOTIC DIGESTIVE CARE CAP 20 BILLI,250,RC,,,,both,2.48,2.23,Cigna,Default,Percent of Total Billed Charges,1.46,,,,1.46,2.02
NF-PROBIOTIC DIGESTIVE CARE CAP 20 BILLI,250,RC,,,,both,2.48,2.23,United Healthcare,Default,Fee Schedule,2.02,,,,1.46,2.02
NF-PROBIOTIC DIGESTIVE CARE ORAL TAB 10M,250,RC,,,,both,2.83,2.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.98,,,,1.67,2.31
NF-PROBIOTIC DIGESTIVE CARE ORAL TAB 10M,250,RC,,,,both,2.83,2.55,Cigna,Default,Percent of Total Billed Charges,1.67,,,,1.67,2.31
NF-PROBIOTIC DIGESTIVE CARE ORAL TAB 10M,250,RC,,,,both,2.83,2.55,United Healthcare,Default,Fee Schedule,2.31,,,,1.67,2.31
NF-OYSCO 500 + D ORAL TABLET 500MG-200IU,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-OYSCO 500 + D ORAL TABLET 500MG-200IU,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-OYSCO 500 + D ORAL TABLET 500MG-200IU,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-VITAMIN C TABLET 100MG,250,RC,,,,both,0.08,0.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-VITAMIN C TABLET 100MG,250,RC,,,,both,0.08,0.07,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-VITAMIN C TABLET 100MG,250,RC,,,,both,0.08,0.07,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
HYDROXYZINE 50 MG/ ML  IM,250,RC,,,,both,37.8,34.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.46,,,,22.3,30.84
HYDROXYZINE 50 MG/ ML  IM,250,RC,,,,both,37.8,34.02,Cigna,Default,Percent of Total Billed Charges,22.3,,,,22.3,30.84
HYDROXYZINE 50 MG/ ML  IM,250,RC,,,,both,37.8,34.02,United Healthcare,Default,Fee Schedule,30.84,,,,22.3,30.84
NF-Morphine Sulfate Oral Cap ER 20MG,250,RC,,,,both,20,18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14,,,,11.8,16.32
NF-Morphine Sulfate Oral Cap ER 20MG,250,RC,,,,both,20,18,Cigna,Default,Percent of Total Billed Charges,11.8,,,,11.8,16.32
NF-Morphine Sulfate Oral Cap ER 20MG,250,RC,,,,both,20,18,United Healthcare,Default,Fee Schedule,16.32,,,,11.8,16.32
NF-Morphine Sulfate Oral Tab ER 15MG,250,RC,,,,both,5.81,5.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.07,,,,3.43,4.74
NF-Morphine Sulfate Oral Tab ER 15MG,250,RC,,,,both,5.81,5.23,Cigna,Default,Percent of Total Billed Charges,3.43,,,,3.43,4.74
NF-Morphine Sulfate Oral Tab ER 15MG,250,RC,,,,both,5.81,5.23,United Healthcare,Default,Fee Schedule,4.74,,,,3.43,4.74
NF-ARAVA ORAL TABLET 20MG,250,RC,,,,both,79.84,71.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.89,,,,47.11,65.15
NF-ARAVA ORAL TABLET 20MG,250,RC,,,,both,79.84,71.86,Cigna,Default,Percent of Total Billed Charges,47.11,,,,47.11,65.15
NF-ARAVA ORAL TABLET 20MG,250,RC,,,,both,79.84,71.86,United Healthcare,Default,Fee Schedule,65.15,,,,47.11,65.15
NF-NITROGLYCERIN SUBLINGUAL TABLET 0.3MG,250,RC,,,,both,2.18,1.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.53,,,,1.29,1.78
NF-NITROGLYCERIN SUBLINGUAL TABLET 0.3MG,250,RC,,,,both,2.18,1.96,Cigna,Default,Percent of Total Billed Charges,1.29,,,,1.29,1.78
NF-NITROGLYCERIN SUBLINGUAL TABLET 0.3MG,250,RC,,,,both,2.18,1.96,United Healthcare,Default,Fee Schedule,1.78,,,,1.29,1.78
NF-ASTEPRO NASAL SPRAY 205.5MCG/1ACT,250,RC,,,,both,28.77,25.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.14,,,,16.97,23.48
NF-ASTEPRO NASAL SPRAY 205.5MCG/1ACT,250,RC,,,,both,28.77,25.89,Cigna,Default,Percent of Total Billed Charges,16.97,,,,16.97,23.48
NF-ASTEPRO NASAL SPRAY 205.5MCG/1ACT,250,RC,,,,both,28.77,25.89,United Healthcare,Default,Fee Schedule,23.48,,,,16.97,23.48
NF-PREMARIN VAGINAL CREAM 0.625MG/1GM,250,RC,,,,both,64.24,57.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.97,,,,37.9,52.42
NF-PREMARIN VAGINAL CREAM 0.625MG/1GM,250,RC,,,,both,64.24,57.82,Cigna,Default,Percent of Total Billed Charges,37.9,,,,37.9,52.42
NF-PREMARIN VAGINAL CREAM 0.625MG/1GM,250,RC,,,,both,64.24,57.82,United Healthcare,Default,Fee Schedule,52.42,,,,37.9,52.42
NF-CHOLECALCIFEROL TAB 1000IU,250,RC,,,,both,0.87,0.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.61,,,,0.51,0.71
NF-CHOLECALCIFEROL TAB 1000IU,250,RC,,,,both,0.87,0.78,Cigna,Default,Percent of Total Billed Charges,0.51,,,,0.51,0.71
NF-CHOLECALCIFEROL TAB 1000IU,250,RC,,,,both,0.87,0.78,United Healthcare,Default,Fee Schedule,0.71,,,,0.51,0.71
NF-FLORAJEN3 ORAL CAPSULE,250,RC,,,,both,2.13,1.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.49,,,,1.26,1.74
NF-FLORAJEN3 ORAL CAPSULE,250,RC,,,,both,2.13,1.92,Cigna,Default,Percent of Total Billed Charges,1.26,,,,1.26,1.74
NF-FLORAJEN3 ORAL CAPSULE,250,RC,,,,both,2.13,1.92,United Healthcare,Default,Fee Schedule,1.74,,,,1.26,1.74
NF-DIOVAN HCT ORAL TABLET 320MG-12.5MG,250,RC,,,,both,58.78,52.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.15,,,,34.68,47.96
NF-DIOVAN HCT ORAL TABLET 320MG-12.5MG,250,RC,,,,both,58.78,52.9,Cigna,Default,Percent of Total Billed Charges,34.68,,,,34.68,47.96
NF-DIOVAN HCT ORAL TABLET 320MG-12.5MG,250,RC,,,,both,58.78,52.9,United Healthcare,Default,Fee Schedule,47.96,,,,34.68,47.96
NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,250,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,250,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,250,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
NF-METROGEL TOPICAL GEL 1%,250,RC,,,,both,31.37,28.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.96,,,,18.51,25.6
NF-METROGEL TOPICAL GEL 1%,250,RC,,,,both,31.37,28.23,Cigna,Default,Percent of Total Billed Charges,18.51,,,,18.51,25.6
NF-METROGEL TOPICAL GEL 1%,250,RC,,,,both,31.37,28.23,United Healthcare,Default,Fee Schedule,25.6,,,,18.51,25.6
NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,250,RC,,,,both,0.55,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.38,,,,0.32,0.45
NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,250,RC,,,,both,0.55,0.5,Cigna,Default,Percent of Total Billed Charges,0.32,,,,0.32,0.45
NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,250,RC,,,,both,0.55,0.5,United Healthcare,Default,Fee Schedule,0.45,,,,0.32,0.45
NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,250,RC,,,,both,0.55,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.38,,,,0.32,0.45
NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,250,RC,,,,both,0.55,0.5,Cigna,Default,Percent of Total Billed Charges,0.32,,,,0.32,0.45
NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,250,RC,,,,both,0.55,0.5,United Healthcare,Default,Fee Schedule,0.45,,,,0.32,0.45
NF-PRAVACHOL ORAL TABLET 20MG,250,RC,,,,both,20.36,18.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.25,,,,12.01,16.61
NF-PRAVACHOL ORAL TABLET 20MG,250,RC,,,,both,20.36,18.32,Cigna,Default,Percent of Total Billed Charges,12.01,,,,12.01,16.61
NF-PRAVACHOL ORAL TABLET 20MG,250,RC,,,,both,20.36,18.32,United Healthcare,Default,Fee Schedule,16.61,,,,12.01,16.61
ASCORBIC ACID INJ SOLN 500MG/1ML,250,RC,,,,both,504.79,454.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,353.35,,,,297.83,411.91
ASCORBIC ACID INJ SOLN 500MG/1ML,250,RC,,,,both,504.79,454.31,Cigna,Default,Percent of Total Billed Charges,297.83,,,,297.83,411.91
ASCORBIC ACID INJ SOLN 500MG/1ML,250,RC,,,,both,504.79,454.31,United Healthcare,Default,Fee Schedule,411.91,,,,297.83,411.91
NF-TRULICITY SUBQ SOLN 0.75MG/0.5ML,250,RC,,,,both,1746.06,1571.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1222.24,,,,1030.18,1424.78
NF-TRULICITY SUBQ SOLN 0.75MG/0.5ML,250,RC,,,,both,1746.06,1571.45,Cigna,Default,Percent of Total Billed Charges,1030.18,,,,1030.18,1424.78
NF-TRULICITY SUBQ SOLN 0.75MG/0.5ML,250,RC,,,,both,1746.06,1571.45,United Healthcare,Default,Fee Schedule,1424.78,,,,1030.18,1424.78
NF-JARDIANCE ORAL TABLET 25MG,250,RC,,,,both,76.2,68.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.34,,,,44.96,62.18
NF-JARDIANCE ORAL TABLET 25MG,250,RC,,,,both,76.2,68.58,Cigna,Default,Percent of Total Billed Charges,44.96,,,,44.96,62.18
NF-JARDIANCE ORAL TABLET 25MG,250,RC,,,,both,76.2,68.58,United Healthcare,Default,Fee Schedule,62.18,,,,44.96,62.18
NF-TIGAN CAP 300MG,250,RC,,,,both,20.12,18.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.08,,,,11.87,16.42
NF-TIGAN CAP 300MG,250,RC,,,,both,20.12,18.11,Cigna,Default,Percent of Total Billed Charges,11.87,,,,11.87,16.42
NF-TIGAN CAP 300MG,250,RC,,,,both,20.12,18.11,United Healthcare,Default,Fee Schedule,16.42,,,,11.87,16.42
NF-CYTOMEL ORAL TABLET 5MCG,250,RC,,,,both,4.68,4.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.28,,,,2.76,3.82
NF-CYTOMEL ORAL TABLET 5MCG,250,RC,,,,both,4.68,4.21,Cigna,Default,Percent of Total Billed Charges,2.76,,,,2.76,3.82
NF-CYTOMEL ORAL TABLET 5MCG,250,RC,,,,both,4.68,4.21,United Healthcare,Default,Fee Schedule,3.82,,,,2.76,3.82
NF-FAMOTIDINE INJECTION 10MG/ML,250,RC,,,,both,2.86,2.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2,,,,1.69,2.33
NF-FAMOTIDINE INJECTION 10MG/ML,250,RC,,,,both,2.86,2.57,Cigna,Default,Percent of Total Billed Charges,1.69,,,,1.69,2.33
NF-FAMOTIDINE INJECTION 10MG/ML,250,RC,,,,both,2.86,2.57,United Healthcare,Default,Fee Schedule,2.33,,,,1.69,2.33
NF-FAMOTIDINE INJECTION 10MG/ML,250,RC,,,,both,1.42,1.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.99,,,,0.84,1.16
NF-FAMOTIDINE INJECTION 10MG/ML,250,RC,,,,both,1.42,1.28,Cigna,Default,Percent of Total Billed Charges,0.84,,,,0.84,1.16
NF-FAMOTIDINE INJECTION 10MG/ML,250,RC,,,,both,1.42,1.28,United Healthcare,Default,Fee Schedule,1.16,,,,0.84,1.16
NF-CLOBETASOL PROPIONATE CREAM 0.05%,250,RC,,,,both,39.73,35.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.81,,,,23.44,32.42
NF-CLOBETASOL PROPIONATE CREAM 0.05%,250,RC,,,,both,39.73,35.76,Cigna,Default,Percent of Total Billed Charges,23.44,,,,23.44,32.42
NF-CLOBETASOL PROPIONATE CREAM 0.05%,250,RC,,,,both,39.73,35.76,United Healthcare,Default,Fee Schedule,32.42,,,,23.44,32.42
NF-BETAMETHASONE DIP CREAM 0.05%,250,RC,,,,both,11.76,10.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.23,,,,6.94,9.6
NF-BETAMETHASONE DIP CREAM 0.05%,250,RC,,,,both,11.76,10.58,Cigna,Default,Percent of Total Billed Charges,6.94,,,,6.94,9.6
NF-BETAMETHASONE DIP CREAM 0.05%,250,RC,,,,both,11.76,10.58,United Healthcare,Default,Fee Schedule,9.6,,,,6.94,9.6
NF-AMERGE TAB 2.5MG,250,RC,,,,both,315.61,284.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220.93,,,,186.21,257.54
NF-AMERGE TAB 2.5MG,250,RC,,,,both,315.61,284.05,Cigna,Default,Percent of Total Billed Charges,186.21,,,,186.21,257.54
NF-AMERGE TAB 2.5MG,250,RC,,,,both,315.61,284.05,United Healthcare,Default,Fee Schedule,257.54,,,,186.21,257.54
NF-IBUPROFEN ORAL TABLET 200MG,250,RC,,,,both,5.33,4.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.73,,,,3.14,4.35
NF-IBUPROFEN ORAL TABLET 200MG,250,RC,,,,both,5.33,4.8,Cigna,Default,Percent of Total Billed Charges,3.14,,,,3.14,4.35
NF-IBUPROFEN ORAL TABLET 200MG,250,RC,,,,both,5.33,4.8,United Healthcare,Default,Fee Schedule,4.35,,,,3.14,4.35
NF-LEVOTHYROXINE ORAL TABLET 200MCG,250,RC,,,,both,2.95,2.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.06,,,,1.74,2.41
NF-LEVOTHYROXINE ORAL TABLET 200MCG,250,RC,,,,both,2.95,2.66,Cigna,Default,Percent of Total Billed Charges,1.74,,,,1.74,2.41
NF-LEVOTHYROXINE ORAL TABLET 200MCG,250,RC,,,,both,2.95,2.66,United Healthcare,Default,Fee Schedule,2.41,,,,1.74,2.41
NF-CELEXA TAB 40MG,250,RC,,,,both,41.26,37.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.88,,,,24.34,33.67
NF-CELEXA TAB 40MG,250,RC,,,,both,41.26,37.13,Cigna,Default,Percent of Total Billed Charges,24.34,,,,24.34,33.67
NF-CELEXA TAB 40MG,250,RC,,,,both,41.26,37.13,United Healthcare,Default,Fee Schedule,33.67,,,,24.34,33.67
NF-AMLODIPINE & BENAZEPRIL HCL 5MG-20MG,250,RC,,,,both,13.28,11.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.3,,,,7.84,10.84
NF-AMLODIPINE & BENAZEPRIL HCL 5MG-20MG,250,RC,,,,both,13.28,11.95,Cigna,Default,Percent of Total Billed Charges,7.84,,,,7.84,10.84
NF-AMLODIPINE & BENAZEPRIL HCL 5MG-20MG,250,RC,,,,both,13.28,11.95,United Healthcare,Default,Fee Schedule,10.84,,,,7.84,10.84
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,26.4,23.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.48,,,,15.58,21.54
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,26.4,23.76,Cigna,Default,Percent of Total Billed Charges,15.58,,,,15.58,21.54
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,26.4,23.76,United Healthcare,Default,Fee Schedule,21.54,,,,15.58,21.54
MIVACURIUM 20MG/10 ML INJ,250,RC,,,,both,143.44,129.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.41,,,,84.63,117.05
MIVACURIUM 20MG/10 ML INJ,250,RC,,,,both,143.44,129.1,Cigna,Default,Percent of Total Billed Charges,84.63,,,,84.63,117.05
MIVACURIUM 20MG/10 ML INJ,250,RC,,,,both,143.44,129.1,United Healthcare,Default,Fee Schedule,117.05,,,,84.63,117.05
NF-CARDIZEM CD 24 HR CAP ER 240MG,250,RC,,,,both,203.96,183.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,142.77,,,,120.34,166.43
NF-CARDIZEM CD 24 HR CAP ER 240MG,250,RC,,,,both,203.96,183.56,Cigna,Default,Percent of Total Billed Charges,120.34,,,,120.34,166.43
NF-CARDIZEM CD 24 HR CAP ER 240MG,250,RC,,,,both,203.96,183.56,United Healthcare,Default,Fee Schedule,166.43,,,,120.34,166.43
NF-ADVAIR HFA 115/21 INH AER 115MCG-21MC,250,RC,,,,both,144.56,130.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.19,,,,85.29,117.96
NF-ADVAIR HFA 115/21 INH AER 115MCG-21MC,250,RC,,,,both,144.56,130.1,Cigna,Default,Percent of Total Billed Charges,85.29,,,,85.29,117.96
NF-ADVAIR HFA 115/21 INH AER 115MCG-21MC,250,RC,,,,both,144.56,130.1,United Healthcare,Default,Fee Schedule,117.96,,,,85.29,117.96
NF-BROVANA INH SOLN 15MCG/2ML,250,RC,,,,both,40.5,36.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.35,,,,23.9,33.05
NF-BROVANA INH SOLN 15MCG/2ML,250,RC,,,,both,40.5,36.45,Cigna,Default,Percent of Total Billed Charges,23.9,,,,23.9,33.05
NF-BROVANA INH SOLN 15MCG/2ML,250,RC,,,,both,40.5,36.45,United Healthcare,Default,Fee Schedule,33.05,,,,23.9,33.05
NF-INSPRA ORAL TABLET 50MG,250,RC,,,,both,50.54,45.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.38,,,,29.82,41.24
NF-INSPRA ORAL TABLET 50MG,250,RC,,,,both,50.54,45.49,Cigna,Default,Percent of Total Billed Charges,29.82,,,,29.82,41.24
NF-INSPRA ORAL TABLET 50MG,250,RC,,,,both,50.54,45.49,United Healthcare,Default,Fee Schedule,41.24,,,,29.82,41.24
NF-VICOPROFEN TABLET,250,RC,,,,both,17.03,15.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.92,,,,10.05,13.9
NF-VICOPROFEN TABLET,250,RC,,,,both,17.03,15.33,Cigna,Default,Percent of Total Billed Charges,10.05,,,,10.05,13.9
NF-VICOPROFEN TABLET,250,RC,,,,both,17.03,15.33,United Healthcare,Default,Fee Schedule,13.9,,,,10.05,13.9
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 2,250,RC,,,,both,1.76,1.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.23,,,,1.04,1.44
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 2,250,RC,,,,both,1.76,1.58,Cigna,Default,Percent of Total Billed Charges,1.04,,,,1.04,1.44
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 2,250,RC,,,,both,1.76,1.58,United Healthcare,Default,Fee Schedule,1.44,,,,1.04,1.44
NF-ELIMITE TOPICAL CREAM 5%,250,RC,,,,both,495,445.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,346.5,,,,292.05,403.92
NF-ELIMITE TOPICAL CREAM 5%,250,RC,,,,both,495,445.5,Cigna,Default,Percent of Total Billed Charges,292.05,,,,292.05,403.92
NF-ELIMITE TOPICAL CREAM 5%,250,RC,,,,both,495,445.5,United Healthcare,Default,Fee Schedule,403.92,,,,292.05,403.92
NF-BUDESONIDE INH/NEB SUSP 0.25MG/2ML,250,RC,,,,both,20.92,18.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.64,,,,12.34,17.07
NF-BUDESONIDE INH/NEB SUSP 0.25MG/2ML,250,RC,,,,both,20.92,18.83,Cigna,Default,Percent of Total Billed Charges,12.34,,,,12.34,17.07
NF-BUDESONIDE INH/NEB SUSP 0.25MG/2ML,250,RC,,,,both,20.92,18.83,United Healthcare,Default,Fee Schedule,17.07,,,,12.34,17.07
NF-CRANBERRY CONCENTRATE CAPSULE 500MG,250,RC,,,,both,0.32,0.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.19,0.26
NF-CRANBERRY CONCENTRATE CAPSULE 500MG,250,RC,,,,both,0.32,0.29,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.26
NF-CRANBERRY CONCENTRATE CAPSULE 500MG,250,RC,,,,both,0.32,0.29,United Healthcare,Default,Fee Schedule,0.26,,,,0.19,0.26
NF-TRIAMCINOLONE ACETONIDE NASAL SPRAY 5,250,RC,,,,both,33.04,29.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.13,,,,19.49,26.96
NF-TRIAMCINOLONE ACETONIDE NASAL SPRAY 5,250,RC,,,,both,33.04,29.74,Cigna,Default,Percent of Total Billed Charges,19.49,,,,19.49,26.96
NF-TRIAMCINOLONE ACETONIDE NASAL SPRAY 5,250,RC,,,,both,33.04,29.74,United Healthcare,Default,Fee Schedule,26.96,,,,19.49,26.96
NF-CALCIUM 600 TAB 600MG,250,RC,,,,both,0.1,0.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.07,,,,0.06,0.08
NF-CALCIUM 600 TAB 600MG,250,RC,,,,both,0.1,0.09,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.08
NF-CALCIUM 600 TAB 600MG,250,RC,,,,both,0.1,0.09,United Healthcare,Default,Fee Schedule,0.08,,,,0.06,0.08
NF-Cyclobenzaprine HCl Oral Tablet 5MG,250,RC,,,,both,6,5.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.2,,,,3.54,4.9
NF-Cyclobenzaprine HCl Oral Tablet 5MG,250,RC,,,,both,6,5.4,Cigna,Default,Percent of Total Billed Charges,3.54,,,,3.54,4.9
NF-Cyclobenzaprine HCl Oral Tablet 5MG,250,RC,,,,both,6,5.4,United Healthcare,Default,Fee Schedule,4.9,,,,3.54,4.9
NF-BENAZEPRIL HCL ORAL TABLET 10MG,250,RC,,,,both,1.14,1.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.8,,,,0.67,0.93
NF-BENAZEPRIL HCL ORAL TABLET 10MG,250,RC,,,,both,1.14,1.03,Cigna,Default,Percent of Total Billed Charges,0.67,,,,0.67,0.93
NF-BENAZEPRIL HCL ORAL TABLET 10MG,250,RC,,,,both,1.14,1.03,United Healthcare,Default,Fee Schedule,0.93,,,,0.67,0.93
NF-ONGLYZA ORAL TABLET 5MG,250,RC,,,,both,44.21,39.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.95,,,,26.08,36.08
NF-ONGLYZA ORAL TABLET 5MG,250,RC,,,,both,44.21,39.79,Cigna,Default,Percent of Total Billed Charges,26.08,,,,26.08,36.08
NF-ONGLYZA ORAL TABLET 5MG,250,RC,,,,both,44.21,39.79,United Healthcare,Default,Fee Schedule,36.08,,,,26.08,36.08
NF-ENALAPRIL/HCTZ 10MG-25MG TABLET,250,RC,,,,both,5.67,5.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.97,,,,3.35,4.63
NF-ENALAPRIL/HCTZ 10MG-25MG TABLET,250,RC,,,,both,5.67,5.1,Cigna,Default,Percent of Total Billed Charges,3.35,,,,3.35,4.63
NF-ENALAPRIL/HCTZ 10MG-25MG TABLET,250,RC,,,,both,5.67,5.1,United Healthcare,Default,Fee Schedule,4.63,,,,3.35,4.63
NF-LEFLUNOMIDE ORAL TABLET 20MG,250,RC,,,,both,72.67,65.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.87,,,,42.88,59.3
NF-LEFLUNOMIDE ORAL TABLET 20MG,250,RC,,,,both,72.67,65.4,Cigna,Default,Percent of Total Billed Charges,42.88,,,,42.88,59.3
NF-LEFLUNOMIDE ORAL TABLET 20MG,250,RC,,,,both,72.67,65.4,United Healthcare,Default,Fee Schedule,59.3,,,,42.88,59.3
NF-ICAPS AREDS ORAL LIQUID FILLED CAPSUL,250,RC,,,,both,1.07,0.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.75,,,,0.63,0.87
NF-ICAPS AREDS ORAL LIQUID FILLED CAPSUL,250,RC,,,,both,1.07,0.96,Cigna,Default,Percent of Total Billed Charges,0.63,,,,0.63,0.87
NF-ICAPS AREDS ORAL LIQUID FILLED CAPSUL,250,RC,,,,both,1.07,0.96,United Healthcare,Default,Fee Schedule,0.87,,,,0.63,0.87
NF-PHENDIMETRAZINE ORAL CAP ER 105MG,250,RC,,,,both,4.8,4.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.36,,,,2.83,3.92
NF-PHENDIMETRAZINE ORAL CAP ER 105MG,250,RC,,,,both,4.8,4.32,Cigna,Default,Percent of Total Billed Charges,2.83,,,,2.83,3.92
NF-PHENDIMETRAZINE ORAL CAP ER 105MG,250,RC,,,,both,4.8,4.32,United Healthcare,Default,Fee Schedule,3.92,,,,2.83,3.92
NF-GLUCOSAMINE & CHONDROITIN 500MG-400MG,250,RC,,,,both,3.73,3.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.61,,,,2.2,3.04
NF-GLUCOSAMINE & CHONDROITIN 500MG-400MG,250,RC,,,,both,3.73,3.36,Cigna,Default,Percent of Total Billed Charges,2.2,,,,2.2,3.04
NF-GLUCOSAMINE & CHONDROITIN 500MG-400MG,250,RC,,,,both,3.73,3.36,United Healthcare,Default,Fee Schedule,3.04,,,,2.2,3.04
NF-IRON 100 WITH VITAMIN C ORAL TABLET,250,RC,,,,both,0.94,0.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.66,,,,0.55,0.77
NF-IRON 100 WITH VITAMIN C ORAL TABLET,250,RC,,,,both,0.94,0.85,Cigna,Default,Percent of Total Billed Charges,0.55,,,,0.55,0.77
NF-IRON 100 WITH VITAMIN C ORAL TABLET,250,RC,,,,both,0.94,0.85,United Healthcare,Default,Fee Schedule,0.77,,,,0.55,0.77
NF-MAG 200 ORAL TABLET 150MG-200MG,250,RC,,,,both,0.3,0.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.21,,,,0.18,0.24
NF-MAG 200 ORAL TABLET 150MG-200MG,250,RC,,,,both,0.3,0.27,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.24
NF-MAG 200 ORAL TABLET 150MG-200MG,250,RC,,,,both,0.3,0.27,United Healthcare,Default,Fee Schedule,0.24,,,,0.18,0.24
NF-OMEGA-3 OIL LIQUID FILLED CAPSULE 100,250,RC,,,,both,0.4,0.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.28,,,,0.24,0.33
NF-OMEGA-3 OIL LIQUID FILLED CAPSULE 100,250,RC,,,,both,0.4,0.36,Cigna,Default,Percent of Total Billed Charges,0.24,,,,0.24,0.33
NF-OMEGA-3 OIL LIQUID FILLED CAPSULE 100,250,RC,,,,both,0.4,0.36,United Healthcare,Default,Fee Schedule,0.33,,,,0.24,0.33
NF-VITAMIN B COMPLEX TAB,250,RC,,,,both,0.08,0.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-VITAMIN B COMPLEX TAB,250,RC,,,,both,0.08,0.07,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-VITAMIN B COMPLEX TAB,250,RC,,,,both,0.08,0.07,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
NF-BRILINTA ORAL TABLET 60MG,250,RC,,,,both,29.47,26.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.63,,,,17.39,24.05
NF-BRILINTA ORAL TABLET 60MG,250,RC,,,,both,29.47,26.52,Cigna,Default,Percent of Total Billed Charges,17.39,,,,17.39,24.05
NF-BRILINTA ORAL TABLET 60MG,250,RC,,,,both,29.47,26.52,United Healthcare,Default,Fee Schedule,24.05,,,,17.39,24.05
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,12.48,11.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.74,,,,7.36,10.18
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,12.48,11.23,Cigna,Default,Percent of Total Billed Charges,7.36,,,,7.36,10.18
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,12.48,11.23,United Healthcare,Default,Fee Schedule,10.18,,,,7.36,10.18
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,9.73,8.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.81,,,,5.74,7.94
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,9.73,8.76,Cigna,Default,Percent of Total Billed Charges,5.74,,,,5.74,7.94
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,9.73,8.76,United Healthcare,Default,Fee Schedule,7.94,,,,5.74,7.94
NF-CILOSTAZOL ORAL TABLET 50MG,250,RC,,,,both,7.3,6.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.11,,,,4.31,5.96
NF-CILOSTAZOL ORAL TABLET 50MG,250,RC,,,,both,7.3,6.57,Cigna,Default,Percent of Total Billed Charges,4.31,,,,4.31,5.96
NF-CILOSTAZOL ORAL TABLET 50MG,250,RC,,,,both,7.3,6.57,United Healthcare,Default,Fee Schedule,5.96,,,,4.31,5.96
NF-PRESERVISION AREDS LIQUID FILLED CAPS,250,RC,,,,both,1.04,0.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.73,,,,0.61,0.85
NF-PRESERVISION AREDS LIQUID FILLED CAPS,250,RC,,,,both,1.04,0.94,Cigna,Default,Percent of Total Billed Charges,0.61,,,,0.61,0.85
NF-PRESERVISION AREDS LIQUID FILLED CAPS,250,RC,,,,both,1.04,0.94,United Healthcare,Default,Fee Schedule,0.85,,,,0.61,0.85
NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,250,RC,,,,both,0.78,0.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.55,,,,0.46,0.64
NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,250,RC,,,,both,0.78,0.7,Cigna,Default,Percent of Total Billed Charges,0.46,,,,0.46,0.64
NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,250,RC,,,,both,0.78,0.7,United Healthcare,Default,Fee Schedule,0.64,,,,0.46,0.64
NF-CRESTOR ORAL TABLET 10MG,250,RC,,,,both,24.64,22.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.25,,,,14.54,20.11
NF-CRESTOR ORAL TABLET 10MG,250,RC,,,,both,24.64,22.18,Cigna,Default,Percent of Total Billed Charges,14.54,,,,14.54,20.11
NF-CRESTOR ORAL TABLET 10MG,250,RC,,,,both,24.64,22.18,United Healthcare,Default,Fee Schedule,20.11,,,,14.54,20.11
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,250,RC,,,,both,4.18,3.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.93,,,,2.47,3.41
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,250,RC,,,,both,4.18,3.76,Cigna,Default,Percent of Total Billed Charges,2.47,,,,2.47,3.41
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,250,RC,,,,both,4.18,3.76,United Healthcare,Default,Fee Schedule,3.41,,,,2.47,3.41
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,43.23,38.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.26,,,,25.51,35.28
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,43.23,38.91,Cigna,Default,Percent of Total Billed Charges,25.51,,,,25.51,35.28
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,43.23,38.91,United Healthcare,Default,Fee Schedule,35.28,,,,25.51,35.28
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,175.33,157.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.73,,,,103.44,143.07
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,175.33,157.8,Cigna,Default,Percent of Total Billed Charges,103.44,,,,103.44,143.07
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,175.33,157.8,United Healthcare,Default,Fee Schedule,143.07,,,,103.44,143.07
NF-LIALDA ORAL DELAYED-RELEASE TABLET 1.,250,RC,,,,both,52.22,47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.55,,,,30.81,42.61
NF-LIALDA ORAL DELAYED-RELEASE TABLET 1.,250,RC,,,,both,52.22,47,Cigna,Default,Percent of Total Billed Charges,30.81,,,,30.81,42.61
NF-LIALDA ORAL DELAYED-RELEASE TABLET 1.,250,RC,,,,both,52.22,47,United Healthcare,Default,Fee Schedule,42.61,,,,30.81,42.61
NF-GLUCOSAMINE & CHONDR CAP 500MG-400MG,250,RC,,,,both,2.56,2.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.79,,,,1.51,2.09
NF-GLUCOSAMINE & CHONDR CAP 500MG-400MG,250,RC,,,,both,2.56,2.3,Cigna,Default,Percent of Total Billed Charges,1.51,,,,1.51,2.09
NF-GLUCOSAMINE & CHONDR CAP 500MG-400MG,250,RC,,,,both,2.56,2.3,United Healthcare,Default,Fee Schedule,2.09,,,,1.51,2.09
NF-CARTIA XT ORAL 24 HR CAP ER 120MG,250,RC,,,,both,4.79,4.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.35,,,,2.83,3.91
NF-CARTIA XT ORAL 24 HR CAP ER 120MG,250,RC,,,,both,4.79,4.31,Cigna,Default,Percent of Total Billed Charges,2.83,,,,2.83,3.91
NF-CARTIA XT ORAL 24 HR CAP ER 120MG,250,RC,,,,both,4.79,4.31,United Healthcare,Default,Fee Schedule,3.91,,,,2.83,3.91
NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,250,RC,,,,both,1.06,0.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.74,,,,0.63,0.86
NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,250,RC,,,,both,1.06,0.95,Cigna,Default,Percent of Total Billed Charges,0.63,,,,0.63,0.86
NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,250,RC,,,,both,1.06,0.95,United Healthcare,Default,Fee Schedule,0.86,,,,0.63,0.86
NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,250,RC,,,,both,75.38,67.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.77,,,,44.47,61.51
NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,250,RC,,,,both,75.38,67.84,Cigna,Default,Percent of Total Billed Charges,44.47,,,,44.47,61.51
NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,250,RC,,,,both,75.38,67.84,United Healthcare,Default,Fee Schedule,61.51,,,,44.47,61.51
NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,250,RC,,,,both,75.38,67.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.77,,,,44.47,61.51
NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,250,RC,,,,both,75.38,67.84,Cigna,Default,Percent of Total Billed Charges,44.47,,,,44.47,61.51
NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,250,RC,,,,both,75.38,67.84,United Healthcare,Default,Fee Schedule,61.51,,,,44.47,61.51
NF-CILOSTAZOL ORAL TABLET 50MG,250,RC,,,,both,7.3,6.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.11,,,,4.31,5.96
NF-CILOSTAZOL ORAL TABLET 50MG,250,RC,,,,both,7.3,6.57,Cigna,Default,Percent of Total Billed Charges,4.31,,,,4.31,5.96
NF-CILOSTAZOL ORAL TABLET 50MG,250,RC,,,,both,7.3,6.57,United Healthcare,Default,Fee Schedule,5.96,,,,4.31,5.96
NF-CRESTOR ORAL TABLET 5MG,250,RC,,,,both,46.17,41.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.32,,,,27.24,37.67
NF-CRESTOR ORAL TABLET 5MG,250,RC,,,,both,46.17,41.55,Cigna,Default,Percent of Total Billed Charges,27.24,,,,27.24,37.67
NF-CRESTOR ORAL TABLET 5MG,250,RC,,,,both,46.17,41.55,United Healthcare,Default,Fee Schedule,37.67,,,,27.24,37.67
NF-TRAVOPROST OPHTH SOLN 0.004%,250,RC,,,,both,314.29,282.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,220,,,,185.43,256.46
NF-TRAVOPROST OPHTH SOLN 0.004%,250,RC,,,,both,314.29,282.86,Cigna,Default,Percent of Total Billed Charges,185.43,,,,185.43,256.46
NF-TRAVOPROST OPHTH SOLN 0.004%,250,RC,,,,both,314.29,282.86,United Healthcare,Default,Fee Schedule,256.46,,,,185.43,256.46
NF-Budesonide Delayed Release Capsule 3M,250,RC,,,,both,75,67.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.5,,,,44.25,61.2
NF-Budesonide Delayed Release Capsule 3M,250,RC,,,,both,75,67.5,Cigna,Default,Percent of Total Billed Charges,44.25,,,,44.25,61.2
NF-Budesonide Delayed Release Capsule 3M,250,RC,,,,both,75,67.5,United Healthcare,Default,Fee Schedule,61.2,,,,44.25,61.2
NF-LOVASTATIN ORAL TABLET 20MG,250,RC,,,,both,12.21,10.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.55,,,,7.2,9.96
NF-LOVASTATIN ORAL TABLET 20MG,250,RC,,,,both,12.21,10.99,Cigna,Default,Percent of Total Billed Charges,7.2,,,,7.2,9.96
NF-LOVASTATIN ORAL TABLET 20MG,250,RC,,,,both,12.21,10.99,United Healthcare,Default,Fee Schedule,9.96,,,,7.2,9.96
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,136.52,122.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.56,,,,80.55,111.4
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,136.52,122.87,Cigna,Default,Percent of Total Billed Charges,80.55,,,,80.55,111.4
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,136.52,122.87,United Healthcare,Default,Fee Schedule,111.4,,,,80.55,111.4
NF-CYTOMEL TABLET 25MCG,250,RC,,,,both,4.73,4.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.31,,,,2.79,3.86
NF-CYTOMEL TABLET 25MCG,250,RC,,,,both,4.73,4.26,Cigna,Default,Percent of Total Billed Charges,2.79,,,,2.79,3.86
NF-CYTOMEL TABLET 25MCG,250,RC,,,,both,4.73,4.26,United Healthcare,Default,Fee Schedule,3.86,,,,2.79,3.86
NF-VITAMIN B COMPLEX INJ SOLN,250,RC,,,,both,8,7.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.6,,,,4.72,6.53
NF-VITAMIN B COMPLEX INJ SOLN,250,RC,,,,both,8,7.2,Cigna,Default,Percent of Total Billed Charges,4.72,,,,4.72,6.53
NF-VITAMIN B COMPLEX INJ SOLN,250,RC,,,,both,8,7.2,United Healthcare,Default,Fee Schedule,6.53,,,,4.72,6.53
NF-ERYTHROMYCIN ORAL TABLET 500MG,250,RC,,,,both,4.73,4.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.31,,,,2.79,3.86
NF-ERYTHROMYCIN ORAL TABLET 500MG,250,RC,,,,both,4.73,4.26,Cigna,Default,Percent of Total Billed Charges,2.79,,,,2.79,3.86
NF-ERYTHROMYCIN ORAL TABLET 500MG,250,RC,,,,both,4.73,4.26,United Healthcare,Default,Fee Schedule,3.86,,,,2.79,3.86
NF-GABITRIL TABLET 16MG,250,RC,,,,both,63.49,57.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,44.44,,,,37.46,51.81
NF-GABITRIL TABLET 16MG,250,RC,,,,both,63.49,57.14,Cigna,Default,Percent of Total Billed Charges,37.46,,,,37.46,51.81
NF-GABITRIL TABLET 16MG,250,RC,,,,both,63.49,57.14,United Healthcare,Default,Fee Schedule,51.81,,,,37.46,51.81
NF-HYDROXYZINE HCL IM SOLN 50MG/1ML,250,RC,,,,both,1.5,1.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.05,,,,0.88,1.22
NF-HYDROXYZINE HCL IM SOLN 50MG/1ML,250,RC,,,,both,1.5,1.35,Cigna,Default,Percent of Total Billed Charges,0.88,,,,0.88,1.22
NF-HYDROXYZINE HCL IM SOLN 50MG/1ML,250,RC,,,,both,1.5,1.35,United Healthcare,Default,Fee Schedule,1.22,,,,0.88,1.22
NF-FELODIPINE EXTENDED RELEASE TAB 10MG,250,RC,,,,both,12.01,10.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.41,,,,7.09,9.8
NF-FELODIPINE EXTENDED RELEASE TAB 10MG,250,RC,,,,both,12.01,10.81,Cigna,Default,Percent of Total Billed Charges,7.09,,,,7.09,9.8
NF-FELODIPINE EXTENDED RELEASE TAB 10MG,250,RC,,,,both,12.01,10.81,United Healthcare,Default,Fee Schedule,9.8,,,,7.09,9.8
NF-CITALOPRAM HBR ORAL TAB 40MG,250,RC,,,,both,1.5,1.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.05,,,,0.88,1.22
NF-CITALOPRAM HBR ORAL TAB 40MG,250,RC,,,,both,1.5,1.35,Cigna,Default,Percent of Total Billed Charges,0.88,,,,0.88,1.22
NF-CITALOPRAM HBR ORAL TAB 40MG,250,RC,,,,both,1.5,1.35,United Healthcare,Default,Fee Schedule,1.22,,,,0.88,1.22
NF-CYANOCOBALAMIN INJ SOLN 1000MCG/1ML,250,RC,,,,both,21.75,19.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.22,,,,12.83,17.75
NF-CYANOCOBALAMIN INJ SOLN 1000MCG/1ML,250,RC,,,,both,21.75,19.58,Cigna,Default,Percent of Total Billed Charges,12.83,,,,12.83,17.75
NF-CYANOCOBALAMIN INJ SOLN 1000MCG/1ML,250,RC,,,,both,21.75,19.58,United Healthcare,Default,Fee Schedule,17.75,,,,12.83,17.75
NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,250,RC,,,,both,6968.17,6271.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4877.72,,,,4111.22,5686.03
NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,250,RC,,,,both,6968.17,6271.35,Cigna,Default,Percent of Total Billed Charges,4111.22,,,,4111.22,5686.03
NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,250,RC,,,,both,6968.17,6271.35,United Healthcare,Default,Fee Schedule,5686.03,,,,4111.22,5686.03
NF-TRICOR ORAL TABLET 145MG,250,RC,,,,both,24.94,22.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.46,,,,14.71,20.35
NF-TRICOR ORAL TABLET 145MG,250,RC,,,,both,24.94,22.45,Cigna,Default,Percent of Total Billed Charges,14.71,,,,14.71,20.35
NF-TRICOR ORAL TABLET 145MG,250,RC,,,,both,24.94,22.45,United Healthcare,Default,Fee Schedule,20.35,,,,14.71,20.35
NF-SOTALOL HCL  ORAL TABLET 160MG,250,RC,,,,both,17.1,15.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.97,,,,10.09,13.95
NF-SOTALOL HCL  ORAL TABLET 160MG,250,RC,,,,both,17.1,15.39,Cigna,Default,Percent of Total Billed Charges,10.09,,,,10.09,13.95
NF-SOTALOL HCL  ORAL TABLET 160MG,250,RC,,,,both,17.1,15.39,United Healthcare,Default,Fee Schedule,13.95,,,,10.09,13.95
NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,250,RC,,,,both,6968.17,6271.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4877.72,,,,4111.22,5686.03
NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,250,RC,,,,both,6968.17,6271.35,Cigna,Default,Percent of Total Billed Charges,4111.22,,,,4111.22,5686.03
NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,250,RC,,,,both,6968.17,6271.35,United Healthcare,Default,Fee Schedule,5686.03,,,,4111.22,5686.03
NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,250,RC,,,,both,8.6,7.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.02,,,,5.07,7.02
NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,250,RC,,,,both,8.6,7.74,Cigna,Default,Percent of Total Billed Charges,5.07,,,,5.07,7.02
NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,250,RC,,,,both,8.6,7.74,United Healthcare,Default,Fee Schedule,7.02,,,,5.07,7.02
EPOETIN ALPHA 2000 UNITS (PROCRIT),J0885,HCPCS,636,RC,,both,260.4,234.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,182.28,,,,153.64,212.49
EPOETIN ALPHA 2000 UNITS (PROCRIT),J0885,HCPCS,636,RC,,both,260.4,234.36,Cigna,Default,Percent of Total Billed Charges,153.64,,,,153.64,212.49
EPOETIN ALPHA 2000 UNITS (PROCRIT),J0885,HCPCS,636,RC,,both,260.4,234.36,United Healthcare,Default,Fee Schedule,212.49,,,,153.64,212.49
NF-INSPRA ORAL TABLET 50MG,250,RC,,,,both,50,45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35,,,,29.5,40.8
NF-INSPRA ORAL TABLET 50MG,250,RC,,,,both,50,45,Cigna,Default,Percent of Total Billed Charges,29.5,,,,29.5,40.8
NF-INSPRA ORAL TABLET 50MG,250,RC,,,,both,50,45,United Healthcare,Default,Fee Schedule,40.8,,,,29.5,40.8
NF-VITAMIN D ORAL TABLET 2000IU,250,RC,,,,both,0.15,0.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.09,0.12
NF-VITAMIN D ORAL TABLET 2000IU,250,RC,,,,both,0.15,0.14,Cigna,Default,Percent of Total Billed Charges,0.09,,,,0.09,0.12
NF-VITAMIN D ORAL TABLET 2000IU,250,RC,,,,both,0.15,0.14,United Healthcare,Default,Fee Schedule,0.12,,,,0.09,0.12
NF-1ST TIER UNIFINE PENTIPS PLUS DEVICE,250,RC,,,,both,1.11,1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.78,,,,0.65,0.91
NF-1ST TIER UNIFINE PENTIPS PLUS DEVICE,250,RC,,,,both,1.11,1,Cigna,Default,Percent of Total Billed Charges,0.65,,,,0.65,0.91
NF-1ST TIER UNIFINE PENTIPS PLUS DEVICE,250,RC,,,,both,1.11,1,United Healthcare,Default,Fee Schedule,0.91,,,,0.65,0.91
NF-BACTRIM DS ORAL TABLET 800MG-160MG,250,RC,,,,both,9.63,8.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.74,,,,5.68,7.86
NF-BACTRIM DS ORAL TABLET 800MG-160MG,250,RC,,,,both,9.63,8.67,Cigna,Default,Percent of Total Billed Charges,5.68,,,,5.68,7.86
NF-BACTRIM DS ORAL TABLET 800MG-160MG,250,RC,,,,both,9.63,8.67,United Healthcare,Default,Fee Schedule,7.86,,,,5.68,7.86
NF-VISTARIL CAPSULE 50MG,250,RC,,,,both,14.38,12.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.07,,,,8.48,11.73
NF-VISTARIL CAPSULE 50MG,250,RC,,,,both,14.38,12.94,Cigna,Default,Percent of Total Billed Charges,8.48,,,,8.48,11.73
NF-VISTARIL CAPSULE 50MG,250,RC,,,,both,14.38,12.94,United Healthcare,Default,Fee Schedule,11.73,,,,8.48,11.73
NF-DALIRESP ORAL TABLET 500MCG,250,RC,,,,both,47.95,43.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.56,,,,28.29,39.13
NF-DALIRESP ORAL TABLET 500MCG,250,RC,,,,both,47.95,43.16,Cigna,Default,Percent of Total Billed Charges,28.29,,,,28.29,39.13
NF-DALIRESP ORAL TABLET 500MCG,250,RC,,,,both,47.95,43.16,United Healthcare,Default,Fee Schedule,39.13,,,,28.29,39.13
NF-MORPHINE SULFATE IR ORAL TABLET 15MG,250,RC,,,,both,1.65,1.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.16,,,,0.97,1.35
NF-MORPHINE SULFATE IR ORAL TABLET 15MG,250,RC,,,,both,1.65,1.49,Cigna,Default,Percent of Total Billed Charges,0.97,,,,0.97,1.35
NF-MORPHINE SULFATE IR ORAL TABLET 15MG,250,RC,,,,both,1.65,1.49,United Healthcare,Default,Fee Schedule,1.35,,,,0.97,1.35
NF-PRO-BIOTIC BLEND ORAL CAPSULE,250,RC,,,,both,0.18,0.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.13,,,,0.11,0.15
NF-PRO-BIOTIC BLEND ORAL CAPSULE,250,RC,,,,both,0.18,0.16,Cigna,Default,Percent of Total Billed Charges,0.11,,,,0.11,0.15
NF-PRO-BIOTIC BLEND ORAL CAPSULE,250,RC,,,,both,0.18,0.16,United Healthcare,Default,Fee Schedule,0.15,,,,0.11,0.15
NF-NICODERM CQ TD PATCH ER 14MG/24HR,250,RC,,,,both,8.97,8.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.28,,,,5.29,7.32
NF-NICODERM CQ TD PATCH ER 14MG/24HR,250,RC,,,,both,8.97,8.07,Cigna,Default,Percent of Total Billed Charges,5.29,,,,5.29,7.32
NF-NICODERM CQ TD PATCH ER 14MG/24HR,250,RC,,,,both,8.97,8.07,United Healthcare,Default,Fee Schedule,7.32,,,,5.29,7.32
NF-NIACIN ORAL TABLET 500MG,250,RC,,,,both,0.11,0.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.08,,,,0.06,0.09
NF-NIACIN ORAL TABLET 500MG,250,RC,,,,both,0.11,0.1,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.09
NF-NIACIN ORAL TABLET 500MG,250,RC,,,,both,0.11,0.1,United Healthcare,Default,Fee Schedule,0.09,,,,0.06,0.09
NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,250,RC,,,,both,17.31,15.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.12,,,,10.21,14.12
NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,250,RC,,,,both,17.31,15.58,Cigna,Default,Percent of Total Billed Charges,10.21,,,,10.21,14.12
NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,250,RC,,,,both,17.31,15.58,United Healthcare,Default,Fee Schedule,14.12,,,,10.21,14.12
NF-PRESERVISION AREDS 2 ORAL LIQ CAP,250,RC,,,,both,0.93,0.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.65,,,,0.55,0.76
NF-PRESERVISION AREDS 2 ORAL LIQ CAP,250,RC,,,,both,0.93,0.84,Cigna,Default,Percent of Total Billed Charges,0.55,,,,0.55,0.76
NF-PRESERVISION AREDS 2 ORAL LIQ CAP,250,RC,,,,both,0.93,0.84,United Healthcare,Default,Fee Schedule,0.76,,,,0.55,0.76
NF-CRANBERRY FRUIT CAPSULE 425MG,250,RC,,,,both,0.24,0.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.17,,,,0.14,0.2
NF-CRANBERRY FRUIT CAPSULE 425MG,250,RC,,,,both,0.24,0.22,Cigna,Default,Percent of Total Billed Charges,0.14,,,,0.14,0.2
NF-CRANBERRY FRUIT CAPSULE 425MG,250,RC,,,,both,0.24,0.22,United Healthcare,Default,Fee Schedule,0.2,,,,0.14,0.2
NF-CRAN-PLUS ORAL CAPSULE,250,RC,,,,both,0.67,0.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.47,,,,0.4,0.55
NF-CRAN-PLUS ORAL CAPSULE,250,RC,,,,both,0.67,0.6,Cigna,Default,Percent of Total Billed Charges,0.4,,,,0.4,0.55
NF-CRAN-PLUS ORAL CAPSULE,250,RC,,,,both,0.67,0.6,United Healthcare,Default,Fee Schedule,0.55,,,,0.4,0.55
NF-SIMVASTATIN ORAL TABLET  20MG,250,RC,,,,both,21.77,19.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.24,,,,12.84,17.76
NF-SIMVASTATIN ORAL TABLET  20MG,250,RC,,,,both,21.77,19.59,Cigna,Default,Percent of Total Billed Charges,12.84,,,,12.84,17.76
NF-SIMVASTATIN ORAL TABLET  20MG,250,RC,,,,both,21.77,19.59,United Healthcare,Default,Fee Schedule,17.76,,,,12.84,17.76
NF-CILOSTAZOL TAB 50MG,250,RC,,,,both,7.3,6.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.11,,,,4.31,5.96
NF-CILOSTAZOL TAB 50MG,250,RC,,,,both,7.3,6.57,Cigna,Default,Percent of Total Billed Charges,4.31,,,,4.31,5.96
NF-CILOSTAZOL TAB 50MG,250,RC,,,,both,7.3,6.57,United Healthcare,Default,Fee Schedule,5.96,,,,4.31,5.96
NF-CYCLOPENTOLATE HCL OPHTH SOLN 0.5%,250,RC,,,,both,20.51,18.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.36,,,,12.1,16.74
NF-CYCLOPENTOLATE HCL OPHTH SOLN 0.5%,250,RC,,,,both,20.51,18.46,Cigna,Default,Percent of Total Billed Charges,12.1,,,,12.1,16.74
NF-CYCLOPENTOLATE HCL OPHTH SOLN 0.5%,250,RC,,,,both,20.51,18.46,United Healthcare,Default,Fee Schedule,16.74,,,,12.1,16.74
NF-CYCLOPENTOLATE HCL OPHTH SOLN 1%,250,RC,,,,both,10.8,9.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.56,,,,6.37,8.81
NF-CYCLOPENTOLATE HCL OPHTH SOLN 1%,250,RC,,,,both,10.8,9.72,Cigna,Default,Percent of Total Billed Charges,6.37,,,,6.37,8.81
NF-CYCLOPENTOLATE HCL OPHTH SOLN 1%,250,RC,,,,both,10.8,9.72,United Healthcare,Default,Fee Schedule,8.81,,,,6.37,8.81
NF-ALPHAGAN P OPTHAMALIC SOLUTION  0.1%,250,RC,,,,both,148.79,133.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.15,,,,87.79,121.41
NF-ALPHAGAN P OPTHAMALIC SOLUTION  0.1%,250,RC,,,,both,148.79,133.91,Cigna,Default,Percent of Total Billed Charges,87.79,,,,87.79,121.41
NF-ALPHAGAN P OPTHAMALIC SOLUTION  0.1%,250,RC,,,,both,148.79,133.91,United Healthcare,Default,Fee Schedule,121.41,,,,87.79,121.41
NF-LATANOPROST OPHTH SOLN 0.005%,250,RC,,,,both,60.5,54.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.35,,,,35.7,49.37
NF-LATANOPROST OPHTH SOLN 0.005%,250,RC,,,,both,60.5,54.45,Cigna,Default,Percent of Total Billed Charges,35.7,,,,35.7,49.37
NF-LATANOPROST OPHTH SOLN 0.005%,250,RC,,,,both,60.5,54.45,United Healthcare,Default,Fee Schedule,49.37,,,,35.7,49.37
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,Cigna,Default,Percent of Total Billed Charges,3.76,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,United Healthcare,Default,Fee Schedule,5.21,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,66.1,59.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.27,,,,39,53.94
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,66.1,59.49,Cigna,Default,Percent of Total Billed Charges,39,,,,39,53.94
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,66.1,59.49,United Healthcare,Default,Fee Schedule,53.94,,,,39,53.94
NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,250,RC,,,,both,27.44,24.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.21,,,,16.19,22.39
NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,250,RC,,,,both,27.44,24.7,Cigna,Default,Percent of Total Billed Charges,16.19,,,,16.19,22.39
NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,250,RC,,,,both,27.44,24.7,United Healthcare,Default,Fee Schedule,22.39,,,,16.19,22.39
NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,250,RC,,,,both,27.44,24.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.21,,,,16.19,22.39
NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,250,RC,,,,both,27.44,24.7,Cigna,Default,Percent of Total Billed Charges,16.19,,,,16.19,22.39
NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,250,RC,,,,both,27.44,24.7,United Healthcare,Default,Fee Schedule,22.39,,,,16.19,22.39
NF-JUBLIA TOPICAL APPLICATION SOLUTION 1,250,RC,,,,both,798.85,718.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,559.2,,,,471.32,651.86
NF-JUBLIA TOPICAL APPLICATION SOLUTION 1,250,RC,,,,both,798.85,718.97,Cigna,Default,Percent of Total Billed Charges,471.32,,,,471.32,651.86
NF-JUBLIA TOPICAL APPLICATION SOLUTION 1,250,RC,,,,both,798.85,718.97,United Healthcare,Default,Fee Schedule,651.86,,,,471.32,651.86
NF-METFORMIN HCL ORAL TABLET 850MG,250,RC,,,,both,4.79,4.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.35,,,,2.83,3.91
NF-METFORMIN HCL ORAL TABLET 850MG,250,RC,,,,both,4.79,4.31,Cigna,Default,Percent of Total Billed Charges,2.83,,,,2.83,3.91
NF-METFORMIN HCL ORAL TABLET 850MG,250,RC,,,,both,4.79,4.31,United Healthcare,Default,Fee Schedule,3.91,,,,2.83,3.91
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.34,6.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.14,,,,4.33,5.99
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.34,6.61,Cigna,Default,Percent of Total Billed Charges,4.33,,,,4.33,5.99
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.34,6.61,United Healthcare,Default,Fee Schedule,5.99,,,,4.33,5.99
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.34,6.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.14,,,,4.33,5.99
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.34,6.61,Cigna,Default,Percent of Total Billed Charges,4.33,,,,4.33,5.99
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.34,6.61,United Healthcare,Default,Fee Schedule,5.99,,,,4.33,5.99
NF-CEFAZOLIN NA-NACL IV SOLN 2GM-0.9%,250,RC,,,,both,2.28,2.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.6,,,,1.35,1.86
NF-CEFAZOLIN NA-NACL IV SOLN 2GM-0.9%,250,RC,,,,both,2.28,2.05,Cigna,Default,Percent of Total Billed Charges,1.35,,,,1.35,1.86
NF-CEFAZOLIN NA-NACL IV SOLN 2GM-0.9%,250,RC,,,,both,2.28,2.05,United Healthcare,Default,Fee Schedule,1.86,,,,1.35,1.86
NF-SACCHARIN CALCIUM POWDER,250,RC,,,,both,11.02,9.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.71,,,,6.5,8.99
NF-SACCHARIN CALCIUM POWDER,250,RC,,,,both,11.02,9.92,Cigna,Default,Percent of Total Billed Charges,6.5,,,,6.5,8.99
NF-SACCHARIN CALCIUM POWDER,250,RC,,,,both,11.02,9.92,United Healthcare,Default,Fee Schedule,8.99,,,,6.5,8.99
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
NF-EVISTA TAB 60MG,250,RC,,,,both,24.85,22.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.4,,,,14.66,20.28
NF-EVISTA TAB 60MG,250,RC,,,,both,24.85,22.37,Cigna,Default,Percent of Total Billed Charges,14.66,,,,14.66,20.28
NF-EVISTA TAB 60MG,250,RC,,,,both,24.85,22.37,United Healthcare,Default,Fee Schedule,20.28,,,,14.66,20.28
NF-GABAPENTIN CAP 100MG,250,RC,,,,both,3.04,2.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.13,,,,1.79,2.48
NF-GABAPENTIN CAP 100MG,250,RC,,,,both,3.04,2.74,Cigna,Default,Percent of Total Billed Charges,1.79,,,,1.79,2.48
NF-GABAPENTIN CAP 100MG,250,RC,,,,both,3.04,2.74,United Healthcare,Default,Fee Schedule,2.48,,,,1.79,2.48
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,250,RC,,,,both,137.39,123.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.17,,,,81.06,112.11
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,250,RC,,,,both,137.39,123.65,Cigna,Default,Percent of Total Billed Charges,81.06,,,,81.06,112.11
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,250,RC,,,,both,137.39,123.65,United Healthcare,Default,Fee Schedule,112.11,,,,81.06,112.11
CEFEPIME 1000 MG INJ,250,RC,,,,both,87.44,78.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.21,,,,51.59,71.35
CEFEPIME 1000 MG INJ,250,RC,,,,both,87.44,78.7,Cigna,Default,Percent of Total Billed Charges,51.59,,,,51.59,71.35
CEFEPIME 1000 MG INJ,250,RC,,,,both,87.44,78.7,United Healthcare,Default,Fee Schedule,71.35,,,,51.59,71.35
TNKASE IV POWDER FOR SOLUTION 50MG,J3101,HCPCS,636,RC,,both,38071.81,34264.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26650.27,,,,22462.37,31066.6
TNKASE IV POWDER FOR SOLUTION 50MG,J3101,HCPCS,636,RC,,both,38071.81,34264.63,Cigna,Default,Percent of Total Billed Charges,22462.37,,,,22462.37,31066.6
TNKASE IV POWDER FOR SOLUTION 50MG,J3101,HCPCS,636,RC,,both,38071.81,34264.63,United Healthcare,Default,Fee Schedule,31066.6,,,,22462.37,31066.6
SOTALOL 150MG/10ML INJ,250,RC,,,,both,7332.51,6599.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5132.76,,,,4326.18,5983.33
