Results
Hospitals Overall - ALL​
Aetna​
| network_a | OPEN ACCESS MANAGED CHOICE | OPEN ACCESS ELECT CHOICE | NATIONAL PPO | NATIONAL EPO |
|---|---|---|---|---|
| NATIONAL EPO | 1 | 1.0 | 0.95 | 1 |
| NATIONAL PPO | 0.95 | 0.90 | 1 | |
| OPEN ACCESS ELECT CHOICE | 1 | 1 | ||
| OPEN ACCESS MANAGED CHOICE | 1 |
Blue Cross Blue Shield of Illinois​
| network_a | PPO PARTICIPATING PROVIDER OPTIONS | BLUE OPTIONS OR BLUE CHOICE OPTIONS | BLUE CHOICE PPO |
|---|---|---|---|
| BLUE CHOICE PPO | 0.8 | 0.80 | 1 |
| BLUE OPTIONS OR BLUE CHOICE OPTIONS | 0.6 | 1 | |
| PPO PARTICIPATING PROVIDER OPTIONS | 1 |
Cigna​
| network_a | PRIORITY HEALTH ALLIANCE | PATHWELL CARELINK NATIONAL OAP | NATIONAL PPO SAR 1 | NATIONAL PPO | NATIONAL OAP | LOCALPLUS SAR | LOCALPLUS | CARELINK NATIONAL OAP | CARELINK |
|---|---|---|---|---|---|---|---|---|---|
| CARELINK | 1 | 1.0 | 0.90 | 0.90 | 1.0 | 0.90 | 0.90 | 1.0 | 1 |
| CARELINK NATIONAL OAP | 1 | 1.0 | 0.90 | 0.90 | 1.0 | 0.90 | 0.90 | 1 | |
| LOCALPLUS | 0.9 | 0.90 | 0.80 | 0.80 | 0.90 | 0.95 | 1 | ||
| LOCALPLUS SAR | 0.9 | 0.90 | 0.80 | 0.80 | 0.90 | 1 | |||
| NATIONAL OAP | 1 | 1.0 | 0.90 | 0.90 | 1 | ||||
| NATIONAL PPO | 0.9 | 0.90 | 1.0 | 1 | |||||
| NATIONAL PPO SAR 1 | 0.9 | 0.90 | 1 | ||||||
| PATHWELL CARELINK NATIONAL OAP | 1 | 1 | |||||||
| PRIORITY HEALTH ALLIANCE | 1 |
United Healthcare​
| network_a | SELECT PLUS | SELECT EPO | POS NONGATED | OXFORD METRO NETWORK | OPTIONS PPO | NEXUS ACO OAP | NAVIGATE | HMO NONGATED | HMO GATED | CORE ESSENTIAL HMO | CORE ESSENTIAL EPO | CORE | COMPASS PLUS | COMPASS HMO | CHOICE PLUS | CHOICE EPO | CHARTER PLUS | CHARTER BALANCED | CHARTER |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARTER | 0.9 | 0.90 | 0.95 | 0.50 | 0.90 | 0.95 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 0.95 | 0.95 | 1.0 | 1.0 | 1 |
| CHARTER BALANCED | 0.9 | 0.90 | 0.95 | 0.50 | 0.90 | 0.95 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 0.95 | 0.95 | 1.0 | 1 | |
| CHARTER PLUS | 0.9 | 0.90 | 0.95 | 0.50 | 0.90 | 0.95 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 0.95 | 0.95 | 1 | ||
| CHOICE EPO | 0.95 | 0.95 | 0.95 | 0.50 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.50 | 1.0 | 1 | |||
| CHOICE PLUS | 0.95 | 0.95 | 0.95 | 0.50 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.50 | 1 | ||||