SOTALOL 150MG/10ML INJ,250,RC,,,,both,7332.51,6599.26,Cigna,Default,Percent of Total Billed Charges,4326.18,,,,4326.18,5983.33
SOTALOL 150MG/10ML INJ,250,RC,,,,both,7332.51,6599.26,United Healthcare,Default,Fee Schedule,5983.33,,,,4326.18,5983.33
NF-PAROXETINE HCL ORAL TABLET 40MG,250,RC,,,,both,2.12,1.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.48,,,,1.25,1.73
NF-PAROXETINE HCL ORAL TABLET 40MG,250,RC,,,,both,2.12,1.91,Cigna,Default,Percent of Total Billed Charges,1.25,,,,1.25,1.73
NF-PAROXETINE HCL ORAL TABLET 40MG,250,RC,,,,both,2.12,1.91,United Healthcare,Default,Fee Schedule,1.73,,,,1.25,1.73
PROCAINAMIDE 1000MG/10ML INJ,636,RC,,,,both,441.08,396.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,308.76,,,,260.24,359.92
PROCAINAMIDE 1000MG/10ML INJ,636,RC,,,,both,441.08,396.97,Cigna,Default,Percent of Total Billed Charges,260.24,,,,260.24,359.92
PROCAINAMIDE 1000MG/10ML INJ,636,RC,,,,both,441.08,396.97,United Healthcare,Default,Fee Schedule,359.92,,,,260.24,359.92
NF-ADVAIR DISKUS 500/50 DISK,250,RC,,,,both,27.06,24.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.94,,,,15.97,22.08
NF-ADVAIR DISKUS 500/50 DISK,250,RC,,,,both,27.06,24.35,Cigna,Default,Percent of Total Billed Charges,15.97,,,,15.97,22.08
NF-ADVAIR DISKUS 500/50 DISK,250,RC,,,,both,27.06,24.35,United Healthcare,Default,Fee Schedule,22.08,,,,15.97,22.08
IV TEMPLATE,636,RC,,,,both,18685.53,16816.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13079.87,,,,11024.46,15247.39
IV TEMPLATE,636,RC,,,,both,18685.53,16816.98,Cigna,Default,Percent of Total Billed Charges,11024.46,,,,11024.46,15247.39
IV TEMPLATE,636,RC,,,,both,18685.53,16816.98,United Healthcare,Default,Fee Schedule,15247.39,,,,11024.46,15247.39
NF-OSELTAMIVIR PHOSPHATE PWD FOR SUSP 6M,250,RC,,,,both,11.82,10.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.27,,,,6.97,9.65
NF-OSELTAMIVIR PHOSPHATE PWD FOR SUSP 6M,250,RC,,,,both,11.82,10.64,Cigna,Default,Percent of Total Billed Charges,6.97,,,,6.97,9.65
NF-OSELTAMIVIR PHOSPHATE PWD FOR SUSP 6M,250,RC,,,,both,11.82,10.64,United Healthcare,Default,Fee Schedule,9.65,,,,6.97,9.65
NF-RAMIPRIL CAP 10MG,250,RC,,,,both,14.54,13.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.18,,,,8.58,11.86
NF-RAMIPRIL CAP 10MG,250,RC,,,,both,14.54,13.09,Cigna,Default,Percent of Total Billed Charges,8.58,,,,8.58,11.86
NF-RAMIPRIL CAP 10MG,250,RC,,,,both,14.54,13.09,United Healthcare,Default,Fee Schedule,11.86,,,,8.58,11.86
NF-FEOSOL ORAL TABLET 45MG,250,RC,,,,both,0.64,0.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.45,,,,0.38,0.52
NF-FEOSOL ORAL TABLET 45MG,250,RC,,,,both,0.64,0.58,Cigna,Default,Percent of Total Billed Charges,0.38,,,,0.38,0.52
NF-FEOSOL ORAL TABLET 45MG,250,RC,,,,both,0.64,0.58,United Healthcare,Default,Fee Schedule,0.52,,,,0.38,0.52
NF-FEOSOL ORAL TABLET 65MG,250,RC,,,,both,0.25,0.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.18,,,,0.15,0.2
NF-FEOSOL ORAL TABLET 65MG,250,RC,,,,both,0.25,0.23,Cigna,Default,Percent of Total Billed Charges,0.15,,,,0.15,0.2
NF-FEOSOL ORAL TABLET 65MG,250,RC,,,,both,0.25,0.23,United Healthcare,Default,Fee Schedule,0.2,,,,0.15,0.2
NF-AFINITOR ORAL TABLET 5MG,250,RC,,,,both,2334.47,2101.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1634.13,,,,1377.34,1904.93
NF-AFINITOR ORAL TABLET 5MG,250,RC,,,,both,2334.47,2101.02,Cigna,Default,Percent of Total Billed Charges,1377.34,,,,1377.34,1904.93
NF-AFINITOR ORAL TABLET 5MG,250,RC,,,,both,2334.47,2101.02,United Healthcare,Default,Fee Schedule,1904.93,,,,1377.34,1904.93
NF-DEXAMETHASONE ELIX 0.5MG/5ML,250,RC,,,,both,1.16,1.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.81,,,,0.68,0.95
NF-DEXAMETHASONE ELIX 0.5MG/5ML,250,RC,,,,both,1.16,1.04,Cigna,Default,Percent of Total Billed Charges,0.68,,,,0.68,0.95
NF-DEXAMETHASONE ELIX 0.5MG/5ML,250,RC,,,,both,1.16,1.04,United Healthcare,Default,Fee Schedule,0.95,,,,0.68,0.95
NF-FEOSOL ORAL TABLET 45MG,250,RC,,,,both,0.62,0.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.43,,,,0.37,0.51
NF-FEOSOL ORAL TABLET 45MG,250,RC,,,,both,0.62,0.56,Cigna,Default,Percent of Total Billed Charges,0.37,,,,0.37,0.51
NF-FEOSOL ORAL TABLET 45MG,250,RC,,,,both,0.62,0.56,United Healthcare,Default,Fee Schedule,0.51,,,,0.37,0.51
NF-CHLORDIAZEPOXIDE CAP 10MG,250,RC,,,,both,2.55,2.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.78,,,,1.5,2.08
NF-CHLORDIAZEPOXIDE CAP 10MG,250,RC,,,,both,2.55,2.3,Cigna,Default,Percent of Total Billed Charges,1.5,,,,1.5,2.08
NF-CHLORDIAZEPOXIDE CAP 10MG,250,RC,,,,both,2.55,2.3,United Healthcare,Default,Fee Schedule,2.08,,,,1.5,2.08
NF-LACTASE TABLET,250,RC,,,,both,0.56,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.39,,,,0.33,0.46
NF-LACTASE TABLET,250,RC,,,,both,0.56,0.5,Cigna,Default,Percent of Total Billed Charges,0.33,,,,0.33,0.46
NF-LACTASE TABLET,250,RC,,,,both,0.56,0.5,United Healthcare,Default,Fee Schedule,0.46,,,,0.33,0.46
NF-THEO-24 24 HR CAP ER 100MG,250,RC,,,,both,9.44,8.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.61,,,,5.57,7.7
NF-THEO-24 24 HR CAP ER 100MG,250,RC,,,,both,9.44,8.5,Cigna,Default,Percent of Total Billed Charges,5.57,,,,5.57,7.7
NF-THEO-24 24 HR CAP ER 100MG,250,RC,,,,both,9.44,8.5,United Healthcare,Default,Fee Schedule,7.7,,,,5.57,7.7
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.93,7.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.55,,,,4.68,6.47
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.93,7.14,Cigna,Default,Percent of Total Billed Charges,4.68,,,,4.68,6.47
NF-AMILORIDE HCL ORAL TABLET 5MG,250,RC,,,,both,7.93,7.14,United Healthcare,Default,Fee Schedule,6.47,,,,4.68,6.47
NF-BONIVA ORAL TABLET 150MG,250,RC,,,,both,621.68,559.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,435.18,,,,366.79,507.29
NF-BONIVA ORAL TABLET 150MG,250,RC,,,,both,621.68,559.51,Cigna,Default,Percent of Total Billed Charges,366.79,,,,366.79,507.29
NF-BONIVA ORAL TABLET 150MG,250,RC,,,,both,621.68,559.51,United Healthcare,Default,Fee Schedule,507.29,,,,366.79,507.29
NF-IBANDRONATE SODIUM ORAL TABLET 150MG,250,RC,,,,both,599.91,539.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,419.94,,,,353.95,489.53
NF-IBANDRONATE SODIUM ORAL TABLET 150MG,250,RC,,,,both,599.91,539.92,Cigna,Default,Percent of Total Billed Charges,353.95,,,,353.95,489.53
NF-IBANDRONATE SODIUM ORAL TABLET 150MG,250,RC,,,,both,599.91,539.92,United Healthcare,Default,Fee Schedule,489.53,,,,353.95,489.53
NF-TAMIFLU PWD FOR SUSP 6MG/1ML,250,RC,,,,both,10.43,9.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.3,,,,6.15,8.51
NF-TAMIFLU PWD FOR SUSP 6MG/1ML,250,RC,,,,both,10.43,9.39,Cigna,Default,Percent of Total Billed Charges,6.15,,,,6.15,8.51
NF-TAMIFLU PWD FOR SUSP 6MG/1ML,250,RC,,,,both,10.43,9.39,United Healthcare,Default,Fee Schedule,8.51,,,,6.15,8.51
NF-ZINC ACETATE CAP 25MG,250,RC,,,,both,6.72,6.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.7,,,,3.96,5.48
NF-ZINC ACETATE CAP 25MG,250,RC,,,,both,6.72,6.05,Cigna,Default,Percent of Total Billed Charges,3.96,,,,3.96,5.48
NF-ZINC ACETATE CAP 25MG,250,RC,,,,both,6.72,6.05,United Healthcare,Default,Fee Schedule,5.48,,,,3.96,5.48
NF-OCUVITE TABLET,250,RC,,,,both,0.39,0.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.27,,,,0.23,0.32
NF-OCUVITE TABLET,250,RC,,,,both,0.39,0.35,Cigna,Default,Percent of Total Billed Charges,0.23,,,,0.23,0.32
NF-OCUVITE TABLET,250,RC,,,,both,0.39,0.35,United Healthcare,Default,Fee Schedule,0.32,,,,0.23,0.32
NF-LISINOPRIL ORAL TABLET 40MG,250,RC,,,,both,6.34,5.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.44,,,,3.74,5.17
NF-LISINOPRIL ORAL TABLET 40MG,250,RC,,,,both,6.34,5.71,Cigna,Default,Percent of Total Billed Charges,3.74,,,,3.74,5.17
NF-LISINOPRIL ORAL TABLET 40MG,250,RC,,,,both,6.34,5.71,United Healthcare,Default,Fee Schedule,5.17,,,,3.74,5.17
NF-PULMICORT FLEXHALER INH/NEB 180MCG/1A,250,RC,,,,both,1123.51,1011.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,786.46,,,,662.87,916.78
NF-PULMICORT FLEXHALER INH/NEB 180MCG/1A,250,RC,,,,both,1123.51,1011.16,Cigna,Default,Percent of Total Billed Charges,662.87,,,,662.87,916.78
NF-PULMICORT FLEXHALER INH/NEB 180MCG/1A,250,RC,,,,both,1123.51,1011.16,United Healthcare,Default,Fee Schedule,916.78,,,,662.87,916.78
NF-BUDESONIDE  INH/NEB PWD 180MCG/1ACT,250,RC,,,,both,1123.51,1011.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,786.46,,,,662.87,916.78
NF-BUDESONIDE  INH/NEB PWD 180MCG/1ACT,250,RC,,,,both,1123.51,1011.16,Cigna,Default,Percent of Total Billed Charges,662.87,,,,662.87,916.78
NF-BUDESONIDE  INH/NEB PWD 180MCG/1ACT,250,RC,,,,both,1123.51,1011.16,United Healthcare,Default,Fee Schedule,916.78,,,,662.87,916.78
NF-MEDIHONEY TOPICAL GEL 80%,250,RC,,,,both,1.41,1.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.99,,,,0.83,1.15
NF-MEDIHONEY TOPICAL GEL 80%,250,RC,,,,both,1.41,1.27,Cigna,Default,Percent of Total Billed Charges,0.83,,,,0.83,1.15
NF-MEDIHONEY TOPICAL GEL 80%,250,RC,,,,both,1.41,1.27,United Healthcare,Default,Fee Schedule,1.15,,,,0.83,1.15
NF-PAPAYA ENZYME TABLET,250,RC,,,,both,14.96,13.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.47,,,,8.83,12.21
NF-PAPAYA ENZYME TABLET,250,RC,,,,both,14.96,13.46,Cigna,Default,Percent of Total Billed Charges,8.83,,,,8.83,12.21
NF-PAPAYA ENZYME TABLET,250,RC,,,,both,14.96,13.46,United Healthcare,Default,Fee Schedule,12.21,,,,8.83,12.21
NF-ARGININE ORAL CAPSULE 600MG,250,RC,,,,both,0.37,0.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.26,,,,0.22,0.3
NF-ARGININE ORAL CAPSULE 600MG,250,RC,,,,both,0.37,0.33,Cigna,Default,Percent of Total Billed Charges,0.22,,,,0.22,0.3
NF-ARGININE ORAL CAPSULE 600MG,250,RC,,,,both,0.37,0.33,United Healthcare,Default,Fee Schedule,0.3,,,,0.22,0.3
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.05,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.03,0.04
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.05,0.05,Cigna,Default,Percent of Total Billed Charges,0.03,,,,0.03,0.04
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.05,0.05,United Healthcare,Default,Fee Schedule,0.04,,,,0.03,0.04
NF-MARINOL LIQ CAP 5MG,250,RC,,,,both,112.24,101.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.57,,,,66.22,91.59
NF-MARINOL LIQ CAP 5MG,250,RC,,,,both,112.24,101.02,Cigna,Default,Percent of Total Billed Charges,66.22,,,,66.22,91.59
NF-MARINOL LIQ CAP 5MG,250,RC,,,,both,112.24,101.02,United Healthcare,Default,Fee Schedule,91.59,,,,66.22,91.59
NF-GLYNASE PRES-TAB ORAL TABLET 3MG,250,RC,,,,both,11.39,10.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.97,,,,6.72,9.29
NF-GLYNASE PRES-TAB ORAL TABLET 3MG,250,RC,,,,both,11.39,10.25,Cigna,Default,Percent of Total Billed Charges,6.72,,,,6.72,9.29
NF-GLYNASE PRES-TAB ORAL TABLET 3MG,250,RC,,,,both,11.39,10.25,United Healthcare,Default,Fee Schedule,9.29,,,,6.72,9.29
NF-ALEVE ARTHRITIS TAB 220MG,250,RC,,,,both,0.32,0.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.19,0.26
NF-ALEVE ARTHRITIS TAB 220MG,250,RC,,,,both,0.32,0.29,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.26
NF-ALEVE ARTHRITIS TAB 220MG,250,RC,,,,both,0.32,0.29,United Healthcare,Default,Fee Schedule,0.26,,,,0.19,0.26
NF-ALEVE CAP 220MG,250,RC,,,,both,0.7,0.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.49,,,,0.41,0.57
NF-ALEVE CAP 220MG,250,RC,,,,both,0.7,0.63,Cigna,Default,Percent of Total Billed Charges,0.41,,,,0.41,0.57
NF-ALEVE CAP 220MG,250,RC,,,,both,0.7,0.63,United Healthcare,Default,Fee Schedule,0.57,,,,0.41,0.57
NF-SAM-E 400 ORAL TABLET EC 400MG,250,RC,,,,both,5.6,5.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.92,,,,3.3,4.57
NF-SAM-E 400 ORAL TABLET EC 400MG,250,RC,,,,both,5.6,5.04,Cigna,Default,Percent of Total Billed Charges,3.3,,,,3.3,4.57
NF-SAM-E 400 ORAL TABLET EC 400MG,250,RC,,,,both,5.6,5.04,United Healthcare,Default,Fee Schedule,4.57,,,,3.3,4.57
NF-NYSTATIN/TRIAMCINOLONE ACETONID OINTM,250,RC,,,,both,22.99,20.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.09,,,,13.56,18.76
NF-NYSTATIN/TRIAMCINOLONE ACETONID OINTM,250,RC,,,,both,22.99,20.69,Cigna,Default,Percent of Total Billed Charges,13.56,,,,13.56,18.76
NF-NYSTATIN/TRIAMCINOLONE ACETONID OINTM,250,RC,,,,both,22.99,20.69,United Healthcare,Default,Fee Schedule,18.76,,,,13.56,18.76
NF-FENOFIBRATE AVPAK ORAL TABLET 48MG,250,RC,,,,both,7.84,7.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.49,,,,4.63,6.4
NF-FENOFIBRATE AVPAK ORAL TABLET 48MG,250,RC,,,,both,7.84,7.06,Cigna,Default,Percent of Total Billed Charges,4.63,,,,4.63,6.4
NF-FENOFIBRATE AVPAK ORAL TABLET 48MG,250,RC,,,,both,7.84,7.06,United Healthcare,Default,Fee Schedule,6.4,,,,4.63,6.4
POTASSIUM PHOSPHATE ORIGINAL TAB 500MG,250,RC,,,,both,2.11,1.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.48,,,,1.24,1.72
POTASSIUM PHOSPHATE ORIGINAL TAB 500MG,250,RC,,,,both,2.11,1.9,Cigna,Default,Percent of Total Billed Charges,1.24,,,,1.24,1.72
POTASSIUM PHOSPHATE ORIGINAL TAB 500MG,250,RC,,,,both,2.11,1.9,United Healthcare,Default,Fee Schedule,1.72,,,,1.24,1.72
NF-MODAFINIL AVPAK ORAL TABLET 200MG,250,RC,,,,both,145.5,130.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.85,,,,85.84,118.73
NF-MODAFINIL AVPAK ORAL TABLET 200MG,250,RC,,,,both,145.5,130.95,Cigna,Default,Percent of Total Billed Charges,85.84,,,,85.84,118.73
NF-MODAFINIL AVPAK ORAL TABLET 200MG,250,RC,,,,both,145.5,130.95,United Healthcare,Default,Fee Schedule,118.73,,,,85.84,118.73
NF-FOSINOPRIL SODIUM ORAL TABLET 40MG,250,RC,,,,both,5.14,4.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.6,,,,3.03,4.19
NF-FOSINOPRIL SODIUM ORAL TABLET 40MG,250,RC,,,,both,5.14,4.63,Cigna,Default,Percent of Total Billed Charges,3.03,,,,3.03,4.19
NF-FOSINOPRIL SODIUM ORAL TABLET 40MG,250,RC,,,,both,5.14,4.63,United Healthcare,Default,Fee Schedule,4.19,,,,3.03,4.19
NF-NEXIUM 24HR CAP DR 20MG,250,RC,,,,both,2.77,2.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.94,,,,1.63,2.26
NF-NEXIUM 24HR CAP DR 20MG,250,RC,,,,both,2.77,2.49,Cigna,Default,Percent of Total Billed Charges,1.63,,,,1.63,2.26
NF-NEXIUM 24HR CAP DR 20MG,250,RC,,,,both,2.77,2.49,United Healthcare,Default,Fee Schedule,2.26,,,,1.63,2.26
NF-BISOPROLOL FUMARATE TAB 5MG,250,RC,,,,both,16.07,14.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.25,,,,9.48,13.11
NF-BISOPROLOL FUMARATE TAB 5MG,250,RC,,,,both,16.07,14.46,Cigna,Default,Percent of Total Billed Charges,9.48,,,,9.48,13.11
NF-BISOPROLOL FUMARATE TAB 5MG,250,RC,,,,both,16.07,14.46,United Healthcare,Default,Fee Schedule,13.11,,,,9.48,13.11
NF-CALTRATE 600 TAB 600MG,250,RC,,,,both,0.57,0.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.4,,,,0.34,0.47
NF-CALTRATE 600 TAB 600MG,250,RC,,,,both,0.57,0.51,Cigna,Default,Percent of Total Billed Charges,0.34,,,,0.34,0.47
NF-CALTRATE 600 TAB 600MG,250,RC,,,,both,0.57,0.51,United Healthcare,Default,Fee Schedule,0.47,,,,0.34,0.47
NF-AFINITOR TAB 10MG,250,RC,,,,both,2565.43,2308.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1795.8,,,,1513.6,2093.39
NF-AFINITOR TAB 10MG,250,RC,,,,both,2565.43,2308.89,Cigna,Default,Percent of Total Billed Charges,1513.6,,,,1513.6,2093.39
NF-AFINITOR TAB 10MG,250,RC,,,,both,2565.43,2308.89,United Healthcare,Default,Fee Schedule,2093.39,,,,1513.6,2093.39
NF-EXEMESTANE ORAL TABLET 25MG,250,RC,,,,both,83.28,74.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.3,,,,49.14,67.96
NF-EXEMESTANE ORAL TABLET 25MG,250,RC,,,,both,83.28,74.95,Cigna,Default,Percent of Total Billed Charges,49.14,,,,49.14,67.96
NF-EXEMESTANE ORAL TABLET 25MG,250,RC,,,,both,83.28,74.95,United Healthcare,Default,Fee Schedule,67.96,,,,49.14,67.96
NF-EXEMESTANE ORAL TABLET 25MG,250,RC,,,,both,83.28,74.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.3,,,,49.14,67.96
NF-EXEMESTANE ORAL TABLET 25MG,250,RC,,,,both,83.28,74.95,Cigna,Default,Percent of Total Billed Charges,49.14,,,,49.14,67.96
NF-EXEMESTANE ORAL TABLET 25MG,250,RC,,,,both,83.28,74.95,United Healthcare,Default,Fee Schedule,67.96,,,,49.14,67.96
NF-VITAMIN D ORAL TABLET 1000IU,250,RC,,,,both,0.11,0.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.08,,,,0.06,0.09
NF-VITAMIN D ORAL TABLET 1000IU,250,RC,,,,both,0.11,0.1,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.09
NF-VITAMIN D ORAL TABLET 1000IU,250,RC,,,,both,0.11,0.1,United Healthcare,Default,Fee Schedule,0.09,,,,0.06,0.09
NF-COENZYME Q10 LIQ CAP 100MG,250,RC,,,,both,2.09,1.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.46,,,,1.23,1.71
NF-COENZYME Q10 LIQ CAP 100MG,250,RC,,,,both,2.09,1.88,Cigna,Default,Percent of Total Billed Charges,1.23,,,,1.23,1.71
NF-COENZYME Q10 LIQ CAP 100MG,250,RC,,,,both,2.09,1.88,United Healthcare,Default,Fee Schedule,1.71,,,,1.23,1.71
NF-NIFEDIPINE AVPAK TAB ER 60MG,250,RC,,,,both,9.02,8.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.31,,,,5.32,7.36
NF-NIFEDIPINE AVPAK TAB ER 60MG,250,RC,,,,both,9.02,8.12,Cigna,Default,Percent of Total Billed Charges,5.32,,,,5.32,7.36
NF-NIFEDIPINE AVPAK TAB ER 60MG,250,RC,,,,both,9.02,8.12,United Healthcare,Default,Fee Schedule,7.36,,,,5.32,7.36
NF-VITAMIN B-12 ORAL SOLUTION 1000MCG/ML,250,RC,,,,both,0.51,0.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.3,0.42
NF-VITAMIN B-12 ORAL SOLUTION 1000MCG/ML,250,RC,,,,both,0.51,0.46,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.42
NF-VITAMIN B-12 ORAL SOLUTION 1000MCG/ML,250,RC,,,,both,0.51,0.46,United Healthcare,Default,Fee Schedule,0.42,,,,0.3,0.42
NF-SAXAGLIPTIN HYDROCHLORIDE TAB 5MG,250,RC,,,,both,51.13,46.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.79,,,,30.17,41.72
NF-SAXAGLIPTIN HYDROCHLORIDE TAB 5MG,250,RC,,,,both,51.13,46.02,Cigna,Default,Percent of Total Billed Charges,30.17,,,,30.17,41.72
NF-SAXAGLIPTIN HYDROCHLORIDE TAB 5MG,250,RC,,,,both,51.13,46.02,United Healthcare,Default,Fee Schedule,41.72,,,,30.17,41.72
NF-PERFOROMIST INH SOLN 20MCG/2ML,250,RC,,,,both,42.04,37.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.43,,,,24.8,34.3
NF-PERFOROMIST INH SOLN 20MCG/2ML,250,RC,,,,both,42.04,37.84,Cigna,Default,Percent of Total Billed Charges,24.8,,,,24.8,34.3
NF-PERFOROMIST INH SOLN 20MCG/2ML,250,RC,,,,both,42.04,37.84,United Healthcare,Default,Fee Schedule,34.3,,,,24.8,34.3
NF-CARBOXYMETHYLCELLULOSE SODIUM-GLYCERI,250,RC,,,,both,5.19,4.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.63,,,,3.06,4.24
NF-CARBOXYMETHYLCELLULOSE SODIUM-GLYCERI,250,RC,,,,both,5.19,4.67,Cigna,Default,Percent of Total Billed Charges,3.06,,,,3.06,4.24
NF-CARBOXYMETHYLCELLULOSE SODIUM-GLYCERI,250,RC,,,,both,5.19,4.67,United Healthcare,Default,Fee Schedule,4.24,,,,3.06,4.24
NF-ALPRAZOLAM DISINTEGRATING TAB 2MG,250,RC,,,,both,17.15,15.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12,,,,10.12,13.99
NF-ALPRAZOLAM DISINTEGRATING TAB 2MG,250,RC,,,,both,17.15,15.44,Cigna,Default,Percent of Total Billed Charges,10.12,,,,10.12,13.99
NF-ALPRAZOLAM DISINTEGRATING TAB 2MG,250,RC,,,,both,17.15,15.44,United Healthcare,Default,Fee Schedule,13.99,,,,10.12,13.99
NF-PROTONIX TAB EC 40MG,250,RC,,,,both,25.83,23.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.08,,,,15.24,21.08
NF-PROTONIX TAB EC 40MG,250,RC,,,,both,25.83,23.25,Cigna,Default,Percent of Total Billed Charges,15.24,,,,15.24,21.08
NF-PROTONIX TAB EC 40MG,250,RC,,,,both,25.83,23.25,United Healthcare,Default,Fee Schedule,21.08,,,,15.24,21.08
NF-QUINAPRIL HCL TAB 40MG,250,RC,,,,both,16.33,14.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.43,,,,9.63,13.33
NF-QUINAPRIL HCL TAB 40MG,250,RC,,,,both,16.33,14.7,Cigna,Default,Percent of Total Billed Charges,9.63,,,,9.63,13.33
NF-QUINAPRIL HCL TAB 40MG,250,RC,,,,both,16.33,14.7,United Healthcare,Default,Fee Schedule,13.33,,,,9.63,13.33
NF-BENAZEPRIL HCL-HCTZ TAB 10MG-12.5MG,250,RC,,,,both,8.94,8.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.26,,,,5.27,7.3
NF-BENAZEPRIL HCL-HCTZ TAB 10MG-12.5MG,250,RC,,,,both,8.94,8.05,Cigna,Default,Percent of Total Billed Charges,5.27,,,,5.27,7.3
NF-BENAZEPRIL HCL-HCTZ TAB 10MG-12.5MG,250,RC,,,,both,8.94,8.05,United Healthcare,Default,Fee Schedule,7.3,,,,5.27,7.3
NF-LOTENSIN HCT ORAL TABLET 10MG-12.5MG,250,RC,,,,both,11.54,10.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.08,,,,6.81,9.42
NF-LOTENSIN HCT ORAL TABLET 10MG-12.5MG,250,RC,,,,both,11.54,10.39,Cigna,Default,Percent of Total Billed Charges,6.81,,,,6.81,9.42
NF-LOTENSIN HCT ORAL TABLET 10MG-12.5MG,250,RC,,,,both,11.54,10.39,United Healthcare,Default,Fee Schedule,9.42,,,,6.81,9.42
NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,250,RC,,,,both,28.38,25.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.87,,,,16.74,23.16
NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,250,RC,,,,both,28.38,25.54,Cigna,Default,Percent of Total Billed Charges,16.74,,,,16.74,23.16
NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,250,RC,,,,both,28.38,25.54,United Healthcare,Default,Fee Schedule,23.16,,,,16.74,23.16
NF-TRIAMCINOLONE ACETONIDE CREAM 0.025%,250,RC,,,,both,0.43,0.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.3,,,,0.25,0.35
NF-TRIAMCINOLONE ACETONIDE CREAM 0.025%,250,RC,,,,both,0.43,0.39,Cigna,Default,Percent of Total Billed Charges,0.25,,,,0.25,0.35
NF-TRIAMCINOLONE ACETONIDE CREAM 0.025%,250,RC,,,,both,0.43,0.39,United Healthcare,Default,Fee Schedule,0.35,,,,0.25,0.35
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.25%,250,RC,,,,both,171.45,154.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,120.02,,,,101.16,139.9
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.25%,250,RC,,,,both,171.45,154.31,Cigna,Default,Percent of Total Billed Charges,101.16,,,,101.16,139.9
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.25%,250,RC,,,,both,171.45,154.31,United Healthcare,Default,Fee Schedule,139.9,,,,101.16,139.9
NF-TRADJENTA TAB 5MG,250,RC,,,,both,67.75,60.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.42,,,,39.97,55.28
NF-TRADJENTA TAB 5MG,250,RC,,,,both,67.75,60.98,Cigna,Default,Percent of Total Billed Charges,39.97,,,,39.97,55.28
NF-TRADJENTA TAB 5MG,250,RC,,,,both,67.75,60.98,United Healthcare,Default,Fee Schedule,55.28,,,,39.97,55.28
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5%,250,RC,,,,both,50.6,45.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.42,,,,29.85,41.29
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5%,250,RC,,,,both,50.6,45.54,Cigna,Default,Percent of Total Billed Charges,29.85,,,,29.85,41.29
NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5%,250,RC,,,,both,50.6,45.54,United Healthcare,Default,Fee Schedule,41.29,,,,29.85,41.29
NF-MICROLIPID OIL,250,RC,,,,both,0.08,0.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-MICROLIPID OIL,250,RC,,,,both,0.08,0.07,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-MICROLIPID OIL,250,RC,,,,both,0.08,0.07,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
NF-LEUPROLIDE ACETATE IM 3 MONTH PWD FOR,250,RC,,,,both,22715.33,20443.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15900.73,,,,13402.04,18535.71
NF-LEUPROLIDE ACETATE IM 3 MONTH PWD FOR,250,RC,,,,both,22715.33,20443.8,Cigna,Default,Percent of Total Billed Charges,13402.04,,,,13402.04,18535.71
NF-LEUPROLIDE ACETATE IM 3 MONTH PWD FOR,250,RC,,,,both,22715.33,20443.8,United Healthcare,Default,Fee Schedule,18535.71,,,,13402.04,18535.71
NF-CHLORASEPTIC MUCOUS MEMBRANE LONZENGE,250,RC,,,,both,0.7,0.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.49,,,,0.41,0.57
NF-CHLORASEPTIC MUCOUS MEMBRANE LONZENGE,250,RC,,,,both,0.7,0.63,Cigna,Default,Percent of Total Billed Charges,0.41,,,,0.41,0.57
NF-CHLORASEPTIC MUCOUS MEMBRANE LONZENGE,250,RC,,,,both,0.7,0.63,United Healthcare,Default,Fee Schedule,0.57,,,,0.41,0.57
NF-1ST TIER UNILET COMFORTOUCH LANCET,250,RC,,,,both,0.19,0.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.13,,,,0.11,0.16
NF-1ST TIER UNILET COMFORTOUCH LANCET,250,RC,,,,both,0.19,0.17,Cigna,Default,Percent of Total Billed Charges,0.11,,,,0.11,0.16
NF-1ST TIER UNILET COMFORTOUCH LANCET,250,RC,,,,both,0.19,0.17,United Healthcare,Default,Fee Schedule,0.16,,,,0.11,0.16
NF-COMBIGAN OPHTH SOLN 0.2%-0.5%,250,RC,,,,both,167.12,150.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.98,,,,98.6,136.37
NF-COMBIGAN OPHTH SOLN 0.2%-0.5%,250,RC,,,,both,167.12,150.41,Cigna,Default,Percent of Total Billed Charges,98.6,,,,98.6,136.37
NF-COMBIGAN OPHTH SOLN 0.2%-0.5%,250,RC,,,,both,167.12,150.41,United Healthcare,Default,Fee Schedule,136.37,,,,98.6,136.37
NF-CO Q-10 CAPSULE 50MG,250,RC,,,,both,1.53,1.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.07,,,,0.9,1.25
NF-CO Q-10 CAPSULE 50MG,250,RC,,,,both,1.53,1.38,Cigna,Default,Percent of Total Billed Charges,0.9,,,,0.9,1.25
NF-CO Q-10 CAPSULE 50MG,250,RC,,,,both,1.53,1.38,United Healthcare,Default,Fee Schedule,1.25,,,,0.9,1.25
NF-HYDROCORTISONE ACETATE CRM 2.5%,250,RC,,,,both,42,37.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.4,,,,24.78,34.27
NF-HYDROCORTISONE ACETATE CRM 2.5%,250,RC,,,,both,42,37.8,Cigna,Default,Percent of Total Billed Charges,24.78,,,,24.78,34.27
NF-HYDROCORTISONE ACETATE CRM 2.5%,250,RC,,,,both,42,37.8,United Healthcare,Default,Fee Schedule,34.27,,,,24.78,34.27
NF-ATOVAQUONE SUSP 750MG/5ML,250,RC,,,,both,9.97,8.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.98,,,,5.88,8.14
NF-ATOVAQUONE SUSP 750MG/5ML,250,RC,,,,both,9.97,8.97,Cigna,Default,Percent of Total Billed Charges,5.88,,,,5.88,8.14
NF-ATOVAQUONE SUSP 750MG/5ML,250,RC,,,,both,9.97,8.97,United Healthcare,Default,Fee Schedule,8.14,,,,5.88,8.14
NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,250,RC,,,,both,28.38,25.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.87,,,,16.74,23.16
NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,250,RC,,,,both,28.38,25.54,Cigna,Default,Percent of Total Billed Charges,16.74,,,,16.74,23.16
NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,250,RC,,,,both,28.38,25.54,United Healthcare,Default,Fee Schedule,23.16,,,,16.74,23.16
NF-DULERA INH AER PWD 5MCG-100MCG/ACT,250,RC,,,,both,124.28,111.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,87,,,,73.33,101.41
NF-DULERA INH AER PWD 5MCG-100MCG/ACT,250,RC,,,,both,124.28,111.85,Cigna,Default,Percent of Total Billed Charges,73.33,,,,73.33,101.41
NF-DULERA INH AER PWD 5MCG-100MCG/ACT,250,RC,,,,both,124.28,111.85,United Healthcare,Default,Fee Schedule,101.41,,,,73.33,101.41
NF-JARDIANCE ORAL TABLET 25MG,637,RC,,,,both,76.55,68.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.58,,,,45.16,62.46
NF-JARDIANCE ORAL TABLET 25MG,637,RC,,,,both,76.55,68.9,Cigna,Default,Percent of Total Billed Charges,45.16,,,,45.16,62.46
NF-JARDIANCE ORAL TABLET 25MG,637,RC,,,,both,76.55,68.9,United Healthcare,Default,Fee Schedule,62.46,,,,45.16,62.46
NF-NICOTINE TD PATCH ER 7MG/24HR,250,RC,,,,both,17.53,15.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.27,,,,10.34,14.3
NF-NICOTINE TD PATCH ER 7MG/24HR,250,RC,,,,both,17.53,15.78,Cigna,Default,Percent of Total Billed Charges,10.34,,,,10.34,14.3
NF-NICOTINE TD PATCH ER 7MG/24HR,250,RC,,,,both,17.53,15.78,United Healthcare,Default,Fee Schedule,14.3,,,,10.34,14.3
NF-BETASERON SUBQ KIT 0.3MG,250,RC,,,,both,1294.11,1164.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,905.88,,,,763.52,1055.99
NF-BETASERON SUBQ KIT 0.3MG,250,RC,,,,both,1294.11,1164.7,Cigna,Default,Percent of Total Billed Charges,763.52,,,,763.52,1055.99
NF-BETASERON SUBQ KIT 0.3MG,250,RC,,,,both,1294.11,1164.7,United Healthcare,Default,Fee Schedule,1055.99,,,,763.52,1055.99
NF-BENAZEPRIL HCL ORAL TABLET 10MG,250,RC,,,,both,5.23,4.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.66,,,,3.09,4.27
NF-BENAZEPRIL HCL ORAL TABLET 10MG,250,RC,,,,both,5.23,4.71,Cigna,Default,Percent of Total Billed Charges,3.09,,,,3.09,4.27
NF-BENAZEPRIL HCL ORAL TABLET 10MG,250,RC,,,,both,5.23,4.71,United Healthcare,Default,Fee Schedule,4.27,,,,3.09,4.27
NF-BENICAR ORAL TABLET 5MG,250,RC,,,,both,28.2,25.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.74,,,,16.64,23.01
NF-BENICAR ORAL TABLET 5MG,250,RC,,,,both,28.2,25.38,Cigna,Default,Percent of Total Billed Charges,16.64,,,,16.64,23.01
NF-BENICAR ORAL TABLET 5MG,250,RC,,,,both,28.2,25.38,United Healthcare,Default,Fee Schedule,23.01,,,,16.64,23.01
NF-CYTOMEL TABLET 0.025MG,250,RC,,,,both,4.9,4.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.43,,,,2.89,4
NF-CYTOMEL TABLET 0.025MG,250,RC,,,,both,4.9,4.41,Cigna,Default,Percent of Total Billed Charges,2.89,,,,2.89,4
NF-CYTOMEL TABLET 0.025MG,250,RC,,,,both,4.9,4.41,United Healthcare,Default,Fee Schedule,4,,,,2.89,4
NF-CYTOMEL TABLET 25MCG,250,RC,,,,both,5.11,4.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.58,,,,3.01,4.17
NF-CYTOMEL TABLET 25MCG,250,RC,,,,both,5.11,4.6,Cigna,Default,Percent of Total Billed Charges,3.01,,,,3.01,4.17
NF-CYTOMEL TABLET 25MCG,250,RC,,,,both,5.11,4.6,United Healthcare,Default,Fee Schedule,4.17,,,,3.01,4.17
NF-VELTASSA POWDERFORSUSPENSION 8.4GM/1P,250,RC,,,,both,216.6,194.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,151.62,,,,127.79,176.75
NF-VELTASSA POWDERFORSUSPENSION 8.4GM/1P,250,RC,,,,both,216.6,194.94,Cigna,Default,Percent of Total Billed Charges,127.79,,,,127.79,176.75
NF-VELTASSA POWDERFORSUSPENSION 8.4GM/1P,250,RC,,,,both,216.6,194.94,United Healthcare,Default,Fee Schedule,176.75,,,,127.79,176.75
NF-CINNAMON ORAL CAPSULE 500MG,250,RC,,,,both,0.21,0.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.15,,,,0.12,0.17
NF-CINNAMON ORAL CAPSULE 500MG,250,RC,,,,both,0.21,0.19,Cigna,Default,Percent of Total Billed Charges,0.12,,,,0.12,0.17
NF-CINNAMON ORAL CAPSULE 500MG,250,RC,,,,both,0.21,0.19,United Healthcare,Default,Fee Schedule,0.17,,,,0.12,0.17
NF-SELENIUM TABLET 100MCG,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-SELENIUM TABLET 100MCG,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-SELENIUM TABLET 100MCG,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-PROCTOCORT RECTAL CREAM 1%,250,RC,,,,both,7.46,6.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.22,,,,4.4,6.09
NF-PROCTOCORT RECTAL CREAM 1%,250,RC,,,,both,7.46,6.71,Cigna,Default,Percent of Total Billed Charges,4.4,,,,4.4,6.09
NF-PROCTOCORT RECTAL CREAM 1%,250,RC,,,,both,7.46,6.71,United Healthcare,Default,Fee Schedule,6.09,,,,4.4,6.09
NF-GAS-X ULTRA STRENGTH LIQ CAP 180MG,250,RC,,,,both,1.23,1.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.86,,,,0.73,1
NF-GAS-X ULTRA STRENGTH LIQ CAP 180MG,250,RC,,,,both,1.23,1.11,Cigna,Default,Percent of Total Billed Charges,0.73,,,,0.73,1
NF-GAS-X ULTRA STRENGTH LIQ CAP 180MG,250,RC,,,,both,1.23,1.11,United Healthcare,Default,Fee Schedule,1,,,,0.73,1
NF-SINUS PRESSURE&CONGESTION RELIEF PE 1,250,RC,,,,both,0.89,0.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.62,,,,0.53,0.73
NF-SINUS PRESSURE&CONGESTION RELIEF PE 1,250,RC,,,,both,0.89,0.8,Cigna,Default,Percent of Total Billed Charges,0.53,,,,0.53,0.73
NF-SINUS PRESSURE&CONGESTION RELIEF PE 1,250,RC,,,,both,0.89,0.8,United Healthcare,Default,Fee Schedule,0.73,,,,0.53,0.73
NF-MYLANTA SUSPENSION,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-MYLANTA SUSPENSION,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-MYLANTA SUSPENSION,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-JARDIANCE ORAL TABLET 10MG,250,RC,,,,both,76.55,68.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.58,,,,45.16,62.46
NF-JARDIANCE ORAL TABLET 10MG,250,RC,,,,both,76.55,68.9,Cigna,Default,Percent of Total Billed Charges,45.16,,,,45.16,62.46
NF-JARDIANCE ORAL TABLET 10MG,250,RC,,,,both,76.55,68.9,United Healthcare,Default,Fee Schedule,62.46,,,,45.16,62.46
NF-TRAVOPROST OPHTH SOLN 0.004%,250,RC,,,,both,326.88,294.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,228.82,,,,192.86,266.73
NF-TRAVOPROST OPHTH SOLN 0.004%,250,RC,,,,both,326.88,294.19,Cigna,Default,Percent of Total Billed Charges,192.86,,,,192.86,266.73
NF-TRAVOPROST OPHTH SOLN 0.004%,250,RC,,,,both,326.88,294.19,United Healthcare,Default,Fee Schedule,266.73,,,,192.86,266.73
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,353.39,318.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,247.37,,,,208.5,288.37
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,353.39,318.05,Cigna,Default,Percent of Total Billed Charges,208.5,,,,208.5,288.37
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,353.39,318.05,United Healthcare,Default,Fee Schedule,288.37,,,,208.5,288.37
NF-CREON ORAL DELAYED RELEASE CAPSULE,250,RC,,,,both,15.2,13.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.64,,,,8.97,12.4
NF-CREON ORAL DELAYED RELEASE CAPSULE,250,RC,,,,both,15.2,13.68,Cigna,Default,Percent of Total Billed Charges,8.97,,,,8.97,12.4
NF-CREON ORAL DELAYED RELEASE CAPSULE,250,RC,,,,both,15.2,13.68,United Healthcare,Default,Fee Schedule,12.4,,,,8.97,12.4
NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB,250,RC,,,,both,18.5,16.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.95,,,,10.92,15.1
NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB,250,RC,,,,both,18.5,16.65,Cigna,Default,Percent of Total Billed Charges,10.92,,,,10.92,15.1
NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB,250,RC,,,,both,18.5,16.65,United Healthcare,Default,Fee Schedule,15.1,,,,10.92,15.1
NF-DAPTOMYCIN IV PWD FOR SOLN 350MG,250,RC,,,,both,1368.16,1231.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,957.71,,,,807.21,1116.42
NF-DAPTOMYCIN IV PWD FOR SOLN 350MG,250,RC,,,,both,1368.16,1231.34,Cigna,Default,Percent of Total Billed Charges,807.21,,,,807.21,1116.42
NF-DAPTOMYCIN IV PWD FOR SOLN 350MG,250,RC,,,,both,1368.16,1231.34,United Healthcare,Default,Fee Schedule,1116.42,,,,807.21,1116.42
NF-ENTOCORT EC CAP DR 3MG,250,RC,,,,both,71.2,64.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.84,,,,42.01,58.1
NF-ENTOCORT EC CAP DR 3MG,250,RC,,,,both,71.2,64.08,Cigna,Default,Percent of Total Billed Charges,42.01,,,,42.01,58.1
NF-ENTOCORT EC CAP DR 3MG,250,RC,,,,both,71.2,64.08,United Healthcare,Default,Fee Schedule,58.1,,,,42.01,58.1
"NF-VITAMIN A CAPSULE 25,000IU",250,RC,,,,both,0.42,0.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.29,,,,0.25,0.34
"NF-VITAMIN A CAPSULE 25,000IU",250,RC,,,,both,0.42,0.38,Cigna,Default,Percent of Total Billed Charges,0.25,,,,0.25,0.34
"NF-VITAMIN A CAPSULE 25,000IU",250,RC,,,,both,0.42,0.38,United Healthcare,Default,Fee Schedule,0.34,,,,0.25,0.34
NF-BIOTIN ORAL CAPSULE 2500MCG,250,RC,,,,both,0.4,0.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.28,,,,0.24,0.33
NF-BIOTIN ORAL CAPSULE 2500MCG,250,RC,,,,both,0.4,0.36,Cigna,Default,Percent of Total Billed Charges,0.24,,,,0.24,0.33
NF-BIOTIN ORAL CAPSULE 2500MCG,250,RC,,,,both,0.4,0.36,United Healthcare,Default,Fee Schedule,0.33,,,,0.24,0.33
NF-JANUMET ORAL TABLET 50MG-1000MG,250,RC,,,,both,19.47,17.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.63,,,,11.49,15.89
NF-JANUMET ORAL TABLET 50MG-1000MG,250,RC,,,,both,19.47,17.52,Cigna,Default,Percent of Total Billed Charges,11.49,,,,11.49,15.89
NF-JANUMET ORAL TABLET 50MG-1000MG,250,RC,,,,both,19.47,17.52,United Healthcare,Default,Fee Schedule,15.89,,,,11.49,15.89
NF-BIMATOPROST OPHTH SOLN 0.01%,250,RC,,,,both,373.38,336.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.37,,,,220.29,304.68
NF-BIMATOPROST OPHTH SOLN 0.01%,250,RC,,,,both,373.38,336.04,Cigna,Default,Percent of Total Billed Charges,220.29,,,,220.29,304.68
NF-BIMATOPROST OPHTH SOLN 0.01%,250,RC,,,,both,373.38,336.04,United Healthcare,Default,Fee Schedule,304.68,,,,220.29,304.68
NF-ALPHAGAN P OPHTH SOLN 0.1%,250,RC,,,,both,151.61,136.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.13,,,,89.45,123.71
NF-ALPHAGAN P OPHTH SOLN 0.1%,250,RC,,,,both,151.61,136.45,Cigna,Default,Percent of Total Billed Charges,89.45,,,,89.45,123.71
NF-ALPHAGAN P OPHTH SOLN 0.1%,250,RC,,,,both,151.61,136.45,United Healthcare,Default,Fee Schedule,123.71,,,,89.45,123.71
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,24.35,21.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.04,,,,14.37,19.87
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,24.35,21.92,Cigna,Default,Percent of Total Billed Charges,14.37,,,,14.37,19.87
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,24.35,21.92,United Healthcare,Default,Fee Schedule,19.87,,,,14.37,19.87
NF-AMILORIDE HCL TAB 5MG,250,RC,,,,both,5.58,5.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.91,,,,3.29,4.55
NF-AMILORIDE HCL TAB 5MG,250,RC,,,,both,5.58,5.02,Cigna,Default,Percent of Total Billed Charges,3.29,,,,3.29,4.55
NF-AMILORIDE HCL TAB 5MG,250,RC,,,,both,5.58,5.02,United Healthcare,Default,Fee Schedule,4.55,,,,3.29,4.55
NF-VITA-BEE WITH C ORAL TABLET,250,RC,,,,both,0.19,0.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.13,,,,0.11,0.16
NF-VITA-BEE WITH C ORAL TABLET,250,RC,,,,both,0.19,0.17,Cigna,Default,Percent of Total Billed Charges,0.11,,,,0.11,0.16
NF-VITA-BEE WITH C ORAL TABLET,250,RC,,,,both,0.19,0.17,United Healthcare,Default,Fee Schedule,0.16,,,,0.11,0.16
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,250,RC,,,,both,8.96,8.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.27,,,,5.29,7.31
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,250,RC,,,,both,8.96,8.06,Cigna,Default,Percent of Total Billed Charges,5.29,,,,5.29,7.31
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,250,RC,,,,both,8.96,8.06,United Healthcare,Default,Fee Schedule,7.31,,,,5.29,7.31
NF-CELEXA TAB 40MG,250,RC,,,,both,28.24,25.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.77,,,,16.66,23.04
NF-CELEXA TAB 40MG,250,RC,,,,both,28.24,25.42,Cigna,Default,Percent of Total Billed Charges,16.66,,,,16.66,23.04
NF-CELEXA TAB 40MG,250,RC,,,,both,28.24,25.42,United Healthcare,Default,Fee Schedule,23.04,,,,16.66,23.04
NF-HYDROXYZINE PAMOATE CAP 50MG,250,RC,,,,both,2.47,2.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.73,,,,1.46,2.02
NF-HYDROXYZINE PAMOATE CAP 50MG,250,RC,,,,both,2.47,2.22,Cigna,Default,Percent of Total Billed Charges,1.46,,,,1.46,2.02
NF-HYDROXYZINE PAMOATE CAP 50MG,250,RC,,,,both,2.47,2.22,United Healthcare,Default,Fee Schedule,2.02,,,,1.46,2.02
NF-ALPHAGAN P OPHTH SOLN 0.1%,250,RC,,,,both,151.54,136.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,106.08,,,,89.41,123.66
NF-ALPHAGAN P OPHTH SOLN 0.1%,250,RC,,,,both,151.54,136.39,Cigna,Default,Percent of Total Billed Charges,89.41,,,,89.41,123.66
NF-ALPHAGAN P OPHTH SOLN 0.1%,250,RC,,,,both,151.54,136.39,United Healthcare,Default,Fee Schedule,123.66,,,,89.41,123.66
NF-RAMIPRIL CAP 10MG,250,RC,,,,both,15.45,13.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.82,,,,9.12,12.61
NF-RAMIPRIL CAP 10MG,250,RC,,,,both,15.45,13.91,Cigna,Default,Percent of Total Billed Charges,9.12,,,,9.12,12.61
NF-RAMIPRIL CAP 10MG,250,RC,,,,both,15.45,13.91,United Healthcare,Default,Fee Schedule,12.61,,,,9.12,12.61
NF-SEREVENT DISKUS INH PWD 50MCG/1ACTUAT,250,RC,,,,both,32.54,29.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.78,,,,19.2,26.55
NF-SEREVENT DISKUS INH PWD 50MCG/1ACTUAT,250,RC,,,,both,32.54,29.29,Cigna,Default,Percent of Total Billed Charges,19.2,,,,19.2,26.55
NF-SEREVENT DISKUS INH PWD 50MCG/1ACTUAT,250,RC,,,,both,32.54,29.29,United Healthcare,Default,Fee Schedule,26.55,,,,19.2,26.55
NF-TELMISARTAN ORAL TABLET 80MG,250,RC,,,,both,19.85,17.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.9,,,,11.71,16.2
NF-TELMISARTAN ORAL TABLET 80MG,250,RC,,,,both,19.85,17.87,Cigna,Default,Percent of Total Billed Charges,11.71,,,,11.71,16.2
NF-TELMISARTAN ORAL TABLET 80MG,250,RC,,,,both,19.85,17.87,United Healthcare,Default,Fee Schedule,16.2,,,,11.71,16.2
NF-TRELEGY ELLIPTA 100/62.5/25MCG INH,250,RC,,,,both,45.84,41.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.09,,,,27.05,37.41
NF-TRELEGY ELLIPTA 100/62.5/25MCG INH,250,RC,,,,both,45.84,41.26,Cigna,Default,Percent of Total Billed Charges,27.05,,,,27.05,37.41
NF-TRELEGY ELLIPTA 100/62.5/25MCG INH,250,RC,,,,both,45.84,41.26,United Healthcare,Default,Fee Schedule,37.41,,,,27.05,37.41
NF-TOBI INH/NEB SOLN 300MG/5ML,250,RC,,,,both,135.98,122.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,95.19,,,,80.23,110.96
NF-TOBI INH/NEB SOLN 300MG/5ML,250,RC,,,,both,135.98,122.38,Cigna,Default,Percent of Total Billed Charges,80.23,,,,80.23,110.96
NF-TOBI INH/NEB SOLN 300MG/5ML,250,RC,,,,both,135.98,122.38,United Healthcare,Default,Fee Schedule,110.96,,,,80.23,110.96
NF-COLESTIPOL HCL TAB 1GM,250,RC,,,,both,5.35,4.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.74,,,,3.16,4.37
NF-COLESTIPOL HCL TAB 1GM,250,RC,,,,both,5.35,4.82,Cigna,Default,Percent of Total Billed Charges,3.16,,,,3.16,4.37
NF-COLESTIPOL HCL TAB 1GM,250,RC,,,,both,5.35,4.82,United Healthcare,Default,Fee Schedule,4.37,,,,3.16,4.37
NF-PROVIGIL ORAL TABLET 200MG,250,RC,,,,both,213.07,191.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,149.15,,,,125.71,173.87
NF-PROVIGIL ORAL TABLET 200MG,250,RC,,,,both,213.07,191.76,Cigna,Default,Percent of Total Billed Charges,125.71,,,,125.71,173.87
NF-PROVIGIL ORAL TABLET 200MG,250,RC,,,,both,213.07,191.76,United Healthcare,Default,Fee Schedule,173.87,,,,125.71,173.87
NF-AMANTADINE HCL LIQ CAP 100MG,250,RC,,,,both,5.59,5.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.91,,,,3.3,4.56
NF-AMANTADINE HCL LIQ CAP 100MG,250,RC,,,,both,5.59,5.03,Cigna,Default,Percent of Total Billed Charges,3.3,,,,3.3,4.56
NF-AMANTADINE HCL LIQ CAP 100MG,250,RC,,,,both,5.59,5.03,United Healthcare,Default,Fee Schedule,4.56,,,,3.3,4.56
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,90.63,81.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.44,,,,53.47,73.95
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,90.63,81.57,Cigna,Default,Percent of Total Billed Charges,53.47,,,,53.47,73.95
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,90.63,81.57,United Healthcare,Default,Fee Schedule,73.95,,,,53.47,73.95
NF-MODAFINIL ORAL TABLET 200MG,250,RC,,,,both,137.21,123.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,96.05,,,,80.95,111.96
NF-MODAFINIL ORAL TABLET 200MG,250,RC,,,,both,137.21,123.49,Cigna,Default,Percent of Total Billed Charges,80.95,,,,80.95,111.96
NF-MODAFINIL ORAL TABLET 200MG,250,RC,,,,both,137.21,123.49,United Healthcare,Default,Fee Schedule,111.96,,,,80.95,111.96
NF-VITAMIN A CAPSULE 8000IU,250,RC,,,,both,0.11,0.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.08,,,,0.06,0.09
NF-VITAMIN A CAPSULE 8000IU,250,RC,,,,both,0.11,0.1,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.09
NF-VITAMIN A CAPSULE 8000IU,250,RC,,,,both,0.11,0.1,United Healthcare,Default,Fee Schedule,0.09,,,,0.06,0.09
NF-FARXIGA ORAL TABLET 5MG,250,RC,,,,both,51.38,46.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.97,,,,30.31,41.93
NF-FARXIGA ORAL TABLET 5MG,250,RC,,,,both,51.38,46.24,Cigna,Default,Percent of Total Billed Charges,30.31,,,,30.31,41.93
NF-FARXIGA ORAL TABLET 5MG,250,RC,,,,both,51.38,46.24,United Healthcare,Default,Fee Schedule,41.93,,,,30.31,41.93
NF-BROVANA INH SOLN 15MCG/2ML,250,RC,,,,both,41.98,37.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.39,,,,24.77,34.26
NF-BROVANA INH SOLN 15MCG/2ML,250,RC,,,,both,41.98,37.78,Cigna,Default,Percent of Total Billed Charges,24.77,,,,24.77,34.26
NF-BROVANA INH SOLN 15MCG/2ML,250,RC,,,,both,41.98,37.78,United Healthcare,Default,Fee Schedule,34.26,,,,24.77,34.26
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,250,RC,,,,both,5.19,4.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.63,,,,3.06,4.24
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,250,RC,,,,both,5.19,4.67,Cigna,Default,Percent of Total Billed Charges,3.06,,,,3.06,4.24
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,250,RC,,,,both,5.19,4.67,United Healthcare,Default,Fee Schedule,4.24,,,,3.06,4.24
NF-SYNJARDY XR ORAL TAB ER 12.5MG-1000MG,250,RC,,,,both,40.21,36.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.15,,,,23.72,32.81
NF-SYNJARDY XR ORAL TAB ER 12.5MG-1000MG,250,RC,,,,both,40.21,36.19,Cigna,Default,Percent of Total Billed Charges,23.72,,,,23.72,32.81
NF-SYNJARDY XR ORAL TAB ER 12.5MG-1000MG,250,RC,,,,both,40.21,36.19,United Healthcare,Default,Fee Schedule,32.81,,,,23.72,32.81
NF-CELEXA TABLET 20MG,250,RC,,,,both,19.69,17.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.78,,,,11.62,16.07
NF-CELEXA TABLET 20MG,250,RC,,,,both,19.69,17.72,Cigna,Default,Percent of Total Billed Charges,11.62,,,,11.62,16.07
NF-CELEXA TABLET 20MG,250,RC,,,,both,19.69,17.72,United Healthcare,Default,Fee Schedule,16.07,,,,11.62,16.07
KAYEXALATE PWDR,637,RC,,,,both,756.77,681.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,529.74,,,,446.49,617.52
KAYEXALATE PWDR,637,RC,,,,both,756.77,681.09,Cigna,Default,Percent of Total Billed Charges,446.49,,,,446.49,617.52
KAYEXALATE PWDR,637,RC,,,,both,756.77,681.09,United Healthcare,Default,Fee Schedule,617.52,,,,446.49,617.52
NF-MILK THISTLE CAPSULE 150MG,250,RC,,,,both,0.91,0.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.64,,,,0.54,0.74
NF-MILK THISTLE CAPSULE 150MG,250,RC,,,,both,0.91,0.82,Cigna,Default,Percent of Total Billed Charges,0.54,,,,0.54,0.74
NF-MILK THISTLE CAPSULE 150MG,250,RC,,,,both,0.91,0.82,United Healthcare,Default,Fee Schedule,0.74,,,,0.54,0.74
NF-GARLIC CAPSULE 500MG,250,RC,,,,both,0.31,0.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.18,0.25
NF-GARLIC CAPSULE 500MG,250,RC,,,,both,0.31,0.28,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.25
NF-GARLIC CAPSULE 500MG,250,RC,,,,both,0.31,0.28,United Healthcare,Default,Fee Schedule,0.25,,,,0.18,0.25
NF-TRIHEXYPHENIDYL HCL TAB 2MG,250,RC,,,,both,0.79,0.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.55,,,,0.47,0.64
NF-TRIHEXYPHENIDYL HCL TAB 2MG,250,RC,,,,both,0.79,0.71,Cigna,Default,Percent of Total Billed Charges,0.47,,,,0.47,0.64
NF-TRIHEXYPHENIDYL HCL TAB 2MG,250,RC,,,,both,0.79,0.71,United Healthcare,Default,Fee Schedule,0.64,,,,0.47,0.64
NF-QVAR REDIHALER INH AEROSOL LIQ 0.04MG,250,RC,,,,both,82.88,74.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.02,,,,48.9,67.63
NF-QVAR REDIHALER INH AEROSOL LIQ 0.04MG,250,RC,,,,both,82.88,74.59,Cigna,Default,Percent of Total Billed Charges,48.9,,,,48.9,67.63
NF-QVAR REDIHALER INH AEROSOL LIQ 0.04MG,250,RC,,,,both,82.88,74.59,United Healthcare,Default,Fee Schedule,67.63,,,,48.9,67.63
NF-METFORMIN HCL ORAL TABLET 850MG,250,RC,,,,both,5.19,4.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.63,,,,3.06,4.24
NF-METFORMIN HCL ORAL TABLET 850MG,250,RC,,,,both,5.19,4.67,Cigna,Default,Percent of Total Billed Charges,3.06,,,,3.06,4.24
NF-METFORMIN HCL ORAL TABLET 850MG,250,RC,,,,both,5.19,4.67,United Healthcare,Default,Fee Schedule,4.24,,,,3.06,4.24
NF-BELBUCA BUCCAL FILM 600MCG,250,RC,,,,both,54.87,49.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.41,,,,32.37,44.77
NF-BELBUCA BUCCAL FILM 600MCG,250,RC,,,,both,54.87,49.38,Cigna,Default,Percent of Total Billed Charges,32.37,,,,32.37,44.77
NF-BELBUCA BUCCAL FILM 600MCG,250,RC,,,,both,54.87,49.38,United Healthcare,Default,Fee Schedule,44.77,,,,32.37,44.77
NF-MIRTAZAPINE DISINTEGRATING TAB 15MG,250,RC,,,,both,10.02,9.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.01,,,,5.91,8.18
NF-MIRTAZAPINE DISINTEGRATING TAB 15MG,250,RC,,,,both,10.02,9.02,Cigna,Default,Percent of Total Billed Charges,5.91,,,,5.91,8.18
NF-MIRTAZAPINE DISINTEGRATING TAB 15MG,250,RC,,,,both,10.02,9.02,United Healthcare,Default,Fee Schedule,8.18,,,,5.91,8.18
NF-TRANEXAMIC ACID ORAL TABLET 650MG,250,RC,,,,both,22.55,20.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.78,,,,13.3,18.4
NF-TRANEXAMIC ACID ORAL TABLET 650MG,250,RC,,,,both,22.55,20.3,Cigna,Default,Percent of Total Billed Charges,13.3,,,,13.3,18.4
NF-TRANEXAMIC ACID ORAL TABLET 650MG,250,RC,,,,both,22.55,20.3,United Healthcare,Default,Fee Schedule,18.4,,,,13.3,18.4
NF-RANITIDINE HCL ORAL SYRUP 15MG/1ML,250,RC,,,,both,3.2,2.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.24,,,,1.89,2.61
NF-RANITIDINE HCL ORAL SYRUP 15MG/1ML,250,RC,,,,both,3.2,2.88,Cigna,Default,Percent of Total Billed Charges,1.89,,,,1.89,2.61
NF-RANITIDINE HCL ORAL SYRUP 15MG/1ML,250,RC,,,,both,3.2,2.88,United Healthcare,Default,Fee Schedule,2.61,,,,1.89,2.61
NF-ESTRADIOL TRANSDERMAL SYS 0.1MG/24HR,250,RC,,,,both,49.09,44.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.36,,,,28.96,40.06
NF-ESTRADIOL TRANSDERMAL SYS 0.1MG/24HR,250,RC,,,,both,49.09,44.18,Cigna,Default,Percent of Total Billed Charges,28.96,,,,28.96,40.06
NF-ESTRADIOL TRANSDERMAL SYS 0.1MG/24HR,250,RC,,,,both,49.09,44.18,United Healthcare,Default,Fee Schedule,40.06,,,,28.96,40.06
NF-SODIUM CHLORIDE,250,RC,,,,both,0.02,0.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-SODIUM CHLORIDE,250,RC,,,,both,0.02,0.02,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-SODIUM CHLORIDE,250,RC,,,,both,0.02,0.02,United Healthcare,Default,Fee Schedule,0.02,,,,0.01,0.02
NF-ACEBUTOLOL HCL CAP 200MG,250,RC,,,,both,4.35,3.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.04,,,,2.57,3.55
NF-ACEBUTOLOL HCL CAP 200MG,250,RC,,,,both,4.35,3.92,Cigna,Default,Percent of Total Billed Charges,2.57,,,,2.57,3.55
NF-ACEBUTOLOL HCL CAP 200MG,250,RC,,,,both,4.35,3.92,United Healthcare,Default,Fee Schedule,3.55,,,,2.57,3.55
NF-SELEGILINE HCL CAP 5MG,250,RC,,,,both,11.68,10.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.18,,,,6.89,9.53
NF-SELEGILINE HCL CAP 5MG,250,RC,,,,both,11.68,10.51,Cigna,Default,Percent of Total Billed Charges,6.89,,,,6.89,9.53
NF-SELEGILINE HCL CAP 5MG,250,RC,,,,both,11.68,10.51,United Healthcare,Default,Fee Schedule,9.53,,,,6.89,9.53
NF-NORGESTIMATE AND ETHINYL ESTRADIOL,250,RC,,,,both,6.07,5.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.25,,,,3.58,4.95
NF-NORGESTIMATE AND ETHINYL ESTRADIOL,250,RC,,,,both,6.07,5.46,Cigna,Default,Percent of Total Billed Charges,3.58,,,,3.58,4.95
NF-NORGESTIMATE AND ETHINYL ESTRADIOL,250,RC,,,,both,6.07,5.46,United Healthcare,Default,Fee Schedule,4.95,,,,3.58,4.95
NF-PYRIDOXINE TAB 100MG,250,RC,,,,both,0.22,0.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.15,,,,0.13,0.18
NF-PYRIDOXINE TAB 100MG,250,RC,,,,both,0.22,0.2,Cigna,Default,Percent of Total Billed Charges,0.13,,,,0.13,0.18
NF-PYRIDOXINE TAB 100MG,250,RC,,,,both,0.22,0.2,United Healthcare,Default,Fee Schedule,0.18,,,,0.13,0.18
NF-VITAMIN B COMPLEX TAB,250,RC,,,,both,2.28,2.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.6,,,,1.35,1.86
NF-VITAMIN B COMPLEX TAB,250,RC,,,,both,2.28,2.05,Cigna,Default,Percent of Total Billed Charges,1.35,,,,1.35,1.86
NF-VITAMIN B COMPLEX TAB,250,RC,,,,both,2.28,2.05,United Healthcare,Default,Fee Schedule,1.86,,,,1.35,1.86
SODIUM CHLORIDE 7% (RESP) 4ML,250,RC,,,,both,16.48,14.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.54,,,,9.72,13.45
SODIUM CHLORIDE 7% (RESP) 4ML,250,RC,,,,both,16.48,14.83,Cigna,Default,Percent of Total Billed Charges,9.72,,,,9.72,13.45
SODIUM CHLORIDE 7% (RESP) 4ML,250,RC,,,,both,16.48,14.83,United Healthcare,Default,Fee Schedule,13.45,,,,9.72,13.45
NF-MACULAR HEALTH FORMULA ORAL CAPSULE,250,RC,,,,both,3.06,2.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.14,,,,1.81,2.5
NF-MACULAR HEALTH FORMULA ORAL CAPSULE,250,RC,,,,both,3.06,2.75,Cigna,Default,Percent of Total Billed Charges,1.81,,,,1.81,2.5
NF-MACULAR HEALTH FORMULA ORAL CAPSULE,250,RC,,,,both,3.06,2.75,United Healthcare,Default,Fee Schedule,2.5,,,,1.81,2.5
NF-DORZOLAMIDE HCL OPHTH SOLN 2%,250,RC,,,,both,29.14,26.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.4,,,,17.19,23.78
NF-DORZOLAMIDE HCL OPHTH SOLN 2%,250,RC,,,,both,29.14,26.23,Cigna,Default,Percent of Total Billed Charges,17.19,,,,17.19,23.78
NF-DORZOLAMIDE HCL OPHTH SOLN 2%,250,RC,,,,both,29.14,26.23,United Healthcare,Default,Fee Schedule,23.78,,,,17.19,23.78
NF-LUMIGAN OPHTH SOLN 0.01%,250,RC,,,,both,373.23,335.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,261.26,,,,220.21,304.56
NF-LUMIGAN OPHTH SOLN 0.01%,250,RC,,,,both,373.23,335.91,Cigna,Default,Percent of Total Billed Charges,220.21,,,,220.21,304.56
NF-LUMIGAN OPHTH SOLN 0.01%,250,RC,,,,both,373.23,335.91,United Healthcare,Default,Fee Schedule,304.56,,,,220.21,304.56
NF-NIACIN ORAL TABLET 100MG,250,RC,,,,both,0.14,0.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.08,0.11
NF-NIACIN ORAL TABLET 100MG,250,RC,,,,both,0.14,0.13,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-NIACIN ORAL TABLET 100MG,250,RC,,,,both,0.14,0.13,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
"NF-OCTREOTIDE ACETATE INJ SOLN 1,000MCG/",250,RC,,,,both,681.08,612.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,476.76,,,,401.84,555.76
"NF-OCTREOTIDE ACETATE INJ SOLN 1,000MCG/",250,RC,,,,both,681.08,612.97,Cigna,Default,Percent of Total Billed Charges,401.84,,,,401.84,555.76
"NF-OCTREOTIDE ACETATE INJ SOLN 1,000MCG/",250,RC,,,,both,681.08,612.97,United Healthcare,Default,Fee Schedule,555.76,,,,401.84,555.76
NF-MORPHINE SULFATE IR ORAL TABLET 15MG,250,RC,,,,both,1.71,1.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.2,,,,1.01,1.4
NF-MORPHINE SULFATE IR ORAL TABLET 15MG,250,RC,,,,both,1.71,1.54,Cigna,Default,Percent of Total Billed Charges,1.01,,,,1.01,1.4
NF-MORPHINE SULFATE IR ORAL TABLET 15MG,250,RC,,,,both,1.71,1.54,United Healthcare,Default,Fee Schedule,1.4,,,,1.01,1.4
NF-PEDVAXHIB IM SOLN 7.5MCG/0.5ML,250,RC,,,,both,270.97,243.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,189.68,,,,159.87,221.11
NF-PEDVAXHIB IM SOLN 7.5MCG/0.5ML,250,RC,,,,both,270.97,243.87,Cigna,Default,Percent of Total Billed Charges,159.87,,,,159.87,221.11
NF-PEDVAXHIB IM SOLN 7.5MCG/0.5ML,250,RC,,,,both,270.97,243.87,United Healthcare,Default,Fee Schedule,221.11,,,,159.87,221.11
NF-VITAMIN K TABLET 0.1MG,250,RC,,,,both,0.17,0.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.12,,,,0.1,0.14
NF-VITAMIN K TABLET 0.1MG,250,RC,,,,both,0.17,0.15,Cigna,Default,Percent of Total Billed Charges,0.1,,,,0.1,0.14
NF-VITAMIN K TABLET 0.1MG,250,RC,,,,both,0.17,0.15,United Healthcare,Default,Fee Schedule,0.14,,,,0.1,0.14
NF-LINZESS CAP 145MCG,250,RC,,,,both,66.96,60.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.87,,,,39.51,54.64
NF-LINZESS CAP 145MCG,250,RC,,,,both,66.96,60.26,Cigna,Default,Percent of Total Billed Charges,39.51,,,,39.51,54.64
NF-LINZESS CAP 145MCG,250,RC,,,,both,66.96,60.26,United Healthcare,Default,Fee Schedule,54.64,,,,39.51,54.64
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,58.05,52.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.64,,,,34.25,47.37
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,58.05,52.25,Cigna,Default,Percent of Total Billed Charges,34.25,,,,34.25,47.37
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,58.05,52.25,United Healthcare,Default,Fee Schedule,47.37,,,,34.25,47.37
NF-ALLEGRA-D 12 HOUR ORAL TAB ER 60MG-12,250,RC,,,,both,3.69,3.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.58,,,,2.18,3.01
NF-ALLEGRA-D 12 HOUR ORAL TAB ER 60MG-12,250,RC,,,,both,3.69,3.32,Cigna,Default,Percent of Total Billed Charges,2.18,,,,2.18,3.01
NF-ALLEGRA-D 12 HOUR ORAL TAB ER 60MG-12,250,RC,,,,both,3.69,3.32,United Healthcare,Default,Fee Schedule,3.01,,,,2.18,3.01
NF-CEFTRIAXONE INJ PWD FOR SOLN 2GM,250,RC,,,,both,365.64,329.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,255.95,,,,215.73,298.36
NF-CEFTRIAXONE INJ PWD FOR SOLN 2GM,250,RC,,,,both,365.64,329.08,Cigna,Default,Percent of Total Billed Charges,215.73,,,,215.73,298.36
NF-CEFTRIAXONE INJ PWD FOR SOLN 2GM,250,RC,,,,both,365.64,329.08,United Healthcare,Default,Fee Schedule,298.36,,,,215.73,298.36
NF-OXYCODONE HCL ORAL TAB 15MG,250,RC,,,,both,8.19,7.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.73,,,,4.83,6.68
NF-OXYCODONE HCL ORAL TAB 15MG,250,RC,,,,both,8.19,7.37,Cigna,Default,Percent of Total Billed Charges,4.83,,,,4.83,6.68
NF-OXYCODONE HCL ORAL TAB 15MG,250,RC,,,,both,8.19,7.37,United Healthcare,Default,Fee Schedule,6.68,,,,4.83,6.68
NF-TRANEXAMIC ACID ORAL TABLET 650MG,250,RC,,,,both,32.04,28.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.43,,,,18.9,26.14
NF-TRANEXAMIC ACID ORAL TABLET 650MG,250,RC,,,,both,32.04,28.84,Cigna,Default,Percent of Total Billed Charges,18.9,,,,18.9,26.14
NF-TRANEXAMIC ACID ORAL TABLET 650MG,250,RC,,,,both,32.04,28.84,United Healthcare,Default,Fee Schedule,26.14,,,,18.9,26.14
NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,250,RC,,,,both,33.16,29.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.21,,,,19.56,27.06
NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,250,RC,,,,both,33.16,29.84,Cigna,Default,Percent of Total Billed Charges,19.56,,,,19.56,27.06
NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,250,RC,,,,both,33.16,29.84,United Healthcare,Default,Fee Schedule,27.06,,,,19.56,27.06
NF-TAGRISSO TAB 80MG,250,RC,,,,both,2406.45,2165.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1684.52,,,,1419.81,1963.66
NF-TAGRISSO TAB 80MG,250,RC,,,,both,2406.45,2165.81,Cigna,Default,Percent of Total Billed Charges,1419.81,,,,1419.81,1963.66
NF-TAGRISSO TAB 80MG,250,RC,,,,both,2406.45,2165.81,United Healthcare,Default,Fee Schedule,1963.66,,,,1419.81,1963.66
NF-DIGESTIVE ENZYMES TABLET,250,RC,,,,both,0.39,0.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.27,,,,0.23,0.32
NF-DIGESTIVE ENZYMES TABLET,250,RC,,,,both,0.39,0.35,Cigna,Default,Percent of Total Billed Charges,0.23,,,,0.23,0.32
NF-DIGESTIVE ENZYMES TABLET,250,RC,,,,both,0.39,0.35,United Healthcare,Default,Fee Schedule,0.32,,,,0.23,0.32
NF-GABAPENTIN AVPAK ORAL TABLET 800MG,250,RC,,,,both,11.96,10.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.37,,,,7.06,9.76
NF-GABAPENTIN AVPAK ORAL TABLET 800MG,250,RC,,,,both,11.96,10.76,Cigna,Default,Percent of Total Billed Charges,7.06,,,,7.06,9.76
NF-GABAPENTIN AVPAK ORAL TABLET 800MG,250,RC,,,,both,11.96,10.76,United Healthcare,Default,Fee Schedule,9.76,,,,7.06,9.76
NF-ZANTAC 150 TAB 150MG,250,RC,,,,both,17.89,16.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.52,,,,10.56,14.6
NF-ZANTAC 150 TAB 150MG,250,RC,,,,both,17.89,16.1,Cigna,Default,Percent of Total Billed Charges,10.56,,,,10.56,14.6
NF-ZANTAC 150 TAB 150MG,250,RC,,,,both,17.89,16.1,United Healthcare,Default,Fee Schedule,14.6,,,,10.56,14.6
NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
NF-ATROVENT HFA INH ORAL/NEB SOLN 17MCG,250,RC,,,,both,144.55,130.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,101.18,,,,85.28,117.95
NF-ATROVENT HFA INH ORAL/NEB SOLN 17MCG,250,RC,,,,both,144.55,130.1,Cigna,Default,Percent of Total Billed Charges,85.28,,,,85.28,117.95
NF-ATROVENT HFA INH ORAL/NEB SOLN 17MCG,250,RC,,,,both,144.55,130.1,United Healthcare,Default,Fee Schedule,117.95,,,,85.28,117.95
NF-BUTALB/APAP/CAFF TABLET 50MG-325MG-40,250,RC,,,,both,8.02,7.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.61,,,,4.73,6.54
NF-BUTALB/APAP/CAFF TABLET 50MG-325MG-40,250,RC,,,,both,8.02,7.22,Cigna,Default,Percent of Total Billed Charges,4.73,,,,4.73,6.54
NF-BUTALB/APAP/CAFF TABLET 50MG-325MG-40,250,RC,,,,both,8.02,7.22,United Healthcare,Default,Fee Schedule,6.54,,,,4.73,6.54
NF-MORPHINE SULFATE 24 HR CAP ER 45MG,250,RC,,,,both,36.74,33.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.72,,,,21.68,29.98
NF-MORPHINE SULFATE 24 HR CAP ER 45MG,250,RC,,,,both,36.74,33.07,Cigna,Default,Percent of Total Billed Charges,21.68,,,,21.68,29.98
NF-MORPHINE SULFATE 24 HR CAP ER 45MG,250,RC,,,,both,36.74,33.07,United Healthcare,Default,Fee Schedule,29.98,,,,21.68,29.98
NF-MUCINEX DM TAB ER,250,RC,,,,both,2.4,2.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.68,,,,1.42,1.96
NF-MUCINEX DM TAB ER,250,RC,,,,both,2.4,2.16,Cigna,Default,Percent of Total Billed Charges,1.42,,,,1.42,1.96
NF-MUCINEX DM TAB ER,250,RC,,,,both,2.4,2.16,United Healthcare,Default,Fee Schedule,1.96,,,,1.42,1.96
NF-LEXAPRO ORAL TABLET 10MG,250,RC,,,,both,17.2,15.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.04,,,,10.15,14.04
NF-LEXAPRO ORAL TABLET 10MG,250,RC,,,,both,17.2,15.48,Cigna,Default,Percent of Total Billed Charges,10.15,,,,10.15,14.04
NF-LEXAPRO ORAL TABLET 10MG,250,RC,,,,both,17.2,15.48,United Healthcare,Default,Fee Schedule,14.04,,,,10.15,14.04
NF-XTANDI LIQ CAP 40MG,250,RC,,,,both,448.86,403.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,314.2,,,,264.83,366.27
NF-XTANDI LIQ CAP 40MG,250,RC,,,,both,448.86,403.97,Cigna,Default,Percent of Total Billed Charges,264.83,,,,264.83,366.27
NF-XTANDI LIQ CAP 40MG,250,RC,,,,both,448.86,403.97,United Healthcare,Default,Fee Schedule,366.27,,,,264.83,366.27
NF-METOPROLOL SUCCINATE CAP ER 25MG,250,RC,,,,both,6.96,6.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.87,,,,4.11,5.68
NF-METOPROLOL SUCCINATE CAP ER 25MG,250,RC,,,,both,6.96,6.26,Cigna,Default,Percent of Total Billed Charges,4.11,,,,4.11,5.68
NF-METOPROLOL SUCCINATE CAP ER 25MG,250,RC,,,,both,6.96,6.26,United Healthcare,Default,Fee Schedule,5.68,,,,4.11,5.68
NF-METOPROLOL SUCCINATE ER TAB ER 25MG,250,RC,,,,both,4.21,3.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.95,,,,2.48,3.44
NF-METOPROLOL SUCCINATE ER TAB ER 25MG,250,RC,,,,both,4.21,3.79,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.44
NF-METOPROLOL SUCCINATE ER TAB ER 25MG,250,RC,,,,both,4.21,3.79,United Healthcare,Default,Fee Schedule,3.44,,,,2.48,3.44
NF-RIVASTIGMINE TD PATCH ER 9.5MG/24HR,250,RC,,,,both,43.73,39.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.61,,,,25.8,35.68
NF-RIVASTIGMINE TD PATCH ER 9.5MG/24HR,250,RC,,,,both,43.73,39.36,Cigna,Default,Percent of Total Billed Charges,25.8,,,,25.8,35.68
NF-RIVASTIGMINE TD PATCH ER 9.5MG/24HR,250,RC,,,,both,43.73,39.36,United Healthcare,Default,Fee Schedule,35.68,,,,25.8,35.68
NF-REFRESH OPHTH SOLUTION,250,RC,,,,both,1.49,1.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.04,,,,0.88,1.22
NF-REFRESH OPHTH SOLUTION,250,RC,,,,both,1.49,1.34,Cigna,Default,Percent of Total Billed Charges,0.88,,,,0.88,1.22
NF-REFRESH OPHTH SOLUTION,250,RC,,,,both,1.49,1.34,United Healthcare,Default,Fee Schedule,1.22,,,,0.88,1.22
NF-PAPAYA ENZYME TABLET,250,RC,,,,both,14.96,13.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.47,,,,8.83,12.21
NF-PAPAYA ENZYME TABLET,250,RC,,,,both,14.96,13.46,Cigna,Default,Percent of Total Billed Charges,8.83,,,,8.83,12.21
NF-PAPAYA ENZYME TABLET,250,RC,,,,both,14.96,13.46,United Healthcare,Default,Fee Schedule,12.21,,,,8.83,12.21
NF-FOLBEE-PLUS CZ TAB,250,RC,,,,both,3.06,2.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.14,,,,1.81,2.5
NF-FOLBEE-PLUS CZ TAB,250,RC,,,,both,3.06,2.75,Cigna,Default,Percent of Total Billed Charges,1.81,,,,1.81,2.5
NF-FOLBEE-PLUS CZ TAB,250,RC,,,,both,3.06,2.75,United Healthcare,Default,Fee Schedule,2.5,,,,1.81,2.5
NF-FOLIC ACID ORAL TABLET 0.8MG,250,RC,,,,both,0.05,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.03,0.04
NF-FOLIC ACID ORAL TABLET 0.8MG,250,RC,,,,both,0.05,0.05,Cigna,Default,Percent of Total Billed Charges,0.03,,,,0.03,0.04
NF-FOLIC ACID ORAL TABLET 0.8MG,250,RC,,,,both,0.05,0.05,United Healthcare,Default,Fee Schedule,0.04,,,,0.03,0.04
NF-PRILOSEC CAP DR 20MG,250,RC,,,,both,27.48,24.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.24,,,,16.21,22.42
NF-PRILOSEC CAP DR 20MG,250,RC,,,,both,27.48,24.73,Cigna,Default,Percent of Total Billed Charges,16.21,,,,16.21,22.42
NF-PRILOSEC CAP DR 20MG,250,RC,,,,both,27.48,24.73,United Healthcare,Default,Fee Schedule,22.42,,,,16.21,22.42
NF-PROGESTERONE IM OIL 50MG/1ML,250,RC,,,,both,16.25,14.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.38,,,,9.59,13.26
NF-PROGESTERONE IM OIL 50MG/1ML,250,RC,,,,both,16.25,14.63,Cigna,Default,Percent of Total Billed Charges,9.59,,,,9.59,13.26
NF-PROGESTERONE IM OIL 50MG/1ML,250,RC,,,,both,16.25,14.63,United Healthcare,Default,Fee Schedule,13.26,,,,9.59,13.26
NF-VIVELLE-DOT TD PATCH ER 0.0375MG/24HR,250,RC,,,,both,78.65,70.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.06,,,,46.4,64.18
NF-VIVELLE-DOT TD PATCH ER 0.0375MG/24HR,250,RC,,,,both,78.65,70.79,Cigna,Default,Percent of Total Billed Charges,46.4,,,,46.4,64.18
NF-VIVELLE-DOT TD PATCH ER 0.0375MG/24HR,250,RC,,,,both,78.65,70.79,United Healthcare,Default,Fee Schedule,64.18,,,,46.4,64.18
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,11.29,10.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.9,,,,6.66,9.21
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,11.29,10.16,Cigna,Default,Percent of Total Billed Charges,6.66,,,,6.66,9.21
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,11.29,10.16,United Healthcare,Default,Fee Schedule,9.21,,,,6.66,9.21
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,250,RC,,,,both,2200.37,1980.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1540.26,,,,1298.22,1795.5
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,250,RC,,,,both,2200.37,1980.33,Cigna,Default,Percent of Total Billed Charges,1298.22,,,,1298.22,1795.5
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,250,RC,,,,both,2200.37,1980.33,United Healthcare,Default,Fee Schedule,1795.5,,,,1298.22,1795.5
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,250,RC,,,,both,2200.33,1980.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1540.23,,,,1298.19,1795.47
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,250,RC,,,,both,2200.33,1980.3,Cigna,Default,Percent of Total Billed Charges,1298.19,,,,1298.19,1795.47
NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,250,RC,,,,both,2200.33,1980.3,United Healthcare,Default,Fee Schedule,1795.47,,,,1298.19,1795.47
NF-MICONAZOLE POWDER,250,RC,,,,both,159.6,143.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,111.72,,,,94.16,130.23
NF-MICONAZOLE POWDER,250,RC,,,,both,159.6,143.64,Cigna,Default,Percent of Total Billed Charges,94.16,,,,94.16,130.23
NF-MICONAZOLE POWDER,250,RC,,,,both,159.6,143.64,United Healthcare,Default,Fee Schedule,130.23,,,,94.16,130.23
NF-MICONAZOLE POWDER,250,RC,,,,both,181.62,163.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,127.13,,,,107.16,148.2
NF-MICONAZOLE POWDER,250,RC,,,,both,181.62,163.46,Cigna,Default,Percent of Total Billed Charges,107.16,,,,107.16,148.2
NF-MICONAZOLE POWDER,250,RC,,,,both,181.62,163.46,United Healthcare,Default,Fee Schedule,148.2,,,,107.16,148.2
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,40.07,36.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.05,,,,23.64,32.7
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,40.07,36.06,Cigna,Default,Percent of Total Billed Charges,23.64,,,,23.64,32.7
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,40.07,36.06,United Healthcare,Default,Fee Schedule,32.7,,,,23.64,32.7
NF-WELLBUTRIN XL TABLET ER 300MG,250,RC,,,,both,37.86,34.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.5,,,,22.34,30.89
NF-WELLBUTRIN XL TABLET ER 300MG,250,RC,,,,both,37.86,34.07,Cigna,Default,Percent of Total Billed Charges,22.34,,,,22.34,30.89
NF-WELLBUTRIN XL TABLET ER 300MG,250,RC,,,,both,37.86,34.07,United Healthcare,Default,Fee Schedule,30.89,,,,22.34,30.89
NF-ARMOUR THYROID TABLET 30MG,250,RC,,,,both,3.41,3.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.39,,,,2.01,2.78
NF-ARMOUR THYROID TABLET 30MG,250,RC,,,,both,3.41,3.07,Cigna,Default,Percent of Total Billed Charges,2.01,,,,2.01,2.78
NF-ARMOUR THYROID TABLET 30MG,250,RC,,,,both,3.41,3.07,United Healthcare,Default,Fee Schedule,2.78,,,,2.01,2.78
NF-GABAPENTIN SUSP 25MG/1ML,250,RC,,,,both,5.62,5.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.93,,,,3.32,4.59
NF-GABAPENTIN SUSP 25MG/1ML,250,RC,,,,both,5.62,5.06,Cigna,Default,Percent of Total Billed Charges,3.32,,,,3.32,4.59
NF-GABAPENTIN SUSP 25MG/1ML,250,RC,,,,both,5.62,5.06,United Healthcare,Default,Fee Schedule,4.59,,,,3.32,4.59
NF-GABAPENTIN ORAL SOLUTION 250MG/5ML,250,RC,,,,both,1.37,1.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.96,,,,0.81,1.12
NF-GABAPENTIN ORAL SOLUTION 250MG/5ML,250,RC,,,,both,1.37,1.23,Cigna,Default,Percent of Total Billed Charges,0.81,,,,0.81,1.12
NF-GABAPENTIN ORAL SOLUTION 250MG/5ML,250,RC,,,,both,1.37,1.23,United Healthcare,Default,Fee Schedule,1.12,,,,0.81,1.12
NF-GABAPENTIN AVPAK ORAL TABLET 600MG,250,RC,,,,both,9.81,8.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.87,,,,5.79,8
NF-GABAPENTIN AVPAK ORAL TABLET 600MG,250,RC,,,,both,9.81,8.83,Cigna,Default,Percent of Total Billed Charges,5.79,,,,5.79,8
NF-GABAPENTIN AVPAK ORAL TABLET 600MG,250,RC,,,,both,9.81,8.83,United Healthcare,Default,Fee Schedule,8,,,,5.79,8
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,70.73,63.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.51,,,,41.73,57.72
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,70.73,63.66,Cigna,Default,Percent of Total Billed Charges,41.73,,,,41.73,57.72
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,70.73,63.66,United Healthcare,Default,Fee Schedule,57.72,,,,41.73,57.72
NF-OXCARBAZEPINE ORAL TABLET 300MG,250,RC,,,,both,10.87,9.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.61,,,,6.41,8.87
NF-OXCARBAZEPINE ORAL TABLET 300MG,250,RC,,,,both,10.87,9.78,Cigna,Default,Percent of Total Billed Charges,6.41,,,,6.41,8.87
NF-OXCARBAZEPINE ORAL TABLET 300MG,250,RC,,,,both,10.87,9.78,United Healthcare,Default,Fee Schedule,8.87,,,,6.41,8.87
NF-PIOGLITAZONE HCL ORAL TABLET 45MG,250,RC,,,,both,50.23,45.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.16,,,,29.64,40.99
NF-PIOGLITAZONE HCL ORAL TABLET 45MG,250,RC,,,,both,50.23,45.21,Cigna,Default,Percent of Total Billed Charges,29.64,,,,29.64,40.99
NF-PIOGLITAZONE HCL ORAL TABLET 45MG,250,RC,,,,both,50.23,45.21,United Healthcare,Default,Fee Schedule,40.99,,,,29.64,40.99
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,4.09,3.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.86,,,,2.41,3.34
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,4.09,3.68,Cigna,Default,Percent of Total Billed Charges,2.41,,,,2.41,3.34
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,4.09,3.68,United Healthcare,Default,Fee Schedule,3.34,,,,2.41,3.34
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,0.93,0.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.65,,,,0.55,0.76
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,0.93,0.84,Cigna,Default,Percent of Total Billed Charges,0.55,,,,0.55,0.76
NF-LISINOPRIL ORAL TABLET 10MG,250,RC,,,,both,0.93,0.84,United Healthcare,Default,Fee Schedule,0.76,,,,0.55,0.76
NF-AMARYL TAB 4MG,250,RC,,,,both,20.07,18.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.05,,,,11.84,16.38
NF-AMARYL TAB 4MG,250,RC,,,,both,20.07,18.06,Cigna,Default,Percent of Total Billed Charges,11.84,,,,11.84,16.38
NF-AMARYL TAB 4MG,250,RC,,,,both,20.07,18.06,United Healthcare,Default,Fee Schedule,16.38,,,,11.84,16.38
NF-ZYPREXA TABLET 7.5MG,250,RC,,,,both,81.7,73.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.19,,,,48.2,66.67
NF-ZYPREXA TABLET 7.5MG,250,RC,,,,both,81.7,73.53,Cigna,Default,Percent of Total Billed Charges,48.2,,,,48.2,66.67
NF-ZYPREXA TABLET 7.5MG,250,RC,,,,both,81.7,73.53,United Healthcare,Default,Fee Schedule,66.67,,,,48.2,66.67
NF-GUAIFENESIN ORAL TABLET 400MG,250,RC,,,,both,12.28,11.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.6,,,,7.25,10.02
NF-GUAIFENESIN ORAL TABLET 400MG,250,RC,,,,both,12.28,11.05,Cigna,Default,Percent of Total Billed Charges,7.25,,,,7.25,10.02
NF-GUAIFENESIN ORAL TABLET 400MG,250,RC,,,,both,12.28,11.05,United Healthcare,Default,Fee Schedule,10.02,,,,7.25,10.02
NF-ANASTROZOLE ORAL TABLET 1MG,250,RC,,,,both,53.21,47.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.25,,,,31.39,43.42
NF-ANASTROZOLE ORAL TABLET 1MG,250,RC,,,,both,53.21,47.89,Cigna,Default,Percent of Total Billed Charges,31.39,,,,31.39,43.42
NF-ANASTROZOLE ORAL TABLET 1MG,250,RC,,,,both,53.21,47.89,United Healthcare,Default,Fee Schedule,43.42,,,,31.39,43.42
NF-VENLAFAXINE HCL AVPAK TAB 75MG,250,RC,,,,both,8.73,7.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.11,,,,5.15,7.12
NF-VENLAFAXINE HCL AVPAK TAB 75MG,250,RC,,,,both,8.73,7.86,Cigna,Default,Percent of Total Billed Charges,5.15,,,,5.15,7.12
NF-VENLAFAXINE HCL AVPAK TAB 75MG,250,RC,,,,both,8.73,7.86,United Healthcare,Default,Fee Schedule,7.12,,,,5.15,7.12
NF-OXYBUTYNIN CHLORIDE ORAL TAB ER 10MG,250,RC,,,,both,14.22,12.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.95,,,,8.39,11.6
NF-OXYBUTYNIN CHLORIDE ORAL TAB ER 10MG,250,RC,,,,both,14.22,12.8,Cigna,Default,Percent of Total Billed Charges,8.39,,,,8.39,11.6
NF-OXYBUTYNIN CHLORIDE ORAL TAB ER 10MG,250,RC,,,,both,14.22,12.8,United Healthcare,Default,Fee Schedule,11.6,,,,8.39,11.6
NF-CONCERTA TAB ER 36MG,250,RC,,,,both,29.39,26.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.57,,,,17.34,23.98
NF-CONCERTA TAB ER 36MG,250,RC,,,,both,29.39,26.45,Cigna,Default,Percent of Total Billed Charges,17.34,,,,17.34,23.98
NF-CONCERTA TAB ER 36MG,250,RC,,,,both,29.39,26.45,United Healthcare,Default,Fee Schedule,23.98,,,,17.34,23.98
NF-NITROSTAT TABLET 0.3MG,250,RC,,,,both,0.45,0.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.32,,,,0.27,0.37
NF-NITROSTAT TABLET 0.3MG,250,RC,,,,both,0.45,0.41,Cigna,Default,Percent of Total Billed Charges,0.27,,,,0.27,0.37
NF-NITROSTAT TABLET 0.3MG,250,RC,,,,both,0.45,0.41,United Healthcare,Default,Fee Schedule,0.37,,,,0.27,0.37
NF-OPDIVO INTRAVENOUS SOLUTION 10MG/1ML,250,RC,,,,both,1401.8,1261.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,981.26,,,,827.06,1143.87
NF-OPDIVO INTRAVENOUS SOLUTION 10MG/1ML,250,RC,,,,both,1401.8,1261.62,Cigna,Default,Percent of Total Billed Charges,827.06,,,,827.06,1143.87
NF-OPDIVO INTRAVENOUS SOLUTION 10MG/1ML,250,RC,,,,both,1401.8,1261.62,United Healthcare,Default,Fee Schedule,1143.87,,,,827.06,1143.87
NF-BEVESPI AEROSPHERE INH 4.8MCG-9MCG/1A,250,RC,,,,both,177.18,159.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.03,,,,104.54,144.58
NF-BEVESPI AEROSPHERE INH 4.8MCG-9MCG/1A,250,RC,,,,both,177.18,159.46,Cigna,Default,Percent of Total Billed Charges,104.54,,,,104.54,144.58
NF-BEVESPI AEROSPHERE INH 4.8MCG-9MCG/1A,250,RC,,,,both,177.18,159.46,United Healthcare,Default,Fee Schedule,144.58,,,,104.54,144.58
NF-KETOCONAZOLE CREAM 2%,250,RC,,,,both,9.8,8.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.86,,,,5.78,8
NF-KETOCONAZOLE CREAM 2%,250,RC,,,,both,9.8,8.82,Cigna,Default,Percent of Total Billed Charges,5.78,,,,5.78,8
NF-KETOCONAZOLE CREAM 2%,250,RC,,,,both,9.8,8.82,United Healthcare,Default,Fee Schedule,8,,,,5.78,8
NF-HOMEOPATHIC CHEW TAB,250,RC,,,,both,1.18,1.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.83,,,,0.7,0.96
NF-HOMEOPATHIC CHEW TAB,250,RC,,,,both,1.18,1.06,Cigna,Default,Percent of Total Billed Charges,0.7,,,,0.7,0.96
NF-HOMEOPATHIC CHEW TAB,250,RC,,,,both,1.18,1.06,United Healthcare,Default,Fee Schedule,0.96,,,,0.7,0.96
NF-PROLENSA OPHTH SOLN 0.07%,250,RC,,,,both,461.27,415.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,322.89,,,,272.15,376.4
NF-PROLENSA OPHTH SOLN 0.07%,250,RC,,,,both,461.27,415.14,Cigna,Default,Percent of Total Billed Charges,272.15,,,,272.15,376.4
NF-PROLENSA OPHTH SOLN 0.07%,250,RC,,,,both,461.27,415.14,United Healthcare,Default,Fee Schedule,376.4,,,,272.15,376.4
NF-MURO-128 OPHTH OINTMENT 5%,250,RC,,,,both,107.5,96.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.25,,,,63.42,87.72
NF-MURO-128 OPHTH OINTMENT 5%,250,RC,,,,both,107.5,96.75,Cigna,Default,Percent of Total Billed Charges,63.42,,,,63.42,87.72
NF-MURO-128 OPHTH OINTMENT 5%,250,RC,,,,both,107.5,96.75,United Healthcare,Default,Fee Schedule,87.72,,,,63.42,87.72
BALOXAVIR 40 MG TAB,250,RC,,,,both,398.22,358.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,278.75,,,,234.95,324.95
BALOXAVIR 40 MG TAB,250,RC,,,,both,398.22,358.4,Cigna,Default,Percent of Total Billed Charges,234.95,,,,234.95,324.95
BALOXAVIR 40 MG TAB,250,RC,,,,both,398.22,358.4,United Healthcare,Default,Fee Schedule,324.95,,,,234.95,324.95
NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG/1,250,RC,,,,both,35.43,31.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.8,,,,20.9,28.91
NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG/1,250,RC,,,,both,35.43,31.89,Cigna,Default,Percent of Total Billed Charges,20.9,,,,20.9,28.91
NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG/1,250,RC,,,,both,35.43,31.89,United Healthcare,Default,Fee Schedule,28.91,,,,20.9,28.91
NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,250,RC,,,,both,0.67,0.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.47,,,,0.4,0.55
NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,250,RC,,,,both,0.67,0.6,Cigna,Default,Percent of Total Billed Charges,0.4,,,,0.4,0.55
NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,250,RC,,,,both,0.67,0.6,United Healthcare,Default,Fee Schedule,0.55,,,,0.4,0.55
NF-CEFOTAXIME INJECTION PWD FOR SOLN 1GM,250,RC,,,,both,28.11,25.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.68,,,,16.58,22.94
NF-CEFOTAXIME INJECTION PWD FOR SOLN 1GM,250,RC,,,,both,28.11,25.3,Cigna,Default,Percent of Total Billed Charges,16.58,,,,16.58,22.94
NF-CEFOTAXIME INJECTION PWD FOR SOLN 1GM,250,RC,,,,both,28.11,25.3,United Healthcare,Default,Fee Schedule,22.94,,,,16.58,22.94
KCENTRA 500 UNIT RANGE,636,RC,,,,both,8466.7,7620.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5926.69,,,,4995.35,6908.83
KCENTRA 500 UNIT RANGE,636,RC,,,,both,8466.7,7620.03,Cigna,Default,Percent of Total Billed Charges,4995.35,,,,4995.35,6908.83
KCENTRA 500 UNIT RANGE,636,RC,,,,both,8466.7,7620.03,United Healthcare,Default,Fee Schedule,6908.83,,,,4995.35,6908.83
NF-CHLORTHALIDONE ORAL TABLET 25MG,250,RC,,,,both,9.46,8.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.62,,,,5.58,7.72
NF-CHLORTHALIDONE ORAL TABLET 25MG,250,RC,,,,both,9.46,8.51,Cigna,Default,Percent of Total Billed Charges,5.58,,,,5.58,7.72
NF-CHLORTHALIDONE ORAL TABLET 25MG,250,RC,,,,both,9.46,8.51,United Healthcare,Default,Fee Schedule,7.72,,,,5.58,7.72
NF-LO LOESTRIN FE ORAL TAB,250,RC,,,,both,26.07,23.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.25,,,,15.38,21.27
NF-LO LOESTRIN FE ORAL TAB,250,RC,,,,both,26.07,23.46,Cigna,Default,Percent of Total Billed Charges,15.38,,,,15.38,21.27
NF-LO LOESTRIN FE ORAL TAB,250,RC,,,,both,26.07,23.46,United Healthcare,Default,Fee Schedule,21.27,,,,15.38,21.27
NF-VITAMIN B12 ORAL TABLET 500MCG,250,RC,,,,both,0.23,0.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.16,,,,0.14,0.19
NF-VITAMIN B12 ORAL TABLET 500MCG,250,RC,,,,both,0.23,0.21,Cigna,Default,Percent of Total Billed Charges,0.14,,,,0.14,0.19
NF-VITAMIN B12 ORAL TABLET 500MCG,250,RC,,,,both,0.23,0.21,United Healthcare,Default,Fee Schedule,0.19,,,,0.14,0.19
NF-VITAMIN B12 ORAL TABLET 1000MCG,250,RC,,,,both,0.38,0.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.27,,,,0.22,0.31
NF-VITAMIN B12 ORAL TABLET 1000MCG,250,RC,,,,both,0.38,0.34,Cigna,Default,Percent of Total Billed Charges,0.22,,,,0.22,0.31
NF-VITAMIN B12 ORAL TABLET 1000MCG,250,RC,,,,both,0.38,0.34,United Healthcare,Default,Fee Schedule,0.31,,,,0.22,0.31
NF-TERAZOSIN HCL CAP 10MG,250,RC,,,,both,6.94,6.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.86,,,,4.09,5.66
NF-TERAZOSIN HCL CAP 10MG,250,RC,,,,both,6.94,6.25,Cigna,Default,Percent of Total Billed Charges,4.09,,,,4.09,5.66
NF-TERAZOSIN HCL CAP 10MG,250,RC,,,,both,6.94,6.25,United Healthcare,Default,Fee Schedule,5.66,,,,4.09,5.66
NF-CARDIZEM ORAL TABLET 60MG,250,RC,,,,both,49.59,44.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.71,,,,29.26,40.47
NF-CARDIZEM ORAL TABLET 60MG,250,RC,,,,both,49.59,44.63,Cigna,Default,Percent of Total Billed Charges,29.26,,,,29.26,40.47
NF-CARDIZEM ORAL TABLET 60MG,250,RC,,,,both,49.59,44.63,United Healthcare,Default,Fee Schedule,40.47,,,,29.26,40.47
NF-LIPITOR ORAL TABLET 20MG,250,RC,,,,both,19.31,17.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.52,,,,11.39,15.76
NF-LIPITOR ORAL TABLET 20MG,250,RC,,,,both,19.31,17.38,Cigna,Default,Percent of Total Billed Charges,11.39,,,,11.39,15.76
NF-LIPITOR ORAL TABLET 20MG,250,RC,,,,both,19.31,17.38,United Healthcare,Default,Fee Schedule,15.76,,,,11.39,15.76
NF-SPRINTEC TABLET,250,RC,,,,both,10.22,9.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.15,,,,6.03,8.34
NF-SPRINTEC TABLET,250,RC,,,,both,10.22,9.2,Cigna,Default,Percent of Total Billed Charges,6.03,,,,6.03,8.34
NF-SPRINTEC TABLET,250,RC,,,,both,10.22,9.2,United Healthcare,Default,Fee Schedule,8.34,,,,6.03,8.34
NF-ARICEPT ORAL TABLET 10MG,250,RC,,,,both,40.93,36.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.65,,,,24.15,33.4
NF-ARICEPT ORAL TABLET 10MG,250,RC,,,,both,40.93,36.84,Cigna,Default,Percent of Total Billed Charges,24.15,,,,24.15,33.4
NF-ARICEPT ORAL TABLET 10MG,250,RC,,,,both,40.93,36.84,United Healthcare,Default,Fee Schedule,33.4,,,,24.15,33.4
NF-NAMENDA TAB 10MG,250,RC,,,,both,36.61,32.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.63,,,,21.6,29.87
NF-NAMENDA TAB 10MG,250,RC,,,,both,36.61,32.95,Cigna,Default,Percent of Total Billed Charges,21.6,,,,21.6,29.87
NF-NAMENDA TAB 10MG,250,RC,,,,both,36.61,32.95,United Healthcare,Default,Fee Schedule,29.87,,,,21.6,29.87
NF-ACTOS ORAL TABLET 45MG,250,RC,,,,both,106.04,95.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.23,,,,62.56,86.53
NF-ACTOS ORAL TABLET 45MG,250,RC,,,,both,106.04,95.44,Cigna,Default,Percent of Total Billed Charges,62.56,,,,62.56,86.53
NF-ACTOS ORAL TABLET 45MG,250,RC,,,,both,106.04,95.44,United Healthcare,Default,Fee Schedule,86.53,,,,62.56,86.53
NF-DULOXETINE CAPSULE DELAYED RELEASE 60,250,RC,,,,both,30.19,27.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.13,,,,17.81,24.64
NF-DULOXETINE CAPSULE DELAYED RELEASE 60,250,RC,,,,both,30.19,27.17,Cigna,Default,Percent of Total Billed Charges,17.81,,,,17.81,24.64
NF-DULOXETINE CAPSULE DELAYED RELEASE 60,250,RC,,,,both,30.19,27.17,United Healthcare,Default,Fee Schedule,24.64,,,,17.81,24.64
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,250,RC,,,,both,1.83,1.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.28,,,,1.08,1.49
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,250,RC,,,,both,1.83,1.65,Cigna,Default,Percent of Total Billed Charges,1.08,,,,1.08,1.49
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,250,RC,,,,both,1.83,1.65,United Healthcare,Default,Fee Schedule,1.49,,,,1.08,1.49
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 1MG,250,RC,,,,both,34.68,31.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.28,,,,20.46,28.3
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 1MG,250,RC,,,,both,34.68,31.21,Cigna,Default,Percent of Total Billed Charges,20.46,,,,20.46,28.3
NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 1MG,250,RC,,,,both,34.68,31.21,United Healthcare,Default,Fee Schedule,28.3,,,,20.46,28.3
NF-FEXOFENADINE HCL ORAL TAB 180MG,250,RC,,,,both,2.78,2.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.95,,,,1.64,2.27
NF-FEXOFENADINE HCL ORAL TAB 180MG,250,RC,,,,both,2.78,2.5,Cigna,Default,Percent of Total Billed Charges,1.64,,,,1.64,2.27
NF-FEXOFENADINE HCL ORAL TAB 180MG,250,RC,,,,both,2.78,2.5,United Healthcare,Default,Fee Schedule,2.27,,,,1.64,2.27
NF-PULMICORT FLEX INH/NEB PWD 180MCG/1AC,250,RC,,,,both,812.43,731.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,568.7,,,,479.33,662.94
NF-PULMICORT FLEX INH/NEB PWD 180MCG/1AC,250,RC,,,,both,812.43,731.19,Cigna,Default,Percent of Total Billed Charges,479.33,,,,479.33,662.94
NF-PULMICORT FLEX INH/NEB PWD 180MCG/1AC,250,RC,,,,both,812.43,731.19,United Healthcare,Default,Fee Schedule,662.94,,,,479.33,662.94
NF-ESOMEPRAZOLE MAGNESIUM CAP DR 40MG,250,RC,,,,both,43.4,39.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.38,,,,25.61,35.41
NF-ESOMEPRAZOLE MAGNESIUM CAP DR 40MG,250,RC,,,,both,43.4,39.06,Cigna,Default,Percent of Total Billed Charges,25.61,,,,25.61,35.41
NF-ESOMEPRAZOLE MAGNESIUM CAP DR 40MG,250,RC,,,,both,43.4,39.06,United Healthcare,Default,Fee Schedule,35.41,,,,25.61,35.41
NF-LETROZOLE ORAL TABLET 2.5MG,250,RC,,,,both,78.34,70.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,54.84,,,,46.22,63.93
NF-LETROZOLE ORAL TABLET 2.5MG,250,RC,,,,both,78.34,70.51,Cigna,Default,Percent of Total Billed Charges,46.22,,,,46.22,63.93
NF-LETROZOLE ORAL TABLET 2.5MG,250,RC,,,,both,78.34,70.51,United Healthcare,Default,Fee Schedule,63.93,,,,46.22,63.93
NF-PRANDIN TAB 2MG,250,RC,,,,both,5.95,5.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.16,,,,3.51,4.86
NF-PRANDIN TAB 2MG,250,RC,,,,both,5.95,5.36,Cigna,Default,Percent of Total Billed Charges,3.51,,,,3.51,4.86
NF-PRANDIN TAB 2MG,250,RC,,,,both,5.95,5.36,United Healthcare,Default,Fee Schedule,4.86,,,,3.51,4.86
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,36.03,32.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.22,,,,21.26,29.4
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,36.03,32.43,Cigna,Default,Percent of Total Billed Charges,21.26,,,,21.26,29.4
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,36.03,32.43,United Healthcare,Default,Fee Schedule,29.4,,,,21.26,29.4
NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,250,RC,,,,both,1.15,1.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.8,,,,0.68,0.94
NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,250,RC,,,,both,1.15,1.04,Cigna,Default,Percent of Total Billed Charges,0.68,,,,0.68,0.94
NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,250,RC,,,,both,1.15,1.04,United Healthcare,Default,Fee Schedule,0.94,,,,0.68,0.94
NF-PRESERVISION AREDS 2 LIQ CAP,250,RC,,,,both,0.93,0.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.65,,,,0.55,0.76
NF-PRESERVISION AREDS 2 LIQ CAP,250,RC,,,,both,0.93,0.84,Cigna,Default,Percent of Total Billed Charges,0.55,,,,0.55,0.76
NF-PRESERVISION AREDS 2 LIQ CAP,250,RC,,,,both,0.93,0.84,United Healthcare,Default,Fee Schedule,0.76,,,,0.55,0.76
NF-PRESERVISION AREDS 2 LIQ CAP,250,RC,,,,both,0.93,0.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.65,,,,0.55,0.76
NF-PRESERVISION AREDS 2 LIQ CAP,250,RC,,,,both,0.93,0.84,Cigna,Default,Percent of Total Billed Charges,0.55,,,,0.55,0.76
NF-PRESERVISION AREDS 2 LIQ CAP,250,RC,,,,both,0.93,0.84,United Healthcare,Default,Fee Schedule,0.76,,,,0.55,0.76
NF-PRANDIN TAB 2MG,250,RC,,,,both,5.78,5.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.05,,,,3.41,4.72
NF-PRANDIN TAB 2MG,250,RC,,,,both,5.78,5.2,Cigna,Default,Percent of Total Billed Charges,3.41,,,,3.41,4.72
NF-PRANDIN TAB 2MG,250,RC,,,,both,5.78,5.2,United Healthcare,Default,Fee Schedule,4.72,,,,3.41,4.72
NF-TURMERIC ORAL TABLET 1053MG,250,RC,,,,both,1.48,1.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.04,,,,0.87,1.21
NF-TURMERIC ORAL TABLET 1053MG,250,RC,,,,both,1.48,1.33,Cigna,Default,Percent of Total Billed Charges,0.87,,,,0.87,1.21
NF-TURMERIC ORAL TABLET 1053MG,250,RC,,,,both,1.48,1.33,United Healthcare,Default,Fee Schedule,1.21,,,,0.87,1.21
"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 200",250,RC,,,,both,1.83,1.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.28,,,,1.08,1.49
"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 200",250,RC,,,,both,1.83,1.65,Cigna,Default,Percent of Total Billed Charges,1.08,,,,1.08,1.49
"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 200",250,RC,,,,both,1.83,1.65,United Healthcare,Default,Fee Schedule,1.49,,,,1.08,1.49
NF-LEVOCARNITINE CAP 300MG,250,RC,,,,both,1.13,1.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.79,,,,0.67,0.92
NF-LEVOCARNITINE CAP 300MG,250,RC,,,,both,1.13,1.02,Cigna,Default,Percent of Total Billed Charges,0.67,,,,0.67,0.92
NF-LEVOCARNITINE CAP 300MG,250,RC,,,,both,1.13,1.02,United Healthcare,Default,Fee Schedule,0.92,,,,0.67,0.92
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.03,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Cigna,Default,Percent of Total Billed Charges,66.61,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,United Healthcare,Default,Fee Schedule,92.13,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.03,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Cigna,Default,Percent of Total Billed Charges,66.61,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,United Healthcare,Default,Fee Schedule,92.13,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.03,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Cigna,Default,Percent of Total Billed Charges,66.61,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,United Healthcare,Default,Fee Schedule,92.13,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.03,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,Cigna,Default,Percent of Total Billed Charges,66.61,,,,66.61,92.13
NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,112.9,101.61,United Healthcare,Default,Fee Schedule,92.13,,,,66.61,92.13
NF-AUGMENTIN XR ORAL TABLET ER 1000MG,250,RC,,,,both,21.78,19.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.25,,,,12.85,17.77
NF-AUGMENTIN XR ORAL TABLET ER 1000MG,250,RC,,,,both,21.78,19.6,Cigna,Default,Percent of Total Billed Charges,12.85,,,,12.85,17.77
NF-AUGMENTIN XR ORAL TABLET ER 1000MG,250,RC,,,,both,21.78,19.6,United Healthcare,Default,Fee Schedule,17.77,,,,12.85,17.77
NF-PRAZOSIN HCL     CAP  2MG,250,RC,,,,both,5.09,4.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.56,,,,3,4.15
NF-PRAZOSIN HCL     CAP  2MG,250,RC,,,,both,5.09,4.58,Cigna,Default,Percent of Total Billed Charges,3,,,,3,4.15
NF-PRAZOSIN HCL     CAP  2MG,250,RC,,,,both,5.09,4.58,United Healthcare,Default,Fee Schedule,4.15,,,,3,4.15
NF-OFLOXACIN OPHTH SOLN 0.3%,250,RC,,,,both,48.45,43.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.92,,,,28.59,39.54
NF-OFLOXACIN OPHTH SOLN 0.3%,250,RC,,,,both,48.45,43.61,Cigna,Default,Percent of Total Billed Charges,28.59,,,,28.59,39.54
NF-OFLOXACIN OPHTH SOLN 0.3%,250,RC,,,,both,48.45,43.61,United Healthcare,Default,Fee Schedule,39.54,,,,28.59,39.54
NF-TOUJEO SUBCUTANEOUS SOLUTION 300U/1ML,250,RC,,,,both,414.63,373.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,290.24,,,,244.63,338.34
NF-TOUJEO SUBCUTANEOUS SOLUTION 300U/1ML,250,RC,,,,both,414.63,373.17,Cigna,Default,Percent of Total Billed Charges,244.63,,,,244.63,338.34
NF-TOUJEO SUBCUTANEOUS SOLUTION 300U/1ML,250,RC,,,,both,414.63,373.17,United Healthcare,Default,Fee Schedule,338.34,,,,244.63,338.34
NF-ZOLOFT TAB 100MG,250,RC,,,,both,13.28,11.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.3,,,,7.84,10.84
NF-ZOLOFT TAB 100MG,250,RC,,,,both,13.28,11.95,Cigna,Default,Percent of Total Billed Charges,7.84,,,,7.84,10.84
NF-ZOLOFT TAB 100MG,250,RC,,,,both,13.28,11.95,United Healthcare,Default,Fee Schedule,10.84,,,,7.84,10.84
NF-SOTALOL HCL AF ORAL TABLET 160MG,250,RC,,,,both,53.79,48.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.65,,,,31.74,43.89
NF-SOTALOL HCL AF ORAL TABLET 160MG,250,RC,,,,both,53.79,48.41,Cigna,Default,Percent of Total Billed Charges,31.74,,,,31.74,43.89
NF-SOTALOL HCL AF ORAL TABLET 160MG,250,RC,,,,both,53.79,48.41,United Healthcare,Default,Fee Schedule,43.89,,,,31.74,43.89
NF-CYMBALTA CAP DR 20MG,250,RC,,,,both,22.21,19.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.55,,,,13.1,18.12
NF-CYMBALTA CAP DR 20MG,250,RC,,,,both,22.21,19.99,Cigna,Default,Percent of Total Billed Charges,13.1,,,,13.1,18.12
NF-CYMBALTA CAP DR 20MG,250,RC,,,,both,22.21,19.99,United Healthcare,Default,Fee Schedule,18.12,,,,13.1,18.12
NF-ESTRADIOL TRANSDERMAL SYS 0.05MG/24HR,250,RC,,,,both,45.34,40.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.74,,,,26.75,37
NF-ESTRADIOL TRANSDERMAL SYS 0.05MG/24HR,250,RC,,,,both,45.34,40.81,Cigna,Default,Percent of Total Billed Charges,26.75,,,,26.75,37
NF-ESTRADIOL TRANSDERMAL SYS 0.05MG/24HR,250,RC,,,,both,45.34,40.81,United Healthcare,Default,Fee Schedule,37,,,,26.75,37
NF-TRIAZOLAM ORAL TABLET 0.25MG,250,RC,,,,both,3.78,3.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.65,,,,2.23,3.08
NF-TRIAZOLAM ORAL TABLET 0.25MG,250,RC,,,,both,3.78,3.4,Cigna,Default,Percent of Total Billed Charges,2.23,,,,2.23,3.08
NF-TRIAZOLAM ORAL TABLET 0.25MG,250,RC,,,,both,3.78,3.4,United Healthcare,Default,Fee Schedule,3.08,,,,2.23,3.08
NF-TYLENOL PM ES SYR 500MG-25MG/15ML,637,RC,,,,both,0.1,0.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.07,,,,0.06,0.08
NF-TYLENOL PM ES SYR 500MG-25MG/15ML,637,RC,,,,both,0.1,0.09,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.08
NF-TYLENOL PM ES SYR 500MG-25MG/15ML,637,RC,,,,both,0.1,0.09,United Healthcare,Default,Fee Schedule,0.08,,,,0.06,0.08
NF-TYLENOL PM EXTRA STRENGTH TABLET,250,RC,,,,both,0.45,0.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.32,,,,0.27,0.37
NF-TYLENOL PM EXTRA STRENGTH TABLET,250,RC,,,,both,0.45,0.41,Cigna,Default,Percent of Total Billed Charges,0.27,,,,0.27,0.37
NF-TYLENOL PM EXTRA STRENGTH TABLET,250,RC,,,,both,0.45,0.41,United Healthcare,Default,Fee Schedule,0.37,,,,0.27,0.37
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,250,RC,,,,both,9.83,8.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.88,,,,5.8,8.02
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,250,RC,,,,both,9.83,8.85,Cigna,Default,Percent of Total Billed Charges,5.8,,,,5.8,8.02
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,250,RC,,,,both,9.83,8.85,United Healthcare,Default,Fee Schedule,8.02,,,,5.8,8.02
NF-INCRUSE ELLIPTA INH PWD 62.5MCG/1ACT,250,RC,,,,both,48.51,43.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.96,,,,28.62,39.58
NF-INCRUSE ELLIPTA INH PWD 62.5MCG/1ACT,250,RC,,,,both,48.51,43.66,Cigna,Default,Percent of Total Billed Charges,28.62,,,,28.62,39.58
NF-INCRUSE ELLIPTA INH PWD 62.5MCG/1ACT,250,RC,,,,both,48.51,43.66,United Healthcare,Default,Fee Schedule,39.58,,,,28.62,39.58
NF-JANUVIA ORAL TABLET 50MG,250,RC,,,,both,88.45,79.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.92,,,,52.19,72.18
NF-JANUVIA ORAL TABLET 50MG,250,RC,,,,both,88.45,79.61,Cigna,Default,Percent of Total Billed Charges,52.19,,,,52.19,72.18
NF-JANUVIA ORAL TABLET 50MG,250,RC,,,,both,88.45,79.61,United Healthcare,Default,Fee Schedule,72.18,,,,52.19,72.18
NF-VYVANSE CAP 70MG,250,RC,,,,both,29.53,26.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.67,,,,17.42,24.1
NF-VYVANSE CAP 70MG,250,RC,,,,both,29.53,26.58,Cigna,Default,Percent of Total Billed Charges,17.42,,,,17.42,24.1
NF-VYVANSE CAP 70MG,250,RC,,,,both,29.53,26.58,United Healthcare,Default,Fee Schedule,24.1,,,,17.42,24.1
NF-ADDERALL TAB 30MG,250,RC,,,,both,33.77,30.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.64,,,,19.92,27.56
NF-ADDERALL TAB 30MG,250,RC,,,,both,33.77,30.39,Cigna,Default,Percent of Total Billed Charges,19.92,,,,19.92,27.56
NF-ADDERALL TAB 30MG,250,RC,,,,both,33.77,30.39,United Healthcare,Default,Fee Schedule,27.56,,,,19.92,27.56
"NF-PALIPERIDONE ORAL TABLET, ER 6MG",250,RC,,,,both,122.11,109.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.48,,,,72.04,99.64
"NF-PALIPERIDONE ORAL TABLET, ER 6MG",250,RC,,,,both,122.11,109.9,Cigna,Default,Percent of Total Billed Charges,72.04,,,,72.04,99.64
"NF-PALIPERIDONE ORAL TABLET, ER 6MG",250,RC,,,,both,122.11,109.9,United Healthcare,Default,Fee Schedule,99.64,,,,72.04,99.64
NF-LACTASE ENZYME ORAL TABLET 3000U,250,RC,,,,both,0.29,0.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.2,,,,0.17,0.24
NF-LACTASE ENZYME ORAL TABLET 3000U,250,RC,,,,both,0.29,0.26,Cigna,Default,Percent of Total Billed Charges,0.17,,,,0.17,0.24
NF-LACTASE ENZYME ORAL TABLET 3000U,250,RC,,,,both,0.29,0.26,United Healthcare,Default,Fee Schedule,0.24,,,,0.17,0.24
NF-SYSTANE OPHTH SOLUTION,250,RC,,,,both,2.34,2.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.64,,,,1.38,1.91
NF-SYSTANE OPHTH SOLUTION,250,RC,,,,both,2.34,2.11,Cigna,Default,Percent of Total Billed Charges,1.38,,,,1.38,1.91
NF-SYSTANE OPHTH SOLUTION,250,RC,,,,both,2.34,2.11,United Healthcare,Default,Fee Schedule,1.91,,,,1.38,1.91
NF-OMEGA-3 KRILL OIL CAPSULE LIQUID FILL,250,RC,,,,both,1.15,1.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.8,,,,0.68,0.94
NF-OMEGA-3 KRILL OIL CAPSULE LIQUID FILL,250,RC,,,,both,1.15,1.04,Cigna,Default,Percent of Total Billed Charges,0.68,,,,0.68,0.94
NF-OMEGA-3 KRILL OIL CAPSULE LIQUID FILL,250,RC,,,,both,1.15,1.04,United Healthcare,Default,Fee Schedule,0.94,,,,0.68,0.94
NF-CAPTOPRIL ORAL TABLET 100MG,250,RC,,,,both,15.23,13.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.66,,,,8.99,12.43
NF-CAPTOPRIL ORAL TABLET 100MG,250,RC,,,,both,15.23,13.71,Cigna,Default,Percent of Total Billed Charges,8.99,,,,8.99,12.43
NF-CAPTOPRIL ORAL TABLET 100MG,250,RC,,,,both,15.23,13.71,United Healthcare,Default,Fee Schedule,12.43,,,,8.99,12.43
NF-WELLBUTRIN ORAL TABLET 100MG,250,RC,,,,both,7.44,6.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.21,,,,4.39,6.07
NF-WELLBUTRIN ORAL TABLET 100MG,250,RC,,,,both,7.44,6.7,Cigna,Default,Percent of Total Billed Charges,4.39,,,,4.39,6.07
NF-WELLBUTRIN ORAL TABLET 100MG,250,RC,,,,both,7.44,6.7,United Healthcare,Default,Fee Schedule,6.07,,,,4.39,6.07
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.82,,,,8.28,11.45
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,Cigna,Default,Percent of Total Billed Charges,8.28,,,,8.28,11.45
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,United Healthcare,Default,Fee Schedule,11.45,,,,8.28,11.45
NF-PROPAFENONE HCL CAP ER 425MG,250,RC,,,,both,32.6,29.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.82,,,,19.23,26.6
NF-PROPAFENONE HCL CAP ER 425MG,250,RC,,,,both,32.6,29.34,Cigna,Default,Percent of Total Billed Charges,19.23,,,,19.23,26.6
NF-PROPAFENONE HCL CAP ER 425MG,250,RC,,,,both,32.6,29.34,United Healthcare,Default,Fee Schedule,26.6,,,,19.23,26.6
NF-ACARBOSE ORAL TABLET 25MG,250,RC,,,,both,3.64,3.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.55,,,,2.15,2.97
NF-ACARBOSE ORAL TABLET 25MG,250,RC,,,,both,3.64,3.28,Cigna,Default,Percent of Total Billed Charges,2.15,,,,2.15,2.97
NF-ACARBOSE ORAL TABLET 25MG,250,RC,,,,both,3.64,3.28,United Healthcare,Default,Fee Schedule,2.97,,,,2.15,2.97
NF-ACARBOSE ORAL TABLET 25MG,250,RC,,,,both,3.64,3.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.55,,,,2.15,2.97
NF-ACARBOSE ORAL TABLET 25MG,250,RC,,,,both,3.64,3.28,Cigna,Default,Percent of Total Billed Charges,2.15,,,,2.15,2.97
NF-ACARBOSE ORAL TABLET 25MG,250,RC,,,,both,3.64,3.28,United Healthcare,Default,Fee Schedule,2.97,,,,2.15,2.97
NF-GLIPIZIDE ORAL TAB ER 10MG,250,RC,,,,both,3.22,2.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.25,,,,1.9,2.63
NF-GLIPIZIDE ORAL TAB ER 10MG,250,RC,,,,both,3.22,2.9,Cigna,Default,Percent of Total Billed Charges,1.9,,,,1.9,2.63
NF-GLIPIZIDE ORAL TAB ER 10MG,250,RC,,,,both,3.22,2.9,United Healthcare,Default,Fee Schedule,2.63,,,,1.9,2.63
NF-MYRBETRIQ ORAL TABLET 25MG,250,RC,,,,both,61.49,55.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.04,,,,36.28,50.18
NF-MYRBETRIQ ORAL TABLET 25MG,250,RC,,,,both,61.49,55.34,Cigna,Default,Percent of Total Billed Charges,36.28,,,,36.28,50.18
NF-MYRBETRIQ ORAL TABLET 25MG,250,RC,,,,both,61.49,55.34,United Healthcare,Default,Fee Schedule,50.18,,,,36.28,50.18
NF-ASMANEX TWIST INH/NEB POWDER 220MCG/A,250,RC,,,,both,739.36,665.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,517.55,,,,436.22,603.32
NF-ASMANEX TWIST INH/NEB POWDER 220MCG/A,250,RC,,,,both,739.36,665.42,Cigna,Default,Percent of Total Billed Charges,436.22,,,,436.22,603.32
NF-ASMANEX TWIST INH/NEB POWDER 220MCG/A,250,RC,,,,both,739.36,665.42,United Healthcare,Default,Fee Schedule,603.32,,,,436.22,603.32
NF-CANNABIDIOL SOLN 100MG/1ML,250,RC,,,,both,59.28,53.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.5,,,,34.98,48.37
NF-CANNABIDIOL SOLN 100MG/1ML,250,RC,,,,both,59.28,53.35,Cigna,Default,Percent of Total Billed Charges,34.98,,,,34.98,48.37
NF-CANNABIDIOL SOLN 100MG/1ML,250,RC,,,,both,59.28,53.35,United Healthcare,Default,Fee Schedule,48.37,,,,34.98,48.37
OSELTAMIVIR 30MG CAP (TAMIFLU),637,RC,,,,both,60.97,54.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.68,,,,35.97,49.75
OSELTAMIVIR 30MG CAP (TAMIFLU),637,RC,,,,both,60.97,54.87,Cigna,Default,Percent of Total Billed Charges,35.97,,,,35.97,49.75
OSELTAMIVIR 30MG CAP (TAMIFLU),637,RC,,,,both,60.97,54.87,United Healthcare,Default,Fee Schedule,49.75,,,,35.97,49.75
NF-HYOSCYAMINE SULFATE DISINTEG TAB 0.12,637,RC,,,,both,2.28,2.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.6,,,,1.35,1.86
NF-HYOSCYAMINE SULFATE DISINTEG TAB 0.12,637,RC,,,,both,2.28,2.05,Cigna,Default,Percent of Total Billed Charges,1.35,,,,1.35,1.86
NF-HYOSCYAMINE SULFATE DISINTEG TAB 0.12,637,RC,,,,both,2.28,2.05,United Healthcare,Default,Fee Schedule,1.86,,,,1.35,1.86
NF-CO-Q-10 ORAL LIQUID CAPSULE 100MG,250,RC,,,,both,0.89,0.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.62,,,,0.53,0.73
NF-CO-Q-10 ORAL LIQUID CAPSULE 100MG,250,RC,,,,both,0.89,0.8,Cigna,Default,Percent of Total Billed Charges,0.53,,,,0.53,0.73
NF-CO-Q-10 ORAL LIQUID CAPSULE 100MG,250,RC,,,,both,0.89,0.8,United Healthcare,Default,Fee Schedule,0.73,,,,0.53,0.73
NF-JOINT BOOST ORAL TABLET,250,RC,,,,both,0.21,0.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.15,,,,0.12,0.17
NF-JOINT BOOST ORAL TABLET,250,RC,,,,both,0.21,0.19,Cigna,Default,Percent of Total Billed Charges,0.12,,,,0.12,0.17
NF-JOINT BOOST ORAL TABLET,250,RC,,,,both,0.21,0.19,United Healthcare,Default,Fee Schedule,0.17,,,,0.12,0.17
NF-ACCUPRIL ORAL TABLET 40MG,250,RC,,,,both,7.92,7.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.54,,,,4.67,6.46
NF-ACCUPRIL ORAL TABLET 40MG,250,RC,,,,both,7.92,7.13,Cigna,Default,Percent of Total Billed Charges,4.67,,,,4.67,6.46
NF-ACCUPRIL ORAL TABLET 40MG,250,RC,,,,both,7.92,7.13,United Healthcare,Default,Fee Schedule,6.46,,,,4.67,6.46
NF-SIMVASTATIN ORAL TABLET 20MG,250,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 20MG,250,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 20MG,250,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
NF-BACTRIM DS ORAL TABLET 800MG-160MG,637,RC,,,,both,12.48,11.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.74,,,,7.36,10.18
NF-BACTRIM DS ORAL TABLET 800MG-160MG,637,RC,,,,both,12.48,11.23,Cigna,Default,Percent of Total Billed Charges,7.36,,,,7.36,10.18
NF-BACTRIM DS ORAL TABLET 800MG-160MG,637,RC,,,,both,12.48,11.23,United Healthcare,Default,Fee Schedule,10.18,,,,7.36,10.18
NF-RAPAFLO CAP 8MG,250,RC,,,,both,41.84,37.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,29.29,,,,24.69,34.14
NF-RAPAFLO CAP 8MG,250,RC,,,,both,41.84,37.66,Cigna,Default,Percent of Total Billed Charges,24.69,,,,24.69,34.14
NF-RAPAFLO CAP 8MG,250,RC,,,,both,41.84,37.66,United Healthcare,Default,Fee Schedule,34.14,,,,24.69,34.14
NF-TRESIBA SUBQ SOLN 100U/1ML,250,RC,,,,both,162.7,146.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,113.89,,,,95.99,132.76
NF-TRESIBA SUBQ SOLN 100U/1ML,250,RC,,,,both,162.7,146.43,Cigna,Default,Percent of Total Billed Charges,95.99,,,,95.99,132.76
NF-TRESIBA SUBQ SOLN 100U/1ML,250,RC,,,,both,162.7,146.43,United Healthcare,Default,Fee Schedule,132.76,,,,95.99,132.76
NF-BYSTOLIC ORAL TABLET 10MG,250,RC,,,,both,22.92,20.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.04,,,,13.52,18.7
NF-BYSTOLIC ORAL TABLET 10MG,250,RC,,,,both,22.92,20.63,Cigna,Default,Percent of Total Billed Charges,13.52,,,,13.52,18.7
NF-BYSTOLIC ORAL TABLET 10MG,250,RC,,,,both,22.92,20.63,United Healthcare,Default,Fee Schedule,18.7,,,,13.52,18.7
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,28.1,25.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.67,,,,16.58,22.93
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,28.1,25.29,Cigna,Default,Percent of Total Billed Charges,16.58,,,,16.58,22.93
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,28.1,25.29,United Healthcare,Default,Fee Schedule,22.93,,,,16.58,22.93
"NF-CREON 24,000 UNITS CAP",250,RC,,,,both,31.78,28.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.25,,,,18.75,25.93
"NF-CREON 24,000 UNITS CAP",250,RC,,,,both,31.78,28.6,Cigna,Default,Percent of Total Billed Charges,18.75,,,,18.75,25.93
"NF-CREON 24,000 UNITS CAP",250,RC,,,,both,31.78,28.6,United Healthcare,Default,Fee Schedule,25.93,,,,18.75,25.93
NF-TRANDOLAPRIL ORAL TABLET 4MG,250,RC,,,,both,4.6,4.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.22,,,,2.71,3.75
NF-TRANDOLAPRIL ORAL TABLET 4MG,250,RC,,,,both,4.6,4.14,Cigna,Default,Percent of Total Billed Charges,2.71,,,,2.71,3.75
NF-TRANDOLAPRIL ORAL TABLET 4MG,250,RC,,,,both,4.6,4.14,United Healthcare,Default,Fee Schedule,3.75,,,,2.71,3.75
NF-HALCION ORAL TABLET 0.25MG,250,RC,,,,both,26.84,24.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.79,,,,15.84,21.9
NF-HALCION ORAL TABLET 0.25MG,250,RC,,,,both,26.84,24.16,Cigna,Default,Percent of Total Billed Charges,15.84,,,,15.84,21.9
NF-HALCION ORAL TABLET 0.25MG,250,RC,,,,both,26.84,24.16,United Healthcare,Default,Fee Schedule,21.9,,,,15.84,21.9
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,75.74,68.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.02,,,,44.69,61.8
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,75.74,68.17,Cigna,Default,Percent of Total Billed Charges,44.69,,,,44.69,61.8
NF-JANUVIA ORAL TABLET 100MG,250,RC,,,,both,75.74,68.17,United Healthcare,Default,Fee Schedule,61.8,,,,44.69,61.8
NF-FLECTOR PATCH ER 1.3%,250,RC,,,,both,50.65,45.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.46,,,,29.88,41.33
NF-FLECTOR PATCH ER 1.3%,250,RC,,,,both,50.65,45.59,Cigna,Default,Percent of Total Billed Charges,29.88,,,,29.88,41.33
NF-FLECTOR PATCH ER 1.3%,250,RC,,,,both,50.65,45.59,United Healthcare,Default,Fee Schedule,41.33,,,,29.88,41.33
NF-BUPROPION HCL ORAL TABLET 75MG,250,RC,,,,both,3.18,2.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.23,,,,1.88,2.59
NF-BUPROPION HCL ORAL TABLET 75MG,250,RC,,,,both,3.18,2.86,Cigna,Default,Percent of Total Billed Charges,1.88,,,,1.88,2.59
NF-BUPROPION HCL ORAL TABLET 75MG,250,RC,,,,both,3.18,2.86,United Healthcare,Default,Fee Schedule,2.59,,,,1.88,2.59
NF-IBRANCE CAP 125MG,250,RC,,,,both,2845.57,2561.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1991.9,,,,1678.89,2321.99
NF-IBRANCE CAP 125MG,250,RC,,,,both,2845.57,2561.01,Cigna,Default,Percent of Total Billed Charges,1678.89,,,,1678.89,2321.99
NF-IBRANCE CAP 125MG,250,RC,,,,both,2845.57,2561.01,United Healthcare,Default,Fee Schedule,2321.99,,,,1678.89,2321.99
NF-LIPITOR TAB 80MG,250,RC,,,,both,75.27,67.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.69,,,,44.41,61.42
NF-LIPITOR TAB 80MG,250,RC,,,,both,75.27,67.74,Cigna,Default,Percent of Total Billed Charges,44.41,,,,44.41,61.42
NF-LIPITOR TAB 80MG,250,RC,,,,both,75.27,67.74,United Healthcare,Default,Fee Schedule,61.42,,,,44.41,61.42
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,401,RC,,,,both,0.04,0.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.03,,,,0.02,0.03
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,401,RC,,,,both,0.04,0.04,Cigna,Default,Percent of Total Billed Charges,0.02,,,,0.02,0.03
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,401,RC,,,,both,0.04,0.04,United Healthcare,Default,Fee Schedule,0.03,,,,0.02,0.03
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,250,RC,,,,both,146.79,132.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,102.75,,,,86.61,119.78
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,250,RC,,,,both,146.79,132.11,Cigna,Default,Percent of Total Billed Charges,86.61,,,,86.61,119.78
NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,250,RC,,,,both,146.79,132.11,United Healthcare,Default,Fee Schedule,119.78,,,,86.61,119.78
NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,50.98,45.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.69,,,,30.08,41.6
NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,50.98,45.88,Cigna,Default,Percent of Total Billed Charges,30.08,,,,30.08,41.6
NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,50.98,45.88,United Healthcare,Default,Fee Schedule,41.6,,,,30.08,41.6
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.27,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,Cigna,Default,Percent of Total Billed Charges,54.17,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,United Healthcare,Default,Fee Schedule,74.93,,,,54.17,74.93
NF-VENTOLIN HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,12.26,11.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.58,,,,7.23,10
NF-VENTOLIN HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,12.26,11.03,Cigna,Default,Percent of Total Billed Charges,7.23,,,,7.23,10
NF-VENTOLIN HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,12.26,11.03,United Healthcare,Default,Fee Schedule,10,,,,7.23,10
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,168.11,151.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,117.68,,,,99.18,137.18
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,168.11,151.3,Cigna,Default,Percent of Total Billed Charges,99.18,,,,99.18,137.18
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,168.11,151.3,United Healthcare,Default,Fee Schedule,137.18,,,,99.18,137.18
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,153.98,138.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,107.79,,,,90.85,125.65
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,153.98,138.58,Cigna,Default,Percent of Total Billed Charges,90.85,,,,90.85,125.65
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,153.98,138.58,United Healthcare,Default,Fee Schedule,125.65,,,,90.85,125.65
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,106.39,95.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,74.47,,,,62.77,86.81
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,106.39,95.75,Cigna,Default,Percent of Total Billed Charges,62.77,,,,62.77,86.81
NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,250,RC,,,,both,106.39,95.75,United Healthcare,Default,Fee Schedule,86.81,,,,62.77,86.81
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.27,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,Cigna,Default,Percent of Total Billed Charges,54.17,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,United Healthcare,Default,Fee Schedule,74.93,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,64.27,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,Cigna,Default,Percent of Total Billed Charges,54.17,,,,54.17,74.93
NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,250,RC,,,,both,91.82,82.64,United Healthcare,Default,Fee Schedule,74.93,,,,54.17,74.93
NF-PROPAFENONE HCL CAP ER 425MG,250,RC,,,,both,40,36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28,,,,23.6,32.64
NF-PROPAFENONE HCL CAP ER 425MG,250,RC,,,,both,40,36,Cigna,Default,Percent of Total Billed Charges,23.6,,,,23.6,32.64
NF-PROPAFENONE HCL CAP ER 425MG,250,RC,,,,both,40,36,United Healthcare,Default,Fee Schedule,32.64,,,,23.6,32.64
NF-DILTIAZEM HCL CAPSULE 90MG,250,RC,,,,both,14.5,13.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.15,,,,8.56,11.83
NF-DILTIAZEM HCL CAPSULE 90MG,250,RC,,,,both,14.5,13.05,Cigna,Default,Percent of Total Billed Charges,8.56,,,,8.56,11.83
NF-DILTIAZEM HCL CAPSULE 90MG,250,RC,,,,both,14.5,13.05,United Healthcare,Default,Fee Schedule,11.83,,,,8.56,11.83
NF-MEMANTINE HCL ORAL TABLET 10MG,250,RC,,,,both,24.41,21.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.09,,,,14.4,19.92
NF-MEMANTINE HCL ORAL TABLET 10MG,250,RC,,,,both,24.41,21.97,Cigna,Default,Percent of Total Billed Charges,14.4,,,,14.4,19.92
NF-MEMANTINE HCL ORAL TABLET 10MG,250,RC,,,,both,24.41,21.97,United Healthcare,Default,Fee Schedule,19.92,,,,14.4,19.92
ALBUTEROL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,12.5,11.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.75,,,,7.38,10.2
ALBUTEROL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,12.5,11.25,Cigna,Default,Percent of Total Billed Charges,7.38,,,,7.38,10.2
ALBUTEROL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,12.5,11.25,United Healthcare,Default,Fee Schedule,10.2,,,,7.38,10.2
IPRATROP/ALB RESP INH 100MCG-20MCG/ACT,250,RC,,,,both,21.04,18.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.73,,,,12.41,17.17
IPRATROP/ALB RESP INH 100MCG-20MCG/ACT,250,RC,,,,both,21.04,18.94,Cigna,Default,Percent of Total Billed Charges,12.41,,,,12.41,17.17
IPRATROP/ALB RESP INH 100MCG-20MCG/ACT,250,RC,,,,both,21.04,18.94,United Healthcare,Default,Fee Schedule,17.17,,,,12.41,17.17
NF-HYZAAR ORAL TABLET 50MG-12.5MG,250,RC,,,,both,8.19,7.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.73,,,,4.83,6.68
NF-HYZAAR ORAL TABLET 50MG-12.5MG,250,RC,,,,both,8.19,7.37,Cigna,Default,Percent of Total Billed Charges,4.83,,,,4.83,6.68
NF-HYZAAR ORAL TABLET 50MG-12.5MG,250,RC,,,,both,8.19,7.37,United Healthcare,Default,Fee Schedule,6.68,,,,4.83,6.68
NF-DONEPEZIL HCL ORAL TABLET 10MG,250,RC,,,,both,31.15,28.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.8,,,,18.38,25.42
NF-DONEPEZIL HCL ORAL TABLET 10MG,250,RC,,,,both,31.15,28.04,Cigna,Default,Percent of Total Billed Charges,18.38,,,,18.38,25.42
NF-DONEPEZIL HCL ORAL TABLET 10MG,250,RC,,,,both,31.15,28.04,United Healthcare,Default,Fee Schedule,25.42,,,,18.38,25.42
NF-VITAMIN E TABLET 100IU,250,RC,,,,both,0.24,0.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.17,,,,0.14,0.2
NF-VITAMIN E TABLET 100IU,250,RC,,,,both,0.24,0.22,Cigna,Default,Percent of Total Billed Charges,0.14,,,,0.14,0.2
NF-VITAMIN E TABLET 100IU,250,RC,,,,both,0.24,0.22,United Healthcare,Default,Fee Schedule,0.2,,,,0.14,0.2
INDOCYANINE GREEN INJ 25MG,250,RC,,,,both,730.1,657.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,511.07,,,,430.76,595.76
INDOCYANINE GREEN INJ 25MG,250,RC,,,,both,730.1,657.09,Cigna,Default,Percent of Total Billed Charges,430.76,,,,430.76,595.76
INDOCYANINE GREEN INJ 25MG,250,RC,,,,both,730.1,657.09,United Healthcare,Default,Fee Schedule,595.76,,,,430.76,595.76
NF-K-PHOS ORIGINAL TAB 500MG,250,RC,,,,both,2.22,2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.55,,,,1.31,1.81
NF-K-PHOS ORIGINAL TAB 500MG,250,RC,,,,both,2.22,2,Cigna,Default,Percent of Total Billed Charges,1.31,,,,1.31,1.81
NF-K-PHOS ORIGINAL TAB 500MG,250,RC,,,,both,2.22,2,United Healthcare,Default,Fee Schedule,1.81,,,,1.31,1.81
NF-VIRT-GARD TAB 1MG-2.2MG-25MG,250,RC,,,,both,2,1.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.4,,,,1.18,1.63
NF-VIRT-GARD TAB 1MG-2.2MG-25MG,250,RC,,,,both,2,1.8,Cigna,Default,Percent of Total Billed Charges,1.18,,,,1.18,1.63
NF-VIRT-GARD TAB 1MG-2.2MG-25MG,250,RC,,,,both,2,1.8,United Healthcare,Default,Fee Schedule,1.63,,,,1.18,1.63
HALOPERIDOL DECAN 50MG/ML INJ,250,RC,,,,both,122.55,110.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,85.78,,,,72.3,100
HALOPERIDOL DECAN 50MG/ML INJ,250,RC,,,,both,122.55,110.3,Cigna,Default,Percent of Total Billed Charges,72.3,,,,72.3,100
HALOPERIDOL DECAN 50MG/ML INJ,250,RC,,,,both,122.55,110.3,United Healthcare,Default,Fee Schedule,100,,,,72.3,100
RAPID INTUBATION KIT,250,RC,,,,both,154.8,139.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.36,,,,91.33,126.32
RAPID INTUBATION KIT,250,RC,,,,both,154.8,139.32,Cigna,Default,Percent of Total Billed Charges,91.33,,,,91.33,126.32
RAPID INTUBATION KIT,250,RC,,,,both,154.8,139.32,United Healthcare,Default,Fee Schedule,126.32,,,,91.33,126.32
NF-FLECTOR PATCH ER 1.3%,250,RC,,,,both,101.62,91.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,71.13,,,,59.96,82.92
NF-FLECTOR PATCH ER 1.3%,250,RC,,,,both,101.62,91.46,Cigna,Default,Percent of Total Billed Charges,59.96,,,,59.96,82.92
NF-FLECTOR PATCH ER 1.3%,250,RC,,,,both,101.62,91.46,United Healthcare,Default,Fee Schedule,82.92,,,,59.96,82.92
NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,637,RC,,,,both,33.16,29.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.21,,,,19.56,27.06
NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,637,RC,,,,both,33.16,29.84,Cigna,Default,Percent of Total Billed Charges,19.56,,,,19.56,27.06
NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,637,RC,,,,both,33.16,29.84,United Healthcare,Default,Fee Schedule,27.06,,,,19.56,27.06
NF-MORPHINE SULFATE CAP ER 20MG,637,RC,,,,both,20.92,18.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.64,,,,12.34,17.07
NF-MORPHINE SULFATE CAP ER 20MG,637,RC,,,,both,20.92,18.83,Cigna,Default,Percent of Total Billed Charges,12.34,,,,12.34,17.07
NF-MORPHINE SULFATE CAP ER 20MG,637,RC,,,,both,20.92,18.83,United Healthcare,Default,Fee Schedule,17.07,,,,12.34,17.07
NF-MORPHINE SULFATE CAP ER 20MG,250,RC,,,,both,21.43,19.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15,,,,12.64,17.49
NF-MORPHINE SULFATE CAP ER 20MG,250,RC,,,,both,21.43,19.29,Cigna,Default,Percent of Total Billed Charges,12.64,,,,12.64,17.49
NF-MORPHINE SULFATE CAP ER 20MG,250,RC,,,,both,21.43,19.29,United Healthcare,Default,Fee Schedule,17.49,,,,12.64,17.49
NF-TIMOLOL MALEATE OPHTH GFS 0.5%,250,RC,,,,both,73.75,66.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.62,,,,43.51,60.18
NF-TIMOLOL MALEATE OPHTH GFS 0.5%,250,RC,,,,both,73.75,66.38,Cigna,Default,Percent of Total Billed Charges,43.51,,,,43.51,60.18
NF-TIMOLOL MALEATE OPHTH GFS 0.5%,250,RC,,,,both,73.75,66.38,United Healthcare,Default,Fee Schedule,60.18,,,,43.51,60.18
NF-DOXEPIN HCL CAP 10MG,250,RC,,,,both,0.81,0.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.57,,,,0.48,0.66
NF-DOXEPIN HCL CAP 10MG,250,RC,,,,both,0.81,0.73,Cigna,Default,Percent of Total Billed Charges,0.48,,,,0.48,0.66
NF-DOXEPIN HCL CAP 10MG,250,RC,,,,both,0.81,0.73,United Healthcare,Default,Fee Schedule,0.66,,,,0.48,0.66
NF-PROTEGRA ANTIOXIDANT CAPSULE,250,RC,,,,both,0.42,0.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.29,,,,0.25,0.34
NF-PROTEGRA ANTIOXIDANT CAPSULE,250,RC,,,,both,0.42,0.38,Cigna,Default,Percent of Total Billed Charges,0.25,,,,0.25,0.34
NF-PROTEGRA ANTIOXIDANT CAPSULE,250,RC,,,,both,0.42,0.38,United Healthcare,Default,Fee Schedule,0.34,,,,0.25,0.34
NF-GERITOL COMPLETE ORAL TABLET,250,RC,,,,both,0.36,0.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.25,,,,0.21,0.29
NF-GERITOL COMPLETE ORAL TABLET,250,RC,,,,both,0.36,0.32,Cigna,Default,Percent of Total Billed Charges,0.21,,,,0.21,0.29
NF-GERITOL COMPLETE ORAL TABLET,250,RC,,,,both,0.36,0.32,United Healthcare,Default,Fee Schedule,0.29,,,,0.21,0.29
NF-ZINC ACETATE CAP 50MG,250,RC,,,,both,13.87,12.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.71,,,,8.18,11.32
NF-ZINC ACETATE CAP 50MG,250,RC,,,,both,13.87,12.48,Cigna,Default,Percent of Total Billed Charges,8.18,,,,8.18,11.32
NF-ZINC ACETATE CAP 50MG,250,RC,,,,both,13.87,12.48,United Healthcare,Default,Fee Schedule,11.32,,,,8.18,11.32
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,637,RC,,,,both,4.42,3.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.09,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,637,RC,,,,both,4.42,3.98,Cigna,Default,Percent of Total Billed Charges,2.61,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,637,RC,,,,both,4.42,3.98,United Healthcare,Default,Fee Schedule,3.61,,,,2.61,3.61
NF-PREDNISOLONE ACETATE OPHTH SUSP 0.12%,250,RC,,,,both,8.71,7.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.1,,,,5.14,7.11
NF-PREDNISOLONE ACETATE OPHTH SUSP 0.12%,250,RC,,,,both,8.71,7.84,Cigna,Default,Percent of Total Billed Charges,5.14,,,,5.14,7.11
NF-PREDNISOLONE ACETATE OPHTH SUSP 0.12%,250,RC,,,,both,8.71,7.84,United Healthcare,Default,Fee Schedule,7.11,,,,5.14,7.11
NF-ENTRESTO ORAL TABLET 24MG-26MG,250,RC,,,,both,43.58,39.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.51,,,,25.71,35.56
NF-ENTRESTO ORAL TABLET 24MG-26MG,250,RC,,,,both,43.58,39.22,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.56
NF-ENTRESTO ORAL TABLET 24MG-26MG,250,RC,,,,both,43.58,39.22,United Healthcare,Default,Fee Schedule,35.56,,,,25.71,35.56
NF-EFFEXOR XR EXTENDED RELEASE CAPSULE 7,250,RC,,,,both,29.84,26.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.89,,,,17.61,24.35
NF-EFFEXOR XR EXTENDED RELEASE CAPSULE 7,250,RC,,,,both,29.84,26.86,Cigna,Default,Percent of Total Billed Charges,17.61,,,,17.61,24.35
NF-EFFEXOR XR EXTENDED RELEASE CAPSULE 7,250,RC,,,,both,29.84,26.86,United Healthcare,Default,Fee Schedule,24.35,,,,17.61,24.35
NF-DILANTIN CAP ER 100MG,250,RC,,,,both,2.62,2.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.83,,,,1.55,2.14
NF-DILANTIN CAP ER 100MG,250,RC,,,,both,2.62,2.36,Cigna,Default,Percent of Total Billed Charges,1.55,,,,1.55,2.14
NF-DILANTIN CAP ER 100MG,250,RC,,,,both,2.62,2.36,United Healthcare,Default,Fee Schedule,2.14,,,,1.55,2.14
NF-FELODIPINE EXTENDED RELEASE TABLET 10,250,RC,,,,both,10.86,9.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.6,,,,6.41,8.86
NF-FELODIPINE EXTENDED RELEASE TABLET 10,250,RC,,,,both,10.86,9.77,Cigna,Default,Percent of Total Billed Charges,6.41,,,,6.41,8.86
NF-FELODIPINE EXTENDED RELEASE TABLET 10,250,RC,,,,both,10.86,9.77,United Healthcare,Default,Fee Schedule,8.86,,,,6.41,8.86
NF-CARTIA XT ORAL 24 HR CAP ER 240MG,250,RC,,,,both,8.2,7.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.74,,,,4.84,6.69
NF-CARTIA XT ORAL 24 HR CAP ER 240MG,250,RC,,,,both,8.2,7.38,Cigna,Default,Percent of Total Billed Charges,4.84,,,,4.84,6.69
NF-CARTIA XT ORAL 24 HR CAP ER 240MG,250,RC,,,,both,8.2,7.38,United Healthcare,Default,Fee Schedule,6.69,,,,4.84,6.69
NF-JANUVIA ORAL TABLET 100MG,637,RC,,,,both,75.74,68.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,53.02,,,,44.69,61.8
NF-JANUVIA ORAL TABLET 100MG,637,RC,,,,both,75.74,68.17,Cigna,Default,Percent of Total Billed Charges,44.69,,,,44.69,61.8
NF-JANUVIA ORAL TABLET 100MG,637,RC,,,,both,75.74,68.17,United Healthcare,Default,Fee Schedule,61.8,,,,44.69,61.8
NF-BICALUTAMIDE ORAL TABLET 50MG,250,RC,,,,both,65.86,59.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.1,,,,38.86,53.74
NF-BICALUTAMIDE ORAL TABLET 50MG,250,RC,,,,both,65.86,59.27,Cigna,Default,Percent of Total Billed Charges,38.86,,,,38.86,53.74
NF-BICALUTAMIDE ORAL TABLET 50MG,250,RC,,,,both,65.86,59.27,United Healthcare,Default,Fee Schedule,53.74,,,,38.86,53.74
NF-FELODIPINE ORAL TAB ER 10MG,250,RC,,,,both,10.86,9.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.6,,,,6.41,8.86
NF-FELODIPINE ORAL TAB ER 10MG,250,RC,,,,both,10.86,9.77,Cigna,Default,Percent of Total Billed Charges,6.41,,,,6.41,8.86
NF-FELODIPINE ORAL TAB ER 10MG,250,RC,,,,both,10.86,9.77,United Healthcare,Default,Fee Schedule,8.86,,,,6.41,8.86
NF-SUMATRIPTAN SUCCINATE ORAL TABLET 25M,250,RC,,,,both,108.21,97.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,75.75,,,,63.84,88.3
NF-SUMATRIPTAN SUCCINATE ORAL TABLET 25M,250,RC,,,,both,108.21,97.39,Cigna,Default,Percent of Total Billed Charges,63.84,,,,63.84,88.3
NF-SUMATRIPTAN SUCCINATE ORAL TABLET 25M,250,RC,,,,both,108.21,97.39,United Healthcare,Default,Fee Schedule,88.3,,,,63.84,88.3
NF-MAGNESIUM OXIDE ORAL TABLET 400MG,637,RC,,,,both,0.36,0.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.25,,,,0.21,0.29
NF-MAGNESIUM OXIDE ORAL TABLET 400MG,637,RC,,,,both,0.36,0.32,Cigna,Default,Percent of Total Billed Charges,0.21,,,,0.21,0.29
NF-MAGNESIUM OXIDE ORAL TABLET 400MG,637,RC,,,,both,0.36,0.32,United Healthcare,Default,Fee Schedule,0.29,,,,0.21,0.29
NF-CINACALCET HCL ORAL TABLET 30MG,250,RC,,,,both,123.63,111.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,86.54,,,,72.94,100.88
NF-CINACALCET HCL ORAL TABLET 30MG,250,RC,,,,both,123.63,111.27,Cigna,Default,Percent of Total Billed Charges,72.94,,,,72.94,100.88
NF-CINACALCET HCL ORAL TABLET 30MG,250,RC,,,,both,123.63,111.27,United Healthcare,Default,Fee Schedule,100.88,,,,72.94,100.88
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,64.81,58.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,45.37,,,,38.24,52.88
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,64.81,58.33,Cigna,Default,Percent of Total Billed Charges,38.24,,,,38.24,52.88
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,64.81,58.33,United Healthcare,Default,Fee Schedule,52.88,,,,38.24,52.88
NF-QUINAPRIL HCL TAB 10MG,250,RC,,,,both,15.1,13.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.57,,,,8.91,12.32
NF-QUINAPRIL HCL TAB 10MG,250,RC,,,,both,15.1,13.59,Cigna,Default,Percent of Total Billed Charges,8.91,,,,8.91,12.32
NF-QUINAPRIL HCL TAB 10MG,250,RC,,,,both,15.1,13.59,United Healthcare,Default,Fee Schedule,12.32,,,,8.91,12.32
NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,250,RC,,,,both,6.71,6.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.7,,,,3.96,5.48
NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,250,RC,,,,both,6.71,6.04,Cigna,Default,Percent of Total Billed Charges,3.96,,,,3.96,5.48
NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,250,RC,,,,both,6.71,6.04,United Healthcare,Default,Fee Schedule,5.48,,,,3.96,5.48
NF-LOTRIMIN AF TOPICAL POWDER 2%,250,RC,,,,both,0.28,0.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.2,,,,0.17,0.23
NF-LOTRIMIN AF TOPICAL POWDER 2%,250,RC,,,,both,0.28,0.25,Cigna,Default,Percent of Total Billed Charges,0.17,,,,0.17,0.23
NF-LOTRIMIN AF TOPICAL POWDER 2%,250,RC,,,,both,0.28,0.25,United Healthcare,Default,Fee Schedule,0.23,,,,0.17,0.23
NF-NORTRIPTYLINE HCL AVPAK CAP 10MG,250,RC,,,,both,2.26,2.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.58,,,,1.33,1.84
NF-NORTRIPTYLINE HCL AVPAK CAP 10MG,250,RC,,,,both,2.26,2.03,Cigna,Default,Percent of Total Billed Charges,1.33,,,,1.33,1.84
NF-NORTRIPTYLINE HCL AVPAK CAP 10MG,250,RC,,,,both,2.26,2.03,United Healthcare,Default,Fee Schedule,1.84,,,,1.33,1.84
NF-FELODIPINE EXTENDED RELEASE TABLET 5M,250,RC,,,,both,6.04,5.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.23,,,,3.56,4.93
NF-FELODIPINE EXTENDED RELEASE TABLET 5M,250,RC,,,,both,6.04,5.44,Cigna,Default,Percent of Total Billed Charges,3.56,,,,3.56,4.93
NF-FELODIPINE EXTENDED RELEASE TABLET 5M,250,RC,,,,both,6.04,5.44,United Healthcare,Default,Fee Schedule,4.93,,,,3.56,4.93
PAMIDRONATE INJ 30MG/10ML,J2430,HCPCS,636,RC,,both,139.32,125.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,97.52,,,,82.2,113.69
PAMIDRONATE INJ 30MG/10ML,J2430,HCPCS,636,RC,,both,139.32,125.39,Cigna,Default,Percent of Total Billed Charges,82.2,,,,82.2,113.69
PAMIDRONATE INJ 30MG/10ML,J2430,HCPCS,636,RC,,both,139.32,125.39,United Healthcare,Default,Fee Schedule,113.69,,,,82.2,113.69
NF-LABETALOL HCL ORAL TABLET 300MG,250,RC,,,,both,4.08,3.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.86,,,,2.41,3.33
NF-LABETALOL HCL ORAL TABLET 300MG,250,RC,,,,both,4.08,3.67,Cigna,Default,Percent of Total Billed Charges,2.41,,,,2.41,3.33
NF-LABETALOL HCL ORAL TABLET 300MG,250,RC,,,,both,4.08,3.67,United Healthcare,Default,Fee Schedule,3.33,,,,2.41,3.33
NF-VENLAFAXINE HCL CAP ER 150MG,250,RC,,,,both,81.04,72.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,56.73,,,,47.81,66.13
NF-VENLAFAXINE HCL CAP ER 150MG,250,RC,,,,both,81.04,72.94,Cigna,Default,Percent of Total Billed Charges,47.81,,,,47.81,66.13
NF-VENLAFAXINE HCL CAP ER 150MG,250,RC,,,,both,81.04,72.94,United Healthcare,Default,Fee Schedule,66.13,,,,47.81,66.13
NF-VENLAFAXINE HCL ORAL TABLET 100MG,250,RC,,,,both,11.84,10.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.29,,,,6.99,9.66
NF-VENLAFAXINE HCL ORAL TABLET 100MG,250,RC,,,,both,11.84,10.66,Cigna,Default,Percent of Total Billed Charges,6.99,,,,6.99,9.66
NF-VENLAFAXINE HCL ORAL TABLET 100MG,250,RC,,,,both,11.84,10.66,United Healthcare,Default,Fee Schedule,9.66,,,,6.99,9.66
NF-ETHAMBUTOL HCL TAB 400MG,250,RC,,,,both,10.7,9.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.49,,,,6.31,8.73
NF-ETHAMBUTOL HCL TAB 400MG,250,RC,,,,both,10.7,9.63,Cigna,Default,Percent of Total Billed Charges,6.31,,,,6.31,8.73
NF-ETHAMBUTOL HCL TAB 400MG,250,RC,,,,both,10.7,9.63,United Healthcare,Default,Fee Schedule,8.73,,,,6.31,8.73
NF-RIFABUTIN CAP 150MG,250,RC,,,,both,18.6,16.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.02,,,,10.97,15.18
NF-RIFABUTIN CAP 150MG,250,RC,,,,both,18.6,16.74,Cigna,Default,Percent of Total Billed Charges,10.97,,,,10.97,15.18
NF-RIFABUTIN CAP 150MG,250,RC,,,,both,18.6,16.74,United Healthcare,Default,Fee Schedule,15.18,,,,10.97,15.18
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.05,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.03,0.04
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.05,0.05,Cigna,Default,Percent of Total Billed Charges,0.03,,,,0.03,0.04
NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,250,RC,,,,both,0.05,0.05,United Healthcare,Default,Fee Schedule,0.04,,,,0.03,0.04
NF-VITAL AF 1.2 CAL SUSP,250,RC,,,,both,0.13,0.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.09,,,,0.08,0.11
NF-VITAL AF 1.2 CAL SUSP,250,RC,,,,both,0.13,0.12,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-VITAL AF 1.2 CAL SUSP,250,RC,,,,both,0.13,0.12,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,250,RC,,,,both,16.68,15.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.68,,,,9.84,13.61
NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,250,RC,,,,both,16.68,15.01,Cigna,Default,Percent of Total Billed Charges,9.84,,,,9.84,13.61
NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,250,RC,,,,both,16.68,15.01,United Healthcare,Default,Fee Schedule,13.61,,,,9.84,13.61
NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,250,RC,,,,both,16.68,15.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.68,,,,9.84,13.61
NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,250,RC,,,,both,16.68,15.01,Cigna,Default,Percent of Total Billed Charges,9.84,,,,9.84,13.61
NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,250,RC,,,,both,16.68,15.01,United Healthcare,Default,Fee Schedule,13.61,,,,9.84,13.61
NF-FENOFIBRATE AVPAK ORAL TABLET 145MG,250,RC,,,,both,20.53,18.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.37,,,,12.11,16.75
NF-FENOFIBRATE AVPAK ORAL TABLET 145MG,250,RC,,,,both,20.53,18.48,Cigna,Default,Percent of Total Billed Charges,12.11,,,,12.11,16.75
NF-FENOFIBRATE AVPAK ORAL TABLET 145MG,250,RC,,,,both,20.53,18.48,United Healthcare,Default,Fee Schedule,16.75,,,,12.11,16.75
NF-LEVOCETIRIZINE DIHCL ORAL TABLET 5MG,250,RC,,,,both,12.31,11.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.62,,,,7.26,10.04
NF-LEVOCETIRIZINE DIHCL ORAL TABLET 5MG,250,RC,,,,both,12.31,11.08,Cigna,Default,Percent of Total Billed Charges,7.26,,,,7.26,10.04
NF-LEVOCETIRIZINE DIHCL ORAL TABLET 5MG,250,RC,,,,both,12.31,11.08,United Healthcare,Default,Fee Schedule,10.04,,,,7.26,10.04
NF-OXYMETAZOLINE HCL NASAL SPRAY 0.05%,250,RC,,,,both,1.41,1.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.99,,,,0.83,1.15
NF-OXYMETAZOLINE HCL NASAL SPRAY 0.05%,250,RC,,,,both,1.41,1.27,Cigna,Default,Percent of Total Billed Charges,0.83,,,,0.83,1.15
NF-OXYMETAZOLINE HCL NASAL SPRAY 0.05%,250,RC,,,,both,1.41,1.27,United Healthcare,Default,Fee Schedule,1.15,,,,0.83,1.15
NF-ELIQUIS TAB 5MG,250,RC,,,,both,37.67,33.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.37,,,,22.23,30.74
NF-ELIQUIS TAB 5MG,250,RC,,,,both,37.67,33.9,Cigna,Default,Percent of Total Billed Charges,22.23,,,,22.23,30.74
NF-ELIQUIS TAB 5MG,250,RC,,,,both,37.67,33.9,United Healthcare,Default,Fee Schedule,30.74,,,,22.23,30.74
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,250,RC,,,,both,15.35,13.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.74,,,,9.06,12.53
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,250,RC,,,,both,15.35,13.82,Cigna,Default,Percent of Total Billed Charges,9.06,,,,9.06,12.53
NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,250,RC,,,,both,15.35,13.82,United Healthcare,Default,Fee Schedule,12.53,,,,9.06,12.53
NF-SILODOSIN CAP 4MG,250,RC,,,,both,35.85,32.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.1,,,,21.15,29.25
NF-SILODOSIN CAP 4MG,250,RC,,,,both,35.85,32.27,Cigna,Default,Percent of Total Billed Charges,21.15,,,,21.15,29.25
NF-SILODOSIN CAP 4MG,250,RC,,,,both,35.85,32.27,United Healthcare,Default,Fee Schedule,29.25,,,,21.15,29.25
NF-CLARINEX ORAL TABLET 5MG,250,RC,,,,both,35.04,31.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.53,,,,20.67,28.59
NF-CLARINEX ORAL TABLET 5MG,250,RC,,,,both,35.04,31.54,Cigna,Default,Percent of Total Billed Charges,20.67,,,,20.67,28.59
NF-CLARINEX ORAL TABLET 5MG,250,RC,,,,both,35.04,31.54,United Healthcare,Default,Fee Schedule,28.59,,,,20.67,28.59
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.39,,,,0.33,0.46
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,Cigna,Default,Percent of Total Billed Charges,0.33,,,,0.33,0.46
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,United Healthcare,Default,Fee Schedule,0.46,,,,0.33,0.46
NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG,250,RC,,,,both,5.83,5.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.08,,,,3.44,4.76
NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG,250,RC,,,,both,5.83,5.25,Cigna,Default,Percent of Total Billed Charges,3.44,,,,3.44,4.76
NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG,250,RC,,,,both,5.83,5.25,United Healthcare,Default,Fee Schedule,4.76,,,,3.44,4.76
NF-CELEXA TAB 20MG,250,RC,,,,both,45.41,40.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.79,,,,26.79,37.05
NF-CELEXA TAB 20MG,250,RC,,,,both,45.41,40.87,Cigna,Default,Percent of Total Billed Charges,26.79,,,,26.79,37.05
NF-CELEXA TAB 20MG,250,RC,,,,both,45.41,40.87,United Healthcare,Default,Fee Schedule,37.05,,,,26.79,37.05
NF-ZOCOR ORAL TABLET 40MG,250,RC,,,,both,38.69,34.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.08,,,,22.83,31.57
NF-ZOCOR ORAL TABLET 40MG,250,RC,,,,both,38.69,34.82,Cigna,Default,Percent of Total Billed Charges,22.83,,,,22.83,31.57
NF-ZOCOR ORAL TABLET 40MG,250,RC,,,,both,38.69,34.82,United Healthcare,Default,Fee Schedule,31.57,,,,22.83,31.57
NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M,250,RC,,,,both,3.22,2.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.25,,,,1.9,2.63
NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M,250,RC,,,,both,3.22,2.9,Cigna,Default,Percent of Total Billed Charges,1.9,,,,1.9,2.63
NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M,250,RC,,,,both,3.22,2.9,United Healthcare,Default,Fee Schedule,2.63,,,,1.9,2.63
NF-EFFEXOR-XR CAP ER 150MG,250,RC,,,,both,44.29,39.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31,,,,26.13,36.14
NF-EFFEXOR-XR CAP ER 150MG,250,RC,,,,both,44.29,39.86,Cigna,Default,Percent of Total Billed Charges,26.13,,,,26.13,36.14
NF-EFFEXOR-XR CAP ER 150MG,250,RC,,,,both,44.29,39.86,United Healthcare,Default,Fee Schedule,36.14,,,,26.13,36.14
NF-ZOLMITRIPTAN DISINTEGRATING TAB 5MG,250,RC,,,,both,620.93,558.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,434.65,,,,366.35,506.68
NF-ZOLMITRIPTAN DISINTEGRATING TAB 5MG,250,RC,,,,both,620.93,558.84,Cigna,Default,Percent of Total Billed Charges,366.35,,,,366.35,506.68
NF-ZOLMITRIPTAN DISINTEGRATING TAB 5MG,250,RC,,,,both,620.93,558.84,United Healthcare,Default,Fee Schedule,506.68,,,,366.35,506.68
NF-ZOLMITRIPTAN ORAL TABLET 5MG,250,RC,,,,both,224.16,201.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,156.91,,,,132.25,182.91
NF-ZOLMITRIPTAN ORAL TABLET 5MG,250,RC,,,,both,224.16,201.74,Cigna,Default,Percent of Total Billed Charges,132.25,,,,132.25,182.91
NF-ZOLMITRIPTAN ORAL TABLET 5MG,250,RC,,,,both,224.16,201.74,United Healthcare,Default,Fee Schedule,182.91,,,,132.25,182.91
NF-CELEBREX CAP 200MG,637,RC,,,,both,29.84,26.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.89,,,,17.61,24.35
NF-CELEBREX CAP 200MG,637,RC,,,,both,29.84,26.86,Cigna,Default,Percent of Total Billed Charges,17.61,,,,17.61,24.35
NF-CELEBREX CAP 200MG,637,RC,,,,both,29.84,26.86,United Healthcare,Default,Fee Schedule,24.35,,,,17.61,24.35
NF-KRILL OIL ORAL LIQUID CAPSULE 500MG,250,RC,,,,both,0.96,0.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.67,,,,0.57,0.78
NF-KRILL OIL ORAL LIQUID CAPSULE 500MG,250,RC,,,,both,0.96,0.86,Cigna,Default,Percent of Total Billed Charges,0.57,,,,0.57,0.78
NF-KRILL OIL ORAL LIQUID CAPSULE 500MG,250,RC,,,,both,0.96,0.86,United Healthcare,Default,Fee Schedule,0.78,,,,0.57,0.78
NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 100-,250,RC,,,,both,13.63,12.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.54,,,,8.04,11.12
NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 100-,250,RC,,,,both,13.63,12.27,Cigna,Default,Percent of Total Billed Charges,8.04,,,,8.04,11.12
NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 100-,250,RC,,,,both,13.63,12.27,United Healthcare,Default,Fee Schedule,11.12,,,,8.04,11.12
NF-1ST BASE CREAM,121,RC,,,,both,55.16,49.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.61,,,,32.54,39.66
NF-1ST BASE CREAM,121,RC,,,,both,55.16,49.64,Cigna,Default,Percent of Total Billed Charges,32.54,,,,32.54,39.66
NF-1ST BASE CREAM,121,RC,,,,both,55.16,49.64,United Healthcare,Default,Percent of Total Billed Charges,39.66,,,,32.54,39.66
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,637,RC,,,,both,4.61,4.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.23,,,,2.72,3.76
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,637,RC,,,,both,4.61,4.15,Cigna,Default,Percent of Total Billed Charges,2.72,,,,2.72,3.76
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,637,RC,,,,both,4.61,4.15,United Healthcare,Default,Fee Schedule,3.76,,,,2.72,3.76
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,637,RC,,,,both,4.2,3.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.94,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,637,RC,,,,both,4.2,3.78,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,637,RC,,,,both,4.2,3.78,United Healthcare,Default,Fee Schedule,3.43,,,,2.48,3.43
NF-POTASSIUM CHLOR/NACL INJ 2MEQ/100ML-0,637,RC,,,,both,0.02,0.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-POTASSIUM CHLOR/NACL INJ 2MEQ/100ML-0,637,RC,,,,both,0.02,0.02,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-POTASSIUM CHLOR/NACL INJ 2MEQ/100ML-0,637,RC,,,,both,0.02,0.02,United Healthcare,Default,Fee Schedule,0.02,,,,0.01,0.02
GABAPENTIN SOLN 250MG/5ML,250,RC,,,,both,34,30.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.8,,,,20.06,27.74
GABAPENTIN SOLN 250MG/5ML,250,RC,,,,both,34,30.6,Cigna,Default,Percent of Total Billed Charges,20.06,,,,20.06,27.74
GABAPENTIN SOLN 250MG/5ML,250,RC,,,,both,34,30.6,United Healthcare,Default,Fee Schedule,27.74,,,,20.06,27.74
ROCURONIUM 50MG/5ML INJ,250,RC,,,,both,45.15,40.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.6,,,,26.64,36.84
ROCURONIUM 50MG/5ML INJ,250,RC,,,,both,45.15,40.64,Cigna,Default,Percent of Total Billed Charges,26.64,,,,26.64,36.84
ROCURONIUM 50MG/5ML INJ,250,RC,,,,both,45.15,40.64,United Healthcare,Default,Fee Schedule,36.84,,,,26.64,36.84
NF-ZINC SULFATE CAP 220MG,250,RC,,,,both,0.48,0.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.34,,,,0.28,0.39
NF-ZINC SULFATE CAP 220MG,250,RC,,,,both,0.48,0.43,Cigna,Default,Percent of Total Billed Charges,0.28,,,,0.28,0.39
NF-ZINC SULFATE CAP 220MG,250,RC,,,,both,0.48,0.43,United Healthcare,Default,Fee Schedule,0.39,,,,0.28,0.39
NF-FOLIC ACID AVPAK ORAL TABLET 0.4MG,250,RC,,,,both,1.1,0.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.77,,,,0.65,0.9
NF-FOLIC ACID AVPAK ORAL TABLET 0.4MG,250,RC,,,,both,1.1,0.99,Cigna,Default,Percent of Total Billed Charges,0.65,,,,0.65,0.9
NF-FOLIC ACID AVPAK ORAL TABLET 0.4MG,250,RC,,,,both,1.1,0.99,United Healthcare,Default,Fee Schedule,0.9,,,,0.65,0.9
NF-SYSTANE OPHTHALMIC OINTMENT 3%-94%,250,RC,,,,both,10.01,9.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.01,,,,5.91,8.17
NF-SYSTANE OPHTHALMIC OINTMENT 3%-94%,250,RC,,,,both,10.01,9.01,Cigna,Default,Percent of Total Billed Charges,5.91,,,,5.91,8.17
NF-SYSTANE OPHTHALMIC OINTMENT 3%-94%,250,RC,,,,both,10.01,9.01,United Healthcare,Default,Fee Schedule,8.17,,,,5.91,8.17
NF-CRANBERRY ORAL TABLET 450MG,250,RC,,,,both,0.14,0.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.08,0.11
NF-CRANBERRY ORAL TABLET 450MG,250,RC,,,,both,0.14,0.13,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-CRANBERRY ORAL TABLET 450MG,250,RC,,,,both,0.14,0.13,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
NF-B COMPLEX TABLET,250,RC,,,,both,0.09,0.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-B COMPLEX TABLET,250,RC,,,,both,0.09,0.08,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-B COMPLEX TABLET,250,RC,,,,both,0.09,0.08,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
NF-GLIPIZIDE ER ORAL TAB ER 2.5MG,250,RC,,,,both,3.78,3.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.65,,,,2.23,3.08
NF-GLIPIZIDE ER ORAL TAB ER 2.5MG,250,RC,,,,both,3.78,3.4,Cigna,Default,Percent of Total Billed Charges,2.23,,,,2.23,3.08
NF-GLIPIZIDE ER ORAL TAB ER 2.5MG,250,RC,,,,both,3.78,3.4,United Healthcare,Default,Fee Schedule,3.08,,,,2.23,3.08
NF-CARTIA XT 24 HR CAP 180MG,250,RC,,,,both,6.66,5.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.66,,,,3.93,5.43
NF-CARTIA XT 24 HR CAP 180MG,250,RC,,,,both,6.66,5.99,Cigna,Default,Percent of Total Billed Charges,3.93,,,,3.93,5.43
NF-CARTIA XT 24 HR CAP 180MG,250,RC,,,,both,6.66,5.99,United Healthcare,Default,Fee Schedule,5.43,,,,3.93,5.43
NF-LUTEIN LIQUID FILLED CAPSULE 20MG,250,RC,,,,both,1.29,1.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.9,,,,0.76,1.05
NF-LUTEIN LIQUID FILLED CAPSULE 20MG,250,RC,,,,both,1.29,1.16,Cigna,Default,Percent of Total Billed Charges,0.76,,,,0.76,1.05
NF-LUTEIN LIQUID FILLED CAPSULE 20MG,250,RC,,,,both,1.29,1.16,United Healthcare,Default,Fee Schedule,1.05,,,,0.76,1.05
NF-PRESERVISION LUTEIN ORAL LIQUID CAPSU,250,RC,,,,both,0.76,0.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.53,,,,0.45,0.62
NF-PRESERVISION LUTEIN ORAL LIQUID CAPSU,250,RC,,,,both,0.76,0.68,Cigna,Default,Percent of Total Billed Charges,0.45,,,,0.45,0.62
NF-PRESERVISION LUTEIN ORAL LIQUID CAPSU,250,RC,,,,both,0.76,0.68,United Healthcare,Default,Fee Schedule,0.62,,,,0.45,0.62
NF-XOPENEX HFA INH/NEB AER PWD 0.045MG/1,250,RC,,,,both,21.84,19.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.29,,,,12.89,17.82
NF-XOPENEX HFA INH/NEB AER PWD 0.045MG/1,250,RC,,,,both,21.84,19.66,Cigna,Default,Percent of Total Billed Charges,12.89,,,,12.89,17.82
NF-XOPENEX HFA INH/NEB AER PWD 0.045MG/1,250,RC,,,,both,21.84,19.66,United Healthcare,Default,Fee Schedule,17.82,,,,12.89,17.82
NF-HALDOL DECANOATE IM OIL 50MG/1ML,250,RC,,,,both,417.95,376.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,292.56,,,,246.59,341.05
NF-HALDOL DECANOATE IM OIL 50MG/1ML,250,RC,,,,both,417.95,376.16,Cigna,Default,Percent of Total Billed Charges,246.59,,,,246.59,341.05
NF-HALDOL DECANOATE IM OIL 50MG/1ML,250,RC,,,,both,417.95,376.16,United Healthcare,Default,Fee Schedule,341.05,,,,246.59,341.05
CREON 6000 UNITS CAP,250,RC,,,,both,10.72,9.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.5,,,,6.32,8.75
CREON 6000 UNITS CAP,250,RC,,,,both,10.72,9.65,Cigna,Default,Percent of Total Billed Charges,6.32,,,,6.32,8.75
CREON 6000 UNITS CAP,250,RC,,,,both,10.72,9.65,United Healthcare,Default,Fee Schedule,8.75,,,,6.32,8.75
NF-CRESTOR TAB 20MG,250,RC,,,,both,21.48,19.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.04,,,,12.67,17.53
NF-CRESTOR TAB 20MG,250,RC,,,,both,21.48,19.33,Cigna,Default,Percent of Total Billed Charges,12.67,,,,12.67,17.53
NF-CRESTOR TAB 20MG,250,RC,,,,both,21.48,19.33,United Healthcare,Default,Fee Schedule,17.53,,,,12.67,17.53
SEPTRA 800MG/160MG 10 CC IV,J3490,HCPCS,636,RC,,both,35.86,32.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.1,,,,21.16,29.26
SEPTRA 800MG/160MG 10 CC IV,J3490,HCPCS,636,RC,,both,35.86,32.27,Cigna,Default,Percent of Total Billed Charges,21.16,,,,21.16,29.26
SEPTRA 800MG/160MG 10 CC IV,J3490,HCPCS,636,RC,,both,35.86,32.27,United Healthcare,Default,Fee Schedule,29.26,,,,21.16,29.26
NF-PREDNISONE ORAL TABLET 2.5MG,250,RC,,,,both,0.66,0.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.46,,,,0.39,0.54
NF-PREDNISONE ORAL TABLET 2.5MG,250,RC,,,,both,0.66,0.59,Cigna,Default,Percent of Total Billed Charges,0.39,,,,0.39,0.54
NF-PREDNISONE ORAL TABLET 2.5MG,250,RC,,,,both,0.66,0.59,United Healthcare,Default,Fee Schedule,0.54,,,,0.39,0.54
NF-RABEPRAZOLE SODIUM ORAL TAB EC 20MG,250,RC,,,,both,45.79,41.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.05,,,,27.02,37.36
NF-RABEPRAZOLE SODIUM ORAL TAB EC 20MG,250,RC,,,,both,45.79,41.21,Cigna,Default,Percent of Total Billed Charges,27.02,,,,27.02,37.36
NF-RABEPRAZOLE SODIUM ORAL TAB EC 20MG,250,RC,,,,both,45.79,41.21,United Healthcare,Default,Fee Schedule,37.36,,,,27.02,37.36
NF-IRON ORAL TABLET 65MG,250,RC,,,,both,0.35,0.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.24,,,,0.21,0.29
NF-IRON ORAL TABLET 65MG,250,RC,,,,both,0.35,0.32,Cigna,Default,Percent of Total Billed Charges,0.21,,,,0.21,0.29
NF-IRON ORAL TABLET 65MG,250,RC,,,,both,0.35,0.32,United Healthcare,Default,Fee Schedule,0.29,,,,0.21,0.29
NF-VITAMIN D3 LIQUID FILLED CAPSULE 25MC,250,RC,,,,both,0.15,0.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.09,0.12
NF-VITAMIN D3 LIQUID FILLED CAPSULE 25MC,250,RC,,,,both,0.15,0.14,Cigna,Default,Percent of Total Billed Charges,0.09,,,,0.09,0.12
NF-VITAMIN D3 LIQUID FILLED CAPSULE 25MC,250,RC,,,,both,0.15,0.14,United Healthcare,Default,Fee Schedule,0.12,,,,0.09,0.12
NF-SIMVASTATIN ORAL TABLET 10MG,250,RC,,,,both,11.28,10.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.9,,,,6.66,9.2
NF-SIMVASTATIN ORAL TABLET 10MG,250,RC,,,,both,11.28,10.15,Cigna,Default,Percent of Total Billed Charges,6.66,,,,6.66,9.2
NF-SIMVASTATIN ORAL TABLET 10MG,250,RC,,,,both,11.28,10.15,United Healthcare,Default,Fee Schedule,9.2,,,,6.66,9.2
NF-DILAUDID ORAL SOLUTION 1MG/1ML,250,RC,,,,both,4.84,4.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.39,,,,2.86,3.95
NF-DILAUDID ORAL SOLUTION 1MG/1ML,250,RC,,,,both,4.84,4.36,Cigna,Default,Percent of Total Billed Charges,2.86,,,,2.86,3.95
NF-DILAUDID ORAL SOLUTION 1MG/1ML,250,RC,,,,both,4.84,4.36,United Healthcare,Default,Fee Schedule,3.95,,,,2.86,3.95
NF-FLUOROMETHOLONE OPHTH SUSP 0.1%,250,RC,,,,both,68.2,61.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.74,,,,40.24,55.65
NF-FLUOROMETHOLONE OPHTH SUSP 0.1%,250,RC,,,,both,68.2,61.38,Cigna,Default,Percent of Total Billed Charges,40.24,,,,40.24,55.65
NF-FLUOROMETHOLONE OPHTH SUSP 0.1%,250,RC,,,,both,68.2,61.38,United Healthcare,Default,Fee Schedule,55.65,,,,40.24,55.65
NF-FLUOROMETHOLONE OPHTH SUSP 0.1%,250,RC,,,,both,68.2,61.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,47.74,,,,40.24,55.65
NF-FLUOROMETHOLONE OPHTH SUSP 0.1%,250,RC,,,,both,68.2,61.38,Cigna,Default,Percent of Total Billed Charges,40.24,,,,40.24,55.65
NF-FLUOROMETHOLONE OPHTH SUSP 0.1%,250,RC,,,,both,68.2,61.38,United Healthcare,Default,Fee Schedule,55.65,,,,40.24,55.65
NF-FISH OIL ORAL LIQ CAP 1200MG,250,RC,,,,both,0.22,0.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.15,,,,0.13,0.18
NF-FISH OIL ORAL LIQ CAP 1200MG,250,RC,,,,both,0.22,0.2,Cigna,Default,Percent of Total Billed Charges,0.13,,,,0.13,0.18
NF-FISH OIL ORAL LIQ CAP 1200MG,250,RC,,,,both,0.22,0.2,United Healthcare,Default,Fee Schedule,0.18,,,,0.13,0.18
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.51,0.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.3,0.42
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.51,0.46,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.42
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.51,0.46,United Healthcare,Default,Fee Schedule,0.42,,,,0.3,0.42
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.41,0.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.29,,,,0.24,0.33
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.41,0.37,Cigna,Default,Percent of Total Billed Charges,0.24,,,,0.24,0.33
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.41,0.37,United Healthcare,Default,Fee Schedule,0.33,,,,0.24,0.33
NF-FOLIC ACID ORAL TABLET 0.4MG,250,RC,,,,both,0.04,0.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.03,,,,0.02,0.03
NF-FOLIC ACID ORAL TABLET 0.4MG,250,RC,,,,both,0.04,0.04,Cigna,Default,Percent of Total Billed Charges,0.02,,,,0.02,0.03
NF-FOLIC ACID ORAL TABLET 0.4MG,250,RC,,,,both,0.04,0.04,United Healthcare,Default,Fee Schedule,0.03,,,,0.02,0.03
NF-CRESTOR ORAL TABLET 20MG,250,RC,,,,both,44.25,39.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.98,,,,26.11,36.11
NF-CRESTOR ORAL TABLET 20MG,250,RC,,,,both,44.25,39.83,Cigna,Default,Percent of Total Billed Charges,26.11,,,,26.11,36.11
NF-CRESTOR ORAL TABLET 20MG,250,RC,,,,both,44.25,39.83,United Healthcare,Default,Fee Schedule,36.11,,,,26.11,36.11
NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL,121,RC,,,,both,0.59,0.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.41,,,,0.35,0.42
NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL,121,RC,,,,both,0.59,0.53,Cigna,Default,Percent of Total Billed Charges,0.35,,,,0.35,0.42
NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL,121,RC,,,,both,0.59,0.53,United Healthcare,Default,Percent of Total Billed Charges,0.42,,,,0.35,0.42
NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL,250,RC,,,,both,0.53,0.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.37,,,,0.31,0.43
NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL,250,RC,,,,both,0.53,0.48,Cigna,Default,Percent of Total Billed Charges,0.31,,,,0.31,0.43
NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL,250,RC,,,,both,0.53,0.48,United Healthcare,Default,Fee Schedule,0.43,,,,0.31,0.43
NF-CANDESARTAN CILEXETIL ORAL TABLET 8MG,250,RC,,,,both,12.69,11.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.88,,,,7.49,10.36
NF-CANDESARTAN CILEXETIL ORAL TABLET 8MG,250,RC,,,,both,12.69,11.42,Cigna,Default,Percent of Total Billed Charges,7.49,,,,7.49,10.36
NF-CANDESARTAN CILEXETIL ORAL TABLET 8MG,250,RC,,,,both,12.69,11.42,United Healthcare,Default,Fee Schedule,10.36,,,,7.49,10.36
NF-TURMERIC ORAL CAPSULE 500MG,250,RC,,,,both,0.54,0.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.38,,,,0.32,0.44
NF-TURMERIC ORAL CAPSULE 500MG,250,RC,,,,both,0.54,0.49,Cigna,Default,Percent of Total Billed Charges,0.32,,,,0.32,0.44
NF-TURMERIC ORAL CAPSULE 500MG,250,RC,,,,both,0.54,0.49,United Healthcare,Default,Fee Schedule,0.44,,,,0.32,0.44
NF-RETAINE PM OPHTHALMIC OINTMENT,250,RC,,,,both,8.64,7.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.05,,,,5.1,7.05
NF-RETAINE PM OPHTHALMIC OINTMENT,250,RC,,,,both,8.64,7.78,Cigna,Default,Percent of Total Billed Charges,5.1,,,,5.1,7.05
NF-RETAINE PM OPHTHALMIC OINTMENT,250,RC,,,,both,8.64,7.78,United Healthcare,Default,Fee Schedule,7.05,,,,5.1,7.05
NF-RETAINE CMC OPHTHALMIC SOLUTION 0.5%,250,RC,,,,both,1.43,1.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1,,,,0.84,1.17
NF-RETAINE CMC OPHTHALMIC SOLUTION 0.5%,250,RC,,,,both,1.43,1.29,Cigna,Default,Percent of Total Billed Charges,0.84,,,,0.84,1.17
NF-RETAINE CMC OPHTHALMIC SOLUTION 0.5%,250,RC,,,,both,1.43,1.29,United Healthcare,Default,Fee Schedule,1.17,,,,0.84,1.17
NF-CITALOPRAM HBR TABLET 40MG,250,RC,,,,both,9.78,8.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.85,,,,5.77,7.98
NF-CITALOPRAM HBR TABLET 40MG,250,RC,,,,both,9.78,8.8,Cigna,Default,Percent of Total Billed Charges,5.77,,,,5.77,7.98
NF-CITALOPRAM HBR TABLET 40MG,250,RC,,,,both,9.78,8.8,United Healthcare,Default,Fee Schedule,7.98,,,,5.77,7.98
NF-TYLENOL 8 HOUR TAB ER 650MG,250,RC,,,,both,0.46,0.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.32,,,,0.27,0.38
NF-TYLENOL 8 HOUR TAB ER 650MG,250,RC,,,,both,0.46,0.41,Cigna,Default,Percent of Total Billed Charges,0.27,,,,0.27,0.38
NF-TYLENOL 8 HOUR TAB ER 650MG,250,RC,,,,both,0.46,0.41,United Healthcare,Default,Fee Schedule,0.38,,,,0.27,0.38
NF-TYLENOL ARTHRITIS ORAL TABLET 650MG,250,RC,,,,both,0.31,0.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.18,0.25
NF-TYLENOL ARTHRITIS ORAL TABLET 650MG,250,RC,,,,both,0.31,0.28,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.25
NF-TYLENOL ARTHRITIS ORAL TABLET 650MG,250,RC,,,,both,0.31,0.28,United Healthcare,Default,Fee Schedule,0.25,,,,0.18,0.25
NF-RYBELSUS ORAL TABLET 7MG,250,RC,,,,both,130.88,117.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,91.62,,,,77.22,106.8
NF-RYBELSUS ORAL TABLET 7MG,250,RC,,,,both,130.88,117.79,Cigna,Default,Percent of Total Billed Charges,77.22,,,,77.22,106.8
NF-RYBELSUS ORAL TABLET 7MG,250,RC,,,,both,130.88,117.79,United Healthcare,Default,Fee Schedule,106.8,,,,77.22,106.8
NF-ONDANSETRON ORAL TABLET 8MG,250,RC,,,,both,166.13,149.52,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,116.29,,,,98.02,135.56
NF-ONDANSETRON ORAL TABLET 8MG,250,RC,,,,both,166.13,149.52,Cigna,Default,Percent of Total Billed Charges,98.02,,,,98.02,135.56
NF-ONDANSETRON ORAL TABLET 8MG,250,RC,,,,both,166.13,149.52,United Healthcare,Default,Fee Schedule,135.56,,,,98.02,135.56
NF-OLMESARTAN MEDOXOMIL ORAL TABLET 20MG,121,RC,,,,both,27.65,24.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.36,,,,16.31,19.88
NF-OLMESARTAN MEDOXOMIL ORAL TABLET 20MG,121,RC,,,,both,27.65,24.89,Cigna,Default,Percent of Total Billed Charges,16.31,,,,16.31,19.88
NF-OLMESARTAN MEDOXOMIL ORAL TABLET 20MG,121,RC,,,,both,27.65,24.89,United Healthcare,Default,Percent of Total Billed Charges,19.88,,,,16.31,19.88
NF-OLMESARTAN MEDOXOMIL ORAL TABLET 40MG,250,RC,,,,both,38.43,34.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.9,,,,22.67,31.36
NF-OLMESARTAN MEDOXOMIL ORAL TABLET 40MG,250,RC,,,,both,38.43,34.59,Cigna,Default,Percent of Total Billed Charges,22.67,,,,22.67,31.36
NF-OLMESARTAN MEDOXOMIL ORAL TABLET 40MG,250,RC,,,,both,38.43,34.59,United Healthcare,Default,Fee Schedule,31.36,,,,22.67,31.36
NF-METOPROLOL TARTRATE ORAL TABLET 100MG,250,RC,,,,both,4.26,3.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.98,,,,2.51,3.48
NF-METOPROLOL TARTRATE ORAL TABLET 100MG,250,RC,,,,both,4.26,3.83,Cigna,Default,Percent of Total Billed Charges,2.51,,,,2.51,3.48
NF-METOPROLOL TARTRATE ORAL TABLET 100MG,250,RC,,,,both,4.26,3.83,United Healthcare,Default,Fee Schedule,3.48,,,,2.51,3.48
NF-FLUVASTATIN SODIUM ORAL TAB ER 80MG,250,RC,,,,both,35.05,31.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.54,,,,20.68,28.6
NF-FLUVASTATIN SODIUM ORAL TAB ER 80MG,250,RC,,,,both,35.05,31.55,Cigna,Default,Percent of Total Billed Charges,20.68,,,,20.68,28.6
NF-FLUVASTATIN SODIUM ORAL TAB ER 80MG,250,RC,,,,both,35.05,31.55,United Healthcare,Default,Fee Schedule,28.6,,,,20.68,28.6
NF-ADVANCED EYE HEALTH LIQ CAP,250,RC,,,,both,1.07,0.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.75,,,,0.63,0.87
NF-ADVANCED EYE HEALTH LIQ CAP,250,RC,,,,both,1.07,0.96,Cigna,Default,Percent of Total Billed Charges,0.63,,,,0.63,0.87
NF-ADVANCED EYE HEALTH LIQ CAP,250,RC,,,,both,1.07,0.96,United Healthcare,Default,Fee Schedule,0.87,,,,0.63,0.87
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.7,0.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.49,,,,0.41,0.57
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.7,0.63,Cigna,Default,Percent of Total Billed Charges,0.41,,,,0.41,0.57
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.7,0.63,United Healthcare,Default,Fee Schedule,0.57,,,,0.41,0.57
NF-VITAMIN C ORAL TABLET 1000MG,250,RC,,,,both,0.31,0.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.18,0.25
NF-VITAMIN C ORAL TABLET 1000MG,250,RC,,,,both,0.31,0.28,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.25
NF-VITAMIN C ORAL TABLET 1000MG,250,RC,,,,both,0.31,0.28,United Healthcare,Default,Fee Schedule,0.25,,,,0.18,0.25
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03%,250,RC,,,,both,14.89,13.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.42,,,,8.79,12.15
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03%,250,RC,,,,both,14.89,13.4,Cigna,Default,Percent of Total Billed Charges,8.79,,,,8.79,12.15
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03%,250,RC,,,,both,14.89,13.4,United Healthcare,Default,Fee Schedule,12.15,,,,8.79,12.15
NF-VIMPAT ORAL TABLET 100MG,250,RC,,,,both,74.71,67.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.3,,,,44.08,60.96
NF-VIMPAT ORAL TABLET 100MG,250,RC,,,,both,74.71,67.24,Cigna,Default,Percent of Total Billed Charges,44.08,,,,44.08,60.96
NF-VIMPAT ORAL TABLET 100MG,250,RC,,,,both,74.71,67.24,United Healthcare,Default,Fee Schedule,60.96,,,,44.08,60.96
MINOCYCLINE 100MG INJ,636,RC,,,,both,1068.64,961.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,748.05,,,,630.5,872.01
MINOCYCLINE 100MG INJ,636,RC,,,,both,1068.64,961.78,Cigna,Default,Percent of Total Billed Charges,630.5,,,,630.5,872.01
MINOCYCLINE 100MG INJ,636,RC,,,,both,1068.64,961.78,United Healthcare,Default,Fee Schedule,872.01,,,,630.5,872.01
REGEN-COV 600MG/10ML INJ,Q0244,HCPCS,636,RC,,both,0.01,0.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
REGEN-COV 600MG/10ML INJ,Q0244,HCPCS,636,RC,,both,0.01,0.01,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.01
REGEN-COV 600MG/10ML INJ,Q0244,HCPCS,636,RC,,both,0.01,0.01,United Healthcare,Default,Fee Schedule,0.01,,,,0.01,0.01
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,46.57,41.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.6,,,,27.48,38
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,46.57,41.91,Cigna,Default,Percent of Total Billed Charges,27.48,,,,27.48,38
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,46.57,41.91,United Healthcare,Default,Fee Schedule,38,,,,27.48,38
NF-INSULIN LISPRO KWIKPEN SUBQ SOLN 100U,250,RC,,,,both,84.86,76.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,59.4,,,,50.07,69.25
NF-INSULIN LISPRO KWIKPEN SUBQ SOLN 100U,250,RC,,,,both,84.86,76.37,Cigna,Default,Percent of Total Billed Charges,50.07,,,,50.07,69.25
NF-INSULIN LISPRO KWIKPEN SUBQ SOLN 100U,250,RC,,,,both,84.86,76.37,United Healthcare,Default,Fee Schedule,69.25,,,,50.07,69.25
NF-FOLIC ACID ORAL TABLET 0.8MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
NF-FOLIC ACID ORAL TABLET 0.8MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
NF-FOLIC ACID ORAL TABLET 0.8MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
NF-BUPROPION SR ORAL TAB ER 100MG,250,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
NF-BUPROPION SR ORAL TAB ER 100MG,250,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
NF-BUPROPION SR ORAL TAB ER 100MG,250,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
NF-LACTATED RINGER'S SOLUTION-POTASSIUM,121,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.04
NF-LACTATED RINGER'S SOLUTION-POTASSIUM,121,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.04
NF-LACTATED RINGER'S SOLUTION-POTASSIUM,121,RC,,,,both,0.06,0.05,United Healthcare,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.04
NF-ICAPS AREDS ORAL TABLET,250,RC,,,,both,0.48,0.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.34,,,,0.28,0.39
NF-ICAPS AREDS ORAL TABLET,250,RC,,,,both,0.48,0.43,Cigna,Default,Percent of Total Billed Charges,0.28,,,,0.28,0.39
NF-ICAPS AREDS ORAL TABLET,250,RC,,,,both,0.48,0.43,United Healthcare,Default,Fee Schedule,0.39,,,,0.28,0.39
NF-EPLERENONE TAB 25MG,250,RC,,,,both,60.22,54.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42.15,,,,35.53,49.14
NF-EPLERENONE TAB 25MG,250,RC,,,,both,60.22,54.2,Cigna,Default,Percent of Total Billed Charges,35.53,,,,35.53,49.14
NF-EPLERENONE TAB 25MG,250,RC,,,,both,60.22,54.2,United Healthcare,Default,Fee Schedule,49.14,,,,35.53,49.14
NF-ETODOLAC CAP 200MG,121,RC,,,,both,5.75,5.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.13
NF-ETODOLAC CAP 200MG,121,RC,,,,both,5.75,5.18,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.13
NF-ETODOLAC CAP 200MG,121,RC,,,,both,5.75,5.18,United Healthcare,Default,Percent of Total Billed Charges,4.13,,,,3.39,4.13
NF-LODINE ORAL TABLET 400MG,250,RC,,,,both,86.88,78.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.82,,,,51.26,70.89
NF-LODINE ORAL TABLET 400MG,250,RC,,,,both,86.88,78.19,Cigna,Default,Percent of Total Billed Charges,51.26,,,,51.26,70.89
NF-LODINE ORAL TABLET 400MG,250,RC,,,,both,86.88,78.19,United Healthcare,Default,Fee Schedule,70.89,,,,51.26,70.89
NF-STIOLTO RESPIMAT INH 2.5-2.5MCG/1ACT,250,RC,,,,both,526.06,473.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,368.24,,,,310.38,429.26
NF-STIOLTO RESPIMAT INH 2.5-2.5MCG/1ACT,250,RC,,,,both,526.06,473.45,Cigna,Default,Percent of Total Billed Charges,310.38,,,,310.38,429.26
NF-STIOLTO RESPIMAT INH 2.5-2.5MCG/1ACT,250,RC,,,,both,526.06,473.45,United Healthcare,Default,Fee Schedule,429.26,,,,310.38,429.26
NF-MAGNESIUM OXIDE TABLET 250MG,250,RC,,,,both,0.08,0.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-MAGNESIUM OXIDE TABLET 250MG,250,RC,,,,both,0.08,0.07,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-MAGNESIUM OXIDE TABLET 250MG,250,RC,,,,both,0.08,0.07,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
NF-BENGAY GREASELESS CREAM 10%-15%,250,RC,,,,both,0.28,0.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.2,,,,0.17,0.23
NF-BENGAY GREASELESS CREAM 10%-15%,250,RC,,,,both,0.28,0.25,Cigna,Default,Percent of Total Billed Charges,0.17,,,,0.17,0.23
NF-BENGAY GREASELESS CREAM 10%-15%,250,RC,,,,both,0.28,0.25,United Healthcare,Default,Fee Schedule,0.23,,,,0.17,0.23
NF-ROPINIROLE HCL TAB 0.5MG,250,RC,,,,both,10.02,9.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.01,,,,5.91,8.18
NF-ROPINIROLE HCL TAB 0.5MG,250,RC,,,,both,10.02,9.02,Cigna,Default,Percent of Total Billed Charges,5.91,,,,5.91,8.18
NF-ROPINIROLE HCL TAB 0.5MG,250,RC,,,,both,10.02,9.02,United Healthcare,Default,Fee Schedule,8.18,,,,5.91,8.18
NF-IRON ORAL TABLET 27MG,250,RC,,,,both,0.1,0.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.07,,,,0.06,0.08
NF-IRON ORAL TABLET 27MG,250,RC,,,,both,0.1,0.09,Cigna,Default,Percent of Total Billed Charges,0.06,,,,0.06,0.08
NF-IRON ORAL TABLET 27MG,250,RC,,,,both,0.1,0.09,United Healthcare,Default,Fee Schedule,0.08,,,,0.06,0.08
NF-DIVALPROEX SODIUM ORAL TAB DR 500MG,250,RC,,,,both,13,11.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.1,,,,7.67,10.61
NF-DIVALPROEX SODIUM ORAL TAB DR 500MG,250,RC,,,,both,13,11.7,Cigna,Default,Percent of Total Billed Charges,7.67,,,,7.67,10.61
NF-DIVALPROEX SODIUM ORAL TAB DR 500MG,250,RC,,,,both,13,11.7,United Healthcare,Default,Fee Schedule,10.61,,,,7.67,10.61
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
NF-DOXYLAMINE SUCC-PYRIDOXINE HCL TAB DR,250,RC,,,,both,31.28,28.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,21.9,,,,18.46,25.52
NF-DOXYLAMINE SUCC-PYRIDOXINE HCL TAB DR,250,RC,,,,both,31.28,28.15,Cigna,Default,Percent of Total Billed Charges,18.46,,,,18.46,25.52
NF-DOXYLAMINE SUCC-PYRIDOXINE HCL TAB DR,250,RC,,,,both,31.28,28.15,United Healthcare,Default,Fee Schedule,25.52,,,,18.46,25.52
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,250,RC,,,,both,9.83,8.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.88,,,,5.8,8.02
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,250,RC,,,,both,9.83,8.85,Cigna,Default,Percent of Total Billed Charges,5.8,,,,5.8,8.02
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,250,RC,,,,both,9.83,8.85,United Healthcare,Default,Fee Schedule,8.02,,,,5.8,8.02
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.17,,,,43.13,59.65
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,Cigna,Default,Percent of Total Billed Charges,43.13,,,,43.13,59.65
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,United Healthcare,Default,Fee Schedule,59.65,,,,43.13,59.65
NF-SOTALOL HCL ORAL TABLET 80MG,250,RC,,,,both,10.25,9.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.18,,,,6.05,8.36
NF-SOTALOL HCL ORAL TABLET 80MG,250,RC,,,,both,10.25,9.23,Cigna,Default,Percent of Total Billed Charges,6.05,,,,6.05,8.36
NF-SOTALOL HCL ORAL TABLET 80MG,250,RC,,,,both,10.25,9.23,United Healthcare,Default,Fee Schedule,8.36,,,,6.05,8.36
NF-FOSINOPRIL ORAL TABLET 40MG,250,RC,,,,both,3.28,2.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.3,,,,1.94,2.68
NF-FOSINOPRIL ORAL TABLET 40MG,250,RC,,,,both,3.28,2.95,Cigna,Default,Percent of Total Billed Charges,1.94,,,,1.94,2.68
NF-FOSINOPRIL ORAL TABLET 40MG,250,RC,,,,both,3.28,2.95,United Healthcare,Default,Fee Schedule,2.68,,,,1.94,2.68
NF-GABAPENTIN CAP 400MG,250,RC,,,,both,35.36,31.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.75,,,,20.86,28.85
NF-GABAPENTIN CAP 400MG,250,RC,,,,both,35.36,31.82,Cigna,Default,Percent of Total Billed Charges,20.86,,,,20.86,28.85
NF-GABAPENTIN CAP 400MG,250,RC,,,,both,35.36,31.82,United Healthcare,Default,Fee Schedule,28.85,,,,20.86,28.85
NF-NIFEDIPINE ER TABLET 60MG,250,RC,,,,both,16.2,14.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.34,,,,9.56,13.22
NF-NIFEDIPINE ER TABLET 60MG,250,RC,,,,both,16.2,14.58,Cigna,Default,Percent of Total Billed Charges,9.56,,,,9.56,13.22
NF-NIFEDIPINE ER TABLET 60MG,250,RC,,,,both,16.2,14.58,United Healthcare,Default,Fee Schedule,13.22,,,,9.56,13.22
NF-MELATONIN ORAL TABLET 10MG,250,RC,,,,both,0.59,0.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.41,,,,0.35,0.48
NF-MELATONIN ORAL TABLET 10MG,250,RC,,,,both,0.59,0.53,Cigna,Default,Percent of Total Billed Charges,0.35,,,,0.35,0.48
NF-MELATONIN ORAL TABLET 10MG,250,RC,,,,both,0.59,0.53,United Healthcare,Default,Fee Schedule,0.48,,,,0.35,0.48
NF-ROSUVASTATIN CALCIUM CAP 5MG,250,RC,,,,both,14.64,13.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.25,,,,8.64,11.95
NF-ROSUVASTATIN CALCIUM CAP 5MG,250,RC,,,,both,14.64,13.18,Cigna,Default,Percent of Total Billed Charges,8.64,,,,8.64,11.95
NF-ROSUVASTATIN CALCIUM CAP 5MG,250,RC,,,,both,14.64,13.18,United Healthcare,Default,Fee Schedule,11.95,,,,8.64,11.95
NF-CRESTOR TAB 5MG,250,RC,,,,both,22.46,20.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.72,,,,13.25,18.33
NF-CRESTOR TAB 5MG,250,RC,,,,both,22.46,20.21,Cigna,Default,Percent of Total Billed Charges,13.25,,,,13.25,18.33
NF-CRESTOR TAB 5MG,250,RC,,,,both,22.46,20.21,United Healthcare,Default,Fee Schedule,18.33,,,,13.25,18.33
NF-DETROL LA CAP ER 4MG,250,RC,,,,both,58.69,52.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.08,,,,34.63,47.89
NF-DETROL LA CAP ER 4MG,250,RC,,,,both,58.69,52.82,Cigna,Default,Percent of Total Billed Charges,34.63,,,,34.63,47.89
NF-DETROL LA CAP ER 4MG,250,RC,,,,both,58.69,52.82,United Healthcare,Default,Fee Schedule,47.89,,,,34.63,47.89
NF-MOVE FREE OMEGA JOINT PLUS LIQ CAP,250,RC,,,,both,3.1,2.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.17,,,,1.83,2.53
NF-MOVE FREE OMEGA JOINT PLUS LIQ CAP,250,RC,,,,both,3.1,2.79,Cigna,Default,Percent of Total Billed Charges,1.83,,,,1.83,2.53
NF-MOVE FREE OMEGA JOINT PLUS LIQ CAP,250,RC,,,,both,3.1,2.79,United Healthcare,Default,Fee Schedule,2.53,,,,1.83,2.53
NF-SUPER B COMPLEX W/C CAPSULE,250,RC,,,,both,0.2,0.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.14,,,,0.12,0.16
NF-SUPER B COMPLEX W/C CAPSULE,250,RC,,,,both,0.2,0.18,Cigna,Default,Percent of Total Billed Charges,0.12,,,,0.12,0.16
NF-SUPER B COMPLEX W/C CAPSULE,250,RC,,,,both,0.2,0.18,United Healthcare,Default,Fee Schedule,0.16,,,,0.12,0.16
NF-LEVOTHYROXINE SODIUM LIQ CAPSULE 137M,250,RC,,,,both,20.3,18.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.21,,,,11.98,16.56
NF-LEVOTHYROXINE SODIUM LIQ CAPSULE 137M,250,RC,,,,both,20.3,18.27,Cigna,Default,Percent of Total Billed Charges,11.98,,,,11.98,16.56
NF-LEVOTHYROXINE SODIUM LIQ CAPSULE 137M,250,RC,,,,both,20.3,18.27,United Healthcare,Default,Fee Schedule,16.56,,,,11.98,16.56
NF-LEXAPRO TAB 5MG,250,RC,,,,both,58.07,52.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40.65,,,,34.26,47.39
NF-LEXAPRO TAB 5MG,250,RC,,,,both,58.07,52.26,Cigna,Default,Percent of Total Billed Charges,34.26,,,,34.26,47.39
NF-LEXAPRO TAB 5MG,250,RC,,,,both,58.07,52.26,United Healthcare,Default,Fee Schedule,47.39,,,,34.26,47.39
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,250,RC,,,,both,1.7,1.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.19,,,,1,1.39
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,250,RC,,,,both,1.7,1.53,Cigna,Default,Percent of Total Billed Charges,1,,,,1,1.39
NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,250,RC,,,,both,1.7,1.53,United Healthcare,Default,Fee Schedule,1.39,,,,1,1.39
IVERMECTIN 3MG TAB,637,RC,,,,both,21.37,19.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.96,,,,12.61,17.44
IVERMECTIN 3MG TAB,637,RC,,,,both,21.37,19.23,Cigna,Default,Percent of Total Billed Charges,12.61,,,,12.61,17.44
IVERMECTIN 3MG TAB,637,RC,,,,both,21.37,19.23,United Healthcare,Default,Fee Schedule,17.44,,,,12.61,17.44
BUDESONIDE 160MCG/FORMOTEROL 4.5MCG/ACT,637,RC,,,,both,22.15,19.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.5,,,,13.07,18.07
BUDESONIDE 160MCG/FORMOTEROL 4.5MCG/ACT,637,RC,,,,both,22.15,19.94,Cigna,Default,Percent of Total Billed Charges,13.07,,,,13.07,18.07
BUDESONIDE 160MCG/FORMOTEROL 4.5MCG/ACT,637,RC,,,,both,22.15,19.94,United Healthcare,Default,Fee Schedule,18.07,,,,13.07,18.07
NF-FARXIGA ORAL TABLET 10MG,250,RC,,,,both,49.93,44.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.95,,,,29.46,40.74
NF-FARXIGA ORAL TABLET 10MG,250,RC,,,,both,49.93,44.94,Cigna,Default,Percent of Total Billed Charges,29.46,,,,29.46,40.74
NF-FARXIGA ORAL TABLET 10MG,250,RC,,,,both,49.93,44.94,United Healthcare,Default,Fee Schedule,40.74,,,,29.46,40.74
NF-NOVOLIN N INJECTION 100U/ML,250,RC,,,,both,66.1,59.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.27,,,,39,53.94
NF-NOVOLIN N INJECTION 100U/ML,250,RC,,,,both,66.1,59.49,Cigna,Default,Percent of Total Billed Charges,39,,,,39,53.94
NF-NOVOLIN N INJECTION 100U/ML,250,RC,,,,both,66.1,59.49,United Healthcare,Default,Fee Schedule,53.94,,,,39,53.94
NF-NOVOLIN R INJECTION 100U/ML,250,RC,,,,both,66.1,59.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.27,,,,39,53.94
NF-NOVOLIN R INJECTION 100U/ML,250,RC,,,,both,66.1,59.49,Cigna,Default,Percent of Total Billed Charges,39,,,,39,53.94
NF-NOVOLIN R INJECTION 100U/ML,250,RC,,,,both,66.1,59.49,United Healthcare,Default,Fee Schedule,53.94,,,,39,53.94
NF-HUMULIN N (NPH) INJECTION 100U/ML,637,RC,,,,both,71.38,64.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.97,,,,42.11,58.25
NF-HUMULIN N (NPH) INJECTION 100U/ML,637,RC,,,,both,71.38,64.24,Cigna,Default,Percent of Total Billed Charges,42.11,,,,42.11,58.25
NF-HUMULIN N (NPH) INJECTION 100U/ML,637,RC,,,,both,71.38,64.24,United Healthcare,Default,Fee Schedule,58.25,,,,42.11,58.25
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,637,RC,,,,both,6.38,5.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,637,RC,,,,both,6.38,5.74,Cigna,Default,Percent of Total Billed Charges,3.76,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,637,RC,,,,both,6.38,5.74,United Healthcare,Default,Fee Schedule,5.21,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,Cigna,Default,Percent of Total Billed Charges,3.76,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,United Healthcare,Default,Fee Schedule,5.21,,,,3.76,5.21
NF-NOVOLIN R INJ SOLN 100U/1ML,250,RC,,,,both,66.1,59.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.27,,,,39,53.94
NF-NOVOLIN R INJ SOLN 100U/1ML,250,RC,,,,both,66.1,59.49,Cigna,Default,Percent of Total Billed Charges,39,,,,39,53.94
NF-NOVOLIN R INJ SOLN 100U/1ML,250,RC,,,,both,66.1,59.49,United Healthcare,Default,Fee Schedule,53.94,,,,39,53.94
NF-DEXTROSE & NACL W/KCL IJ 5%-0.45%-0.0,637,RC,,,,both,0.02,0.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-DEXTROSE & NACL W/KCL IJ 5%-0.45%-0.0,637,RC,,,,both,0.02,0.02,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-DEXTROSE & NACL W/KCL IJ 5%-0.45%-0.0,637,RC,,,,both,0.02,0.02,United Healthcare,Default,Fee Schedule,0.02,,,,0.01,0.02
NF-KETOROLAC TROMETHAMINE TAB 10MG,250,RC,,,,both,8.63,7.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.04,,,,5.09,7.04
NF-KETOROLAC TROMETHAMINE TAB 10MG,250,RC,,,,both,8.63,7.77,Cigna,Default,Percent of Total Billed Charges,5.09,,,,5.09,7.04
NF-KETOROLAC TROMETHAMINE TAB 10MG,250,RC,,,,both,8.63,7.77,United Healthcare,Default,Fee Schedule,7.04,,,,5.09,7.04
NF-SUDAFED ORAL TABLET 30MG,250,RC,,,,both,0.97,0.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.68,,,,0.57,0.79
NF-SUDAFED ORAL TABLET 30MG,250,RC,,,,both,0.97,0.87,Cigna,Default,Percent of Total Billed Charges,0.57,,,,0.57,0.79
NF-SUDAFED ORAL TABLET 30MG,250,RC,,,,both,0.97,0.87,United Healthcare,Default,Fee Schedule,0.79,,,,0.57,0.79
NF-CELEXA TAB 20MG,250,RC,,,,both,17.13,15.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.99,,,,10.11,13.98
NF-CELEXA TAB 20MG,250,RC,,,,both,17.13,15.42,Cigna,Default,Percent of Total Billed Charges,10.11,,,,10.11,13.98
NF-CELEXA TAB 20MG,250,RC,,,,both,17.13,15.42,United Healthcare,Default,Fee Schedule,13.98,,,,10.11,13.98
NF-BREZTRI AEROSPHERE INH AER LIQ,250,RC,,,,both,264.85,238.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,185.4,,,,156.26,216.12
NF-BREZTRI AEROSPHERE INH AER LIQ,250,RC,,,,both,264.85,238.37,Cigna,Default,Percent of Total Billed Charges,156.26,,,,156.26,216.12
NF-BREZTRI AEROSPHERE INH AER LIQ,250,RC,,,,both,264.85,238.37,United Healthcare,Default,Fee Schedule,216.12,,,,156.26,216.12
NF-RIZATRIPTAN BENZOATE DIS TAB 10MG,250,RC,,,,both,261.68,235.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,183.18,,,,154.39,213.53
NF-RIZATRIPTAN BENZOATE DIS TAB 10MG,250,RC,,,,both,261.68,235.51,Cigna,Default,Percent of Total Billed Charges,154.39,,,,154.39,213.53
NF-RIZATRIPTAN BENZOATE DIS TAB 10MG,250,RC,,,,both,261.68,235.51,United Healthcare,Default,Fee Schedule,213.53,,,,154.39,213.53
NF-LORAZEPAM INTENSOL CONCENTRATE 2MG/ML,250,RC,,,,both,6.4,5.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.48,,,,3.78,5.22
NF-LORAZEPAM INTENSOL CONCENTRATE 2MG/ML,250,RC,,,,both,6.4,5.76,Cigna,Default,Percent of Total Billed Charges,3.78,,,,3.78,5.22
NF-LORAZEPAM INTENSOL CONCENTRATE 2MG/ML,250,RC,,,,both,6.4,5.76,United Healthcare,Default,Fee Schedule,5.22,,,,3.78,5.22
NF-FLECAINIDE ACETATE ORAL TABLET 50MG,250,RC,,,,both,8.08,7.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.66,,,,4.77,6.59
NF-FLECAINIDE ACETATE ORAL TABLET 50MG,250,RC,,,,both,8.08,7.27,Cigna,Default,Percent of Total Billed Charges,4.77,,,,4.77,6.59
NF-FLECAINIDE ACETATE ORAL TABLET 50MG,250,RC,,,,both,8.08,7.27,United Healthcare,Default,Fee Schedule,6.59,,,,4.77,6.59
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,196.99,177.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,137.89,,,,116.22,160.74
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,196.99,177.29,Cigna,Default,Percent of Total Billed Charges,116.22,,,,116.22,160.74
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,196.99,177.29,United Healthcare,Default,Fee Schedule,160.74,,,,116.22,160.74
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,9.73,8.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.81,,,,5.74,7.94
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,9.73,8.76,Cigna,Default,Percent of Total Billed Charges,5.74,,,,5.74,7.94
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,250,RC,,,,both,9.73,8.76,United Healthcare,Default,Fee Schedule,7.94,,,,5.74,7.94
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 20MG,250,RC,,,,both,10.14,9.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.1,,,,5.98,8.27
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 20MG,250,RC,,,,both,10.14,9.13,Cigna,Default,Percent of Total Billed Charges,5.98,,,,5.98,8.27
NF-CITALOPRAM HYDROBROMIDE ORAL TAB 20MG,250,RC,,,,both,10.14,9.13,United Healthcare,Default,Fee Schedule,8.27,,,,5.98,8.27
NF-MAXALT ORAL TABLET 10MG,250,RC,,,,both,143.05,128.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,100.14,,,,84.4,116.73
NF-MAXALT ORAL TABLET 10MG,250,RC,,,,both,143.05,128.75,Cigna,Default,Percent of Total Billed Charges,84.4,,,,84.4,116.73
NF-MAXALT ORAL TABLET 10MG,250,RC,,,,both,143.05,128.75,United Healthcare,Default,Fee Schedule,116.73,,,,84.4,116.73
NF-HUMALOG KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,169.73,152.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,118.81,,,,100.14,138.5
NF-HUMALOG KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,169.73,152.76,Cigna,Default,Percent of Total Billed Charges,100.14,,,,100.14,138.5
NF-HUMALOG KWIKPEN SUBQ SOLN 100U/1ML,250,RC,,,,both,169.73,152.76,United Healthcare,Default,Fee Schedule,138.5,,,,100.14,138.5
NF-MAXALT-MLT DISINTEGRATING TAB 10MG,250,RC,,,,both,175.54,157.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.88,,,,103.57,143.24
NF-MAXALT-MLT DISINTEGRATING TAB 10MG,250,RC,,,,both,175.54,157.99,Cigna,Default,Percent of Total Billed Charges,103.57,,,,103.57,143.24
NF-MAXALT-MLT DISINTEGRATING TAB 10MG,250,RC,,,,both,175.54,157.99,United Healthcare,Default,Fee Schedule,143.24,,,,103.57,143.24
NF-TORSEMIDE ORAL TABLET 5MG,250,RC,,,,both,2.54,2.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.78,,,,1.5,2.07
NF-TORSEMIDE ORAL TABLET 5MG,250,RC,,,,both,2.54,2.29,Cigna,Default,Percent of Total Billed Charges,1.5,,,,1.5,2.07
NF-TORSEMIDE ORAL TABLET 5MG,250,RC,,,,both,2.54,2.29,United Healthcare,Default,Fee Schedule,2.07,,,,1.5,2.07
NF-VALSARTAN ORAL TABLET 160MG,250,RC,,,,both,20.85,18.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.6,,,,12.3,17.01
NF-VALSARTAN ORAL TABLET 160MG,250,RC,,,,both,20.85,18.77,Cigna,Default,Percent of Total Billed Charges,12.3,,,,12.3,17.01
NF-VALSARTAN ORAL TABLET 160MG,250,RC,,,,both,20.85,18.77,United Healthcare,Default,Fee Schedule,17.01,,,,12.3,17.01
NF-EPLERENONE ORAL TABLET 50MG,250,RC,,,,both,16.66,14.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.66,,,,9.83,13.59
NF-EPLERENONE ORAL TABLET 50MG,250,RC,,,,both,16.66,14.99,Cigna,Default,Percent of Total Billed Charges,9.83,,,,9.83,13.59
NF-EPLERENONE ORAL TABLET 50MG,250,RC,,,,both,16.66,14.99,United Healthcare,Default,Fee Schedule,13.59,,,,9.83,13.59
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,3.53,3.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.47,,,,2.08,2.88
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,3.53,3.18,Cigna,Default,Percent of Total Billed Charges,2.08,,,,2.08,2.88
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,3.53,3.18,United Healthcare,Default,Fee Schedule,2.88,,,,2.08,2.88
FLUORESCEIN 500MG/5ML INJ,250,RC,,,,both,371.52,334.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.06,,,,219.2,303.16
FLUORESCEIN 500MG/5ML INJ,250,RC,,,,both,371.52,334.37,Cigna,Default,Percent of Total Billed Charges,219.2,,,,219.2,303.16
FLUORESCEIN 500MG/5ML INJ,250,RC,,,,both,371.52,334.37,United Healthcare,Default,Fee Schedule,303.16,,,,219.2,303.16
NF-PREVAGEN ORAL CAP 10MG-50MCG,250,RC,,,,both,3.8,3.42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.66,,,,2.24,3.1
NF-PREVAGEN ORAL CAP 10MG-50MCG,250,RC,,,,both,3.8,3.42,Cigna,Default,Percent of Total Billed Charges,2.24,,,,2.24,3.1
NF-PREVAGEN ORAL CAP 10MG-50MCG,250,RC,,,,both,3.8,3.42,United Healthcare,Default,Fee Schedule,3.1,,,,2.24,3.1
NF-AMITRIPTYLINE HCL ORAL TABLET 100MG,250,RC,,,,both,10.16,9.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.11,,,,5.99,8.29
NF-AMITRIPTYLINE HCL ORAL TABLET 100MG,250,RC,,,,both,10.16,9.14,Cigna,Default,Percent of Total Billed Charges,5.99,,,,5.99,8.29
NF-AMITRIPTYLINE HCL ORAL TABLET 100MG,250,RC,,,,both,10.16,9.14,United Healthcare,Default,Fee Schedule,8.29,,,,5.99,8.29
NF-NORTRIPTYLINE CAPSULE 10MG,250,RC,,,,both,1.95,1.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.36,,,,1.15,1.59
NF-NORTRIPTYLINE CAPSULE 10MG,250,RC,,,,both,1.95,1.76,Cigna,Default,Percent of Total Billed Charges,1.15,,,,1.15,1.59
NF-NORTRIPTYLINE CAPSULE 10MG,250,RC,,,,both,1.95,1.76,United Healthcare,Default,Fee Schedule,1.59,,,,1.15,1.59
APIXABAN 5MG TABLET,637,RC,,,,both,51.12,46.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.78,,,,30.16,41.71
APIXABAN 5MG TABLET,637,RC,,,,both,51.12,46.01,Cigna,Default,Percent of Total Billed Charges,30.16,,,,30.16,41.71
APIXABAN 5MG TABLET,637,RC,,,,both,51.12,46.01,United Healthcare,Default,Fee Schedule,41.71,,,,30.16,41.71
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.17,,,,43.13,59.65
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,Cigna,Default,Percent of Total Billed Charges,43.13,,,,43.13,59.65
TIMOLOL 0.5% OPTH SOLN 5 ML,637,RC,,,,both,73.1,65.79,United Healthcare,Default,Fee Schedule,59.65,,,,43.13,59.65
NF-DESITIN ORIGINAL TOPICAL OINTMENT 40%,250,RC,,,,both,0.14,0.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.08,0.11
NF-DESITIN ORIGINAL TOPICAL OINTMENT 40%,250,RC,,,,both,0.14,0.13,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-DESITIN ORIGINAL TOPICAL OINTMENT 40%,250,RC,,,,both,0.14,0.13,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,250,RC,,,,both,3.22,2.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.25,,,,1.9,2.63
NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,250,RC,,,,both,3.22,2.9,Cigna,Default,Percent of Total Billed Charges,1.9,,,,1.9,2.63
NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,250,RC,,,,both,3.22,2.9,United Healthcare,Default,Fee Schedule,2.63,,,,1.9,2.63
NF-MINOCYCLINE HCL CAP 100MG,250,RC,,,,both,13.59,12.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.51,,,,8.02,11.09
NF-MINOCYCLINE HCL CAP 100MG,250,RC,,,,both,13.59,12.23,Cigna,Default,Percent of Total Billed Charges,8.02,,,,8.02,11.09
NF-MINOCYCLINE HCL CAP 100MG,250,RC,,,,both,13.59,12.23,United Healthcare,Default,Fee Schedule,11.09,,,,8.02,11.09
NF-HYDROCHLOROTHIAZIDE ORAL TABLET 50MG,250,RC,,,,both,0.96,0.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.67,,,,0.57,0.78
NF-HYDROCHLOROTHIAZIDE ORAL TABLET 50MG,250,RC,,,,both,0.96,0.86,Cigna,Default,Percent of Total Billed Charges,0.57,,,,0.57,0.78
NF-HYDROCHLOROTHIAZIDE ORAL TABLET 50MG,250,RC,,,,both,0.96,0.86,United Healthcare,Default,Fee Schedule,0.78,,,,0.57,0.78
NF-COLESTIPOL ORAL TABLET 1GM,250,RC,,,,both,6.8,6.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.76,,,,4.01,5.55
NF-COLESTIPOL ORAL TABLET 1GM,250,RC,,,,both,6.8,6.12,Cigna,Default,Percent of Total Billed Charges,4.01,,,,4.01,5.55
NF-COLESTIPOL ORAL TABLET 1GM,250,RC,,,,both,6.8,6.12,United Healthcare,Default,Fee Schedule,5.55,,,,4.01,5.55
NF-COLESTIPOL HCL TAB 1GM,250,RC,,,,both,4.95,4.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.46,,,,2.92,4.04
NF-COLESTIPOL HCL TAB 1GM,250,RC,,,,both,4.95,4.46,Cigna,Default,Percent of Total Billed Charges,2.92,,,,2.92,4.04
NF-COLESTIPOL HCL TAB 1GM,250,RC,,,,both,4.95,4.46,United Healthcare,Default,Fee Schedule,4.04,,,,2.92,4.04
NF-LOVASTATIN ORAL TABLET 10MG,250,RC,,,,both,5.38,4.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.77,,,,3.17,4.39
NF-LOVASTATIN ORAL TABLET 10MG,250,RC,,,,both,5.38,4.84,Cigna,Default,Percent of Total Billed Charges,3.17,,,,3.17,4.39
NF-LOVASTATIN ORAL TABLET 10MG,250,RC,,,,both,5.38,4.84,United Healthcare,Default,Fee Schedule,4.39,,,,3.17,4.39
NF-AMIODARONE HCL ORAL TABLET 100MG,250,RC,,,,both,29.72,26.75,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.8,,,,17.53,24.25
NF-AMIODARONE HCL ORAL TABLET 100MG,250,RC,,,,both,29.72,26.75,Cigna,Default,Percent of Total Billed Charges,17.53,,,,17.53,24.25
NF-AMIODARONE HCL ORAL TABLET 100MG,250,RC,,,,both,29.72,26.75,United Healthcare,Default,Fee Schedule,24.25,,,,17.53,24.25
NF-MINOCYCLINE HCL,250,RC,,,,both,24.08,21.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.86,,,,14.21,19.65
NF-MINOCYCLINE HCL,250,RC,,,,both,24.08,21.67,Cigna,Default,Percent of Total Billed Charges,14.21,,,,14.21,19.65
NF-MINOCYCLINE HCL,250,RC,,,,both,24.08,21.67,United Healthcare,Default,Fee Schedule,19.65,,,,14.21,19.65
FLUVOXAMINE MALEATE 50MG TABLET,637,RC,,,,both,11.07,9.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.75,,,,6.53,9.03
FLUVOXAMINE MALEATE 50MG TABLET,637,RC,,,,both,11.07,9.96,Cigna,Default,Percent of Total Billed Charges,6.53,,,,6.53,9.03
FLUVOXAMINE MALEATE 50MG TABLET,637,RC,,,,both,11.07,9.96,United Healthcare,Default,Fee Schedule,9.03,,,,6.53,9.03
NF-CARBAMAZEPINE CAP ER 300MG,250,RC,,,,both,2.59,2.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.81,,,,1.53,2.11
NF-CARBAMAZEPINE CAP ER 300MG,250,RC,,,,both,2.59,2.33,Cigna,Default,Percent of Total Billed Charges,1.53,,,,1.53,2.11
NF-CARBAMAZEPINE CAP ER 300MG,250,RC,,,,both,2.59,2.33,United Healthcare,Default,Fee Schedule,2.11,,,,1.53,2.11
NF-QUINAPRIL HCL TAB 10MG,250,RC,,,,both,23.36,21.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.35,,,,13.78,19.06
NF-QUINAPRIL HCL TAB 10MG,250,RC,,,,both,23.36,21.02,Cigna,Default,Percent of Total Billed Charges,13.78,,,,13.78,19.06
NF-QUINAPRIL HCL TAB 10MG,250,RC,,,,both,23.36,21.02,United Healthcare,Default,Fee Schedule,19.06,,,,13.78,19.06
NF-CHLOROTHIAZIDE SOD IV PWD FOR SOLN 0.,250,RC,,,,both,1428.96,1286.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1000.27,,,,843.09,1166.03
NF-CHLOROTHIAZIDE SOD IV PWD FOR SOLN 0.,250,RC,,,,both,1428.96,1286.06,Cigna,Default,Percent of Total Billed Charges,843.09,,,,843.09,1166.03
NF-CHLOROTHIAZIDE SOD IV PWD FOR SOLN 0.,250,RC,,,,both,1428.96,1286.06,United Healthcare,Default,Fee Schedule,1166.03,,,,843.09,1166.03
NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,250,RC,,,,both,16.85,15.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.8,,,,9.94,13.75
NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,250,RC,,,,both,16.85,15.17,Cigna,Default,Percent of Total Billed Charges,9.94,,,,9.94,13.75
NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,250,RC,,,,both,16.85,15.17,United Healthcare,Default,Fee Schedule,13.75,,,,9.94,13.75
NF-FIBERCON ORAL TABLET 625MG,250,RC,,,,both,0.42,0.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.29,,,,0.25,0.34
NF-FIBERCON ORAL TABLET 625MG,250,RC,,,,both,0.42,0.38,Cigna,Default,Percent of Total Billed Charges,0.25,,,,0.25,0.34
NF-FIBERCON ORAL TABLET 625MG,250,RC,,,,both,0.42,0.38,United Healthcare,Default,Fee Schedule,0.34,,,,0.25,0.34
NF-CHLOROTHIAZIDE IV POWDER FOR SOLN 0.5,250,RC,,,,both,1428.96,1286.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1000.27,,,,843.09,1166.03
NF-CHLOROTHIAZIDE IV POWDER FOR SOLN 0.5,250,RC,,,,both,1428.96,1286.06,Cigna,Default,Percent of Total Billed Charges,843.09,,,,843.09,1166.03
NF-CHLOROTHIAZIDE IV POWDER FOR SOLN 0.5,250,RC,,,,both,1428.96,1286.06,United Healthcare,Default,Fee Schedule,1166.03,,,,843.09,1166.03
NF-NALTREXONE HCL ORAL TABLET 50MG,250,RC,,,,both,10.94,9.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.66,,,,6.45,8.93
NF-NALTREXONE HCL ORAL TABLET 50MG,250,RC,,,,both,10.94,9.85,Cigna,Default,Percent of Total Billed Charges,6.45,,,,6.45,8.93
NF-NALTREXONE HCL ORAL TABLET 50MG,250,RC,,,,both,10.94,9.85,United Healthcare,Default,Fee Schedule,8.93,,,,6.45,8.93
NF-KLONOPIN TABLET 1MG,250,RC,,,,both,13.97,12.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.78,,,,8.24,11.4
NF-KLONOPIN TABLET 1MG,250,RC,,,,both,13.97,12.57,Cigna,Default,Percent of Total Billed Charges,8.24,,,,8.24,11.4
NF-KLONOPIN TABLET 1MG,250,RC,,,,both,13.97,12.57,United Healthcare,Default,Fee Schedule,11.4,,,,8.24,11.4
REMDESIVIR 100MG INJ (VEKLURY),250,RC,,,,both,2683.2,2414.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1878.24,,,,1583.09,2189.49
REMDESIVIR 100MG INJ (VEKLURY),250,RC,,,,both,2683.2,2414.88,Cigna,Default,Percent of Total Billed Charges,1583.09,,,,1583.09,2189.49
REMDESIVIR 100MG INJ (VEKLURY),250,RC,,,,both,2683.2,2414.88,United Healthcare,Default,Fee Schedule,2189.49,,,,1583.09,2189.49
NF-FLUVOXAMINE MALEATE TAB 50MG,250,RC,,,,both,10.29,9.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.2,,,,6.07,8.4
NF-FLUVOXAMINE MALEATE TAB 50MG,250,RC,,,,both,10.29,9.26,Cigna,Default,Percent of Total Billed Charges,6.07,,,,6.07,8.4
NF-FLUVOXAMINE MALEATE TAB 50MG,250,RC,,,,both,10.29,9.26,United Healthcare,Default,Fee Schedule,8.4,,,,6.07,8.4
NF-FLUVOXAMINE MALEATE CAP ER 100MG,250,RC,,,,both,40.73,36.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.51,,,,24.03,33.24
NF-FLUVOXAMINE MALEATE CAP ER 100MG,250,RC,,,,both,40.73,36.66,Cigna,Default,Percent of Total Billed Charges,24.03,,,,24.03,33.24
NF-FLUVOXAMINE MALEATE CAP ER 100MG,250,RC,,,,both,40.73,36.66,United Healthcare,Default,Fee Schedule,33.24,,,,24.03,33.24
NF-ADVAIR DISKUS 100/50 DISK,250,RC,,,,both,25.36,22.82,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.75,,,,14.96,20.69
NF-ADVAIR DISKUS 100/50 DISK,250,RC,,,,both,25.36,22.82,Cigna,Default,Percent of Total Billed Charges,14.96,,,,14.96,20.69
NF-ADVAIR DISKUS 100/50 DISK,250,RC,,,,both,25.36,22.82,United Healthcare,Default,Fee Schedule,20.69,,,,14.96,20.69
NF-FEXOFENADINE HCL/PSEUDOEPHEDRINE HCL,250,RC,,,,both,26.1,23.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.27,,,,15.4,21.3
NF-FEXOFENADINE HCL/PSEUDOEPHEDRINE HCL,250,RC,,,,both,26.1,23.49,Cigna,Default,Percent of Total Billed Charges,15.4,,,,15.4,21.3
NF-FEXOFENADINE HCL/PSEUDOEPHEDRINE HCL,250,RC,,,,both,26.1,23.49,United Healthcare,Default,Fee Schedule,21.3,,,,15.4,21.3
VITAMIN C 1000 MG  TAB (ASCORBIC ACID),637,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
VITAMIN C 1000 MG  TAB (ASCORBIC ACID),637,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
VITAMIN C 1000 MG  TAB (ASCORBIC ACID),637,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
NF-FLUVOXAMINE MALEATE TAB 50MG,250,RC,,,,both,10.29,9.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.2,,,,6.07,8.4
NF-FLUVOXAMINE MALEATE TAB 50MG,250,RC,,,,both,10.29,9.26,Cigna,Default,Percent of Total Billed Charges,6.07,,,,6.07,8.4
NF-FLUVOXAMINE MALEATE TAB 50MG,250,RC,,,,both,10.29,9.26,United Healthcare,Default,Fee Schedule,8.4,,,,6.07,8.4
NF-VITAMIN E CAPSULE 1000IU,250,RC,,,,both,0.32,0.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.19,0.26
NF-VITAMIN E CAPSULE 1000IU,250,RC,,,,both,0.32,0.29,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.26
NF-VITAMIN E CAPSULE 1000IU,250,RC,,,,both,0.32,0.29,United Healthcare,Default,Fee Schedule,0.26,,,,0.19,0.26
NF-FEBUXOSTAT ORAL TABLET 40MG,250,RC,,,,both,49.51,44.56,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.66,,,,29.21,40.4
NF-FEBUXOSTAT ORAL TABLET 40MG,250,RC,,,,both,49.51,44.56,Cigna,Default,Percent of Total Billed Charges,29.21,,,,29.21,40.4
NF-FEBUXOSTAT ORAL TABLET 40MG,250,RC,,,,both,49.51,44.56,United Healthcare,Default,Fee Schedule,40.4,,,,29.21,40.4
NF-NASACORT ALLERGY 24HR NASAL SPRAY 55M,250,RC,,,,both,6.46,5.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.52,,,,3.81,5.27
NF-NASACORT ALLERGY 24HR NASAL SPRAY 55M,250,RC,,,,both,6.46,5.81,Cigna,Default,Percent of Total Billed Charges,3.81,,,,3.81,5.27
NF-NASACORT ALLERGY 24HR NASAL SPRAY 55M,250,RC,,,,both,6.46,5.81,United Healthcare,Default,Fee Schedule,5.27,,,,3.81,5.27
NF-JANUMET XR ORAL TAB ER 1000MG-100MG,250,RC,,,,both,79.49,71.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,55.64,,,,46.9,64.86
NF-JANUMET XR ORAL TAB ER 1000MG-100MG,250,RC,,,,both,79.49,71.54,Cigna,Default,Percent of Total Billed Charges,46.9,,,,46.9,64.86
NF-JANUMET XR ORAL TAB ER 1000MG-100MG,250,RC,,,,both,79.49,71.54,United Healthcare,Default,Fee Schedule,64.86,,,,46.9,64.86
NF-PRIMIDONE ORAL TABLET 250MG,250,RC,,,,both,4.2,3.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.94,,,,2.48,3.43
NF-PRIMIDONE ORAL TABLET 250MG,250,RC,,,,both,4.2,3.78,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.43
NF-PRIMIDONE ORAL TABLET 250MG,250,RC,,,,both,4.2,3.78,United Healthcare,Default,Fee Schedule,3.43,,,,2.48,3.43
NACL 0.9% + 40 MEQ KCL 1000 ML IV FLUID,636,RC,,,,both,52.05,46.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.44,,,,30.71,42.47
NACL 0.9% + 40 MEQ KCL 1000 ML IV FLUID,636,RC,,,,both,52.05,46.85,Cigna,Default,Percent of Total Billed Charges,30.71,,,,30.71,42.47
NACL 0.9% + 40 MEQ KCL 1000 ML IV FLUID,636,RC,,,,both,52.05,46.85,United Healthcare,Default,Fee Schedule,42.47,,,,30.71,42.47
NF-NAMZARIC CAP ER 7MG-10MG,250,RC,,,,both,81.61,73.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,57.13,,,,48.15,66.59
NF-NAMZARIC CAP ER 7MG-10MG,250,RC,,,,both,81.61,73.45,Cigna,Default,Percent of Total Billed Charges,48.15,,,,48.15,66.59
NF-NAMZARIC CAP ER 7MG-10MG,250,RC,,,,both,81.61,73.45,United Healthcare,Default,Fee Schedule,66.59,,,,48.15,66.59
NF-DOXYCYCLINE CAP 50MG,250,RC,,,,both,5.8,5.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.06,,,,3.42,4.73
NF-DOXYCYCLINE CAP 50MG,250,RC,,,,both,5.8,5.22,Cigna,Default,Percent of Total Billed Charges,3.42,,,,3.42,4.73
NF-DOXYCYCLINE CAP 50MG,250,RC,,,,both,5.8,5.22,United Healthcare,Default,Fee Schedule,4.73,,,,3.42,4.73
CEFTRIAXONE 2000MG INJ (ROCEPHIN),J0696,HCPCS,636,RC,,both,392.62,353.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,274.83,,,,231.65,320.38
CEFTRIAXONE 2000MG INJ (ROCEPHIN),J0696,HCPCS,636,RC,,both,392.62,353.36,Cigna,Default,Percent of Total Billed Charges,231.65,,,,231.65,320.38
CEFTRIAXONE 2000MG INJ (ROCEPHIN),J0696,HCPCS,636,RC,,both,392.62,353.36,United Healthcare,Default,Fee Schedule,320.38,,,,231.65,320.38
NF-MAYZENT ORAL TABLET 2MG,250,RC,,,,both,1289.24,1160.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,902.47,,,,760.65,1052.02
NF-MAYZENT ORAL TABLET 2MG,250,RC,,,,both,1289.24,1160.32,Cigna,Default,Percent of Total Billed Charges,760.65,,,,760.65,1052.02
NF-MAYZENT ORAL TABLET 2MG,250,RC,,,,both,1289.24,1160.32,United Healthcare,Default,Fee Schedule,1052.02,,,,760.65,1052.02
NF-DALFAMPRIDINE ORAL TAB ER 10MG,250,RC,,,,both,189.48,170.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.64,,,,111.79,154.62
NF-DALFAMPRIDINE ORAL TAB ER 10MG,250,RC,,,,both,189.48,170.53,Cigna,Default,Percent of Total Billed Charges,111.79,,,,111.79,154.62
NF-DALFAMPRIDINE ORAL TAB ER 10MG,250,RC,,,,both,189.48,170.53,United Healthcare,Default,Fee Schedule,154.62,,,,111.79,154.62
NF-DILTIAZEM 24 HR CAP ER 240MG,250,RC,,,,both,7.79,7.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.45,,,,4.6,6.36
NF-DILTIAZEM 24 HR CAP ER 240MG,250,RC,,,,both,7.79,7.01,Cigna,Default,Percent of Total Billed Charges,4.6,,,,4.6,6.36
NF-DILTIAZEM 24 HR CAP ER 240MG,250,RC,,,,both,7.79,7.01,United Healthcare,Default,Fee Schedule,6.36,,,,4.6,6.36
NF-QUINAPRIL HCL/HCTZ ORAL TAB 20MG-25MG,250,RC,,,,both,4.89,4.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.42,,,,2.89,3.99
NF-QUINAPRIL HCL/HCTZ ORAL TAB 20MG-25MG,250,RC,,,,both,4.89,4.4,Cigna,Default,Percent of Total Billed Charges,2.89,,,,2.89,3.99
NF-QUINAPRIL HCL/HCTZ ORAL TAB 20MG-25MG,250,RC,,,,both,4.89,4.4,United Healthcare,Default,Fee Schedule,3.99,,,,2.89,3.99
NF-ROSUVASTATIN CALCIUM AVPAK TABLET 10M,250,RC,,,,both,5.49,4.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.84,,,,3.24,4.48
NF-ROSUVASTATIN CALCIUM AVPAK TABLET 10M,250,RC,,,,both,5.49,4.94,Cigna,Default,Percent of Total Billed Charges,3.24,,,,3.24,4.48
NF-ROSUVASTATIN CALCIUM AVPAK TABLET 10M,250,RC,,,,both,5.49,4.94,United Healthcare,Default,Fee Schedule,4.48,,,,3.24,4.48
NF-ETOMIDATE INTRAVENOUS SOLUTION 2MG/1M,250,RC,,,,both,3.75,3.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.62,,,,2.21,3.06
NF-ETOMIDATE INTRAVENOUS SOLUTION 2MG/1M,250,RC,,,,both,3.75,3.38,Cigna,Default,Percent of Total Billed Charges,2.21,,,,2.21,3.06
NF-ETOMIDATE INTRAVENOUS SOLUTION 2MG/1M,250,RC,,,,both,3.75,3.38,United Healthcare,Default,Fee Schedule,3.06,,,,2.21,3.06
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,4.2,3.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.94,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,4.2,3.78,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,4.2,3.78,United Healthcare,Default,Fee Schedule,3.43,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,4.2,3.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.94,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,4.2,3.78,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.43
NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML,250,RC,,,,both,4.2,3.78,United Healthcare,Default,Fee Schedule,3.43,,,,2.48,3.43
NF-NEPRO WITH CARB STEADY ORAL SUSP,250,RC,,,,both,0.06,0.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-NEPRO WITH CARB STEADY ORAL SUSP,250,RC,,,,both,0.06,0.05,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.05
NF-NEPRO WITH CARB STEADY ORAL SUSP,250,RC,,,,both,0.06,0.05,United Healthcare,Default,Fee Schedule,0.05,,,,0.04,0.05
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,44.82,40.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.37,,,,26.44,36.57
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,44.82,40.34,Cigna,Default,Percent of Total Billed Charges,26.44,,,,26.44,36.57
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,44.82,40.34,United Healthcare,Default,Fee Schedule,36.57,,,,26.44,36.57
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,22.72,20.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.9,,,,13.4,18.54
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,22.72,20.45,Cigna,Default,Percent of Total Billed Charges,13.4,,,,13.4,18.54
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,22.72,20.45,United Healthcare,Default,Fee Schedule,18.54,,,,13.4,18.54
NF-EUTHYROX ORAL TABLET 75MCG,250,RC,,,,both,2.19,1.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.53,,,,1.29,1.79
NF-EUTHYROX ORAL TABLET 75MCG,250,RC,,,,both,2.19,1.97,Cigna,Default,Percent of Total Billed Charges,1.29,,,,1.29,1.79
NF-EUTHYROX ORAL TABLET 75MCG,250,RC,,,,both,2.19,1.97,United Healthcare,Default,Fee Schedule,1.79,,,,1.29,1.79
NF-ALTACE ORAL CAPSULE 10MG,250,RC,,,,both,4.82,4.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.37,,,,2.84,3.93
NF-ALTACE ORAL CAPSULE 10MG,250,RC,,,,both,4.82,4.34,Cigna,Default,Percent of Total Billed Charges,2.84,,,,2.84,3.93
NF-ALTACE ORAL CAPSULE 10MG,250,RC,,,,both,4.82,4.34,United Healthcare,Default,Fee Schedule,3.93,,,,2.84,3.93
NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25,250,RC,,,,both,1.57,1.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.1,,,,0.93,1.28
NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25,250,RC,,,,both,1.57,1.41,Cigna,Default,Percent of Total Billed Charges,0.93,,,,0.93,1.28
NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25,250,RC,,,,both,1.57,1.41,United Healthcare,Default,Fee Schedule,1.28,,,,0.93,1.28
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,45.44,40.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.81,,,,26.81,37.08
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,45.44,40.9,Cigna,Default,Percent of Total Billed Charges,26.81,,,,26.81,37.08
NF-MORPHINE SULFATE CAP ER 60MG,250,RC,,,,both,45.44,40.9,United Healthcare,Default,Fee Schedule,37.08,,,,26.81,37.08
NF-MORPHINE SULFATE IR ORAL TABLET 30MG,250,RC,,,,both,7.3,6.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.11,,,,4.31,5.96
NF-MORPHINE SULFATE IR ORAL TABLET 30MG,250,RC,,,,both,7.3,6.57,Cigna,Default,Percent of Total Billed Charges,4.31,,,,4.31,5.96
NF-MORPHINE SULFATE IR ORAL TABLET 30MG,250,RC,,,,both,7.3,6.57,United Healthcare,Default,Fee Schedule,5.96,,,,4.31,5.96
NF-LANSOPRAZOLE PWD FOR SUSP 3MG/1ML,250,RC,,,,both,1.84,1.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.29,,,,1.09,1.5
NF-LANSOPRAZOLE PWD FOR SUSP 3MG/1ML,250,RC,,,,both,1.84,1.66,Cigna,Default,Percent of Total Billed Charges,1.09,,,,1.09,1.5
NF-LANSOPRAZOLE PWD FOR SUSP 3MG/1ML,250,RC,,,,both,1.84,1.66,United Healthcare,Default,Fee Schedule,1.5,,,,1.09,1.5
LIDOCAINE JELLY 2% 6ML (XYLOCAINE),250,RC,,,,both,36.12,32.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.28,,,,21.31,29.47
LIDOCAINE JELLY 2% 6ML (XYLOCAINE),250,RC,,,,both,36.12,32.51,Cigna,Default,Percent of Total Billed Charges,21.31,,,,21.31,29.47
LIDOCAINE JELLY 2% 6ML (XYLOCAINE),250,RC,,,,both,36.12,32.51,United Healthcare,Default,Fee Schedule,29.47,,,,21.31,29.47
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
NF-PANTOPRAZOLE 20MG TABLET,250,RC,,,,both,15.94,14.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.16,,,,9.4,13.01
NF-PANTOPRAZOLE 20MG TABLET,250,RC,,,,both,15.94,14.35,Cigna,Default,Percent of Total Billed Charges,9.4,,,,9.4,13.01
NF-PANTOPRAZOLE 20MG TABLET,250,RC,,,,both,15.94,14.35,United Healthcare,Default,Fee Schedule,13.01,,,,9.4,13.01
NF-TRIAMCINOLONE ACETONIDE CREAM 0.1%,250,RC,,,,both,0.27,0.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.19,,,,0.16,0.22
NF-TRIAMCINOLONE ACETONIDE CREAM 0.1%,250,RC,,,,both,0.27,0.24,Cigna,Default,Percent of Total Billed Charges,0.16,,,,0.16,0.22
NF-TRIAMCINOLONE ACETONIDE CREAM 0.1%,250,RC,,,,both,0.27,0.24,United Healthcare,Default,Fee Schedule,0.22,,,,0.16,0.22
NF-SUBOXONE SL FILM 8MG-2MG,250,RC,,,,both,43.12,38.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.18,,,,25.44,35.19
NF-SUBOXONE SL FILM 8MG-2MG,250,RC,,,,both,43.12,38.81,Cigna,Default,Percent of Total Billed Charges,25.44,,,,25.44,35.19
NF-SUBOXONE SL FILM 8MG-2MG,250,RC,,,,both,43.12,38.81,United Healthcare,Default,Fee Schedule,35.19,,,,25.44,35.19
NF-PROCTOSOL-HC RECTAL CREAM 2.5%,250,RC,,,,both,3.52,3.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.46,,,,2.08,2.87
NF-PROCTOSOL-HC RECTAL CREAM 2.5%,250,RC,,,,both,3.52,3.17,Cigna,Default,Percent of Total Billed Charges,2.08,,,,2.08,2.87
NF-PROCTOSOL-HC RECTAL CREAM 2.5%,250,RC,,,,both,3.52,3.17,United Healthcare,Default,Fee Schedule,2.87,,,,2.08,2.87
NF-TRULICITY SUBQ SOLN 1.5MG/0.5ML,250,RC,,,,both,2127.74,1914.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1489.42,,,,1255.37,1736.24
NF-TRULICITY SUBQ SOLN 1.5MG/0.5ML,250,RC,,,,both,2127.74,1914.97,Cigna,Default,Percent of Total Billed Charges,1255.37,,,,1255.37,1736.24
NF-TRULICITY SUBQ SOLN 1.5MG/0.5ML,250,RC,,,,both,2127.74,1914.97,United Healthcare,Default,Fee Schedule,1736.24,,,,1255.37,1736.24
NF-I-VITE LUTEIN ORAL TABLET,250,RC,,,,both,0.31,0.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.18,0.25
NF-I-VITE LUTEIN ORAL TABLET,250,RC,,,,both,0.31,0.28,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.25
NF-I-VITE LUTEIN ORAL TABLET,250,RC,,,,both,0.31,0.28,United Healthcare,Default,Fee Schedule,0.25,,,,0.18,0.25
NF-MYLANTA TONIGHT ORAL SUSPENSION,250,RC,,,,both,0.07,0.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.05,,,,0.04,0.06
NF-MYLANTA TONIGHT ORAL SUSPENSION,250,RC,,,,both,0.07,0.06,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.06
NF-MYLANTA TONIGHT ORAL SUSPENSION,250,RC,,,,both,0.07,0.06,United Healthcare,Default,Fee Schedule,0.06,,,,0.04,0.06
NF-ALPHAGAN P OPHTH SOLN 0.15%,250,RC,,,,both,189.52,170.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,132.66,,,,111.82,154.65
NF-ALPHAGAN P OPHTH SOLN 0.15%,250,RC,,,,both,189.52,170.57,Cigna,Default,Percent of Total Billed Charges,111.82,,,,111.82,154.65
NF-ALPHAGAN P OPHTH SOLN 0.15%,250,RC,,,,both,189.52,170.57,United Healthcare,Default,Fee Schedule,154.65,,,,111.82,154.65
NF-CARTIA XT ORAL 24 HR CAP ER 120MG,250,RC,,,,both,4.89,4.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.42,,,,2.89,3.99
NF-CARTIA XT ORAL 24 HR CAP ER 120MG,250,RC,,,,both,4.89,4.4,Cigna,Default,Percent of Total Billed Charges,2.89,,,,2.89,3.99
NF-CARTIA XT ORAL 24 HR CAP ER 120MG,250,RC,,,,both,4.89,4.4,United Healthcare,Default,Fee Schedule,3.99,,,,2.89,3.99
NF-ROSUVASTATIN CALCIUM CAP 10MG,250,RC,,,,both,14.64,13.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.25,,,,8.64,11.95
NF-ROSUVASTATIN CALCIUM CAP 10MG,250,RC,,,,both,14.64,13.18,Cigna,Default,Percent of Total Billed Charges,8.64,,,,8.64,11.95
NF-ROSUVASTATIN CALCIUM CAP 10MG,250,RC,,,,both,14.64,13.18,United Healthcare,Default,Fee Schedule,11.95,,,,8.64,11.95
NF-ADVAIR HFA 230/21 INH AER 230MCG-21MC,250,RC,,,,both,194.73,175.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,136.31,,,,114.89,158.9
NF-ADVAIR HFA 230/21 INH AER 230MCG-21MC,250,RC,,,,both,194.73,175.26,Cigna,Default,Percent of Total Billed Charges,114.89,,,,114.89,158.9
NF-ADVAIR HFA 230/21 INH AER 230MCG-21MC,250,RC,,,,both,194.73,175.26,United Healthcare,Default,Fee Schedule,158.9,,,,114.89,158.9
NF-LORAZEPAM ORAL TABLET 1MG,250,RC,,,,both,3.63,3.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.54,,,,2.14,2.96
NF-LORAZEPAM ORAL TABLET 1MG,250,RC,,,,both,3.63,3.27,Cigna,Default,Percent of Total Billed Charges,2.14,,,,2.14,2.96
NF-LORAZEPAM ORAL TABLET 1MG,250,RC,,,,both,3.63,3.27,United Healthcare,Default,Fee Schedule,2.96,,,,2.14,2.96
KCENTRA 548 IU,J7168,HCPCS,636,RC,,both,8435.91,7592.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5905.14,,,,4977.19,6883.7
KCENTRA 548 IU,J7168,HCPCS,636,RC,,both,8435.91,7592.32,Cigna,Default,Percent of Total Billed Charges,4977.19,,,,4977.19,6883.7
KCENTRA 548 IU,J7168,HCPCS,636,RC,,both,8435.91,7592.32,United Healthcare,Default,Fee Schedule,6883.7,,,,4977.19,6883.7
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,250,RC,,,,both,34.45,31.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.12,,,,20.33,28.11
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,250,RC,,,,both,34.45,31.01,Cigna,Default,Percent of Total Billed Charges,20.33,,,,20.33,28.11
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,250,RC,,,,both,34.45,31.01,United Healthcare,Default,Fee Schedule,28.11,,,,20.33,28.11
NF-POTASSIUM CHLORIDE IV SOLN 30MEQ/100M,250,RC,,,,both,0.13,0.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.09,,,,0.08,0.11
NF-POTASSIUM CHLORIDE IV SOLN 30MEQ/100M,250,RC,,,,both,0.13,0.12,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-POTASSIUM CHLORIDE IV SOLN 30MEQ/100M,250,RC,,,,both,0.13,0.12,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
NF-SODIUM CHLORIDE,250,RC,,,,both,0.02,0.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-SODIUM CHLORIDE,250,RC,,,,both,0.02,0.02,Cigna,Default,Percent of Total Billed Charges,0.01,,,,0.01,0.02
NF-SODIUM CHLORIDE,250,RC,,,,both,0.02,0.02,United Healthcare,Default,Fee Schedule,0.02,,,,0.01,0.02
NF-ANTIBIOTIC OINTMENT,250,RC,,,,both,0.63,0.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.44,,,,0.37,0.51
NF-ANTIBIOTIC OINTMENT,250,RC,,,,both,0.63,0.57,Cigna,Default,Percent of Total Billed Charges,0.37,,,,0.37,0.51
NF-ANTIBIOTIC OINTMENT,250,RC,,,,both,0.63,0.57,United Healthcare,Default,Fee Schedule,0.51,,,,0.37,0.51
NF-ZOSYN IV SOLUTION 4GM-0.5GM/100ML,250,RC,,,,both,1.22,1.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.85,,,,0.72,1
NF-ZOSYN IV SOLUTION 4GM-0.5GM/100ML,250,RC,,,,both,1.22,1.1,Cigna,Default,Percent of Total Billed Charges,0.72,,,,0.72,1
NF-ZOSYN IV SOLUTION 4GM-0.5GM/100ML,250,RC,,,,both,1.22,1.1,United Healthcare,Default,Fee Schedule,1,,,,0.72,1
PIPERACILLIN/TAZOBACTAM 4GM/.5GM INJ,J2543,HCPCS,636,RC,,both,93.53,84.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.47,,,,55.18,76.32
PIPERACILLIN/TAZOBACTAM 4GM/.5GM INJ,J2543,HCPCS,636,RC,,both,93.53,84.18,Cigna,Default,Percent of Total Billed Charges,55.18,,,,55.18,76.32
PIPERACILLIN/TAZOBACTAM 4GM/.5GM INJ,J2543,HCPCS,636,RC,,both,93.53,84.18,United Healthcare,Default,Fee Schedule,76.32,,,,55.18,76.32
NF-FOSINOPRIL SODIUM ORAL TABLET 20MG,250,RC,,,,both,4.76,4.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.33,,,,2.81,3.88
NF-FOSINOPRIL SODIUM ORAL TABLET 20MG,250,RC,,,,both,4.76,4.28,Cigna,Default,Percent of Total Billed Charges,2.81,,,,2.81,3.88
NF-FOSINOPRIL SODIUM ORAL TABLET 20MG,250,RC,,,,both,4.76,4.28,United Healthcare,Default,Fee Schedule,3.88,,,,2.81,3.88
NF-8HR ARTHRITIS PAIN RELIEF TABER 650MG,250,RC,,,,both,0.3,0.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.21,,,,0.18,0.24
NF-8HR ARTHRITIS PAIN RELIEF TABER 650MG,250,RC,,,,both,0.3,0.27,Cigna,Default,Percent of Total Billed Charges,0.18,,,,0.18,0.24
NF-8HR ARTHRITIS PAIN RELIEF TABER 650MG,250,RC,,,,both,0.3,0.27,United Healthcare,Default,Fee Schedule,0.24,,,,0.18,0.24
NF-VISION HEALTH ORAL LIQUID CAPSULE,250,RC,,,,both,0.63,0.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.44,,,,0.37,0.51
NF-VISION HEALTH ORAL LIQUID CAPSULE,250,RC,,,,both,0.63,0.57,Cigna,Default,Percent of Total Billed Charges,0.37,,,,0.37,0.51
NF-VISION HEALTH ORAL LIQUID CAPSULE,250,RC,,,,both,0.63,0.57,United Healthcare,Default,Fee Schedule,0.51,,,,0.37,0.51
NF-NEXIUM 24HR ORAL TABLET DR 20MG,250,RC,,,,both,3.71,3.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.6,,,,2.19,3.03
NF-NEXIUM 24HR ORAL TABLET DR 20MG,250,RC,,,,both,3.71,3.34,Cigna,Default,Percent of Total Billed Charges,2.19,,,,2.19,3.03
NF-NEXIUM 24HR ORAL TABLET DR 20MG,250,RC,,,,both,3.71,3.34,United Healthcare,Default,Fee Schedule,3.03,,,,2.19,3.03
NF-VIT B COMPLEX AND IRON-VIT B COMPLEX,250,RC,,,,both,10.29,9.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.2,,,,6.07,8.4
NF-VIT B COMPLEX AND IRON-VIT B COMPLEX,250,RC,,,,both,10.29,9.26,Cigna,Default,Percent of Total Billed Charges,6.07,,,,6.07,8.4
NF-VIT B COMPLEX AND IRON-VIT B COMPLEX,250,RC,,,,both,10.29,9.26,United Healthcare,Default,Fee Schedule,8.4,,,,6.07,8.4
NF-VIT. B COMPLEX AND MINERAL-VIT. B COM,250,RC,,,,both,29.78,26.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.85,,,,17.57,24.3
NF-VIT. B COMPLEX AND MINERAL-VIT. B COM,250,RC,,,,both,29.78,26.8,Cigna,Default,Percent of Total Billed Charges,17.57,,,,17.57,24.3
NF-VIT. B COMPLEX AND MINERAL-VIT. B COM,250,RC,,,,both,29.78,26.8,United Healthcare,Default,Fee Schedule,24.3,,,,17.57,24.3
NF-FLAX SEED OIL CAPSULE 1000MG,250,RC,,,,both,0.32,0.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.19,0.26
NF-FLAX SEED OIL CAPSULE 1000MG,250,RC,,,,both,0.32,0.29,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.26
NF-FLAX SEED OIL CAPSULE 1000MG,250,RC,,,,both,0.32,0.29,United Healthcare,Default,Fee Schedule,0.26,,,,0.19,0.26
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,25.95,23.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.16,,,,15.31,21.18
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,25.95,23.36,Cigna,Default,Percent of Total Billed Charges,15.31,,,,15.31,21.18
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,25.95,23.36,United Healthcare,Default,Fee Schedule,21.18,,,,15.31,21.18
NF-MORPHINE SULFATE IR ORAL TABLET 30MG,250,RC,,,,both,3.67,3.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.57,,,,2.17,2.99
NF-MORPHINE SULFATE IR ORAL TABLET 30MG,250,RC,,,,both,3.67,3.3,Cigna,Default,Percent of Total Billed Charges,2.17,,,,2.17,2.99
NF-MORPHINE SULFATE IR ORAL TABLET 30MG,250,RC,,,,both,3.67,3.3,United Healthcare,Default,Fee Schedule,2.99,,,,2.17,2.99
NF-AMOXICILLIN    CAP  500MG,250,RC,,,,both,1.56,1.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.09,,,,0.92,1.27
NF-AMOXICILLIN    CAP  500MG,250,RC,,,,both,1.56,1.4,Cigna,Default,Percent of Total Billed Charges,0.92,,,,0.92,1.27
NF-AMOXICILLIN    CAP  500MG,250,RC,,,,both,1.56,1.4,United Healthcare,Default,Fee Schedule,1.27,,,,0.92,1.27
NF-METFORMIN HCL ORAL TAB ER 1000MG,250,RC,,,,both,480.95,432.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,336.66,,,,283.76,392.46
NF-METFORMIN HCL ORAL TAB ER 1000MG,250,RC,,,,both,480.95,432.86,Cigna,Default,Percent of Total Billed Charges,283.76,,,,283.76,392.46
NF-METFORMIN HCL ORAL TAB ER 1000MG,250,RC,,,,both,480.95,432.86,United Healthcare,Default,Fee Schedule,392.46,,,,283.76,392.46
NF-CELEXA TAB 20MG,250,RC,,,,both,19.34,17.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.54,,,,11.41,15.78
NF-CELEXA TAB 20MG,250,RC,,,,both,19.34,17.41,Cigna,Default,Percent of Total Billed Charges,11.41,,,,11.41,15.78
NF-CELEXA TAB 20MG,250,RC,,,,both,19.34,17.41,United Healthcare,Default,Fee Schedule,15.78,,,,11.41,15.78
NF-PRAZOSIN HCL CAP 5MG,250,RC,,,,both,8.73,7.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.11,,,,5.15,7.12
NF-PRAZOSIN HCL CAP 5MG,250,RC,,,,both,8.73,7.86,Cigna,Default,Percent of Total Billed Charges,5.15,,,,5.15,7.12
NF-PRAZOSIN HCL CAP 5MG,250,RC,,,,both,8.73,7.86,United Healthcare,Default,Fee Schedule,7.12,,,,5.15,7.12
NF-CYCLOSPORINE OPHTH  EMULSION 0.05%,250,RC,,,,both,51.65,46.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.16,,,,30.47,42.15
NF-CYCLOSPORINE OPHTH  EMULSION 0.05%,250,RC,,,,both,51.65,46.49,Cigna,Default,Percent of Total Billed Charges,30.47,,,,30.47,42.15
NF-CYCLOSPORINE OPHTH  EMULSION 0.05%,250,RC,,,,both,51.65,46.49,United Healthcare,Default,Fee Schedule,42.15,,,,30.47,42.15
NF-PREGABALIN CAP 200MG,250,RC,,,,both,43.23,38.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.26,,,,25.51,35.28
NF-PREGABALIN CAP 200MG,250,RC,,,,both,43.23,38.91,Cigna,Default,Percent of Total Billed Charges,25.51,,,,25.51,35.28
NF-PREGABALIN CAP 200MG,250,RC,,,,both,43.23,38.91,United Healthcare,Default,Fee Schedule,35.28,,,,25.51,35.28
NF-PROTONIX INJECTION 40MG,250,RC,,,,both,24.36,21.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.05,,,,14.37,19.88
NF-PROTONIX INJECTION 40MG,250,RC,,,,both,24.36,21.92,Cigna,Default,Percent of Total Billed Charges,14.37,,,,14.37,19.88
NF-PROTONIX INJECTION 40MG,250,RC,,,,both,24.36,21.92,United Healthcare,Default,Fee Schedule,19.88,,,,14.37,19.88
NF-ERLEADA ORAL TABLET 60MG,250,RC,,,,both,541.05,486.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,378.74,,,,319.22,441.5
NF-ERLEADA ORAL TABLET 60MG,250,RC,,,,both,541.05,486.95,Cigna,Default,Percent of Total Billed Charges,319.22,,,,319.22,441.5
NF-ERLEADA ORAL TABLET 60MG,250,RC,,,,both,541.05,486.95,United Healthcare,Default,Fee Schedule,441.5,,,,319.22,441.5
CEFAZOLIN 2000MG INJ (ANCEF),J0689,HCPCS,636,RC,,both,31.44,28.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.01,,,,18.55,25.66
CEFAZOLIN 2000MG INJ (ANCEF),J0689,HCPCS,636,RC,,both,31.44,28.3,Cigna,Default,Percent of Total Billed Charges,18.55,,,,18.55,25.66
CEFAZOLIN 2000MG INJ (ANCEF),J0689,HCPCS,636,RC,,both,31.44,28.3,United Healthcare,Default,Fee Schedule,25.66,,,,18.55,25.66
NF-SERTRALINE HCL ORAL TABLET 25MG,250,RC,,,,both,11.01,9.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.71,,,,6.5,8.98
NF-SERTRALINE HCL ORAL TABLET 25MG,250,RC,,,,both,11.01,9.91,Cigna,Default,Percent of Total Billed Charges,6.5,,,,6.5,8.98
NF-SERTRALINE HCL ORAL TABLET 25MG,250,RC,,,,both,11.01,9.91,United Healthcare,Default,Fee Schedule,8.98,,,,6.5,8.98
NF-ESCITALOPRAM ORAL TABLET 5MG,250,RC,,,,both,19.92,17.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.94,,,,11.75,16.25
NF-ESCITALOPRAM ORAL TABLET 5MG,250,RC,,,,both,19.92,17.93,Cigna,Default,Percent of Total Billed Charges,11.75,,,,11.75,16.25
NF-ESCITALOPRAM ORAL TABLET 5MG,250,RC,,,,both,19.92,17.93,United Healthcare,Default,Fee Schedule,16.25,,,,11.75,16.25
NF-COLACE LIQ CAP 50MG,250,RC,,,,both,1.17,1.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.82,,,,0.69,0.95
NF-COLACE LIQ CAP 50MG,250,RC,,,,both,1.17,1.05,Cigna,Default,Percent of Total Billed Charges,0.69,,,,0.69,0.95
NF-COLACE LIQ CAP 50MG,250,RC,,,,both,1.17,1.05,United Healthcare,Default,Fee Schedule,0.95,,,,0.69,0.95
NF-FLOVENT DISKUS INH PWD 100MCG/1ACT,250,RC,,,,both,16.36,14.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.45,,,,9.65,13.35
NF-FLOVENT DISKUS INH PWD 100MCG/1ACT,250,RC,,,,both,16.36,14.72,Cigna,Default,Percent of Total Billed Charges,9.65,,,,9.65,13.35
NF-FLOVENT DISKUS INH PWD 100MCG/1ACT,250,RC,,,,both,16.36,14.72,United Healthcare,Default,Fee Schedule,13.35,,,,9.65,13.35
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.06%,250,RC,,,,both,20.54,18.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.38,,,,12.12,16.76
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.06%,250,RC,,,,both,20.54,18.49,Cigna,Default,Percent of Total Billed Charges,12.12,,,,12.12,16.76
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.06%,250,RC,,,,both,20.54,18.49,United Healthcare,Default,Fee Schedule,16.76,,,,12.12,16.76
NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 50-1,250,RC,,,,both,10.01,9.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.01,,,,5.91,8.17
NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 50-1,250,RC,,,,both,10.01,9.01,Cigna,Default,Percent of Total Billed Charges,5.91,,,,5.91,8.17
NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 50-1,250,RC,,,,both,10.01,9.01,United Healthcare,Default,Fee Schedule,8.17,,,,5.91,8.17
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,44.22,39.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.95,,,,26.09,36.08
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,44.22,39.8,Cigna,Default,Percent of Total Billed Charges,26.09,,,,26.09,36.08
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,44.22,39.8,United Healthcare,Default,Fee Schedule,36.08,,,,26.09,36.08
NF-MURO-128 OPHTH SOLUTION 5%,250,RC,,,,both,27.2,24.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.04,,,,16.05,22.2
NF-MURO-128 OPHTH SOLUTION 5%,250,RC,,,,both,27.2,24.48,Cigna,Default,Percent of Total Billed Charges,16.05,,,,16.05,22.2
NF-MURO-128 OPHTH SOLUTION 5%,250,RC,,,,both,27.2,24.48,United Healthcare,Default,Fee Schedule,22.2,,,,16.05,22.2
NF-BRIMONIDINE-TIMOLOL OPHTH SOLN 0.2%-0,250,RC,,,,both,177.31,159.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,124.12,,,,104.61,144.68
NF-BRIMONIDINE-TIMOLOL OPHTH SOLN 0.2%-0,250,RC,,,,both,177.31,159.58,Cigna,Default,Percent of Total Billed Charges,104.61,,,,104.61,144.68
NF-BRIMONIDINE-TIMOLOL OPHTH SOLN 0.2%-0,250,RC,,,,both,177.31,159.58,United Healthcare,Default,Fee Schedule,144.68,,,,104.61,144.68
NF-HYDRALAZINE HCL ORAL TAB 50MG,250,RC,,,,both,2.42,2.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.69,,,,1.43,1.97
NF-HYDRALAZINE HCL ORAL TAB 50MG,250,RC,,,,both,2.42,2.18,Cigna,Default,Percent of Total Billed Charges,1.43,,,,1.43,1.97
NF-HYDRALAZINE HCL ORAL TAB 50MG,250,RC,,,,both,2.42,2.18,United Healthcare,Default,Fee Schedule,1.97,,,,1.43,1.97
NF-FLUOXETINE HCL CAP 20MG,250,RC,,,,both,25.86,23.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.1,,,,15.26,21.1
NF-FLUOXETINE HCL CAP 20MG,250,RC,,,,both,25.86,23.27,Cigna,Default,Percent of Total Billed Charges,15.26,,,,15.26,21.1
NF-FLUOXETINE HCL CAP 20MG,250,RC,,,,both,25.86,23.27,United Healthcare,Default,Fee Schedule,21.1,,,,15.26,21.1
NF-TRELEGY ELLIPTA 200/62.5/25MCG/INH,250,RC,,,,both,49.53,44.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,34.67,,,,29.22,40.42
NF-TRELEGY ELLIPTA 200/62.5/25MCG/INH,250,RC,,,,both,49.53,44.58,Cigna,Default,Percent of Total Billed Charges,29.22,,,,29.22,40.42
NF-TRELEGY ELLIPTA 200/62.5/25MCG/INH,250,RC,,,,both,49.53,44.58,United Healthcare,Default,Fee Schedule,40.42,,,,29.22,40.42
NF-PRADAXA CAP 150MG,250,RC,,,,both,32.05,28.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.44,,,,18.91,26.15
NF-PRADAXA CAP 150MG,250,RC,,,,both,32.05,28.85,Cigna,Default,Percent of Total Billed Charges,18.91,,,,18.91,26.15
NF-PRADAXA CAP 150MG,250,RC,,,,both,32.05,28.85,United Healthcare,Default,Fee Schedule,26.15,,,,18.91,26.15
NF-BIOTIN CAP 5000MCG,250,RC,,,,both,0.4,0.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.28,,,,0.24,0.33
NF-BIOTIN CAP 5000MCG,250,RC,,,,both,0.4,0.36,Cigna,Default,Percent of Total Billed Charges,0.24,,,,0.24,0.33
NF-BIOTIN CAP 5000MCG,250,RC,,,,both,0.4,0.36,United Healthcare,Default,Fee Schedule,0.33,,,,0.24,0.33
NF-MESALAMINE CAP DR 400MG,250,RC,,,,both,18.62,16.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.03,,,,10.99,15.19
NF-MESALAMINE CAP DR 400MG,250,RC,,,,both,18.62,16.76,Cigna,Default,Percent of Total Billed Charges,10.99,,,,10.99,15.19
NF-MESALAMINE CAP DR 400MG,250,RC,,,,both,18.62,16.76,United Healthcare,Default,Fee Schedule,15.19,,,,10.99,15.19
NF-POTASSIUM CHLORIDE ORAL SOLN 40MEQ/15,250,RC,,,,both,6.5,5.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.55,,,,3.84,5.3
NF-POTASSIUM CHLORIDE ORAL SOLN 40MEQ/15,250,RC,,,,both,6.5,5.85,Cigna,Default,Percent of Total Billed Charges,3.84,,,,3.84,5.3
NF-POTASSIUM CHLORIDE ORAL SOLN 40MEQ/15,250,RC,,,,both,6.5,5.85,United Healthcare,Default,Fee Schedule,5.3,,,,3.84,5.3
NF-PEPTIDE 1.5 SUSPENSION,250,RC,,,,both,0.09,0.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-PEPTIDE 1.5 SUSPENSION,250,RC,,,,both,0.09,0.08,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-PEPTIDE 1.5 SUSPENSION,250,RC,,,,both,0.09,0.08,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
KETAMINE 500MG/ 5ML INJ (KETALAR),250,RC,,,,both,68.83,61.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.18,,,,40.61,56.17
KETAMINE 500MG/ 5ML INJ (KETALAR),250,RC,,,,both,68.83,61.95,Cigna,Default,Percent of Total Billed Charges,40.61,,,,40.61,56.17
KETAMINE 500MG/ 5ML INJ (KETALAR),250,RC,,,,both,68.83,61.95,United Healthcare,Default,Fee Schedule,56.17,,,,40.61,56.17
NF-OFLOXACIN OPHTHALMIC SOLUTION 0.3%,250,RC,,,,both,16.75,15.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.72,,,,9.88,13.67
NF-OFLOXACIN OPHTHALMIC SOLUTION 0.3%,250,RC,,,,both,16.75,15.08,Cigna,Default,Percent of Total Billed Charges,9.88,,,,9.88,13.67
NF-OFLOXACIN OPHTHALMIC SOLUTION 0.3%,250,RC,,,,both,16.75,15.08,United Healthcare,Default,Fee Schedule,13.67,,,,9.88,13.67
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,44.22,39.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.95,,,,26.09,36.08
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,44.22,39.8,Cigna,Default,Percent of Total Billed Charges,26.09,,,,26.09,36.08
NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,250,RC,,,,both,44.22,39.8,United Healthcare,Default,Fee Schedule,36.08,,,,26.09,36.08
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.86,0.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.6,,,,0.51,0.7
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.86,0.77,Cigna,Default,Percent of Total Billed Charges,0.51,,,,0.51,0.7
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.86,0.77,United Healthcare,Default,Fee Schedule,0.7,,,,0.51,0.7
NF-GLUCOSAMINE COMPLEX TABLET,250,RC,,,,both,0.53,0.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.37,,,,0.31,0.43
NF-GLUCOSAMINE COMPLEX TABLET,250,RC,,,,both,0.53,0.48,Cigna,Default,Percent of Total Billed Charges,0.31,,,,0.31,0.43
NF-GLUCOSAMINE COMPLEX TABLET,250,RC,,,,both,0.53,0.48,United Healthcare,Default,Fee Schedule,0.43,,,,0.31,0.43
NF-TURMERIC CAP 400MG,250,RC,,,,both,0.39,0.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.27,,,,0.23,0.32
NF-TURMERIC CAP 400MG,250,RC,,,,both,0.39,0.35,Cigna,Default,Percent of Total Billed Charges,0.23,,,,0.23,0.32
NF-TURMERIC CAP 400MG,250,RC,,,,both,0.39,0.35,United Healthcare,Default,Fee Schedule,0.32,,,,0.23,0.32
LUPRON DEPOT INJ 30MG FOR 4MONTH ADMIN,J9217,HCPCS,636,RC,,both,38267.68,34440.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26787.38,,,,22577.93,31226.43
LUPRON DEPOT INJ 30MG FOR 4MONTH ADMIN,J9217,HCPCS,636,RC,,both,38267.68,34440.91,Cigna,Default,Percent of Total Billed Charges,22577.93,,,,22577.93,31226.43
LUPRON DEPOT INJ 30MG FOR 4MONTH ADMIN,J9217,HCPCS,636,RC,,both,38267.68,34440.91,United Healthcare,Default,Fee Schedule,31226.43,,,,22577.93,31226.43
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
NF-CRESTOR ORAL TABLET 40MG,250,RC,,,,both,22.19,19.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.53,,,,13.09,18.11
NF-CRESTOR ORAL TABLET 40MG,250,RC,,,,both,22.19,19.97,Cigna,Default,Percent of Total Billed Charges,13.09,,,,13.09,18.11
NF-CRESTOR ORAL TABLET 40MG,250,RC,,,,both,22.19,19.97,United Healthcare,Default,Fee Schedule,18.11,,,,13.09,18.11
NF-APPLE CIDER VINEGAR PLUS ORAL TABLET,250,RC,,,,both,0.61,0.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.43,,,,0.36,0.5
NF-APPLE CIDER VINEGAR PLUS ORAL TABLET,250,RC,,,,both,0.61,0.55,Cigna,Default,Percent of Total Billed Charges,0.36,,,,0.36,0.5
NF-APPLE CIDER VINEGAR PLUS ORAL TABLET,250,RC,,,,both,0.61,0.55,United Healthcare,Default,Fee Schedule,0.5,,,,0.36,0.5
NF-ESTROVEN ENERGY ORAL TABLET,250,RC,,,,both,2.64,2.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.85,,,,1.56,2.15
NF-ESTROVEN ENERGY ORAL TABLET,250,RC,,,,both,2.64,2.38,Cigna,Default,Percent of Total Billed Charges,1.56,,,,1.56,2.15
NF-ESTROVEN ENERGY ORAL TABLET,250,RC,,,,both,2.64,2.38,United Healthcare,Default,Fee Schedule,2.15,,,,1.56,2.15
NF-FERROUS GLUCONATE TABLET 240MG,250,RC,,,,both,0.33,0.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.23,,,,0.19,0.27
NF-FERROUS GLUCONATE TABLET 240MG,250,RC,,,,both,0.33,0.3,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.27
NF-FERROUS GLUCONATE TABLET 240MG,250,RC,,,,both,0.33,0.3,United Healthcare,Default,Fee Schedule,0.27,,,,0.19,0.27
NF-SPRINTEC TAB 35MCG-0.25MG,250,RC,,,,both,4.6,4.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.22,,,,2.71,3.75
NF-SPRINTEC TAB 35MCG-0.25MG,250,RC,,,,both,4.6,4.14,Cigna,Default,Percent of Total Billed Charges,2.71,,,,2.71,3.75
NF-SPRINTEC TAB 35MCG-0.25MG,250,RC,,,,both,4.6,4.14,United Healthcare,Default,Fee Schedule,3.75,,,,2.71,3.75
NF-WOMENS DAILY MULTI FORMULA ORAL TABLE,250,RC,,,,both,0.34,0.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.24,,,,0.2,0.28
NF-WOMENS DAILY MULTI FORMULA ORAL TABLE,250,RC,,,,both,0.34,0.31,Cigna,Default,Percent of Total Billed Charges,0.2,,,,0.2,0.28
NF-WOMENS DAILY MULTI FORMULA ORAL TABLE,250,RC,,,,both,0.34,0.31,United Healthcare,Default,Fee Schedule,0.28,,,,0.2,0.28
NF-IRBESARTAN ORAL TABLET 300MG,250,RC,,,,both,14.77,13.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.34,,,,8.71,12.05
NF-IRBESARTAN ORAL TABLET 300MG,250,RC,,,,both,14.77,13.29,Cigna,Default,Percent of Total Billed Charges,8.71,,,,8.71,12.05
NF-IRBESARTAN ORAL TABLET 300MG,250,RC,,,,both,14.77,13.29,United Healthcare,Default,Fee Schedule,12.05,,,,8.71,12.05
NF-AMLODIPINE-OLMESARTAN ORAL TAB 10MG-4,250,RC,,,,both,39.61,35.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.73,,,,23.37,32.32
NF-AMLODIPINE-OLMESARTAN ORAL TAB 10MG-4,250,RC,,,,both,39.61,35.65,Cigna,Default,Percent of Total Billed Charges,23.37,,,,23.37,32.32
NF-AMLODIPINE-OLMESARTAN ORAL TAB 10MG-4,250,RC,,,,both,39.61,35.65,United Healthcare,Default,Fee Schedule,32.32,,,,23.37,32.32
NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,53.99,48.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.79,,,,31.85,44.06
NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,53.99,48.59,Cigna,Default,Percent of Total Billed Charges,31.85,,,,31.85,44.06
NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,250,RC,,,,both,53.99,48.59,United Healthcare,Default,Fee Schedule,44.06,,,,31.85,44.06
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
NF-PRAVACHOL ORAL TABLET 40MG,250,RC,,,,both,26.91,24.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.84,,,,15.88,21.96
NF-PRAVACHOL ORAL TABLET 40MG,250,RC,,,,both,26.91,24.22,Cigna,Default,Percent of Total Billed Charges,15.88,,,,15.88,21.96
NF-PRAVACHOL ORAL TABLET 40MG,250,RC,,,,both,26.91,24.22,United Healthcare,Default,Fee Schedule,21.96,,,,15.88,21.96
NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,250,RC,,,,both,12.86,11.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9,,,,7.59,10.49
NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,250,RC,,,,both,12.86,11.57,Cigna,Default,Percent of Total Billed Charges,7.59,,,,7.59,10.49
NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,250,RC,,,,both,12.86,11.57,United Healthcare,Default,Fee Schedule,10.49,,,,7.59,10.49
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
NF-CARBIDOPA AND LEVODOPA TAB ER 50MG-20,250,RC,,,,both,7.22,6.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.05,,,,4.26,5.89
NF-CARBIDOPA AND LEVODOPA TAB ER 50MG-20,250,RC,,,,both,7.22,6.5,Cigna,Default,Percent of Total Billed Charges,4.26,,,,4.26,5.89
NF-CARBIDOPA AND LEVODOPA TAB ER 50MG-20,250,RC,,,,both,7.22,6.5,United Healthcare,Default,Fee Schedule,5.89,,,,4.26,5.89
NF-EYE DROPS OPHTHALMIC SOLUTION 0.05%,250,RC,,,,both,0.51,0.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.3,0.42
NF-EYE DROPS OPHTHALMIC SOLUTION 0.05%,250,RC,,,,both,0.51,0.46,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.42
NF-EYE DROPS OPHTHALMIC SOLUTION 0.05%,250,RC,,,,both,0.51,0.46,United Healthcare,Default,Fee Schedule,0.42,,,,0.3,0.42
NF-AMIODARONE HCL ORAL TABLET 400MG,250,RC,,,,both,22.12,19.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.48,,,,13.05,18.05
NF-AMIODARONE HCL ORAL TABLET 400MG,250,RC,,,,both,22.12,19.91,Cigna,Default,Percent of Total Billed Charges,13.05,,,,13.05,18.05
NF-AMIODARONE HCL ORAL TABLET 400MG,250,RC,,,,both,22.12,19.91,United Healthcare,Default,Fee Schedule,18.05,,,,13.05,18.05
NF-LOSARTAN/HCTZ ORAL TABLET 50MG-12.5MG,250,RC,,,,both,10.01,9.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.01,,,,5.91,8.17
NF-LOSARTAN/HCTZ ORAL TABLET 50MG-12.5MG,250,RC,,,,both,10.01,9.01,Cigna,Default,Percent of Total Billed Charges,5.91,,,,5.91,8.17
NF-LOSARTAN/HCTZ ORAL TABLET 50MG-12.5MG,250,RC,,,,both,10.01,9.01,United Healthcare,Default,Fee Schedule,8.17,,,,5.91,8.17
NF-BUDESONIDE CAP DR 3MG,250,RC,,,,both,65.85,59.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.1,,,,38.85,53.73
NF-BUDESONIDE CAP DR 3MG,250,RC,,,,both,65.85,59.27,Cigna,Default,Percent of Total Billed Charges,38.85,,,,38.85,53.73
NF-BUDESONIDE CAP DR 3MG,250,RC,,,,both,65.85,59.27,United Healthcare,Default,Fee Schedule,53.73,,,,38.85,53.73
MICAFUNGIN 100 MG IV,250,RC,,,,both,247.68,222.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,173.38,,,,146.13,202.11
MICAFUNGIN 100 MG IV,250,RC,,,,both,247.68,222.91,Cigna,Default,Percent of Total Billed Charges,146.13,,,,146.13,202.11
MICAFUNGIN 100 MG IV,250,RC,,,,both,247.68,222.91,United Healthcare,Default,Fee Schedule,202.11,,,,146.13,202.11
BUDESONIDE 3MG CAP,250,RC,,,,both,69.66,62.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.76,,,,41.1,56.84
BUDESONIDE 3MG CAP,250,RC,,,,both,69.66,62.69,Cigna,Default,Percent of Total Billed Charges,41.1,,,,41.1,56.84
BUDESONIDE 3MG CAP,250,RC,,,,both,69.66,62.69,United Healthcare,Default,Fee Schedule,56.84,,,,41.1,56.84
NF-PAROXETINE HCL AVPAK ORAL TABLET 30MG,250,RC,,,,both,10.87,9.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.61,,,,6.41,8.87
NF-PAROXETINE HCL AVPAK ORAL TABLET 30MG,250,RC,,,,both,10.87,9.78,Cigna,Default,Percent of Total Billed Charges,6.41,,,,6.41,8.87
NF-PAROXETINE HCL AVPAK ORAL TABLET 30MG,250,RC,,,,both,10.87,9.78,United Healthcare,Default,Fee Schedule,8.87,,,,6.41,8.87
NF-LACRI-LUBE S.O.P. OPHTH OINTMENT,250,RC,,,,both,12.09,10.88,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.46,,,,7.13,9.87
NF-LACRI-LUBE S.O.P. OPHTH OINTMENT,250,RC,,,,both,12.09,10.88,Cigna,Default,Percent of Total Billed Charges,7.13,,,,7.13,9.87
NF-LACRI-LUBE S.O.P. OPHTH OINTMENT,250,RC,,,,both,12.09,10.88,United Healthcare,Default,Fee Schedule,9.87,,,,7.13,9.87
NF-ALEVE ARTHRITIS TAB 220MG,250,RC,,,,both,0.32,0.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.22,,,,0.19,0.26
NF-ALEVE ARTHRITIS TAB 220MG,250,RC,,,,both,0.32,0.29,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.26
NF-ALEVE ARTHRITIS TAB 220MG,250,RC,,,,both,0.32,0.29,United Healthcare,Default,Fee Schedule,0.26,,,,0.19,0.26
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.51,0.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.3,0.42
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.51,0.46,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.42
NF-ALEVE ORAL TABLET 220MG,250,RC,,,,both,0.51,0.46,United Healthcare,Default,Fee Schedule,0.42,,,,0.3,0.42
NF-ROSUVASTATIN CALCIUM CAP 20MG,250,RC,,,,both,15.87,14.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.11,,,,9.36,12.95
NF-ROSUVASTATIN CALCIUM CAP 20MG,250,RC,,,,both,15.87,14.28,Cigna,Default,Percent of Total Billed Charges,9.36,,,,9.36,12.95
NF-ROSUVASTATIN CALCIUM CAP 20MG,250,RC,,,,both,15.87,14.28,United Healthcare,Default,Fee Schedule,12.95,,,,9.36,12.95
NF-SYNJARDY XR ORAL TAB ER 25MG-1000MG,250,RC,,,,both,91.28,82.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,63.9,,,,53.86,74.48
NF-SYNJARDY XR ORAL TAB ER 25MG-1000MG,250,RC,,,,both,91.28,82.15,Cigna,Default,Percent of Total Billed Charges,53.86,,,,53.86,74.48
NF-SYNJARDY XR ORAL TAB ER 25MG-1000MG,250,RC,,,,both,91.28,82.15,United Healthcare,Default,Fee Schedule,74.48,,,,53.86,74.48
NF-RHOPRESSA OPHTHALMIC SOLUTION 0.02%,250,RC,,,,both,570.43,513.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,399.3,,,,336.55,465.47
NF-RHOPRESSA OPHTHALMIC SOLUTION 0.02%,250,RC,,,,both,570.43,513.39,Cigna,Default,Percent of Total Billed Charges,336.55,,,,336.55,465.47
NF-RHOPRESSA OPHTHALMIC SOLUTION 0.02%,250,RC,,,,both,570.43,513.39,United Healthcare,Default,Fee Schedule,465.47,,,,336.55,465.47
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,10.27,9.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.19,,,,6.06,8.38
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,10.27,9.24,Cigna,Default,Percent of Total Billed Charges,6.06,,,,6.06,8.38
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,10.27,9.24,United Healthcare,Default,Fee Schedule,8.38,,,,6.06,8.38
NF-ARMOUR THYROID TABLET 15MG,250,RC,,,,both,0.23,0.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.16,,,,0.14,0.19
NF-ARMOUR THYROID TABLET 15MG,250,RC,,,,both,0.23,0.21,Cigna,Default,Percent of Total Billed Charges,0.14,,,,0.14,0.19
NF-ARMOUR THYROID TABLET 15MG,250,RC,,,,both,0.23,0.21,United Healthcare,Default,Fee Schedule,0.19,,,,0.14,0.19
NF-ESTRADIOL GEL 0.06%,250,RC,,,,both,17.84,16.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.49,,,,10.53,14.56
NF-ESTRADIOL GEL 0.06%,250,RC,,,,both,17.84,16.06,Cigna,Default,Percent of Total Billed Charges,10.53,,,,10.53,14.56
NF-ESTRADIOL GEL 0.06%,250,RC,,,,both,17.84,16.06,United Healthcare,Default,Fee Schedule,14.56,,,,10.53,14.56
NF-TESTOSTERONE CYPIONATE IM OIL 100MG/1,250,RC,,,,both,37.04,33.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.93,,,,21.85,30.22
NF-TESTOSTERONE CYPIONATE IM OIL 100MG/1,250,RC,,,,both,37.04,33.34,Cigna,Default,Percent of Total Billed Charges,21.85,,,,21.85,30.22
NF-TESTOSTERONE CYPIONATE IM OIL 100MG/1,250,RC,,,,both,37.04,33.34,United Healthcare,Default,Fee Schedule,30.22,,,,21.85,30.22
NF-ORAJEL INSTANT PAIN RELIEF GEL,250,RC,,,,both,2.74,2.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.92,,,,1.62,2.24
NF-ORAJEL INSTANT PAIN RELIEF GEL,250,RC,,,,both,2.74,2.47,Cigna,Default,Percent of Total Billed Charges,1.62,,,,1.62,2.24
NF-ORAJEL INSTANT PAIN RELIEF GEL,250,RC,,,,both,2.74,2.47,United Healthcare,Default,Fee Schedule,2.24,,,,1.62,2.24
NF-ORAJEL INSTANT PAIN RELIEF GEL,250,RC,,,,both,2.74,2.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.92,,,,1.62,2.24
NF-ORAJEL INSTANT PAIN RELIEF GEL,250,RC,,,,both,2.74,2.47,Cigna,Default,Percent of Total Billed Charges,1.62,,,,1.62,2.24
NF-ORAJEL INSTANT PAIN RELIEF GEL,250,RC,,,,both,2.74,2.47,United Healthcare,Default,Fee Schedule,2.24,,,,1.62,2.24
NF-ORAJEL MOUTH SORE MEDICINE,250,RC,,,,both,5.39,4.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.77,,,,3.18,4.4
NF-ORAJEL MOUTH SORE MEDICINE,250,RC,,,,both,5.39,4.85,Cigna,Default,Percent of Total Billed Charges,3.18,,,,3.18,4.4
NF-ORAJEL MOUTH SORE MEDICINE,250,RC,,,,both,5.39,4.85,United Healthcare,Default,Fee Schedule,4.4,,,,3.18,4.4
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,66.1,59.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,46.27,,,,39,53.94
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,66.1,59.49,Cigna,Default,Percent of Total Billed Charges,39,,,,39,53.94
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,66.1,59.49,United Healthcare,Default,Fee Schedule,53.94,,,,39,53.94
NF-BENICAR ORAL TABLET 40MG,250,RC,,,,both,18.07,16.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.65,,,,10.66,14.75
NF-BENICAR ORAL TABLET 40MG,250,RC,,,,both,18.07,16.26,Cigna,Default,Percent of Total Billed Charges,10.66,,,,10.66,14.75
NF-BENICAR ORAL TABLET 40MG,250,RC,,,,both,18.07,16.26,United Healthcare,Default,Fee Schedule,14.75,,,,10.66,14.75
NF-VITAMIN D3 & K 1000U/100MCG,250,RC,,,,both,0.15,0.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.09,0.12
NF-VITAMIN D3 & K 1000U/100MCG,250,RC,,,,both,0.15,0.14,Cigna,Default,Percent of Total Billed Charges,0.09,,,,0.09,0.12
NF-VITAMIN D3 & K 1000U/100MCG,250,RC,,,,both,0.15,0.14,United Healthcare,Default,Fee Schedule,0.12,,,,0.09,0.12
NF-NORTRIPTYLINE HCL CAP 10MG,250,RC,,,,both,0.5,0.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.35,,,,0.3,0.41
NF-NORTRIPTYLINE HCL CAP 10MG,250,RC,,,,both,0.5,0.45,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.41
NF-NORTRIPTYLINE HCL CAP 10MG,250,RC,,,,both,0.5,0.45,United Healthcare,Default,Fee Schedule,0.41,,,,0.3,0.41
NF-INDOMETHACIN CAP 50MG,250,RC,,,,both,4.19,3.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.93,,,,2.47,3.42
NF-INDOMETHACIN CAP 50MG,250,RC,,,,both,4.19,3.77,Cigna,Default,Percent of Total Billed Charges,2.47,,,,2.47,3.42
NF-INDOMETHACIN CAP 50MG,250,RC,,,,both,4.19,3.77,United Healthcare,Default,Fee Schedule,3.42,,,,2.47,3.42
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.47,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,Cigna,Default,Percent of Total Billed Charges,3.76,,,,3.76,5.21
NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,250,RC,,,,both,6.38,5.74,United Healthcare,Default,Fee Schedule,5.21,,,,3.76,5.21
LIDOCAINE W/EPI INJ 1.5% 10ML,250,RC,,,,both,42.98,38.68,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.09,,,,25.36,35.07
LIDOCAINE W/EPI INJ 1.5% 10ML,250,RC,,,,both,42.98,38.68,Cigna,Default,Percent of Total Billed Charges,25.36,,,,25.36,35.07
LIDOCAINE W/EPI INJ 1.5% 10ML,250,RC,,,,both,42.98,38.68,United Healthcare,Default,Fee Schedule,35.07,,,,25.36,35.07
NF-LASIX TAB 80MG,250,RC,,,,both,6.49,5.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.54,,,,3.83,5.3
NF-LASIX TAB 80MG,250,RC,,,,both,6.49,5.84,Cigna,Default,Percent of Total Billed Charges,3.83,,,,3.83,5.3
NF-LASIX TAB 80MG,250,RC,,,,both,6.49,5.84,United Healthcare,Default,Fee Schedule,5.3,,,,3.83,5.3
NF-SALIVAMAX MM PWD FOR SOLN,250,RC,,,,both,46.67,42,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.67,,,,27.54,38.08
NF-SALIVAMAX MM PWD FOR SOLN,250,RC,,,,both,46.67,42,Cigna,Default,Percent of Total Billed Charges,27.54,,,,27.54,38.08
NF-SALIVAMAX MM PWD FOR SOLN,250,RC,,,,both,46.67,42,United Healthcare,Default,Fee Schedule,38.08,,,,27.54,38.08
NF-TABRECTA ORAL TAB 200MG,250,RC,,,,both,856.23,770.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,599.36,,,,505.18,698.68
NF-TABRECTA ORAL TAB 200MG,250,RC,,,,both,856.23,770.61,Cigna,Default,Percent of Total Billed Charges,505.18,,,,505.18,698.68
NF-TABRECTA ORAL TAB 200MG,250,RC,,,,both,856.23,770.61,United Healthcare,Default,Fee Schedule,698.68,,,,505.18,698.68
NF-CEFEPIME HCL IV SOLN 1GM/50ML,250,RC,,,,both,2.55,2.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.78,,,,1.5,2.08
NF-CEFEPIME HCL IV SOLN 1GM/50ML,250,RC,,,,both,2.55,2.3,Cigna,Default,Percent of Total Billed Charges,1.5,,,,1.5,2.08
NF-CEFEPIME HCL IV SOLN 1GM/50ML,250,RC,,,,both,2.55,2.3,United Healthcare,Default,Fee Schedule,2.08,,,,1.5,2.08
NF-CEFEPIME HCL INJ PWD FOR SOLN 1GM,250,RC,,,,both,29.23,26.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.46,,,,17.25,23.85
NF-CEFEPIME HCL INJ PWD FOR SOLN 1GM,250,RC,,,,both,29.23,26.31,Cigna,Default,Percent of Total Billed Charges,17.25,,,,17.25,23.85
NF-CEFEPIME HCL INJ PWD FOR SOLN 1GM,250,RC,,,,both,29.23,26.31,United Healthcare,Default,Fee Schedule,23.85,,,,17.25,23.85
NF-HYDROXYZINE PAMOATE CAP 100MG,250,RC,,,,both,4.76,4.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.33,,,,2.81,3.88
NF-HYDROXYZINE PAMOATE CAP 100MG,250,RC,,,,both,4.76,4.28,Cigna,Default,Percent of Total Billed Charges,2.81,,,,2.81,3.88
NF-HYDROXYZINE PAMOATE CAP 100MG,250,RC,,,,both,4.76,4.28,United Healthcare,Default,Fee Schedule,3.88,,,,2.81,3.88
NF-ATIVAN ORAL TABLET 0.5MG,250,RC,,,,both,149.03,134.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,104.32,,,,87.93,121.61
NF-ATIVAN ORAL TABLET 0.5MG,250,RC,,,,both,149.03,134.13,Cigna,Default,Percent of Total Billed Charges,87.93,,,,87.93,121.61
NF-ATIVAN ORAL TABLET 0.5MG,250,RC,,,,both,149.03,134.13,United Healthcare,Default,Fee Schedule,121.61,,,,87.93,121.61
NF-BISOPROLOL-HYDROCHLOROTHIAZIDE TAB 2.,250,RC,,,,both,5.52,4.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.86,,,,3.26,4.5
NF-BISOPROLOL-HYDROCHLOROTHIAZIDE TAB 2.,250,RC,,,,both,5.52,4.97,Cigna,Default,Percent of Total Billed Charges,3.26,,,,3.26,4.5
NF-BISOPROLOL-HYDROCHLOROTHIAZIDE TAB 2.,250,RC,,,,both,5.52,4.97,United Healthcare,Default,Fee Schedule,4.5,,,,3.26,4.5
NF-CARVEDILOL ORAL TABLET 25MG,250,RC,,,,both,7.79,7.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.45,,,,4.6,6.36
NF-CARVEDILOL ORAL TABLET 25MG,250,RC,,,,both,7.79,7.01,Cigna,Default,Percent of Total Billed Charges,4.6,,,,4.6,6.36
NF-CARVEDILOL ORAL TABLET 25MG,250,RC,,,,both,7.79,7.01,United Healthcare,Default,Fee Schedule,6.36,,,,4.6,6.36
NF-OLMESARTAN MEDOXOMIL ORAL TAB 40MG,250,RC,,,,both,38.43,34.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.9,,,,22.67,31.36
NF-OLMESARTAN MEDOXOMIL ORAL TAB 40MG,250,RC,,,,both,38.43,34.59,Cigna,Default,Percent of Total Billed Charges,22.67,,,,22.67,31.36
NF-OLMESARTAN MEDOXOMIL ORAL TAB 40MG,250,RC,,,,both,38.43,34.59,United Healthcare,Default,Fee Schedule,31.36,,,,22.67,31.36
NF-MAGNESIUM CITRATE SOLN 1.75GM/30ML,250,RC,,,,both,0.33,0.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.23,,,,0.19,0.27
NF-MAGNESIUM CITRATE SOLN 1.75GM/30ML,250,RC,,,,both,0.33,0.3,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.27
NF-MAGNESIUM CITRATE SOLN 1.75GM/30ML,250,RC,,,,both,0.33,0.3,United Healthcare,Default,Fee Schedule,0.27,,,,0.19,0.27
NF-IFE-BIMIX 30/1 30MG-1MG/1ML,250,RC,,,,both,300.36,270.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,210.25,,,,177.21,245.09
NF-IFE-BIMIX 30/1 30MG-1MG/1ML,250,RC,,,,both,300.36,270.32,Cigna,Default,Percent of Total Billed Charges,177.21,,,,177.21,245.09
NF-IFE-BIMIX 30/1 30MG-1MG/1ML,250,RC,,,,both,300.36,270.32,United Healthcare,Default,Fee Schedule,245.09,,,,177.21,245.09
NF-MAGNESIUM GLYCINATE POWDER,250,RC,,,,both,2.66,2.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.86,,,,1.57,2.17
NF-MAGNESIUM GLYCINATE POWDER,250,RC,,,,both,2.66,2.39,Cigna,Default,Percent of Total Billed Charges,1.57,,,,1.57,2.17
NF-MAGNESIUM GLYCINATE POWDER,250,RC,,,,both,2.66,2.39,United Healthcare,Default,Fee Schedule,2.17,,,,1.57,2.17
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,88.08,79.27,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.66,,,,51.97,71.87
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,88.08,79.27,Cigna,Default,Percent of Total Billed Charges,51.97,,,,51.97,71.87
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,88.08,79.27,United Healthcare,Default,Fee Schedule,71.87,,,,51.97,71.87
NF-CHLORPHENIRAMINE MALEATE ORAL TABLET,250,RC,,,,both,0.33,0.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.23,,,,0.19,0.27
NF-CHLORPHENIRAMINE MALEATE ORAL TABLET,250,RC,,,,both,0.33,0.3,Cigna,Default,Percent of Total Billed Charges,0.19,,,,0.19,0.27
NF-CHLORPHENIRAMINE MALEATE ORAL TABLET,250,RC,,,,both,0.33,0.3,United Healthcare,Default,Fee Schedule,0.27,,,,0.19,0.27
NF-LOPERAMIDE HCL   CAP  2MG,250,RC,,,,both,5.33,4.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.73,,,,3.14,4.35
NF-LOPERAMIDE HCL   CAP  2MG,250,RC,,,,both,5.33,4.8,Cigna,Default,Percent of Total Billed Charges,3.14,,,,3.14,4.35
NF-LOPERAMIDE HCL   CAP  2MG,250,RC,,,,both,5.33,4.8,United Healthcare,Default,Fee Schedule,4.35,,,,3.14,4.35
NF-PRIMIDONE ORAL TABLET 50MG,250,RC,,,,both,6.19,5.57,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.33,,,,3.65,5.05
NF-PRIMIDONE ORAL TABLET 50MG,250,RC,,,,both,6.19,5.57,Cigna,Default,Percent of Total Billed Charges,3.65,,,,3.65,5.05
NF-PRIMIDONE ORAL TABLET 50MG,250,RC,,,,both,6.19,5.57,United Healthcare,Default,Fee Schedule,5.05,,,,3.65,5.05
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,20.68,18.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.48,,,,12.2,16.87
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,20.68,18.61,Cigna,Default,Percent of Total Billed Charges,12.2,,,,12.2,16.87
NF-PROGESTERONE LIQ CAP 100MG,250,RC,,,,both,20.68,18.61,United Healthcare,Default,Fee Schedule,16.87,,,,12.2,16.87
NF-LIOTHYRONINE SODIUM ORAL TABLET 5MCG,250,RC,,,,both,7.56,6.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.29,,,,4.46,6.17
NF-LIOTHYRONINE SODIUM ORAL TABLET 5MCG,250,RC,,,,both,7.56,6.8,Cigna,Default,Percent of Total Billed Charges,4.46,,,,4.46,6.17
NF-LIOTHYRONINE SODIUM ORAL TABLET 5MCG,250,RC,,,,both,7.56,6.8,United Healthcare,Default,Fee Schedule,6.17,,,,4.46,6.17
NF-LIOTHYRONINE SODIUM ORAL TABLET 5MCG,250,RC,,,,both,6.68,6.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.68,,,,3.94,5.45
NF-LIOTHYRONINE SODIUM ORAL TABLET 5MCG,250,RC,,,,both,6.68,6.01,Cigna,Default,Percent of Total Billed Charges,3.94,,,,3.94,5.45
NF-LIOTHYRONINE SODIUM ORAL TABLET 5MCG,250,RC,,,,both,6.68,6.01,United Healthcare,Default,Fee Schedule,5.45,,,,3.94,5.45
NF-LEVOTHYROXINE ORAL TABLET 100MCG,250,RC,,,,both,2.25,2.03,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.58,,,,1.33,1.84
NF-LEVOTHYROXINE ORAL TABLET 100MCG,250,RC,,,,both,2.25,2.03,Cigna,Default,Percent of Total Billed Charges,1.33,,,,1.33,1.84
NF-LEVOTHYROXINE ORAL TABLET 100MCG,250,RC,,,,both,2.25,2.03,United Healthcare,Default,Fee Schedule,1.84,,,,1.33,1.84
NF-1ST TIER UNIFINE PENTIPS NEEDLE DEVIC,250,RC,,,,both,1.04,0.94,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.73,,,,0.61,0.85
NF-1ST TIER UNIFINE PENTIPS NEEDLE DEVIC,250,RC,,,,both,1.04,0.94,Cigna,Default,Percent of Total Billed Charges,0.61,,,,0.61,0.85
NF-1ST TIER UNIFINE PENTIPS NEEDLE DEVIC,250,RC,,,,both,1.04,0.94,United Healthcare,Default,Fee Schedule,0.85,,,,0.61,0.85
NF-AMLODIPINE & BENAZEPRIL HCL 5MG-40MG,250,RC,,,,both,17.82,16.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.47,,,,10.51,14.54
NF-AMLODIPINE & BENAZEPRIL HCL 5MG-40MG,250,RC,,,,both,17.82,16.04,Cigna,Default,Percent of Total Billed Charges,10.51,,,,10.51,14.54
NF-AMLODIPINE & BENAZEPRIL HCL 5MG-40MG,250,RC,,,,both,17.82,16.04,United Healthcare,Default,Fee Schedule,14.54,,,,10.51,14.54
NF-ACCOLATE ORAL TABLET 20MG,250,RC,,,,both,8.22,7.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.75,,,,4.85,6.71
NF-ACCOLATE ORAL TABLET 20MG,250,RC,,,,both,8.22,7.4,Cigna,Default,Percent of Total Billed Charges,4.85,,,,4.85,6.71
NF-ACCOLATE ORAL TABLET 20MG,250,RC,,,,both,8.22,7.4,United Healthcare,Default,Fee Schedule,6.71,,,,4.85,6.71
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.82,,,,8.28,11.45
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,Cigna,Default,Percent of Total Billed Charges,8.28,,,,8.28,11.45
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,United Healthcare,Default,Fee Schedule,11.45,,,,8.28,11.45
NF-TRAZODONE HCL ORAL TABLET 150MG,250,RC,,,,both,11.17,10.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.82,,,,6.59,9.11
NF-TRAZODONE HCL ORAL TABLET 150MG,250,RC,,,,both,11.17,10.05,Cigna,Default,Percent of Total Billed Charges,6.59,,,,6.59,9.11
NF-TRAZODONE HCL ORAL TABLET 150MG,250,RC,,,,both,11.17,10.05,United Healthcare,Default,Fee Schedule,9.11,,,,6.59,9.11
NF-OXYCONTIN TAB ER 20MG,250,RC,,,,both,28.14,25.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.7,,,,16.6,22.96
NF-OXYCONTIN TAB ER 20MG,250,RC,,,,both,28.14,25.33,Cigna,Default,Percent of Total Billed Charges,16.6,,,,16.6,22.96
NF-OXYCONTIN TAB ER 20MG,250,RC,,,,both,28.14,25.33,United Healthcare,Default,Fee Schedule,22.96,,,,16.6,22.96
NF-MICARDIS ORAL TABLET 20MG,250,RC,,,,both,22.44,20.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.71,,,,13.24,18.31
NF-MICARDIS ORAL TABLET 20MG,250,RC,,,,both,22.44,20.2,Cigna,Default,Percent of Total Billed Charges,13.24,,,,13.24,18.31
NF-MICARDIS ORAL TABLET 20MG,250,RC,,,,both,22.44,20.2,United Healthcare,Default,Fee Schedule,18.31,,,,13.24,18.31
NF-DECADRON ORAL TABLET 4MG,250,RC,,,,both,19.03,17.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.32,,,,11.23,15.53
NF-DECADRON ORAL TABLET 4MG,250,RC,,,,both,19.03,17.13,Cigna,Default,Percent of Total Billed Charges,11.23,,,,11.23,15.53
NF-DECADRON ORAL TABLET 4MG,250,RC,,,,both,19.03,17.13,United Healthcare,Default,Fee Schedule,15.53,,,,11.23,15.53
DEXMEDETOMIDINE 180MCG SL TABLET,637,RC,,,,both,541.8,487.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,379.26,,,,319.66,442.11
DEXMEDETOMIDINE 180MCG SL TABLET,637,RC,,,,both,541.8,487.62,Cigna,Default,Percent of Total Billed Charges,319.66,,,,319.66,442.11
DEXMEDETOMIDINE 180MCG SL TABLET,637,RC,,,,both,541.8,487.62,United Healthcare,Default,Fee Schedule,442.11,,,,319.66,442.11
Clindamycin/PREMIX IVPB: 600MG/50ML,J3490,HCPCS,636,RC,,both,55.11,49.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,38.58,,,,32.51,44.97
Clindamycin/PREMIX IVPB: 600MG/50ML,J3490,HCPCS,636,RC,,both,55.11,49.6,Cigna,Default,Percent of Total Billed Charges,32.51,,,,32.51,44.97
Clindamycin/PREMIX IVPB: 600MG/50ML,J3490,HCPCS,636,RC,,both,55.11,49.6,United Healthcare,Default,Fee Schedule,44.97,,,,32.51,44.97
Cefepime/NS IVPB: 1000MG/100ML,250,RC,,,,both,395.14,355.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,276.6,,,,233.13,322.43
Cefepime/NS IVPB: 1000MG/100ML,250,RC,,,,both,395.14,355.63,Cigna,Default,Percent of Total Billed Charges,233.13,,,,233.13,322.43
Cefepime/NS IVPB: 1000MG/100ML,250,RC,,,,both,395.14,355.63,United Healthcare,Default,Fee Schedule,322.43,,,,233.13,322.43
FORMOTEROL FUM NEB 20MCG/2ML (PERFOMIST),636,RC,,,,both,95.91,86.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,67.14,,,,56.59,78.26
FORMOTEROL FUM NEB 20MCG/2ML (PERFOMIST),636,RC,,,,both,95.91,86.32,Cigna,Default,Percent of Total Billed Charges,56.59,,,,56.59,78.26
FORMOTEROL FUM NEB 20MCG/2ML (PERFOMIST),636,RC,,,,both,95.91,86.32,United Healthcare,Default,Fee Schedule,78.26,,,,56.59,78.26
NF-PHENTERMINE HCL CAP 37.5MG,250,RC,,,,both,6.28,5.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.4,,,,3.71,5.12
NF-PHENTERMINE HCL CAP 37.5MG,250,RC,,,,both,6.28,5.65,Cigna,Default,Percent of Total Billed Charges,3.71,,,,3.71,5.12
NF-PHENTERMINE HCL CAP 37.5MG,250,RC,,,,both,6.28,5.65,United Healthcare,Default,Fee Schedule,5.12,,,,3.71,5.12
PYRIDOSTIGMINE BROMIDE 60MG,637,RC,,,,both,6.75,6.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.72,,,,3.98,5.51
PYRIDOSTIGMINE BROMIDE 60MG,637,RC,,,,both,6.75,6.08,Cigna,Default,Percent of Total Billed Charges,3.98,,,,3.98,5.51
PYRIDOSTIGMINE BROMIDE 60MG,637,RC,,,,both,6.75,6.08,United Healthcare,Default,Fee Schedule,5.51,,,,3.98,5.51
NF-PYRIDOSTIGMINE BROMIDE ORAL TABLET 60,250,RC,,,,both,5.1,4.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.57,,,,3.01,4.16
NF-PYRIDOSTIGMINE BROMIDE ORAL TABLET 60,250,RC,,,,both,5.1,4.59,Cigna,Default,Percent of Total Billed Charges,3.01,,,,3.01,4.16
NF-PYRIDOSTIGMINE BROMIDE ORAL TABLET 60,250,RC,,,,both,5.1,4.59,United Healthcare,Default,Fee Schedule,4.16,,,,3.01,4.16
NF-PRAZOSIN HCL CAP 1MG,250,RC,,,,both,7.1,6.39,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.97,,,,4.19,5.79
NF-PRAZOSIN HCL CAP 1MG,250,RC,,,,both,7.1,6.39,Cigna,Default,Percent of Total Billed Charges,4.19,,,,4.19,5.79
NF-PRAZOSIN HCL CAP 1MG,250,RC,,,,both,7.1,6.39,United Healthcare,Default,Fee Schedule,5.79,,,,4.19,5.79
NF-OXCARBAZEPINE ORAL TABLET 150MG,250,RC,,,,both,5.78,5.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.05,,,,3.41,4.72
NF-OXCARBAZEPINE ORAL TABLET 150MG,250,RC,,,,both,5.78,5.2,Cigna,Default,Percent of Total Billed Charges,3.41,,,,3.41,4.72
NF-OXCARBAZEPINE ORAL TABLET 150MG,250,RC,,,,both,5.78,5.2,United Healthcare,Default,Fee Schedule,4.72,,,,3.41,4.72
NF-DILT-XR 24 HOUR ORAL CAPSULE ER 240MG,250,RC,,,,both,5.73,5.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.01,,,,3.38,4.68
NF-DILT-XR 24 HOUR ORAL CAPSULE ER 240MG,250,RC,,,,both,5.73,5.16,Cigna,Default,Percent of Total Billed Charges,3.38,,,,3.38,4.68
NF-DILT-XR 24 HOUR ORAL CAPSULE ER 240MG,250,RC,,,,both,5.73,5.16,United Healthcare,Default,Fee Schedule,4.68,,,,3.38,4.68
NF-SEROQUEL XR ORAL TAB ER 150MG,250,RC,,,,both,70.78,63.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.55,,,,41.76,57.76
NF-SEROQUEL XR ORAL TAB ER 150MG,250,RC,,,,both,70.78,63.7,Cigna,Default,Percent of Total Billed Charges,41.76,,,,41.76,57.76
NF-SEROQUEL XR ORAL TAB ER 150MG,250,RC,,,,both,70.78,63.7,United Healthcare,Default,Fee Schedule,57.76,,,,41.76,57.76
NF-COQ10 RX ORAL CAPSULE 200MG,250,RC,,,,both,9.33,8.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.53,,,,5.5,7.61
NF-COQ10 RX ORAL CAPSULE 200MG,250,RC,,,,both,9.33,8.4,Cigna,Default,Percent of Total Billed Charges,5.5,,,,5.5,7.61
NF-COQ10 RX ORAL CAPSULE 200MG,250,RC,,,,both,9.33,8.4,United Healthcare,Default,Fee Schedule,7.61,,,,5.5,7.61
NF-BISOPROLOL FUMARATE ORAL TABLET 10MG,250,RC,,,,both,9.01,8.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.31,,,,5.32,7.35
NF-BISOPROLOL FUMARATE ORAL TABLET 10MG,250,RC,,,,both,9.01,8.11,Cigna,Default,Percent of Total Billed Charges,5.32,,,,5.32,7.35
NF-BISOPROLOL FUMARATE ORAL TABLET 10MG,250,RC,,,,both,9.01,8.11,United Healthcare,Default,Fee Schedule,7.35,,,,5.32,7.35
NF-FLUTICASONE FUROATE/VILANTEROL ELLIPT,250,RC,,,,both,29.17,26.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.42,,,,17.21,23.8
NF-FLUTICASONE FUROATE/VILANTEROL ELLIPT,250,RC,,,,both,29.17,26.25,Cigna,Default,Percent of Total Billed Charges,17.21,,,,17.21,23.8
NF-FLUTICASONE FUROATE/VILANTEROL ELLIPT,250,RC,,,,both,29.17,26.25,United Healthcare,Default,Fee Schedule,23.8,,,,17.21,23.8
NF-BUMETANIDE ORAL TABLET 0.5MG,250,RC,,,,both,4.33,3.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.03,,,,2.55,3.53
NF-BUMETANIDE ORAL TABLET 0.5MG,250,RC,,,,both,4.33,3.9,Cigna,Default,Percent of Total Billed Charges,2.55,,,,2.55,3.53
NF-BUMETANIDE ORAL TABLET 0.5MG,250,RC,,,,both,4.33,3.9,United Healthcare,Default,Fee Schedule,3.53,,,,2.55,3.53
NF-CALTRATE 600 + D ORAL TABLET 600MG-20,250,RC,,,,both,0.51,0.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.3,0.42
NF-CALTRATE 600 + D ORAL TABLET 600MG-20,250,RC,,,,both,0.51,0.46,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.42
NF-CALTRATE 600 + D ORAL TABLET 600MG-20,250,RC,,,,both,0.51,0.46,United Healthcare,Default,Fee Schedule,0.42,,,,0.3,0.42
NF-MESALAMINE CAP ER 0.375GM,250,RC,,,,both,20.41,18.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.29,,,,12.04,16.65
NF-MESALAMINE CAP ER 0.375GM,250,RC,,,,both,20.41,18.37,Cigna,Default,Percent of Total Billed Charges,12.04,,,,12.04,16.65
NF-MESALAMINE CAP ER 0.375GM,250,RC,,,,both,20.41,18.37,United Healthcare,Default,Fee Schedule,16.65,,,,12.04,16.65
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,22.46,20.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.72,,,,13.25,18.33
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,22.46,20.21,Cigna,Default,Percent of Total Billed Charges,13.25,,,,13.25,18.33
NF-MORPHINE SULFATE CAP ER 30MG,250,RC,,,,both,22.46,20.21,United Healthcare,Default,Fee Schedule,18.33,,,,13.25,18.33
NF-ENTRESTO TAB 24MG-26MG,250,RC,,,,both,53.44,48.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.41,,,,31.53,43.61
NF-ENTRESTO TAB 24MG-26MG,250,RC,,,,both,53.44,48.1,Cigna,Default,Percent of Total Billed Charges,31.53,,,,31.53,43.61
NF-ENTRESTO TAB 24MG-26MG,250,RC,,,,both,53.44,48.1,United Healthcare,Default,Fee Schedule,43.61,,,,31.53,43.61
NF-ENTRESTO ORAL TABLET 24MG-26MG,250,RC,,,,both,37,33.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.9,,,,21.83,30.19
NF-ENTRESTO ORAL TABLET 24MG-26MG,250,RC,,,,both,37,33.3,Cigna,Default,Percent of Total Billed Charges,21.83,,,,21.83,30.19
NF-ENTRESTO ORAL TABLET 24MG-26MG,250,RC,,,,both,37,33.3,United Healthcare,Default,Fee Schedule,30.19,,,,21.83,30.19
NF-TAGRISSO ORAL TABLET 80MG,250,RC,,,,both,2581.55,2323.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1807.08,,,,1523.11,2106.54
NF-TAGRISSO ORAL TABLET 80MG,250,RC,,,,both,2581.55,2323.4,Cigna,Default,Percent of Total Billed Charges,1523.11,,,,1523.11,2106.54
NF-TAGRISSO ORAL TABLET 80MG,250,RC,,,,both,2581.55,2323.4,United Healthcare,Default,Fee Schedule,2106.54,,,,1523.11,2106.54
NF-CELEXA TABLET 40MG,250,RC,,,,both,18.59,16.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.01,,,,10.97,15.17
NF-CELEXA TABLET 40MG,250,RC,,,,both,18.59,16.73,Cigna,Default,Percent of Total Billed Charges,10.97,,,,10.97,15.17
NF-CELEXA TABLET 40MG,250,RC,,,,both,18.59,16.73,United Healthcare,Default,Fee Schedule,15.17,,,,10.97,15.17
NF-CELEXA TAB 40MG,250,RC,,,,both,47.39,42.65,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,33.17,,,,27.96,38.67
NF-CELEXA TAB 40MG,250,RC,,,,both,47.39,42.65,Cigna,Default,Percent of Total Billed Charges,27.96,,,,27.96,38.67
NF-CELEXA TAB 40MG,250,RC,,,,both,47.39,42.65,United Healthcare,Default,Fee Schedule,38.67,,,,27.96,38.67
NF-RYTARY CAP ER 48.75MG-195MG,250,RC,,,,both,18.47,16.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.93,,,,10.9,15.07
NF-RYTARY CAP ER 48.75MG-195MG,250,RC,,,,both,18.47,16.62,Cigna,Default,Percent of Total Billed Charges,10.9,,,,10.9,15.07
NF-RYTARY CAP ER 48.75MG-195MG,250,RC,,,,both,18.47,16.62,United Healthcare,Default,Fee Schedule,15.07,,,,10.9,15.07
NF-CELEXA TAB 10MG,250,RC,,,,both,43.57,39.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,30.5,,,,25.71,35.55
NF-CELEXA TAB 10MG,250,RC,,,,both,43.57,39.21,Cigna,Default,Percent of Total Billed Charges,25.71,,,,25.71,35.55
NF-CELEXA TAB 10MG,250,RC,,,,both,43.57,39.21,United Healthcare,Default,Fee Schedule,35.55,,,,25.71,35.55
NF-CALCIUM CARBONATE WITH VITAMIN D 600-,250,RC,,,,both,0.2,0.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.14,,,,0.12,0.16
NF-CALCIUM CARBONATE WITH VITAMIN D 600-,250,RC,,,,both,0.2,0.18,Cigna,Default,Percent of Total Billed Charges,0.12,,,,0.12,0.16
NF-CALCIUM CARBONATE WITH VITAMIN D 600-,250,RC,,,,both,0.2,0.18,United Healthcare,Default,Fee Schedule,0.16,,,,0.12,0.16
NF-ASPIRIN CAP ER 24HR 162.5MG,250,RC,,,,both,28.8,25.92,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.16,,,,16.99,23.5
NF-ASPIRIN CAP ER 24HR 162.5MG,250,RC,,,,both,28.8,25.92,Cigna,Default,Percent of Total Billed Charges,16.99,,,,16.99,23.5
NF-ASPIRIN CAP ER 24HR 162.5MG,250,RC,,,,both,28.8,25.92,United Healthcare,Default,Fee Schedule,23.5,,,,16.99,23.5
NF-ASPIRIN-CALCIUM CARBONATE TAB 81MG-77,250,RC,,,,both,0.51,0.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.3,0.42
NF-ASPIRIN-CALCIUM CARBONATE TAB 81MG-77,250,RC,,,,both,0.51,0.46,Cigna,Default,Percent of Total Billed Charges,0.3,,,,0.3,0.42
NF-ASPIRIN-CALCIUM CARBONATE TAB 81MG-77,250,RC,,,,both,0.51,0.46,United Healthcare,Default,Fee Schedule,0.42,,,,0.3,0.42
NF-DENOSUMAB SUBQ SOLN 60MG/1ML,250,RC,,,,both,7508.68,6757.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5256.08,,,,4430.12,6127.08
NF-DENOSUMAB SUBQ SOLN 60MG/1ML,250,RC,,,,both,7508.68,6757.81,Cigna,Default,Percent of Total Billed Charges,4430.12,,,,4430.12,6127.08
NF-DENOSUMAB SUBQ SOLN 60MG/1ML,250,RC,,,,both,7508.68,6757.81,United Healthcare,Default,Fee Schedule,6127.08,,,,4430.12,6127.08
NF-PANTOPRAZOLE SODIUM AVPAK TAB DR 20MG,250,RC,,,,both,15.94,14.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.16,,,,9.4,13.01
NF-PANTOPRAZOLE SODIUM AVPAK TAB DR 20MG,250,RC,,,,both,15.94,14.35,Cigna,Default,Percent of Total Billed Charges,9.4,,,,9.4,13.01
NF-PANTOPRAZOLE SODIUM AVPAK TAB DR 20MG,250,RC,,,,both,15.94,14.35,United Healthcare,Default,Fee Schedule,13.01,,,,9.4,13.01
NF-ERLEADA ORAL TABLET 240MG,250,RC,,,,both,2272.41,2045.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1590.69,,,,1340.72,1854.29
NF-ERLEADA ORAL TABLET 240MG,250,RC,,,,both,2272.41,2045.17,Cigna,Default,Percent of Total Billed Charges,1340.72,,,,1340.72,1854.29
NF-ERLEADA ORAL TABLET 240MG,250,RC,,,,both,2272.41,2045.17,United Healthcare,Default,Fee Schedule,1854.29,,,,1340.72,1854.29
NF-CALAMINE TOPICAL LOTION 8%-8%,250,RC,,,,both,0.09,0.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-CALAMINE TOPICAL LOTION 8%-8%,250,RC,,,,both,0.09,0.08,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-CALAMINE TOPICAL LOTION 8%-8%,250,RC,,,,both,0.09,0.08,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
NF-CALAMINE PHENOLATED LOTION 8%-1%,250,RC,,,,both,0.09,0.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.06,,,,0.05,0.07
NF-CALAMINE PHENOLATED LOTION 8%-1%,250,RC,,,,both,0.09,0.08,Cigna,Default,Percent of Total Billed Charges,0.05,,,,0.05,0.07
NF-CALAMINE PHENOLATED LOTION 8%-1%,250,RC,,,,both,0.09,0.08,United Healthcare,Default,Fee Schedule,0.07,,,,0.05,0.07
NF-TRELEGY ELLIPTA 200/62.5/25MCG/INH,250,RC,,,,both,51.08,45.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.76,,,,30.14,41.68
NF-TRELEGY ELLIPTA 200/62.5/25MCG/INH,250,RC,,,,both,51.08,45.97,Cigna,Default,Percent of Total Billed Charges,30.14,,,,30.14,41.68
NF-TRELEGY ELLIPTA 200/62.5/25MCG/INH,250,RC,,,,both,51.08,45.97,United Healthcare,Default,Fee Schedule,41.68,,,,30.14,41.68
NF-BENAZEPRIL HCL ORAL TABLET 40MG,250,RC,,,,both,4.2,3.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.94,,,,2.48,3.43
NF-BENAZEPRIL HCL ORAL TABLET 40MG,250,RC,,,,both,4.2,3.78,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.43
NF-BENAZEPRIL HCL ORAL TABLET 40MG,250,RC,,,,both,4.2,3.78,United Healthcare,Default,Fee Schedule,3.43,,,,2.48,3.43
NF-LOTRISONE CREAM,250,RC,,,,both,5.51,4.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.86,,,,3.25,4.5
NF-LOTRISONE CREAM,250,RC,,,,both,5.51,4.96,Cigna,Default,Percent of Total Billed Charges,3.25,,,,3.25,4.5
NF-LOTRISONE CREAM,250,RC,,,,both,5.51,4.96,United Healthcare,Default,Fee Schedule,4.5,,,,3.25,4.5
NF-MEXILETINE HCL CAP 150MG,250,RC,,,,both,3.62,3.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.53,,,,2.14,2.95
NF-MEXILETINE HCL CAP 150MG,250,RC,,,,both,3.62,3.26,Cigna,Default,Percent of Total Billed Charges,2.14,,,,2.14,2.95
NF-MEXILETINE HCL CAP 150MG,250,RC,,,,both,3.62,3.26,United Healthcare,Default,Fee Schedule,2.95,,,,2.14,2.95
NF-ZESTORETIC ORAL TABLET 10MG-12.5MG,250,RC,,,,both,5.12,4.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.58,,,,3.02,4.18
NF-ZESTORETIC ORAL TABLET 10MG-12.5MG,250,RC,,,,both,5.12,4.61,Cigna,Default,Percent of Total Billed Charges,3.02,,,,3.02,4.18
NF-ZESTORETIC ORAL TABLET 10MG-12.5MG,250,RC,,,,both,5.12,4.61,United Healthcare,Default,Fee Schedule,4.18,,,,3.02,4.18
DEXMEDETOMIDINE 400MCG/100ML IVPB PREMIX,250,RC,,,,both,309.6,278.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,216.72,,,,182.66,252.63
DEXMEDETOMIDINE 400MCG/100ML IVPB PREMIX,250,RC,,,,both,309.6,278.64,Cigna,Default,Percent of Total Billed Charges,182.66,,,,182.66,252.63
DEXMEDETOMIDINE 400MCG/100ML IVPB PREMIX,250,RC,,,,both,309.6,278.64,United Healthcare,Default,Fee Schedule,252.63,,,,182.66,252.63
NF-ENALAPRIL MALEATE ORAL TABLET 10MG,250,RC,,,,both,6.41,5.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.49,,,,3.78,5.23
NF-ENALAPRIL MALEATE ORAL TABLET 10MG,250,RC,,,,both,6.41,5.77,Cigna,Default,Percent of Total Billed Charges,3.78,,,,3.78,5.23
NF-ENALAPRIL MALEATE ORAL TABLET 10MG,250,RC,,,,both,6.41,5.77,United Healthcare,Default,Fee Schedule,5.23,,,,3.78,5.23
NF-HUMULIN R CONCENTRATE U-500 INJ 500U/,250,RC,,,,both,356.88,321.19,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,249.82,,,,210.56,291.21
NF-HUMULIN R CONCENTRATE U-500 INJ 500U/,250,RC,,,,both,356.88,321.19,Cigna,Default,Percent of Total Billed Charges,210.56,,,,210.56,291.21
NF-HUMULIN R CONCENTRATE U-500 INJ 500U/,250,RC,,,,both,356.88,321.19,United Healthcare,Default,Fee Schedule,291.21,,,,210.56,291.21
NF-NORTRIPTYLINE HCL CAP 10MG,250,RC,,,,both,1.38,1.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.97,,,,0.81,1.13
NF-NORTRIPTYLINE HCL CAP 10MG,250,RC,,,,both,1.38,1.24,Cigna,Default,Percent of Total Billed Charges,0.81,,,,0.81,1.13
NF-NORTRIPTYLINE HCL CAP 10MG,250,RC,,,,both,1.38,1.24,United Healthcare,Default,Fee Schedule,1.13,,,,0.81,1.13
NF-NORTREL 7/7/7 ORAL TABLET,250,RC,,,,both,11.35,10.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.94,,,,6.7,9.26
NF-NORTREL 7/7/7 ORAL TABLET,250,RC,,,,both,11.35,10.22,Cigna,Default,Percent of Total Billed Charges,6.7,,,,6.7,9.26
NF-NORTREL 7/7/7 ORAL TABLET,250,RC,,,,both,11.35,10.22,United Healthcare,Default,Fee Schedule,9.26,,,,6.7,9.26
NF-NORTRIPTYLINE HCL AVPAK CAP 50MG,250,RC,,,,both,2.51,2.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.76,,,,1.48,2.05
NF-NORTRIPTYLINE HCL AVPAK CAP 50MG,250,RC,,,,both,2.51,2.26,Cigna,Default,Percent of Total Billed Charges,1.48,,,,1.48,2.05
NF-NORTRIPTYLINE HCL AVPAK CAP 50MG,250,RC,,,,both,2.51,2.26,United Healthcare,Default,Fee Schedule,2.05,,,,1.48,2.05
NF-PROVIGIL ORAL TABLET 100MG,250,RC,,,,both,226.93,204.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,158.85,,,,133.89,185.17
NF-PROVIGIL ORAL TABLET 100MG,250,RC,,,,both,226.93,204.24,Cigna,Default,Percent of Total Billed Charges,133.89,,,,133.89,185.17
NF-PROVIGIL ORAL TABLET 100MG,250,RC,,,,both,226.93,204.24,United Healthcare,Default,Fee Schedule,185.17,,,,133.89,185.17
NF-DUODERM SIGNAL TAPERED EDGE DRSG DEVI,250,RC,,,,both,85.91,77.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.14,,,,50.69,70.1
NF-DUODERM SIGNAL TAPERED EDGE DRSG DEVI,250,RC,,,,both,85.91,77.32,Cigna,Default,Percent of Total Billed Charges,50.69,,,,50.69,70.1
NF-DUODERM SIGNAL TAPERED EDGE DRSG DEVI,250,RC,,,,both,85.91,77.32,United Healthcare,Default,Fee Schedule,70.1,,,,50.69,70.1
NF-RYTARY CAP ER 23.75MG-95MG,250,RC,,,,both,18.47,16.62,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.93,,,,10.9,15.07
NF-RYTARY CAP ER 23.75MG-95MG,250,RC,,,,both,18.47,16.62,Cigna,Default,Percent of Total Billed Charges,10.9,,,,10.9,15.07
NF-RYTARY CAP ER 23.75MG-95MG,250,RC,,,,both,18.47,16.62,United Healthcare,Default,Fee Schedule,15.07,,,,10.9,15.07
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,26.11,23.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.28,,,,15.4,21.31
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,26.11,23.5,Cigna,Default,Percent of Total Billed Charges,15.4,,,,15.4,21.31
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,26.11,23.5,United Healthcare,Default,Fee Schedule,21.31,,,,15.4,21.31
NF-ATACAND ORAL TABLET 16MG,250,RC,,,,both,9.84,8.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.89,,,,5.81,8.03
NF-ATACAND ORAL TABLET 16MG,250,RC,,,,both,9.84,8.86,Cigna,Default,Percent of Total Billed Charges,5.81,,,,5.81,8.03
NF-ATACAND ORAL TABLET 16MG,250,RC,,,,both,9.84,8.86,United Healthcare,Default,Fee Schedule,8.03,,,,5.81,8.03
NF-DIAZEPAM ORAL TABLET 2MG,250,RC,,,,both,3.04,2.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.13,,,,1.79,2.48
NF-DIAZEPAM ORAL TABLET 2MG,250,RC,,,,both,3.04,2.74,Cigna,Default,Percent of Total Billed Charges,1.79,,,,1.79,2.48
NF-DIAZEPAM ORAL TABLET 2MG,250,RC,,,,both,3.04,2.74,United Healthcare,Default,Fee Schedule,2.48,,,,1.79,2.48
NF-LEVALBUTEROL TARTRATE 0.045MG/1ACT,250,RC,,,,both,19.65,17.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.76,,,,11.59,16.03
NF-LEVALBUTEROL TARTRATE 0.045MG/1ACT,250,RC,,,,both,19.65,17.69,Cigna,Default,Percent of Total Billed Charges,11.59,,,,11.59,16.03
NF-LEVALBUTEROL TARTRATE 0.045MG/1ACT,250,RC,,,,both,19.65,17.69,United Healthcare,Default,Fee Schedule,16.03,,,,11.59,16.03
NF-VALACYCLOVIR HCL ORAL TABLET 500MG,250,RC,,,,both,28.9,26.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.23,,,,17.05,23.58
NF-VALACYCLOVIR HCL ORAL TABLET 500MG,250,RC,,,,both,28.9,26.01,Cigna,Default,Percent of Total Billed Charges,17.05,,,,17.05,23.58
NF-VALACYCLOVIR HCL ORAL TABLET 500MG,250,RC,,,,both,28.9,26.01,United Healthcare,Default,Fee Schedule,23.58,,,,17.05,23.58
NF-XARELTO ORAL TABLET 15MG,250,RC,,,,both,86.79,78.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,60.75,,,,51.21,70.82
NF-XARELTO ORAL TABLET 15MG,250,RC,,,,both,86.79,78.11,Cigna,Default,Percent of Total Billed Charges,51.21,,,,51.21,70.82
NF-XARELTO ORAL TABLET 15MG,250,RC,,,,both,86.79,78.11,United Healthcare,Default,Fee Schedule,70.82,,,,51.21,70.82
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,31.63,28.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,22.14,,,,18.66,25.81
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,31.63,28.47,Cigna,Default,Percent of Total Billed Charges,18.66,,,,18.66,25.81
NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,250,RC,,,,both,31.63,28.47,United Healthcare,Default,Fee Schedule,25.81,,,,18.66,25.81
NF-ARAVA ORAL TABLET 20MG,250,RC,,,,both,72.18,64.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.53,,,,42.59,58.9
NF-ARAVA ORAL TABLET 20MG,250,RC,,,,both,72.18,64.96,Cigna,Default,Percent of Total Billed Charges,42.59,,,,42.59,58.9
NF-ARAVA ORAL TABLET 20MG,250,RC,,,,both,72.18,64.96,United Healthcare,Default,Fee Schedule,58.9,,,,42.59,58.9
NF-PANTOPRAZOLE SODIUM ORAL TAB DR 20MG,250,RC,,,,both,21.07,18.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.75,,,,12.43,17.19
NF-PANTOPRAZOLE SODIUM ORAL TAB DR 20MG,250,RC,,,,both,21.07,18.96,Cigna,Default,Percent of Total Billed Charges,12.43,,,,12.43,17.19
NF-PANTOPRAZOLE SODIUM ORAL TAB DR 20MG,250,RC,,,,both,21.07,18.96,United Healthcare,Default,Fee Schedule,17.19,,,,12.43,17.19
NF-ESTRADIOL TD PATCH ER 0.075MG/24HR,250,RC,,,,both,72.9,65.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.03,,,,43.01,59.49
NF-ESTRADIOL TD PATCH ER 0.075MG/24HR,250,RC,,,,both,72.9,65.61,Cigna,Default,Percent of Total Billed Charges,43.01,,,,43.01,59.49
NF-ESTRADIOL TD PATCH ER 0.075MG/24HR,250,RC,,,,both,72.9,65.61,United Healthcare,Default,Fee Schedule,59.49,,,,43.01,59.49
NF-CO-Q10 TABLET 60MG,250,RC,,,,both,1.33,1.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.93,,,,0.78,1.09
NF-CO-Q10 TABLET 60MG,250,RC,,,,both,1.33,1.2,Cigna,Default,Percent of Total Billed Charges,0.78,,,,0.78,1.09
NF-CO-Q10 TABLET 60MG,250,RC,,,,both,1.33,1.2,United Healthcare,Default,Fee Schedule,1.09,,,,0.78,1.09
NF-CALCIUM & VITAMIN D3 600MG-20MCG,250,RC,,,,both,0.36,0.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.25,,,,0.21,0.29
NF-CALCIUM & VITAMIN D3 600MG-20MCG,250,RC,,,,both,0.36,0.32,Cigna,Default,Percent of Total Billed Charges,0.21,,,,0.21,0.29
NF-CALCIUM & VITAMIN D3 600MG-20MCG,250,RC,,,,both,0.36,0.32,United Healthcare,Default,Fee Schedule,0.29,,,,0.21,0.29
NF-CO-Q10 ORAL CAPSULE 100MG,250,RC,,,,both,1.47,1.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.03,,,,0.87,1.2
NF-CO-Q10 ORAL CAPSULE 100MG,250,RC,,,,both,1.47,1.32,Cigna,Default,Percent of Total Billed Charges,0.87,,,,0.87,1.2
NF-CO-Q10 ORAL CAPSULE 100MG,250,RC,,,,both,1.47,1.32,United Healthcare,Default,Fee Schedule,1.2,,,,0.87,1.2
NF-PRALUENT SUBQ SOLN 75MG/1ML,250,RC,,,,both,2688,2419.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1881.6,,,,1585.92,2193.41
NF-PRALUENT SUBQ SOLN 75MG/1ML,250,RC,,,,both,2688,2419.2,Cigna,Default,Percent of Total Billed Charges,1585.92,,,,1585.92,2193.41
NF-PRALUENT SUBQ SOLN 75MG/1ML,250,RC,,,,both,2688,2419.2,United Healthcare,Default,Fee Schedule,2193.41,,,,1585.92,2193.41
NF-TRADJENTA ORAL TABLET 5MG,250,RC,,,,both,84.01,75.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,58.81,,,,49.57,68.55
NF-TRADJENTA ORAL TABLET 5MG,250,RC,,,,both,84.01,75.61,Cigna,Default,Percent of Total Billed Charges,49.57,,,,49.57,68.55
NF-TRADJENTA ORAL TABLET 5MG,250,RC,,,,both,84.01,75.61,United Healthcare,Default,Fee Schedule,68.55,,,,49.57,68.55
NF-METHOCARBAMOL 1000MG TAB,250,RC,,,,both,112.88,101.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,79.02,,,,66.6,92.11
NF-METHOCARBAMOL 1000MG TAB,250,RC,,,,both,112.88,101.59,Cigna,Default,Percent of Total Billed Charges,66.6,,,,66.6,92.11
NF-METHOCARBAMOL 1000MG TAB,250,RC,,,,both,112.88,101.59,United Healthcare,Default,Fee Schedule,92.11,,,,66.6,92.11
NF-OXYCODONE HCL CAP 5MG,250,RC,,,,both,7.4,6.66,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.18,,,,4.37,6.04
NF-OXYCODONE HCL CAP 5MG,250,RC,,,,both,7.4,6.66,Cigna,Default,Percent of Total Billed Charges,4.37,,,,4.37,6.04
NF-OXYCODONE HCL CAP 5MG,250,RC,,,,both,7.4,6.66,United Healthcare,Default,Fee Schedule,6.04,,,,4.37,6.04
NF-EZETIMIBE ORAL TABLET 10MG,250,RC,,,,both,41.12,37.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.78,,,,24.26,33.55
NF-EZETIMIBE ORAL TABLET 10MG,250,RC,,,,both,41.12,37.01,Cigna,Default,Percent of Total Billed Charges,24.26,,,,24.26,33.55
NF-EZETIMIBE ORAL TABLET 10MG,250,RC,,,,both,41.12,37.01,United Healthcare,Default,Fee Schedule,33.55,,,,24.26,33.55
NF-PRESERVISION ORAL LIQUID CAPSULE,250,RC,,,,both,1.06,0.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.74,,,,0.63,0.86
NF-PRESERVISION ORAL LIQUID CAPSULE,250,RC,,,,both,1.06,0.95,Cigna,Default,Percent of Total Billed Charges,0.63,,,,0.63,0.86
NF-PRESERVISION ORAL LIQUID CAPSULE,250,RC,,,,both,1.06,0.95,United Healthcare,Default,Fee Schedule,0.86,,,,0.63,0.86
NF-ROSUVASTATIN CALCIUM CAP 5MG,250,RC,,,,both,15.87,14.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.11,,,,9.36,12.95
NF-ROSUVASTATIN CALCIUM CAP 5MG,250,RC,,,,both,15.87,14.28,Cigna,Default,Percent of Total Billed Charges,9.36,,,,9.36,12.95
NF-ROSUVASTATIN CALCIUM CAP 5MG,250,RC,,,,both,15.87,14.28,United Healthcare,Default,Fee Schedule,12.95,,,,9.36,12.95
NF-ROSUVASTATIN CALCIUM ORAL TABLET 5MG,250,RC,,,,both,28.58,25.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.01,,,,16.86,23.32
NF-ROSUVASTATIN CALCIUM ORAL TABLET 5MG,250,RC,,,,both,28.58,25.72,Cigna,Default,Percent of Total Billed Charges,16.86,,,,16.86,23.32
NF-ROSUVASTATIN CALCIUM ORAL TABLET 5MG,250,RC,,,,both,28.58,25.72,United Healthcare,Default,Fee Schedule,23.32,,,,16.86,23.32
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,119.26,107.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,83.48,,,,70.36,97.32
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,119.26,107.33,Cigna,Default,Percent of Total Billed Charges,70.36,,,,70.36,97.32
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,119.26,107.33,United Healthcare,Default,Fee Schedule,97.32,,,,70.36,97.32
NF-CREON CAP DR 36000U-114000U-180000U,250,RC,,,,both,57.14,51.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,40,,,,33.71,46.63
NF-CREON CAP DR 36000U-114000U-180000U,250,RC,,,,both,57.14,51.43,Cigna,Default,Percent of Total Billed Charges,33.71,,,,33.71,46.63
NF-CREON CAP DR 36000U-114000U-180000U,250,RC,,,,both,57.14,51.43,United Healthcare,Default,Fee Schedule,46.63,,,,33.71,46.63
NF-PREGABALIN CAP 200MG,250,RC,,,,both,27.6,24.84,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.32,,,,16.28,22.52
NF-PREGABALIN CAP 200MG,250,RC,,,,both,27.6,24.84,Cigna,Default,Percent of Total Billed Charges,16.28,,,,16.28,22.52
NF-PREGABALIN CAP 200MG,250,RC,,,,both,27.6,24.84,United Healthcare,Default,Fee Schedule,22.52,,,,16.28,22.52
NF-PREGABALIN CAP 225MG,250,RC,,,,both,23.41,21.07,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.39,,,,13.81,19.1
NF-PREGABALIN CAP 225MG,250,RC,,,,both,23.41,21.07,Cigna,Default,Percent of Total Billed Charges,13.81,,,,13.81,19.1
NF-PREGABALIN CAP 225MG,250,RC,,,,both,23.41,21.07,United Healthcare,Default,Fee Schedule,19.1,,,,13.81,19.1
NF-ASHLYNA TAB 30MCG-0.15MG;0.01MG,250,RC,,,,both,13.4,12.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.38,,,,7.91,10.93
NF-ASHLYNA TAB 30MCG-0.15MG;0.01MG,250,RC,,,,both,13.4,12.06,Cigna,Default,Percent of Total Billed Charges,7.91,,,,7.91,10.93
NF-ASHLYNA TAB 30MCG-0.15MG;0.01MG,250,RC,,,,both,13.4,12.06,United Healthcare,Default,Fee Schedule,10.93,,,,7.91,10.93
NF-GEMTESA ORAL TABLET 75MG,250,RC,,,,both,75.54,67.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,52.88,,,,44.57,61.64
NF-GEMTESA ORAL TABLET 75MG,250,RC,,,,both,75.54,67.99,Cigna,Default,Percent of Total Billed Charges,44.57,,,,44.57,61.64
NF-GEMTESA ORAL TABLET 75MG,250,RC,,,,both,75.54,67.99,United Healthcare,Default,Fee Schedule,61.64,,,,44.57,61.64
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,198.95,179.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,139.26,,,,117.38,162.34
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,198.95,179.06,Cigna,Default,Percent of Total Billed Charges,117.38,,,,117.38,162.34
NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,250,RC,,,,both,198.95,179.06,United Healthcare,Default,Fee Schedule,162.34,,,,117.38,162.34
NF-TELMISARTAN ORAL TABLET 20MG,250,RC,,,,both,22.06,19.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.44,,,,13.02,18
NF-TELMISARTAN ORAL TABLET 20MG,250,RC,,,,both,22.06,19.85,Cigna,Default,Percent of Total Billed Charges,13.02,,,,13.02,18
NF-TELMISARTAN ORAL TABLET 20MG,250,RC,,,,both,22.06,19.85,United Healthcare,Default,Fee Schedule,18,,,,13.02,18
NF-PRAZOSIN HCL     CAP  2MG,250,RC,,,,both,5.09,4.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.56,,,,3,4.15
NF-PRAZOSIN HCL     CAP  2MG,250,RC,,,,both,5.09,4.58,Cigna,Default,Percent of Total Billed Charges,3,,,,3,4.15
NF-PRAZOSIN HCL     CAP  2MG,250,RC,,,,both,5.09,4.58,United Healthcare,Default,Fee Schedule,4.15,,,,3,4.15
NF-CHANTIX TAB 1MG,250,RC,,,,both,40.23,36.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.16,,,,23.74,32.83
NF-CHANTIX TAB 1MG,250,RC,,,,both,40.23,36.21,Cigna,Default,Percent of Total Billed Charges,23.74,,,,23.74,32.83
NF-CHANTIX TAB 1MG,250,RC,,,,both,40.23,36.21,United Healthcare,Default,Fee Schedule,32.83,,,,23.74,32.83
NF-ALTACE CAP 10MG,250,RC,,,,both,4.82,4.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.37,,,,2.84,3.93
NF-ALTACE CAP 10MG,250,RC,,,,both,4.82,4.34,Cigna,Default,Percent of Total Billed Charges,2.84,,,,2.84,3.93
NF-ALTACE CAP 10MG,250,RC,,,,both,4.82,4.34,United Healthcare,Default,Fee Schedule,3.93,,,,2.84,3.93
NF-ALTACE CAP 10MG,250,RC,,,,both,4.82,4.34,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.37,,,,2.84,3.93
NF-ALTACE CAP 10MG,250,RC,,,,both,4.82,4.34,Cigna,Default,Percent of Total Billed Charges,2.84,,,,2.84,3.93
NF-ALTACE CAP 10MG,250,RC,,,,both,4.82,4.34,United Healthcare,Default,Fee Schedule,3.93,,,,2.84,3.93
NF-TRELEGY ELLIPTA 100/62.5/25MCG/INH,250,RC,,,,both,51.08,45.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.76,,,,30.14,41.68
NF-TRELEGY ELLIPTA 100/62.5/25MCG/INH,250,RC,,,,both,51.08,45.97,Cigna,Default,Percent of Total Billed Charges,30.14,,,,30.14,41.68
NF-TRELEGY ELLIPTA 100/62.5/25MCG/INH,250,RC,,,,both,51.08,45.97,United Healthcare,Default,Fee Schedule,41.68,,,,30.14,41.68
NF-PRENATAL COMPLETE MULTIVITAMIN LIQ CA,250,RC,,,,both,1.47,1.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.03,,,,0.87,1.2
NF-PRENATAL COMPLETE MULTIVITAMIN LIQ CA,250,RC,,,,both,1.47,1.32,Cigna,Default,Percent of Total Billed Charges,0.87,,,,0.87,1.2
NF-PRENATAL COMPLETE MULTIVITAMIN LIQ CA,250,RC,,,,both,1.47,1.32,United Healthcare,Default,Fee Schedule,1.2,,,,0.87,1.2
NF-COLACE ORAL TABLET 50MG-8.6MG,250,RC,,,,both,1.37,1.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.96,,,,0.81,1.12
NF-COLACE ORAL TABLET 50MG-8.6MG,250,RC,,,,both,1.37,1.23,Cigna,Default,Percent of Total Billed Charges,0.81,,,,0.81,1.12
NF-COLACE ORAL TABLET 50MG-8.6MG,250,RC,,,,both,1.37,1.23,United Healthcare,Default,Fee Schedule,1.12,,,,0.81,1.12
NF-SIMVASTATIN ORAL TABLET 20MG,250,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 20MG,250,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 20MG,250,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
NF-LUMIGAN OPHTH SOLN 0.01%,250,RC,,,,both,459.5,413.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,321.65,,,,271.1,374.95
NF-LUMIGAN OPHTH SOLN 0.01%,250,RC,,,,both,459.5,413.55,Cigna,Default,Percent of Total Billed Charges,271.1,,,,271.1,374.95
NF-LUMIGAN OPHTH SOLN 0.01%,250,RC,,,,both,459.5,413.55,United Healthcare,Default,Fee Schedule,374.95,,,,271.1,374.95
NF-DORZOLAMIDE HCL OPHTHALMIC SOLUTION 2,250,RC,,,,both,26.72,24.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.7,,,,15.76,21.8
NF-DORZOLAMIDE HCL OPHTHALMIC SOLUTION 2,250,RC,,,,both,26.72,24.05,Cigna,Default,Percent of Total Billed Charges,15.76,,,,15.76,21.8
NF-DORZOLAMIDE HCL OPHTHALMIC SOLUTION 2,250,RC,,,,both,26.72,24.05,United Healthcare,Default,Fee Schedule,21.8,,,,15.76,21.8
LINACLOTIDE 72MCG CAPSULE  (LINZESS),250,RC,,,,both,93.04,83.74,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,65.13,,,,54.89,75.92
LINACLOTIDE 72MCG CAPSULE  (LINZESS),250,RC,,,,both,93.04,83.74,Cigna,Default,Percent of Total Billed Charges,54.89,,,,54.89,75.92
LINACLOTIDE 72MCG CAPSULE  (LINZESS),250,RC,,,,both,93.04,83.74,United Healthcare,Default,Fee Schedule,75.92,,,,54.89,75.92
NF-HEARTBURN ANTACID CHEW TAB 160MG-105M,250,RC,,,,both,0.18,0.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.13,,,,0.11,0.15
NF-HEARTBURN ANTACID CHEW TAB 160MG-105M,250,RC,,,,both,0.18,0.16,Cigna,Default,Percent of Total Billed Charges,0.11,,,,0.11,0.15
NF-HEARTBURN ANTACID CHEW TAB 160MG-105M,250,RC,,,,both,0.18,0.16,United Healthcare,Default,Fee Schedule,0.15,,,,0.11,0.15
NF-ARMODAFINIL ORAL TABLET 250MG,250,RC,,,,both,87.45,78.71,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,61.22,,,,51.6,71.36
NF-ARMODAFINIL ORAL TABLET 250MG,250,RC,,,,both,87.45,78.71,Cigna,Default,Percent of Total Billed Charges,51.6,,,,51.6,71.36
NF-ARMODAFINIL ORAL TABLET 250MG,250,RC,,,,both,87.45,78.71,United Healthcare,Default,Fee Schedule,71.36,,,,51.6,71.36
NF-DESVENLAFAXINE ORAL TAB ER 100MG,250,RC,,,,both,45.87,41.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,32.11,,,,27.06,37.43
NF-DESVENLAFAXINE ORAL TAB ER 100MG,250,RC,,,,both,45.87,41.28,Cigna,Default,Percent of Total Billed Charges,27.06,,,,27.06,37.43
NF-DESVENLAFAXINE ORAL TAB ER 100MG,250,RC,,,,both,45.87,41.28,United Healthcare,Default,Fee Schedule,37.43,,,,27.06,37.43
NF-DILTIAZEM HCL 24 HR CAP ER 360MG,250,RC,,,,both,10.36,9.32,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.25,,,,6.11,8.45
NF-DILTIAZEM HCL 24 HR CAP ER 360MG,250,RC,,,,both,10.36,9.32,Cigna,Default,Percent of Total Billed Charges,6.11,,,,6.11,8.45
NF-DILTIAZEM HCL 24 HR CAP ER 360MG,250,RC,,,,both,10.36,9.32,United Healthcare,Default,Fee Schedule,8.45,,,,6.11,8.45
NF-TOPROL XL TAB ER 25MG,250,RC,,,,both,5.74,5.17,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.02,,,,3.39,4.68
NF-TOPROL XL TAB ER 25MG,250,RC,,,,both,5.74,5.17,Cigna,Default,Percent of Total Billed Charges,3.39,,,,3.39,4.68
NF-TOPROL XL TAB ER 25MG,250,RC,,,,both,5.74,5.17,United Healthcare,Default,Fee Schedule,4.68,,,,3.39,4.68
NF-ENTRESTO ORAL TABLET 97MG-103MG,250,RC,,,,both,37,33.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.9,,,,21.83,30.19
NF-ENTRESTO ORAL TABLET 97MG-103MG,250,RC,,,,both,37,33.3,Cigna,Default,Percent of Total Billed Charges,21.83,,,,21.83,30.19
NF-ENTRESTO ORAL TABLET 97MG-103MG,250,RC,,,,both,37,33.3,United Healthcare,Default,Fee Schedule,30.19,,,,21.83,30.19
NF-CARVEDILOL ORAL CAPSULE ER 10MG,250,RC,,,,both,41.29,37.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,28.9,,,,24.36,33.69
NF-CARVEDILOL ORAL CAPSULE ER 10MG,250,RC,,,,both,41.29,37.16,Cigna,Default,Percent of Total Billed Charges,24.36,,,,24.36,33.69
NF-CARVEDILOL ORAL CAPSULE ER 10MG,250,RC,,,,both,41.29,37.16,United Healthcare,Default,Fee Schedule,33.69,,,,24.36,33.69
NF-RESTASIS MULTIDOSE OPHTH EMUL 0.05%,250,RC,,,,both,372.42,335.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,260.69,,,,219.73,303.89
NF-RESTASIS MULTIDOSE OPHTH EMUL 0.05%,250,RC,,,,both,372.42,335.18,Cigna,Default,Percent of Total Billed Charges,219.73,,,,219.73,303.89
NF-RESTASIS MULTIDOSE OPHTH EMUL 0.05%,250,RC,,,,both,372.42,335.18,United Healthcare,Default,Fee Schedule,303.89,,,,219.73,303.89
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.7,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,Cigna,Default,Percent of Total Billed Charges,11.55,,,,11.55,15.97
NF-SIMVASTATIN ORAL TABLET 40MG,250,RC,,,,both,19.57,17.61,United Healthcare,Default,Fee Schedule,15.97,,,,11.55,15.97
NF-WELLBUTRIN XL 24 HR TAB ER 150MG,250,RC,,,,both,13.73,12.36,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.61,,,,8.1,11.2
NF-WELLBUTRIN XL 24 HR TAB ER 150MG,250,RC,,,,both,13.73,12.36,Cigna,Default,Percent of Total Billed Charges,8.1,,,,8.1,11.2
NF-WELLBUTRIN XL 24 HR TAB ER 150MG,250,RC,,,,both,13.73,12.36,United Healthcare,Default,Fee Schedule,11.2,,,,8.1,11.2
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,250,RC,,,,both,71.6,64.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.12,,,,42.24,58.43
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,250,RC,,,,both,71.6,64.44,Cigna,Default,Percent of Total Billed Charges,42.24,,,,42.24,58.43
NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG,250,RC,,,,both,71.6,64.44,United Healthcare,Default,Fee Schedule,58.43,,,,42.24,58.43
NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,250,RC,,,,both,7.77,6.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.44,,,,4.58,6.34
NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,250,RC,,,,both,7.77,6.99,Cigna,Default,Percent of Total Billed Charges,4.58,,,,4.58,6.34
NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,250,RC,,,,both,7.77,6.99,United Healthcare,Default,Fee Schedule,6.34,,,,4.58,6.34
NF-PRISTIQ EXTENDED-RELEASE TABLET 100MG,250,RC,,,,both,70.07,63.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.05,,,,41.34,57.18
NF-PRISTIQ EXTENDED-RELEASE TABLET 100MG,250,RC,,,,both,70.07,63.06,Cigna,Default,Percent of Total Billed Charges,41.34,,,,41.34,57.18
NF-PRISTIQ EXTENDED-RELEASE TABLET 100MG,250,RC,,,,both,70.07,63.06,United Healthcare,Default,Fee Schedule,57.18,,,,41.34,57.18
"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 100",250,RC,,,,both,1.31,1.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.92,,,,0.77,1.07
"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 100",250,RC,,,,both,1.31,1.18,Cigna,Default,Percent of Total Billed Charges,0.77,,,,0.77,1.07
"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 100",250,RC,,,,both,1.31,1.18,United Healthcare,Default,Fee Schedule,1.07,,,,0.77,1.07
NF-AZO YEAST PLUS ORAL TABLET,250,RC,,,,both,0.8,0.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.56,,,,0.47,0.65
NF-AZO YEAST PLUS ORAL TABLET,250,RC,,,,both,0.8,0.72,Cigna,Default,Percent of Total Billed Charges,0.47,,,,0.47,0.65
NF-AZO YEAST PLUS ORAL TABLET,250,RC,,,,both,0.8,0.72,United Healthcare,Default,Fee Schedule,0.65,,,,0.47,0.65
NF-GUAIFENESIN/DEXTROMETHORPHAN HBR TAB,250,RC,,,,both,1.24,1.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.87,,,,0.73,1.01
NF-GUAIFENESIN/DEXTROMETHORPHAN HBR TAB,250,RC,,,,both,1.24,1.12,Cigna,Default,Percent of Total Billed Charges,0.73,,,,0.73,1.01
NF-GUAIFENESIN/DEXTROMETHORPHAN HBR TAB,250,RC,,,,both,1.24,1.12,United Healthcare,Default,Fee Schedule,1.01,,,,0.73,1.01
NF-MUCINEX DM ORAL TAB ER 30MG-600MG,250,RC,,,,both,4.2,3.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.94,,,,2.48,3.43
NF-MUCINEX DM ORAL TAB ER 30MG-600MG,250,RC,,,,both,4.2,3.78,Cigna,Default,Percent of Total Billed Charges,2.48,,,,2.48,3.43
NF-MUCINEX DM ORAL TAB ER 30MG-600MG,250,RC,,,,both,4.2,3.78,United Healthcare,Default,Fee Schedule,3.43,,,,2.48,3.43
NF-PRAVASTATIN SODIUM ORAL TABLET 80MG,250,RC,,,,both,19.18,17.26,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,13.43,,,,11.32,15.65
NF-PRAVASTATIN SODIUM ORAL TABLET 80MG,250,RC,,,,both,19.18,17.26,Cigna,Default,Percent of Total Billed Charges,11.32,,,,11.32,15.65
NF-PRAVASTATIN SODIUM ORAL TABLET 80MG,250,RC,,,,both,19.18,17.26,United Healthcare,Default,Fee Schedule,15.65,,,,11.32,15.65
NF-CREON CAP DR 6000U-19000U-30000U,250,RC,,,,both,9.5,8.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.65,,,,5.6,7.75
NF-CREON CAP DR 6000U-19000U-30000U,250,RC,,,,both,9.5,8.55,Cigna,Default,Percent of Total Billed Charges,5.6,,,,5.6,7.75
NF-CREON CAP DR 6000U-19000U-30000U,250,RC,,,,both,9.5,8.55,United Healthcare,Default,Fee Schedule,7.75,,,,5.6,7.75
NF-LEVETIRACETAM ORAL TABLET 250MG,250,RC,,,,both,11.5,10.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.05,,,,6.78,9.38
NF-LEVETIRACETAM ORAL TABLET 250MG,250,RC,,,,both,11.5,10.35,Cigna,Default,Percent of Total Billed Charges,6.78,,,,6.78,9.38
NF-LEVETIRACETAM ORAL TABLET 250MG,250,RC,,,,both,11.5,10.35,United Healthcare,Default,Fee Schedule,9.38,,,,6.78,9.38
NF-VITAMIN B12 ORAL TABLET 500MCG,250,RC,,,,both,0.78,0.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.55,,,,0.46,0.64
NF-VITAMIN B12 ORAL TABLET 500MCG,250,RC,,,,both,0.78,0.7,Cigna,Default,Percent of Total Billed Charges,0.46,,,,0.46,0.64
NF-VITAMIN B12 ORAL TABLET 500MCG,250,RC,,,,both,0.78,0.7,United Healthcare,Default,Fee Schedule,0.64,,,,0.46,0.64
NF-TACROLIMUS CAP 1MG,250,RC,,,,both,17.84,16.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.49,,,,10.53,14.56
NF-TACROLIMUS CAP 1MG,250,RC,,,,both,17.84,16.06,Cigna,Default,Percent of Total Billed Charges,10.53,,,,10.53,14.56
NF-TACROLIMUS CAP 1MG,250,RC,,,,both,17.84,16.06,United Healthcare,Default,Fee Schedule,14.56,,,,10.53,14.56
NF-SOTALOL HCL TAB 80MG,250,RC,,,,both,112.01,100.81,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,78.41,,,,66.09,91.4
NF-SOTALOL HCL TAB 80MG,250,RC,,,,both,112.01,100.81,Cigna,Default,Percent of Total Billed Charges,66.09,,,,66.09,91.4
NF-SOTALOL HCL TAB 80MG,250,RC,,,,both,112.01,100.81,United Healthcare,Default,Fee Schedule,91.4,,,,66.09,91.4
NF-CREON ORAL DELAYED RELEASE CAPSULE,250,RC,,,,both,9.5,8.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.65,,,,5.6,7.75
NF-CREON ORAL DELAYED RELEASE CAPSULE,250,RC,,,,both,9.5,8.55,Cigna,Default,Percent of Total Billed Charges,5.6,,,,5.6,7.75
NF-CREON ORAL DELAYED RELEASE CAPSULE,250,RC,,,,both,9.5,8.55,United Healthcare,Default,Fee Schedule,7.75,,,,5.6,7.75
NF-POTASSIUM CHELATED TABLET 99MG,250,RC,,,,both,0.17,0.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.12,,,,0.1,0.14
NF-POTASSIUM CHELATED TABLET 99MG,250,RC,,,,both,0.17,0.15,Cigna,Default,Percent of Total Billed Charges,0.1,,,,0.1,0.14
NF-POTASSIUM CHELATED TABLET 99MG,250,RC,,,,both,0.17,0.15,United Healthcare,Default,Fee Schedule,0.14,,,,0.1,0.14
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.39,,,,0.33,0.46
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,Cigna,Default,Percent of Total Billed Charges,0.33,,,,0.33,0.46
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,United Healthcare,Default,Fee Schedule,0.46,,,,0.33,0.46
NF-ARMOUR THYROID TABLET 60MG,250,RC,,,,both,4.43,3.99,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.1,,,,2.61,3.61
NF-ARMOUR THYROID TABLET 60MG,250,RC,,,,both,4.43,3.99,Cigna,Default,Percent of Total Billed Charges,2.61,,,,2.61,3.61
NF-ARMOUR THYROID TABLET 60MG,250,RC,,,,both,4.43,3.99,United Healthcare,Default,Fee Schedule,3.61,,,,2.61,3.61
NF-UBRELVY ORAL TABLET 50MG,250,RC,,,,both,472.32,425.09,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,330.62,,,,278.67,385.41
NF-UBRELVY ORAL TABLET 50MG,250,RC,,,,both,472.32,425.09,Cigna,Default,Percent of Total Billed Charges,278.67,,,,278.67,385.41
NF-UBRELVY ORAL TABLET 50MG,250,RC,,,,both,472.32,425.09,United Healthcare,Default,Fee Schedule,385.41,,,,278.67,385.41
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,250,RC,,,,both,4.04,3.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.83,,,,2.38,3.3
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,250,RC,,,,both,4.04,3.64,Cigna,Default,Percent of Total Billed Charges,2.38,,,,2.38,3.3
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,250,RC,,,,both,4.04,3.64,United Healthcare,Default,Fee Schedule,3.3,,,,2.38,3.3
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,250,RC,,,,both,5.1,4.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.57,,,,3.01,4.16
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,250,RC,,,,both,5.1,4.59,Cigna,Default,Percent of Total Billed Charges,3.01,,,,3.01,4.16
NF-SYSTANE BALANCE OPHTH SOLN 0.6%,250,RC,,,,both,5.1,4.59,United Healthcare,Default,Fee Schedule,4.16,,,,3.01,4.16
NF-LENALIDOMIDE CAP 2.5MG,250,RC,,,,both,3999.48,3599.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2799.64,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 2.5MG,250,RC,,,,both,3999.48,3599.53,Cigna,Default,Percent of Total Billed Charges,2359.69,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 2.5MG,250,RC,,,,both,3999.48,3599.53,United Healthcare,Default,Fee Schedule,3263.58,,,,2359.69,3263.58
NF-ROSUVASTATIN CALCIUM ORAL TABLET 40MG,250,RC,,,,both,35.78,32.2,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.05,,,,21.11,29.2
NF-ROSUVASTATIN CALCIUM ORAL TABLET 40MG,250,RC,,,,both,35.78,32.2,Cigna,Default,Percent of Total Billed Charges,21.11,,,,21.11,29.2
NF-ROSUVASTATIN CALCIUM ORAL TABLET 40MG,250,RC,,,,both,35.78,32.2,United Healthcare,Default,Fee Schedule,29.2,,,,21.11,29.2
NF-HYZAAR ORAL TABLET 50MG-12.5MG,250,RC,,,,both,22.63,20.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.84,,,,13.35,18.47
NF-HYZAAR ORAL TABLET 50MG-12.5MG,250,RC,,,,both,22.63,20.37,Cigna,Default,Percent of Total Billed Charges,13.35,,,,13.35,18.47
NF-HYZAAR ORAL TABLET 50MG-12.5MG,250,RC,,,,both,22.63,20.37,United Healthcare,Default,Fee Schedule,18.47,,,,13.35,18.47
NF-AVAPRO ORAL TABLET 300MG,250,RC,,,,both,17.74,15.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.42,,,,10.47,14.48
NF-AVAPRO ORAL TABLET 300MG,250,RC,,,,both,17.74,15.97,Cigna,Default,Percent of Total Billed Charges,10.47,,,,10.47,14.48
NF-AVAPRO ORAL TABLET 300MG,250,RC,,,,both,17.74,15.97,United Healthcare,Default,Fee Schedule,14.48,,,,10.47,14.48
NF-FLECAINIDE ACETATE AVPAK TAB 50MG,250,RC,,,,both,16.21,14.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.35,,,,9.56,13.23
NF-FLECAINIDE ACETATE AVPAK TAB 50MG,250,RC,,,,both,16.21,14.59,Cigna,Default,Percent of Total Billed Charges,9.56,,,,9.56,13.23
NF-FLECAINIDE ACETATE AVPAK TAB 50MG,250,RC,,,,both,16.21,14.59,United Healthcare,Default,Fee Schedule,13.23,,,,9.56,13.23
NF-DROXIDOPA CAP 100MG,250,RC,,,,both,188.34,169.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,131.84,,,,111.12,153.69
NF-DROXIDOPA CAP 100MG,250,RC,,,,both,188.34,169.51,Cigna,Default,Percent of Total Billed Charges,111.12,,,,111.12,153.69
NF-DROXIDOPA CAP 100MG,250,RC,,,,both,188.34,169.51,United Healthcare,Default,Fee Schedule,153.69,,,,111.12,153.69
NF-MYLANTA MAXIMUM STRENGTH ORAL SUSPENS,250,RC,,,,both,0.07,0.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.05,,,,0.04,0.06
NF-MYLANTA MAXIMUM STRENGTH ORAL SUSPENS,250,RC,,,,both,0.07,0.06,Cigna,Default,Percent of Total Billed Charges,0.04,,,,0.04,0.06
NF-MYLANTA MAXIMUM STRENGTH ORAL SUSPENS,250,RC,,,,both,0.07,0.06,United Healthcare,Default,Fee Schedule,0.06,,,,0.04,0.06
NF-NORTHERA CAP 200MG,250,RC,,,,both,376.68,339.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,263.68,,,,222.24,307.37
NF-NORTHERA CAP 200MG,250,RC,,,,both,376.68,339.01,Cigna,Default,Percent of Total Billed Charges,222.24,,,,222.24,307.37
NF-NORTHERA CAP 200MG,250,RC,,,,both,376.68,339.01,United Healthcare,Default,Fee Schedule,307.37,,,,222.24,307.37
NF-PYRIDOSTIGMINE BROMIDE ORAL TABLET 30,250,RC,,,,both,34.81,31.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,24.37,,,,20.54,28.4
NF-PYRIDOSTIGMINE BROMIDE ORAL TABLET 30,250,RC,,,,both,34.81,31.33,Cigna,Default,Percent of Total Billed Charges,20.54,,,,20.54,28.4
NF-PYRIDOSTIGMINE BROMIDE ORAL TABLET 30,250,RC,,,,both,34.81,31.33,United Healthcare,Default,Fee Schedule,28.4,,,,20.54,28.4
NF-CARBIDOPA/LEVODOPA TABLET 25MG-100MG,250,RC,,,,both,0.86,0.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.6,,,,0.51,0.7
NF-CARBIDOPA/LEVODOPA TABLET 25MG-100MG,250,RC,,,,both,0.86,0.77,Cigna,Default,Percent of Total Billed Charges,0.51,,,,0.51,0.7
NF-CARBIDOPA/LEVODOPA TABLET 25MG-100MG,250,RC,,,,both,0.86,0.77,United Healthcare,Default,Fee Schedule,0.7,,,,0.51,0.7
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.86,0.77,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.6,,,,0.51,0.7
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.86,0.77,Cigna,Default,Percent of Total Billed Charges,0.51,,,,0.51,0.7
NF-D-MANNOSE ORAL CAPSULE 300MG,250,RC,,,,both,0.86,0.77,United Healthcare,Default,Fee Schedule,0.7,,,,0.51,0.7
NF-TAMBOCOR ORAL TABLET 50MG,250,RC,,,,both,11.08,9.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.76,,,,6.54,9.04
NF-TAMBOCOR ORAL TABLET 50MG,250,RC,,,,both,11.08,9.97,Cigna,Default,Percent of Total Billed Charges,6.54,,,,6.54,9.04
NF-TAMBOCOR ORAL TABLET 50MG,250,RC,,,,both,11.08,9.97,United Healthcare,Default,Fee Schedule,9.04,,,,6.54,9.04
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,175.33,157.8,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,122.73,,,,103.44,143.07
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,175.33,157.8,Cigna,Default,Percent of Total Billed Charges,103.44,,,,103.44,143.07
NF-TRAVATAN Z OPHTH SOLN 0.004%,250,RC,,,,both,175.33,157.8,United Healthcare,Default,Fee Schedule,143.07,,,,103.44,143.07
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.39,,,,0.33,0.46
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,Cigna,Default,Percent of Total Billed Charges,0.33,,,,0.33,0.46
NF-COQ10 ORAL CAPSULE 100MG,250,RC,,,,both,0.56,0.5,United Healthcare,Default,Fee Schedule,0.46,,,,0.33,0.46
NF-SYNTHROID ORAL TABLET 137MCG,250,RC,,,,both,7.21,6.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.05,,,,4.25,5.88
NF-SYNTHROID ORAL TABLET 137MCG,250,RC,,,,both,7.21,6.49,Cigna,Default,Percent of Total Billed Charges,4.25,,,,4.25,5.88
NF-SYNTHROID ORAL TABLET 137MCG,250,RC,,,,both,7.21,6.49,United Healthcare,Default,Fee Schedule,5.88,,,,4.25,5.88
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.09,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,Cigna,Default,Percent of Total Billed Charges,2.61,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,United Healthcare,Default,Fee Schedule,3.61,,,,2.61,3.61
NF-LIOTHYRONINE SODIUM ORAL TABLET 25MCG,250,RC,,,,both,4.25,3.83,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.98,,,,2.51,3.47
NF-LIOTHYRONINE SODIUM ORAL TABLET 25MCG,250,RC,,,,both,4.25,3.83,Cigna,Default,Percent of Total Billed Charges,2.51,,,,2.51,3.47
NF-LIOTHYRONINE SODIUM ORAL TABLET 25MCG,250,RC,,,,both,4.25,3.83,United Healthcare,Default,Fee Schedule,3.47,,,,2.51,3.47
NF-MAGNESIUM CITRATE ORAL CAPSULE 100MG,250,RC,,,,both,1.12,1.01,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.78,,,,0.66,0.91
NF-MAGNESIUM CITRATE ORAL CAPSULE 100MG,250,RC,,,,both,1.12,1.01,Cigna,Default,Percent of Total Billed Charges,0.66,,,,0.66,0.91
NF-MAGNESIUM CITRATE ORAL CAPSULE 100MG,250,RC,,,,both,1.12,1.01,United Healthcare,Default,Fee Schedule,0.91,,,,0.66,0.91
NF-BUTALBITAL COMPOUND W/CODEINE CAPSULE,250,RC,,,,both,16.33,14.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.43,,,,9.63,13.33
NF-BUTALBITAL COMPOUND W/CODEINE CAPSULE,250,RC,,,,both,16.33,14.7,Cigna,Default,Percent of Total Billed Charges,9.63,,,,9.63,13.33
NF-BUTALBITAL COMPOUND W/CODEINE CAPSULE,250,RC,,,,both,16.33,14.7,United Healthcare,Default,Fee Schedule,13.33,,,,9.63,13.33
NF-VALIUM ORAL TABLET 2MG,250,RC,,,,both,23.4,21.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,16.38,,,,13.81,19.09
NF-VALIUM ORAL TABLET 2MG,250,RC,,,,both,23.4,21.06,Cigna,Default,Percent of Total Billed Charges,13.81,,,,13.81,19.09
NF-VALIUM ORAL TABLET 2MG,250,RC,,,,both,23.4,21.06,United Healthcare,Default,Fee Schedule,19.09,,,,13.81,19.09
NF-BECONASE AQ SPRAY 0.042MG/ACT,250,RC,,,,both,56.32,50.69,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,39.42,,,,33.23,45.96
NF-BECONASE AQ SPRAY 0.042MG/ACT,250,RC,,,,both,56.32,50.69,Cigna,Default,Percent of Total Billed Charges,33.23,,,,33.23,45.96
NF-BECONASE AQ SPRAY 0.042MG/ACT,250,RC,,,,both,56.32,50.69,United Healthcare,Default,Fee Schedule,45.96,,,,33.23,45.96
NF-HALOG CRM 0.1%,250,RC,,,,both,8.91,8.02,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.24,,,,5.26,7.27
NF-HALOG CRM 0.1%,250,RC,,,,both,8.91,8.02,Cigna,Default,Percent of Total Billed Charges,5.26,,,,5.26,7.27
NF-HALOG CRM 0.1%,250,RC,,,,both,8.91,8.02,United Healthcare,Default,Fee Schedule,7.27,,,,5.26,7.27
NF-HAIR VITAMINS EXTRA STRENGTH TABLET,250,RC,,,,both,0.56,0.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.39,,,,0.33,0.46
NF-HAIR VITAMINS EXTRA STRENGTH TABLET,250,RC,,,,both,0.56,0.5,Cigna,Default,Percent of Total Billed Charges,0.33,,,,0.33,0.46
NF-HAIR VITAMINS EXTRA STRENGTH TABLET,250,RC,,,,both,0.56,0.5,United Healthcare,Default,Fee Schedule,0.46,,,,0.33,0.46
NF-ESTROVEN COMPLETE MENOPAUSE RELIEF,250,RC,,,,both,2.36,2.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.65,,,,1.39,1.93
NF-ESTROVEN COMPLETE MENOPAUSE RELIEF,250,RC,,,,both,2.36,2.12,Cigna,Default,Percent of Total Billed Charges,1.39,,,,1.39,1.93
NF-ESTROVEN COMPLETE MENOPAUSE RELIEF,250,RC,,,,both,2.36,2.12,United Healthcare,Default,Fee Schedule,1.93,,,,1.39,1.93
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.82,,,,8.28,11.45
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,Cigna,Default,Percent of Total Billed Charges,8.28,,,,8.28,11.45
NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,250,RC,,,,both,14.03,12.63,United Healthcare,Default,Fee Schedule,11.45,,,,8.28,11.45
NF-METRONIDAZOLE BENZOATE PWD,250,RC,,,,both,60,54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,42,,,,35.4,48.96
NF-METRONIDAZOLE BENZOATE PWD,250,RC,,,,both,60,54,Cigna,Default,Percent of Total Billed Charges,35.4,,,,35.4,48.96
NF-METRONIDAZOLE BENZOATE PWD,250,RC,,,,both,60,54,United Healthcare,Default,Fee Schedule,48.96,,,,35.4,48.96
NF-EMPAGLIFLOZIN TAB 25MG,250,RC,,,,both,94.93,85.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,66.45,,,,56.01,77.46
NF-EMPAGLIFLOZIN TAB 25MG,250,RC,,,,both,94.93,85.44,Cigna,Default,Percent of Total Billed Charges,56.01,,,,56.01,77.46
NF-EMPAGLIFLOZIN TAB 25MG,250,RC,,,,both,94.93,85.44,United Healthcare,Default,Fee Schedule,77.46,,,,56.01,77.46
NF-TAMOXIFEN CITRATE ORAL TABLET 20MG,250,RC,,,,both,15.15,13.64,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.6,,,,8.94,12.36
NF-TAMOXIFEN CITRATE ORAL TABLET 20MG,250,RC,,,,both,15.15,13.64,Cigna,Default,Percent of Total Billed Charges,8.94,,,,8.94,12.36
NF-TAMOXIFEN CITRATE ORAL TABLET 20MG,250,RC,,,,both,15.15,13.64,United Healthcare,Default,Fee Schedule,12.36,,,,8.94,12.36
NF-LEVOXYL ORAL TABLET 200MCG,250,RC,,,,both,2.27,2.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.59,,,,1.34,1.85
NF-LEVOXYL ORAL TABLET 200MCG,250,RC,,,,both,2.27,2.04,Cigna,Default,Percent of Total Billed Charges,1.34,,,,1.34,1.85
NF-LEVOXYL ORAL TABLET 200MCG,250,RC,,,,both,2.27,2.04,United Healthcare,Default,Fee Schedule,1.85,,,,1.34,1.85
NF-HUMALOG INJECTION SOLUTION 100U/ML,250,RC,,,,both,131.85,118.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,92.3,,,,77.79,107.59
NF-HUMALOG INJECTION SOLUTION 100U/ML,250,RC,,,,both,131.85,118.67,Cigna,Default,Percent of Total Billed Charges,77.79,,,,77.79,107.59
NF-HUMALOG INJECTION SOLUTION 100U/ML,250,RC,,,,both,131.85,118.67,United Healthcare,Default,Fee Schedule,107.59,,,,77.79,107.59
NF-FLUOXETINE HCL CAP 40MG,250,RC,,,,both,22.14,19.93,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,15.5,,,,13.06,18.07
NF-FLUOXETINE HCL CAP 40MG,250,RC,,,,both,22.14,19.93,Cigna,Default,Percent of Total Billed Charges,13.06,,,,13.06,18.07
NF-FLUOXETINE HCL CAP 40MG,250,RC,,,,both,22.14,19.93,United Healthcare,Default,Fee Schedule,18.07,,,,13.06,18.07
NF-CELEXA TAB 20MG,250,RC,,,,both,29.48,26.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,20.64,,,,17.39,24.06
NF-CELEXA TAB 20MG,250,RC,,,,both,29.48,26.53,Cigna,Default,Percent of Total Billed Charges,17.39,,,,17.39,24.06
NF-CELEXA TAB 20MG,250,RC,,,,both,29.48,26.53,United Healthcare,Default,Fee Schedule,24.06,,,,17.39,24.06
NF-ENTRESTO ORAL TABLET 97MG-103MG,250,RC,,,,both,53.44,48.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.41,,,,31.53,43.61
NF-ENTRESTO ORAL TABLET 97MG-103MG,250,RC,,,,both,53.44,48.1,Cigna,Default,Percent of Total Billed Charges,31.53,,,,31.53,43.61
NF-ENTRESTO ORAL TABLET 97MG-103MG,250,RC,,,,both,53.44,48.1,United Healthcare,Default,Fee Schedule,43.61,,,,31.53,43.61
NF-MIRABEGRON TAB ER 50MG,250,RC,,,,both,71.5,64.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.05,,,,42.18,58.34
NF-MIRABEGRON TAB ER 50MG,250,RC,,,,both,71.5,64.35,Cigna,Default,Percent of Total Billed Charges,42.18,,,,42.18,58.34
NF-MIRABEGRON TAB ER 50MG,250,RC,,,,both,71.5,64.35,United Healthcare,Default,Fee Schedule,58.34,,,,42.18,58.34
NF-UPNEEQ OPHTH SOLUTION 0.1%,250,RC,,,,both,33.33,30,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,23.33,,,,19.66,27.2
NF-UPNEEQ OPHTH SOLUTION 0.1%,250,RC,,,,both,33.33,30,Cigna,Default,Percent of Total Billed Charges,19.66,,,,19.66,27.2
NF-UPNEEQ OPHTH SOLUTION 0.1%,250,RC,,,,both,33.33,30,United Healthcare,Default,Fee Schedule,27.2,,,,19.66,27.2
NF-SYSTANE COMPLETE OPHTH SOLN 0.6%,250,RC,,,,both,5.82,5.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.07,,,,3.43,4.75
NF-SYSTANE COMPLETE OPHTH SOLN 0.6%,250,RC,,,,both,5.82,5.24,Cigna,Default,Percent of Total Billed Charges,3.43,,,,3.43,4.75
NF-SYSTANE COMPLETE OPHTH SOLN 0.6%,250,RC,,,,both,5.82,5.24,United Healthcare,Default,Fee Schedule,4.75,,,,3.43,4.75
NF-ARICEPT ORAL TABLET 23MG,250,RC,,,,both,72.38,65.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.67,,,,42.7,59.06
NF-ARICEPT ORAL TABLET 23MG,250,RC,,,,both,72.38,65.14,Cigna,Default,Percent of Total Billed Charges,42.7,,,,42.7,59.06
NF-ARICEPT ORAL TABLET 23MG,250,RC,,,,both,72.38,65.14,United Healthcare,Default,Fee Schedule,59.06,,,,42.7,59.06
NF-LENALIDOMIDE CAP 5MG,250,RC,,,,both,3999.48,3599.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2799.64,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 5MG,250,RC,,,,both,3999.48,3599.53,Cigna,Default,Percent of Total Billed Charges,2359.69,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 5MG,250,RC,,,,both,3999.48,3599.53,United Healthcare,Default,Fee Schedule,3263.58,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 5MG,250,RC,,,,both,3999.48,3599.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2799.64,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 5MG,250,RC,,,,both,3999.48,3599.53,Cigna,Default,Percent of Total Billed Charges,2359.69,,,,2359.69,3263.58
NF-LENALIDOMIDE CAP 5MG,250,RC,,,,both,3999.48,3599.53,United Healthcare,Default,Fee Schedule,3263.58,,,,2359.69,3263.58
NF-LACTAID ORAL TABLET 3000U,250,RC,,,,both,0.49,0.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.34,,,,0.29,0.4
NF-LACTAID ORAL TABLET 3000U,250,RC,,,,both,0.49,0.44,Cigna,Default,Percent of Total Billed Charges,0.29,,,,0.29,0.4
NF-LACTAID ORAL TABLET 3000U,250,RC,,,,both,0.49,0.44,United Healthcare,Default,Fee Schedule,0.4,,,,0.29,0.4
NF-OZEMPIC 1MG DOSES SUBQ SOLN 4MG/3ML,C9399,HCPCS,250,RC,,both,1497.23,1347.51,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1048.06,,,,883.37,1221.74
NF-OZEMPIC 1MG DOSES SUBQ SOLN 4MG/3ML,C9399,HCPCS,250,RC,,both,1497.23,1347.51,Cigna,Default,Percent of Total Billed Charges,883.37,,,,883.37,1221.74
NF-OZEMPIC 1MG DOSES SUBQ SOLN 4MG/3ML,C9399,HCPCS,250,RC,,both,1497.23,1347.51,United Healthcare,Default,Fee Schedule,1221.74,,,,883.37,1221.74
NF-NUPERCAINAL OINTMENT 1%,250,RC,,,,both,0.96,0.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.67,,,,0.57,0.78
NF-NUPERCAINAL OINTMENT 1%,250,RC,,,,both,0.96,0.86,Cigna,Default,Percent of Total Billed Charges,0.57,,,,0.57,0.78
NF-NUPERCAINAL OINTMENT 1%,250,RC,,,,both,0.96,0.86,United Healthcare,Default,Fee Schedule,0.78,,,,0.57,0.78
NF-MEDIHONEY TOPICAL GEL 100%,250,RC,,,,both,3.85,3.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.7,,,,2.27,3.14
NF-MEDIHONEY TOPICAL GEL 100%,250,RC,,,,both,3.85,3.47,Cigna,Default,Percent of Total Billed Charges,2.27,,,,2.27,3.14
NF-MEDIHONEY TOPICAL GEL 100%,250,RC,,,,both,3.85,3.47,United Healthcare,Default,Fee Schedule,3.14,,,,2.27,3.14
NF-MEDIHONEY TOPICAL GEL 100%,250,RC,,,,both,3.85,3.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.7,,,,2.27,3.14
NF-MEDIHONEY TOPICAL GEL 100%,250,RC,,,,both,3.85,3.47,Cigna,Default,Percent of Total Billed Charges,2.27,,,,2.27,3.14
NF-MEDIHONEY TOPICAL GEL 100%,250,RC,,,,both,3.85,3.47,United Healthcare,Default,Fee Schedule,3.14,,,,2.27,3.14
NF-AMERGE TAB 2.5MG,250,RC,,,,both,271.57,244.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,190.1,,,,160.23,221.6
NF-AMERGE TAB 2.5MG,250,RC,,,,both,271.57,244.41,Cigna,Default,Percent of Total Billed Charges,160.23,,,,160.23,221.6
NF-AMERGE TAB 2.5MG,250,RC,,,,both,271.57,244.41,United Healthcare,Default,Fee Schedule,221.6,,,,160.23,221.6
NF-PRESERVISION ORAL LIQUID CAPSULE,250,RC,,,,both,1.06,0.95,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.74,,,,0.63,0.86
NF-PRESERVISION ORAL LIQUID CAPSULE,250,RC,,,,both,1.06,0.95,Cigna,Default,Percent of Total Billed Charges,0.63,,,,0.63,0.86
NF-PRESERVISION ORAL LIQUID CAPSULE,250,RC,,,,both,1.06,0.95,United Healthcare,Default,Fee Schedule,0.86,,,,0.63,0.86
NF-CALCIUM 600 TABLET 600MG,250,RC,,,,both,0.13,0.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.09,,,,0.08,0.11
NF-CALCIUM 600 TABLET 600MG,250,RC,,,,both,0.13,0.12,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-CALCIUM 600 TABLET 600MG,250,RC,,,,both,0.13,0.12,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
NF-PANTOPRAZOLE SODIUM AVPAK TAB DR 40MG,250,RC,,,,both,16.11,14.5,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.28,,,,9.5,13.15
NF-PANTOPRAZOLE SODIUM AVPAK TAB DR 40MG,250,RC,,,,both,16.11,14.5,Cigna,Default,Percent of Total Billed Charges,9.5,,,,9.5,13.15
NF-PANTOPRAZOLE SODIUM AVPAK TAB DR 40MG,250,RC,,,,both,16.11,14.5,United Healthcare,Default,Fee Schedule,13.15,,,,9.5,13.15
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,37,33.3,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.9,,,,21.83,30.19
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,37,33.3,Cigna,Default,Percent of Total Billed Charges,21.83,,,,21.83,30.19
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,37,33.3,United Healthcare,Default,Fee Schedule,30.19,,,,21.83,30.19
NF-FERROUS SULFAT TAB  325MG,250,RC,,,,both,0.13,0.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.09,,,,0.08,0.11
NF-FERROUS SULFAT TAB  325MG,250,RC,,,,both,0.13,0.12,Cigna,Default,Percent of Total Billed Charges,0.08,,,,0.08,0.11
NF-FERROUS SULFAT TAB  325MG,250,RC,,,,both,0.13,0.12,United Healthcare,Default,Fee Schedule,0.11,,,,0.08,0.11
NF-GLUCOSAMINE CHONDROITIN 1500/1200 CAP,250,RC,,,,both,0.97,0.87,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.68,,,,0.57,0.79
NF-GLUCOSAMINE CHONDROITIN 1500/1200 CAP,250,RC,,,,both,0.97,0.87,Cigna,Default,Percent of Total Billed Charges,0.57,,,,0.57,0.79
NF-GLUCOSAMINE CHONDROITIN 1500/1200 CAP,250,RC,,,,both,0.97,0.87,United Healthcare,Default,Fee Schedule,0.79,,,,0.57,0.79
NF-LEVOTHYROXINE ORAL TABLET 100MCG,250,RC,,,,both,2.34,2.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.64,,,,1.38,1.91
NF-LEVOTHYROXINE ORAL TABLET 100MCG,250,RC,,,,both,2.34,2.11,Cigna,Default,Percent of Total Billed Charges,1.38,,,,1.38,1.91
NF-LEVOTHYROXINE ORAL TABLET 100MCG,250,RC,,,,both,2.34,2.11,United Healthcare,Default,Fee Schedule,1.91,,,,1.38,1.91
NF-MAGNESIUM SULFATE CRYSTAL,250,RC,,,,both,0.23,0.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.16,,,,0.14,0.19
NF-MAGNESIUM SULFATE CRYSTAL,250,RC,,,,both,0.23,0.21,Cigna,Default,Percent of Total Billed Charges,0.14,,,,0.14,0.19
NF-MAGNESIUM SULFATE CRYSTAL,250,RC,,,,both,0.23,0.21,United Healthcare,Default,Fee Schedule,0.19,,,,0.14,0.19
NF-SYNTHROID ORAL TABLET 100MCG,250,RC,,,,both,7.21,6.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.05,,,,4.25,5.88
NF-SYNTHROID ORAL TABLET 100MCG,250,RC,,,,both,7.21,6.49,Cigna,Default,Percent of Total Billed Charges,4.25,,,,4.25,5.88
NF-SYNTHROID ORAL TABLET 100MCG,250,RC,,,,both,7.21,6.49,United Healthcare,Default,Fee Schedule,5.88,,,,4.25,5.88
NF-ATROVENT HFA SOLN INH ORAL NEB 0.017M,250,RC,,,,both,50.13,45.12,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.09,,,,29.58,40.91
NF-ATROVENT HFA SOLN INH ORAL NEB 0.017M,250,RC,,,,both,50.13,45.12,Cigna,Default,Percent of Total Billed Charges,29.58,,,,29.58,40.91
NF-ATROVENT HFA SOLN INH ORAL NEB 0.017M,250,RC,,,,both,50.13,45.12,United Healthcare,Default,Fee Schedule,40.91,,,,29.58,40.91
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03%,250,RC,,,,both,14.89,13.4,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,10.42,,,,8.79,12.15
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03%,250,RC,,,,both,14.89,13.4,Cigna,Default,Percent of Total Billed Charges,8.79,,,,8.79,12.15
NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03%,250,RC,,,,both,14.89,13.4,United Healthcare,Default,Fee Schedule,12.15,,,,8.79,12.15
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.15,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,Cigna,Default,Percent of Total Billed Charges,7.71,,,,7.71,10.67
NF-PRAVASTATIN ORAL TABLET 20MG,250,RC,,,,both,13.07,11.76,United Healthcare,Default,Fee Schedule,10.67,,,,7.71,10.67
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,71.5,64.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,50.05,,,,42.18,58.34
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,71.5,64.35,Cigna,Default,Percent of Total Billed Charges,42.18,,,,42.18,58.34
NF-MYRBETRIQ ORAL TABLET 50MG,250,RC,,,,both,71.5,64.35,United Healthcare,Default,Fee Schedule,58.34,,,,42.18,58.34
NF-CREON CAP DR 24000U-76000U-120000U,250,RC,,,,both,37.03,33.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.92,,,,21.85,30.22
NF-CREON CAP DR 24000U-76000U-120000U,250,RC,,,,both,37.03,33.33,Cigna,Default,Percent of Total Billed Charges,21.85,,,,21.85,30.22
NF-CREON CAP DR 24000U-76000U-120000U,250,RC,,,,both,37.03,33.33,United Healthcare,Default,Fee Schedule,30.22,,,,21.85,30.22
NF-PREMARIN ORAL TABLET 0.3MG,250,RC,,,,both,4.92,4.43,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.44,,,,2.9,4.01
NF-PREMARIN ORAL TABLET 0.3MG,250,RC,,,,both,4.92,4.43,Cigna,Default,Percent of Total Billed Charges,2.9,,,,2.9,4.01
NF-PREMARIN ORAL TABLET 0.3MG,250,RC,,,,both,4.92,4.43,United Healthcare,Default,Fee Schedule,4.01,,,,2.9,4.01
NF-HUMIRA SUBCUTANEOUS KIT,250,RC,,,,both,16614.28,14952.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11630,,,,9802.43,13557.25
NF-HUMIRA SUBCUTANEOUS KIT,250,RC,,,,both,16614.28,14952.85,Cigna,Default,Percent of Total Billed Charges,9802.43,,,,9802.43,13557.25
NF-HUMIRA SUBCUTANEOUS KIT,250,RC,,,,both,16614.28,14952.85,United Healthcare,Default,Fee Schedule,13557.25,,,,9802.43,13557.25
NF-HUMIRA SUBQ KIT 40MG/0.8ML,250,RC,,,,both,16614.28,14952.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11630,,,,9802.43,13557.25
NF-HUMIRA SUBQ KIT 40MG/0.8ML,250,RC,,,,both,16614.28,14952.85,Cigna,Default,Percent of Total Billed Charges,9802.43,,,,9802.43,13557.25
NF-HUMIRA SUBQ KIT 40MG/0.8ML,250,RC,,,,both,16614.28,14952.85,United Healthcare,Default,Fee Schedule,13557.25,,,,9802.43,13557.25
NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25,250,RC,,,,both,1.57,1.41,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.1,,,,0.93,1.28
NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25,250,RC,,,,both,1.57,1.41,Cigna,Default,Percent of Total Billed Charges,0.93,,,,0.93,1.28
NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25,250,RC,,,,both,1.57,1.41,United Healthcare,Default,Fee Schedule,1.28,,,,0.93,1.28
NF-GLIMEPIRIDE ORAL TABLET 2MG,250,RC,,,,both,2.53,2.28,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.77,,,,1.49,2.06
NF-GLIMEPIRIDE ORAL TABLET 2MG,250,RC,,,,both,2.53,2.28,Cigna,Default,Percent of Total Billed Charges,1.49,,,,1.49,2.06
NF-GLIMEPIRIDE ORAL TABLET 2MG,250,RC,,,,both,2.53,2.28,United Healthcare,Default,Fee Schedule,2.06,,,,1.49,2.06
NF-DECADRON TAB 6MG,250,RC,,,,both,28.55,25.7,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,19.98,,,,16.84,23.3
NF-DECADRON TAB 6MG,250,RC,,,,both,28.55,25.7,Cigna,Default,Percent of Total Billed Charges,16.84,,,,16.84,23.3
NF-DECADRON TAB 6MG,250,RC,,,,both,28.55,25.7,United Healthcare,Default,Fee Schedule,23.3,,,,16.84,23.3
NF-LEVOTHYROXINE ORAL TABLET 50MCG,250,RC,,,,both,1.98,1.78,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.39,,,,1.17,1.62
NF-LEVOTHYROXINE ORAL TABLET 50MCG,250,RC,,,,both,1.98,1.78,Cigna,Default,Percent of Total Billed Charges,1.17,,,,1.17,1.62
NF-LEVOTHYROXINE ORAL TABLET 50MCG,250,RC,,,,both,1.98,1.78,United Healthcare,Default,Fee Schedule,1.62,,,,1.17,1.62
NF-SOTALOL HCL AF ORAL TABLET 120MG,250,RC,,,,both,1.25,1.13,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.88,,,,0.74,1.02
NF-SOTALOL HCL AF ORAL TABLET 120MG,250,RC,,,,both,1.25,1.13,Cigna,Default,Percent of Total Billed Charges,0.74,,,,0.74,1.02
NF-SOTALOL HCL AF ORAL TABLET 120MG,250,RC,,,,both,1.25,1.13,United Healthcare,Default,Fee Schedule,1.02,,,,0.74,1.02
NF-TRELEGY ELLIPTA 100/62.5/25MCG/INH,250,RC,,,,both,51.01,45.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,35.71,,,,30.1,41.62
NF-TRELEGY ELLIPTA 100/62.5/25MCG/INH,250,RC,,,,both,51.01,45.91,Cigna,Default,Percent of Total Billed Charges,30.1,,,,30.1,41.62
NF-TRELEGY ELLIPTA 100/62.5/25MCG/INH,250,RC,,,,both,51.01,45.91,United Healthcare,Default,Fee Schedule,41.62,,,,30.1,41.62
NF-ACIDOPHILUS ORAL CAPSULE,250,RC,,,,both,0.12,0.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.08,,,,0.07,0.1
NF-ACIDOPHILUS ORAL CAPSULE,250,RC,,,,both,0.12,0.11,Cigna,Default,Percent of Total Billed Charges,0.07,,,,0.07,0.1
NF-ACIDOPHILUS ORAL CAPSULE,250,RC,,,,both,0.12,0.11,United Healthcare,Default,Fee Schedule,0.1,,,,0.07,0.1
NF-THERA-M MULTIPLE TABLET,250,RC,,,,both,0.12,0.11,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.08,,,,0.07,0.1
NF-THERA-M MULTIPLE TABLET,250,RC,,,,both,0.12,0.11,Cigna,Default,Percent of Total Billed Charges,0.07,,,,0.07,0.1
NF-THERA-M MULTIPLE TABLET,250,RC,,,,both,0.12,0.11,United Healthcare,Default,Fee Schedule,0.1,,,,0.07,0.1
NF-MUCUS RELIEF D TAB ER 600MG-60MG,250,RC,,,,both,2.75,2.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.92,,,,1.62,2.24
NF-MUCUS RELIEF D TAB ER 600MG-60MG,250,RC,,,,both,2.75,2.48,Cigna,Default,Percent of Total Billed Charges,1.62,,,,1.62,2.24
NF-MUCUS RELIEF D TAB ER 600MG-60MG,250,RC,,,,both,2.75,2.48,United Healthcare,Default,Fee Schedule,2.24,,,,1.62,2.24
NF-ICY HOT CREAM,250,RC,,,,both,0.52,0.47,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.36,,,,0.31,0.42
NF-ICY HOT CREAM,250,RC,,,,both,0.52,0.47,Cigna,Default,Percent of Total Billed Charges,0.31,,,,0.31,0.42
NF-ICY HOT CREAM,250,RC,,,,both,0.52,0.47,United Healthcare,Default,Fee Schedule,0.42,,,,0.31,0.42
NF-OLMESARTAN MEDOXOMIL-HYDROCHLOROTHIAZ,250,RC,,,,both,38.43,34.59,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,26.9,,,,22.67,31.36
NF-OLMESARTAN MEDOXOMIL-HYDROCHLOROTHIAZ,250,RC,,,,both,38.43,34.59,Cigna,Default,Percent of Total Billed Charges,22.67,,,,22.67,31.36
NF-OLMESARTAN MEDOXOMIL-HYDROCHLOROTHIAZ,250,RC,,,,both,38.43,34.59,United Healthcare,Default,Fee Schedule,31.36,,,,22.67,31.36
NF-VERAPAMIL HCL CAPSULE 120MG,250,RC,,,,both,7.76,6.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,5.43,,,,4.58,6.33
NF-VERAPAMIL HCL CAPSULE 120MG,250,RC,,,,both,7.76,6.98,Cigna,Default,Percent of Total Billed Charges,4.58,,,,4.58,6.33
NF-VERAPAMIL HCL CAPSULE 120MG,250,RC,,,,both,7.76,6.98,United Healthcare,Default,Fee Schedule,6.33,,,,4.58,6.33
NF-B12 ORAL SOLUTION 1000MCG/15ML,250,RC,,,,both,0.15,0.14,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.1,,,,0.09,0.12
NF-B12 ORAL SOLUTION 1000MCG/15ML,250,RC,,,,both,0.15,0.14,Cigna,Default,Percent of Total Billed Charges,0.09,,,,0.09,0.12
NF-B12 ORAL SOLUTION 1000MCG/15ML,250,RC,,,,both,0.15,0.14,United Healthcare,Default,Fee Schedule,0.12,,,,0.09,0.12
NF-DOPTELET ORAL TAB 20MG,250,RC,,,,both,1975.73,1778.16,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1383.01,,,,1165.68,1612.2
NF-DOPTELET ORAL TAB 20MG,250,RC,,,,both,1975.73,1778.16,Cigna,Default,Percent of Total Billed Charges,1165.68,,,,1165.68,1612.2
NF-DOPTELET ORAL TAB 20MG,250,RC,,,,both,1975.73,1778.16,United Healthcare,Default,Fee Schedule,1612.2,,,,1165.68,1612.2
NF-KRAZATI ORAL TABLET 200MG,250,RC,,,,both,557.74,501.97,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,390.42,,,,329.07,455.12
NF-KRAZATI ORAL TABLET 200MG,250,RC,,,,both,557.74,501.97,Cigna,Default,Percent of Total Billed Charges,329.07,,,,329.07,455.12
NF-KRAZATI ORAL TABLET 200MG,250,RC,,,,both,557.74,501.97,United Healthcare,Default,Fee Schedule,455.12,,,,329.07,455.12
NF-ZEGERID CAP 20MG-1100MG,250,RC,,,,both,529.09,476.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,370.36,,,,312.16,431.74
NF-ZEGERID CAP 20MG-1100MG,250,RC,,,,both,529.09,476.18,Cigna,Default,Percent of Total Billed Charges,312.16,,,,312.16,431.74
NF-ZEGERID CAP 20MG-1100MG,250,RC,,,,both,529.09,476.18,United Healthcare,Default,Fee Schedule,431.74,,,,312.16,431.74
NF-RYBELSUS ORAL TABLET 7MG,250,RC,,,,both,154.96,139.46,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,108.47,,,,91.43,126.45
NF-RYBELSUS ORAL TABLET 7MG,250,RC,,,,both,154.96,139.46,Cigna,Default,Percent of Total Billed Charges,91.43,,,,91.43,126.45
NF-RYBELSUS ORAL TABLET 7MG,250,RC,,,,both,154.96,139.46,United Healthcare,Default,Fee Schedule,126.45,,,,91.43,126.45
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,53.44,48.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,37.41,,,,31.53,43.61
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,53.44,48.1,Cigna,Default,Percent of Total Billed Charges,31.53,,,,31.53,43.61
NF-ENTRESTO ORAL TABLET 49MG-51MG,250,RC,,,,both,53.44,48.1,United Healthcare,Default,Fee Schedule,43.61,,,,31.53,43.61
NF-FIORICET ORAL CAPSULE 300MG-50MG-40MG,250,RC,,,,both,36.94,33.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.86,,,,21.79,30.14
NF-FIORICET ORAL CAPSULE 300MG-50MG-40MG,250,RC,,,,both,36.94,33.25,Cigna,Default,Percent of Total Billed Charges,21.79,,,,21.79,30.14
NF-FIORICET ORAL CAPSULE 300MG-50MG-40MG,250,RC,,,,both,36.94,33.25,United Healthcare,Default,Fee Schedule,30.14,,,,21.79,30.14
NF-CONSTULOSE ORAL SOLN 10GM/15ML,250,RC,,,,both,0.34,0.31,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.24,,,,0.2,0.28
NF-CONSTULOSE ORAL SOLN 10GM/15ML,250,RC,,,,both,0.34,0.31,Cigna,Default,Percent of Total Billed Charges,0.2,,,,0.2,0.28
NF-CONSTULOSE ORAL SOLN 10GM/15ML,250,RC,,,,both,0.34,0.31,United Healthcare,Default,Fee Schedule,0.28,,,,0.2,0.28
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 4,250,RC,,,,both,10.74,9.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.52,,,,6.34,8.76
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 4,250,RC,,,,both,10.74,9.67,Cigna,Default,Percent of Total Billed Charges,6.34,,,,6.34,8.76
NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 4,250,RC,,,,both,10.74,9.67,United Healthcare,Default,Fee Schedule,8.76,,,,6.34,8.76
NF-BILBERRY EXTRACT CAPSULE,250,RC,,,,both,0.54,0.49,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.38,,,,0.32,0.44
NF-BILBERRY EXTRACT CAPSULE,250,RC,,,,both,0.54,0.49,Cigna,Default,Percent of Total Billed Charges,0.32,,,,0.32,0.44
NF-BILBERRY EXTRACT CAPSULE,250,RC,,,,both,0.54,0.49,United Healthcare,Default,Fee Schedule,0.44,,,,0.32,0.44
NF-GARLIC CAPSULE 300MG,250,RC,,,,both,0.37,0.33,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.26,,,,0.22,0.3
NF-GARLIC CAPSULE 300MG,250,RC,,,,both,0.37,0.33,Cigna,Default,Percent of Total Billed Charges,0.22,,,,0.22,0.3
NF-GARLIC CAPSULE 300MG,250,RC,,,,both,0.37,0.33,United Healthcare,Default,Fee Schedule,0.3,,,,0.22,0.3
NF-FERROUS GLUCONATE ORAL TABLET 324MG,250,RC,,,,both,0.24,0.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.17,,,,0.14,0.2
NF-FERROUS GLUCONATE ORAL TABLET 324MG,250,RC,,,,both,0.24,0.22,Cigna,Default,Percent of Total Billed Charges,0.14,,,,0.14,0.2
NF-FERROUS GLUCONATE ORAL TABLET 324MG,250,RC,,,,both,0.24,0.22,United Healthcare,Default,Fee Schedule,0.2,,,,0.14,0.2
NF-VITAMIN D3 DIS TAB 125MCG,250,RC,,,,both,0.61,0.55,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.43,,,,0.36,0.5
NF-VITAMIN D3 DIS TAB 125MCG,250,RC,,,,both,0.61,0.55,Cigna,Default,Percent of Total Billed Charges,0.36,,,,0.36,0.5
NF-VITAMIN D3 DIS TAB 125MCG,250,RC,,,,both,0.61,0.55,United Healthcare,Default,Fee Schedule,0.5,,,,0.36,0.5
NF-FLUTICASONE PROPIONATE 0.05MG/1ACT,250,RC,,,,both,21.31,19.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,14.92,,,,12.57,17.39
NF-FLUTICASONE PROPIONATE 0.05MG/1ACT,250,RC,,,,both,21.31,19.18,Cigna,Default,Percent of Total Billed Charges,12.57,,,,12.57,17.39
NF-FLUTICASONE PROPIONATE 0.05MG/1ACT,250,RC,,,,both,21.31,19.18,United Healthcare,Default,Fee Schedule,17.39,,,,12.57,17.39
NF-ZINC BALANCE CAPSULE,250,RC,,,,both,0.53,0.48,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.37,,,,0.31,0.43
NF-ZINC BALANCE CAPSULE,250,RC,,,,both,0.53,0.48,Cigna,Default,Percent of Total Billed Charges,0.31,,,,0.31,0.43
NF-ZINC BALANCE CAPSULE,250,RC,,,,both,0.53,0.48,United Healthcare,Default,Fee Schedule,0.43,,,,0.31,0.43
NF-FENOFIBRATE CAP 50MG,250,RC,,,,both,17.41,15.67,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,12.19,,,,10.27,14.21
NF-FENOFIBRATE CAP 50MG,250,RC,,,,both,17.41,15.67,Cigna,Default,Percent of Total Billed Charges,10.27,,,,10.27,14.21
NF-FENOFIBRATE CAP 50MG,250,RC,,,,both,17.41,15.67,United Healthcare,Default,Fee Schedule,14.21,,,,10.27,14.21
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,105.51,94.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,73.86,,,,62.25,86.1
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,105.51,94.96,Cigna,Default,Percent of Total Billed Charges,62.25,,,,62.25,86.1
NF-MODAFINIL ORAL TABLET 100MG,250,RC,,,,both,105.51,94.96,United Healthcare,Default,Fee Schedule,86.1,,,,62.25,86.1
NF-TRAMADOL/APAP ORAL TABLET 37.5MG-325M,250,RC,,,,both,8.58,7.72,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.01,,,,5.06,7
NF-TRAMADOL/APAP ORAL TABLET 37.5MG-325M,250,RC,,,,both,8.58,7.72,Cigna,Default,Percent of Total Billed Charges,5.06,,,,5.06,7
NF-TRAMADOL/APAP ORAL TABLET 37.5MG-325M,250,RC,,,,both,8.58,7.72,United Healthcare,Default,Fee Schedule,7,,,,5.06,7
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.09,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,Cigna,Default,Percent of Total Billed Charges,2.61,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,United Healthcare,Default,Fee Schedule,3.61,,,,2.61,3.61
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,250,RC,,,,both,0.88,0.79,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.62,,,,0.52,0.72
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,250,RC,,,,both,0.88,0.79,Cigna,Default,Percent of Total Billed Charges,0.52,,,,0.52,0.72
NF-ALLEGRA ALLERGY ORAL TABLET 180MG,250,RC,,,,both,0.88,0.79,United Healthcare,Default,Fee Schedule,0.72,,,,0.52,0.72
NF-LYSINE 500 TABLET 500MG,250,RC,,,,both,0.17,0.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.12,,,,0.1,0.14
NF-LYSINE 500 TABLET 500MG,250,RC,,,,both,0.17,0.15,Cigna,Default,Percent of Total Billed Charges,0.1,,,,0.1,0.14
NF-LYSINE 500 TABLET 500MG,250,RC,,,,both,0.17,0.15,United Healthcare,Default,Fee Schedule,0.14,,,,0.1,0.14
NF-LISINOPRIL/HCTZ 20MG-12.5MG,250,RC,,,,both,4.85,4.37,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.4,,,,2.86,3.96
NF-LISINOPRIL/HCTZ 20MG-12.5MG,250,RC,,,,both,4.85,4.37,Cigna,Default,Percent of Total Billed Charges,2.86,,,,2.86,3.96
NF-LISINOPRIL/HCTZ 20MG-12.5MG,250,RC,,,,both,4.85,4.37,United Healthcare,Default,Fee Schedule,3.96,,,,2.86,3.96
NF-POTASSIUM CHLORIDE CAP ER 8MEQ,250,RC,,,,both,3.76,3.38,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.63,,,,2.22,3.07
NF-POTASSIUM CHLORIDE CAP ER 8MEQ,250,RC,,,,both,3.76,3.38,Cigna,Default,Percent of Total Billed Charges,2.22,,,,2.22,3.07
NF-POTASSIUM CHLORIDE CAP ER 8MEQ,250,RC,,,,both,3.76,3.38,United Healthcare,Default,Fee Schedule,3.07,,,,2.22,3.07
NF-AUGMENTIN ES-600 PWD FOR SUSP 600MG/5,250,RC,,,,both,3.39,3.05,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.37,,,,2,2.77
NF-AUGMENTIN ES-600 PWD FOR SUSP 600MG/5,250,RC,,,,both,3.39,3.05,Cigna,Default,Percent of Total Billed Charges,2,,,,2,2.77
NF-AUGMENTIN ES-600 PWD FOR SUSP 600MG/5,250,RC,,,,both,3.39,3.05,United Healthcare,Default,Fee Schedule,2.77,,,,2,2.77
NF-AMOXICILLIN & CLAVULANATE 600-42.9/5,250,RC,,,,both,0.67,0.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,0.47,,,,0.4,0.55
NF-AMOXICILLIN & CLAVULANATE 600-42.9/5,250,RC,,,,both,0.67,0.6,Cigna,Default,Percent of Total Billed Charges,0.4,,,,0.4,0.55
NF-AMOXICILLIN & CLAVULANATE 600-42.9/5,250,RC,,,,both,0.67,0.6,United Healthcare,Default,Fee Schedule,0.55,,,,0.4,0.55
NF-VENLAFAXINE HCL CAP ER 150MG,250,RC,,,,both,73.58,66.22,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,51.51,,,,43.41,60.04
NF-VENLAFAXINE HCL CAP ER 150MG,250,RC,,,,both,73.58,66.22,Cigna,Default,Percent of Total Billed Charges,43.41,,,,43.41,60.04
NF-VENLAFAXINE HCL CAP ER 150MG,250,RC,,,,both,73.58,66.22,United Healthcare,Default,Fee Schedule,60.04,,,,43.41,60.04
NF-CALCIUM ACETATE CAP 667MG,250,RC,,,,both,2.87,2.58,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.01,,,,1.69,2.34
NF-CALCIUM ACETATE CAP 667MG,250,RC,,,,both,2.87,2.58,Cigna,Default,Percent of Total Billed Charges,1.69,,,,1.69,2.34
NF-CALCIUM ACETATE CAP 667MG,250,RC,,,,both,2.87,2.58,United Healthcare,Default,Fee Schedule,2.34,,,,1.69,2.34
NF-PROTONIX ORAL GRANULES 40MG,250,RC,,,,both,69.16,62.24,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.41,,,,40.8,56.43
NF-PROTONIX ORAL GRANULES 40MG,250,RC,,,,both,69.16,62.24,Cigna,Default,Percent of Total Billed Charges,40.8,,,,40.8,56.43
NF-PROTONIX ORAL GRANULES 40MG,250,RC,,,,both,69.16,62.24,United Healthcare,Default,Fee Schedule,56.43,,,,40.8,56.43
NF-PROTONIX ORAL TAB DR 40MG,250,RC,,,,both,25.44,22.9,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,17.81,,,,15.01,20.76
NF-PROTONIX ORAL TAB DR 40MG,250,RC,,,,both,25.44,22.9,Cigna,Default,Percent of Total Billed Charges,15.01,,,,15.01,20.76
NF-PROTONIX ORAL TAB DR 40MG,250,RC,,,,both,25.44,22.9,United Healthcare,Default,Fee Schedule,20.76,,,,15.01,20.76
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.09,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,Cigna,Default,Percent of Total Billed Charges,2.61,,,,2.61,3.61
NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,250,RC,,,,both,4.42,3.98,United Healthcare,Default,Fee Schedule,3.61,,,,2.61,3.61
NF-CILOSTAZOL AVPAK TAB 50MG,250,RC,,,,both,8.93,8.04,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.25,,,,5.27,7.29
NF-CILOSTAZOL AVPAK TAB 50MG,250,RC,,,,both,8.93,8.04,Cigna,Default,Percent of Total Billed Charges,5.27,,,,5.27,7.29
NF-CILOSTAZOL AVPAK TAB 50MG,250,RC,,,,both,8.93,8.04,United Healthcare,Default,Fee Schedule,7.29,,,,5.27,7.29
NF-WIXELA INHUB INHALATION DISK 500/50,250,RC,,,,both,39.38,35.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,27.57,,,,23.23,32.13
NF-WIXELA INHUB INHALATION DISK 500/50,250,RC,,,,both,39.38,35.44,Cigna,Default,Percent of Total Billed Charges,23.23,,,,23.23,32.13
NF-WIXELA INHUB INHALATION DISK 500/50,250,RC,,,,both,39.38,35.44,United Healthcare,Default,Fee Schedule,32.13,,,,23.23,32.13
NF-DONEPEZIL HCL ORAL TABLET 23MG,250,RC,,,,both,45.43,40.89,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,31.8,,,,26.8,37.07
NF-DONEPEZIL HCL ORAL TABLET 23MG,250,RC,,,,both,45.43,40.89,Cigna,Default,Percent of Total Billed Charges,26.8,,,,26.8,37.07
NF-DONEPEZIL HCL ORAL TABLET 23MG,250,RC,,,,both,45.43,40.89,United Healthcare,Default,Fee Schedule,37.07,,,,26.8,37.07
NF-PROTONIX ORAL TAB DR 40MG,250,RC,,,,both,69.48,62.53,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.64,,,,40.99,56.7
NF-PROTONIX ORAL TAB DR 40MG,250,RC,,,,both,69.48,62.53,Cigna,Default,Percent of Total Billed Charges,40.99,,,,40.99,56.7
NF-PROTONIX ORAL TAB DR 40MG,250,RC,,,,both,69.48,62.53,United Healthcare,Default,Fee Schedule,56.7,,,,40.99,56.7
NF-LOVASTATIN ORAL TABLET 20MG,250,RC,,,,both,9.49,8.54,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,6.64,,,,5.6,7.74
NF-LOVASTATIN ORAL TABLET 20MG,250,RC,,,,both,9.49,8.54,Cigna,Default,Percent of Total Billed Charges,5.6,,,,5.6,7.74
NF-LOVASTATIN ORAL TABLET 20MG,250,RC,,,,both,9.49,8.54,United Healthcare,Default,Fee Schedule,7.74,,,,5.6,7.74
NF-LORAZEPAM ORAL TABLET 0.5MG,250,RC,,,,both,2.71,2.44,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.9,,,,1.6,2.21
NF-LORAZEPAM ORAL TABLET 0.5MG,250,RC,,,,both,2.71,2.44,Cigna,Default,Percent of Total Billed Charges,1.6,,,,1.6,2.21
NF-LORAZEPAM ORAL TABLET 0.5MG,250,RC,,,,both,2.71,2.44,United Healthcare,Default,Fee Schedule,2.21,,,,1.6,2.21
NF-MINOCYCLINE HCL CAP 50MG,250,RC,,,,both,6.57,5.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.6,,,,3.88,5.36
NF-MINOCYCLINE HCL CAP 50MG,250,RC,,,,both,6.57,5.91,Cigna,Default,Percent of Total Billed Charges,3.88,,,,3.88,5.36
NF-MINOCYCLINE HCL CAP 50MG,250,RC,,,,both,6.57,5.91,United Healthcare,Default,Fee Schedule,5.36,,,,3.88,5.36
NF-TOLTERODINE TARTRATE CAP ER 2MG,250,RC,,,,both,52.05,46.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,36.44,,,,30.71,42.47
NF-TOLTERODINE TARTRATE CAP ER 2MG,250,RC,,,,both,52.05,46.85,Cigna,Default,Percent of Total Billed Charges,30.71,,,,30.71,42.47
NF-TOLTERODINE TARTRATE CAP ER 2MG,250,RC,,,,both,52.05,46.85,United Healthcare,Default,Fee Schedule,42.47,,,,30.71,42.47
NF-PRISTIQ EXTENDED-RELEASE TABLET 50MG,250,RC,,,,both,70.07,63.06,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,49.05,,,,41.34,57.18
NF-PRISTIQ EXTENDED-RELEASE TABLET 50MG,250,RC,,,,both,70.07,63.06,Cigna,Default,Percent of Total Billed Charges,41.34,,,,41.34,57.18
NF-PRISTIQ EXTENDED-RELEASE TABLET 50MG,250,RC,,,,both,70.07,63.06,United Healthcare,Default,Fee Schedule,57.18,,,,41.34,57.18
NF-DAPSONE ORAL TABLET 25MG,250,RC,,,,both,10.95,9.86,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.66,,,,6.46,8.94
NF-DAPSONE ORAL TABLET 25MG,250,RC,,,,both,10.95,9.86,Cigna,Default,Percent of Total Billed Charges,6.46,,,,6.46,8.94
NF-DAPSONE ORAL TABLET 25MG,250,RC,,,,both,10.95,9.86,United Healthcare,Default,Fee Schedule,8.94,,,,6.46,8.94
NF-CABOZANTINIB MALATE TAB 20MG,250,RC,,,,both,4093.57,3684.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2865.5,,,,2415.21,3340.35
NF-CABOZANTINIB MALATE TAB 20MG,250,RC,,,,both,4093.57,3684.21,Cigna,Default,Percent of Total Billed Charges,2415.21,,,,2415.21,3340.35
NF-CABOZANTINIB MALATE TAB 20MG,250,RC,,,,both,4093.57,3684.21,United Healthcare,Default,Fee Schedule,3340.35,,,,2415.21,3340.35
LOSARTAN 50MG TAB (COZAAR),637,RC,,,,both,10.23,9.21,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.16,,,,6.04,8.35
LOSARTAN 50MG TAB (COZAAR),637,RC,,,,both,10.23,9.21,Cigna,Default,Percent of Total Billed Charges,6.04,,,,6.04,8.35
LOSARTAN 50MG TAB (COZAAR),637,RC,,,,both,10.23,9.21,United Healthcare,Default,Fee Schedule,8.35,,,,6.04,8.35
NEPRO 240 ML SUPPLEMENT,637,RC,,,,both,16.5,14.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.55,,,,9.74,13.46
NEPRO 240 ML SUPPLEMENT,637,RC,,,,both,16.5,14.85,Cigna,Default,Percent of Total Billed Charges,9.74,,,,9.74,13.46
NEPRO 240 ML SUPPLEMENT,637,RC,,,,both,16.5,14.85,United Healthcare,Default,Fee Schedule,13.46,,,,9.74,13.46
RIFAXIMIN 200MG TAB (XIFAXAN),250,RC,,,,both,16.87,15.18,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,11.81,,,,9.95,13.77
RIFAXIMIN 200MG TAB (XIFAXAN),250,RC,,,,both,16.87,15.18,Cigna,Default,Percent of Total Billed Charges,9.95,,,,9.95,13.77
RIFAXIMIN 200MG TAB (XIFAXAN),250,RC,,,,both,16.87,15.18,United Healthcare,Default,Fee Schedule,13.77,,,,9.95,13.77
METHAZOLAMIDE 50MG,250,RC,,,,both,4,3.6,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,2.8,,,,2.36,3.26
METHAZOLAMIDE 50MG,250,RC,,,,both,4,3.6,Cigna,Default,Percent of Total Billed Charges,2.36,,,,2.36,3.26
METHAZOLAMIDE 50MG,250,RC,,,,both,4,3.6,United Healthcare,Default,Fee Schedule,3.26,,,,2.36,3.26
ADMIN OF FLU VIRUS VACCINE,G0008,HCPCS,771,RC,,both,10.25,9.23,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.18,,,,6.05,7.18
ADMIN OF FLU VIRUS VACCINE,G0008,HCPCS,771,RC,,both,10.25,9.23,Cigna,Default,Percent of Total Billed Charges,6.05,,,,6.05,7.18
ADMIN OF FLU VIRUS VACCINE,G0008,HCPCS,771,RC,,both,10.25,9.23,United Healthcare,Default,Fee Schedule,,,,,6.05,7.18
ADULT FLU PREFILLED SYRINGE,90656,HCPCS,636,RC,,both,10.5,9.45,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,7.35,,,,6.2,8.57
ADULT FLU PREFILLED SYRINGE,90656,HCPCS,636,RC,,both,10.5,9.45,Cigna,Default,Percent of Total Billed Charges,6.2,,,,6.2,8.57
ADULT FLU PREFILLED SYRINGE,90656,HCPCS,636,RC,,both,10.5,9.45,United Healthcare,Default,Fee Schedule,8.57,,,,6.2,8.57
PEDIATRIC PREFILLED SYRINGE,90655,HCPCS,636,RC,,both,13.5,12.15,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,9.45,,,,7.96,11.02
PEDIATRIC PREFILLED SYRINGE,90655,HCPCS,636,RC,,both,13.5,12.15,Cigna,Default,Percent of Total Billed Charges,7.96,,,,7.96,11.02
PEDIATRIC PREFILLED SYRINGE,90655,HCPCS,636,RC,,both,13.5,12.15,United Healthcare,Default,Fee Schedule,11.02,,,,7.96,11.02
INFLUENZA VIRUS VACCINE 65+,90662,HCPCS,636,RC,,both,26.75,24.08,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,18.72,,,,15.78,21.83
INFLUENZA VIRUS VACCINE 65+,90662,HCPCS,636,RC,,both,26.75,24.08,Cigna,Default,Percent of Total Billed Charges,15.78,,,,15.78,21.83
INFLUENZA VIRUS VACCINE 65+,90662,HCPCS,636,RC,,both,26.75,24.08,United Healthcare,Default,Fee Schedule,21.83,,,,15.78,21.83
MNT INDIVIDUAL ASSESSMENT,97802,HCPCS,942,RC,,both,69.96,62.96,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,48.97,,,,41.28,57.09
MNT INDIVIDUAL ASSESSMENT,97802,HCPCS,942,RC,,both,69.96,62.96,Cigna,Default,Percent of Total Billed Charges,41.28,,,,41.28,57.09
MNT INDIVIDUAL ASSESSMENT,97802,HCPCS,942,RC,,both,69.96,62.96,United Healthcare,Default,Fee Schedule,57.09,,,,41.28,57.09
MNT INDIVIDUAL FOLLOW-UP,97803,HCPCS,942,RC,,both,62.54,56.29,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,43.78,,,,36.9,51.03
MNT INDIVIDUAL FOLLOW-UP,97803,HCPCS,942,RC,,both,62.54,56.29,Cigna,Default,Percent of Total Billed Charges,36.9,,,,36.9,51.03
MNT INDIVIDUAL FOLLOW-UP,97803,HCPCS,942,RC,,both,62.54,56.29,United Healthcare,Default,Fee Schedule,51.03,,,,36.9,51.03
MNT GROUP ASSESSMENT,97804,HCPCS,942,RC,,both,36.57,32.91,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,25.6,,,,21.58,29.84
MNT GROUP ASSESSMENT,97804,HCPCS,942,RC,,both,36.57,32.91,Cigna,Default,Percent of Total Billed Charges,21.58,,,,21.58,29.84
MNT GROUP ASSESSMENT,97804,HCPCS,942,RC,,both,36.57,32.91,United Healthcare,Default,Fee Schedule,29.84,,,,21.58,29.84
MNT INDIVIDUAL REASSESSMENT CHANGE COND,G0270,HCPCS,942,RC,,both,59,53.1,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,41.3,,,,34.81,48.14
MNT INDIVIDUAL REASSESSMENT CHANGE COND,G0270,HCPCS,942,RC,,both,59,53.1,Cigna,Default,Percent of Total Billed Charges,34.81,,,,34.81,48.14
MNT INDIVIDUAL REASSESSMENT CHANGE COND,G0270,HCPCS,942,RC,,both,59,53.1,United Healthcare,Default,Fee Schedule,48.14,,,,34.81,48.14
CAL COUNT,942,RC,,,,both,11.5,10.35,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,8.05,,,,6.78,9.38
CAL COUNT,942,RC,,,,both,11.5,10.35,Cigna,Default,Percent of Total Billed Charges,6.78,,,,6.78,9.38
CAL COUNT,942,RC,,,,both,11.5,10.35,United Healthcare,Default,Fee Schedule,9.38,,,,6.78,9.38
EXCHANGE LIST FOR WEIGHT MANAGEMENT,270,RC,,,,both,5.25,4.73,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,3.68,,,,3.1,4.28
EXCHANGE LIST FOR WEIGHT MANAGEMENT,270,RC,,,,both,5.25,4.73,Cigna,Default,Percent of Total Billed Charges,3.1,,,,3.1,4.28
EXCHANGE LIST FOR WEIGHT MANAGEMENT,270,RC,,,,both,5.25,4.73,United Healthcare,Default,Fee Schedule,4.28,,,,3.1,4.28
EXCHANGE LIST FOR MEAL PLANNING,270,RC,,,,both,6.5,5.85,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,4.55,,,,3.84,5.3
EXCHANGE LIST FOR MEAL PLANNING,270,RC,,,,both,6.5,5.85,Cigna,Default,Percent of Total Billed Charges,3.84,,,,3.84,5.3
EXCHANGE LIST FOR MEAL PLANNING,270,RC,,,,both,6.5,5.85,United Healthcare,Default,Fee Schedule,5.3,,,,3.84,5.3
FIRST STEP IN DIABETES MEAL PLANNING,270,RC,,,,both,2.5,2.25,Blue Cross Blue Shield of IL,Default,Percent of Total Billed Charges,1.75,,,,1.48,2.04
FIRST STEP IN DIABETES MEAL PLANNING,270,RC,,,,both,2.5,2.25,Cigna,Default,Percent of Total Billed Charges,1.48,,,,1.48,2.04
FIRST STEP IN DIABETES MEAL PLANNING,270,RC,,,,both,2.5,2.25,United Healthcare,Default,Fee Schedule,2.04,,,,1.48,2.04