| COMPASS HMO | 0.5 | 0.50 | 0.70 | 0.40 | 0.50 | 0.50 | 0.50 | 0.70 | 0.70 | 0.60 | 0.60 | 0.60 | 1.0 | 1 | |||||
| COMPASS PLUS | 0.6 | 0.50 | 0.70 | 0.40 | 0.50 | 0.50 | 0.50 | 0.70 | 0.70 | 0.60 | 0.60 | 0.60 | 1 | ||||||
| CORE | 0.95 | 0.95 | 0.95 | 0.50 | 0.90 | 0.90 | 0.95 | 0.95 | 0.95 | 1.0 | 1.0 | 1 | |||||||
| CORE ESSENTIAL EPO | 0.9 | 0.90 | 0.95 | 0.50 | 0.90 | 0.90 | 0.95 | 0.95 | 0.95 | 1.0 | 1 | ||||||||
| CORE ESSENTIAL HMO | 0.95 | 0.90 | 0.95 | 0.50 | 0.90 | 0.90 | 0.95 | 0.95 | 0.95 | 1 | |||||||||
| HMO GATED | 0.95 | 0.95 | 0.95 | 0.50 | 0.90 | 0.95 | 0.95 | 0.95 | 1 | ||||||||||
| HMO NONGATED | 0.95 | 0.95 | 1.0 | 0.50 | 0.90 | 0.95 | 0.95 | 1 | |||||||||||
| NAVIGATE | 0.95 | 0.95 | 0.95 | 0.50 | 0.90 | 0.90 | 1 | ||||||||||||
| NEXUS ACO OAP | 0.9 | 0.90 | 0.95 | 0.40 | 0.90 | 1 | |||||||||||||
| OPTIONS PPO | 0.9 | 0.90 | 0.90 | 0.50 | 1 | ||||||||||||||
| OXFORD METRO NETWORK | 0.5 | 0.50 | 0.50 | 1 | |||||||||||||||
| POS NONGATED | 0.95 | 0.95 | 1 | ||||||||||||||||
| SELECT EPO | 1 | 1 | |||||||||||||||||
| SELECT PLUS | 1 |
Hospital By Billing Code Type - MS-DRG​
Aetna​
| network_a | OPEN ACCESS MANAGED CHOICE | OPEN ACCESS ELECT CHOICE | NATIONAL PPO | NATIONAL EPO |
|---|---|---|---|---|
| NATIONAL EPO | 1 | 1.0 | 0.90 | 1 |
| NATIONAL PPO | 0.9 | 0.90 | 1 | |
| OPEN ACCESS ELECT CHOICE | 1 | 1 | ||
| OPEN ACCESS MANAGED CHOICE | 1 |
Blue Cross Blue Shield of Illinois​
| network_a | PPO PARTICIPATING PROVIDER OPTIONS | BLUE OPTIONS OR BLUE CHOICE OPTIONS |
|---|---|---|
| BLUE OPTIONS OR BLUE CHOICE OPTIONS | 0.3 | 1 |
| PPO PARTICIPATING PROVIDER OPTIONS | 1 |
Cigna​
| network_a | PRIORITY HEALTH ALLIANCE | PATHWELL CARELINK NATIONAL OAP | NATIONAL PPO SAR 1 | NATIONAL PPO | NATIONAL OAP | LOCALPLUS SAR | LOCALPLUS | CARELINK NATIONAL OAP | CARELINK |
|---|---|---|---|---|---|---|---|---|---|
| CARELINK | 1 | 1.0 | 0.80 | 0.80 | 1.0 | 0.80 | 0.80 | 1.0 | 1 |
| CARELINK NATIONAL OAP | 1 | 1.0 | 0.80 | 0.80 | 1.0 | 0.80 | 0.80 | 1 | |
| LOCALPLUS | 0.8 | 0.80 | 0.70 | 0.70 | 0.80 | 0.95 | 1 | ||
| LOCALPLUS SAR | 0.8 | 0.80 | 0.70 | 0.70 | 0.80 | 1 | |||
| NATIONAL OAP | 1 | 1.0 | 0.80 | 0.80 | 1 | ||||
| NATIONAL PPO | 0.8 | 0.80 | 1.0 | 1 | |||||
| NATIONAL PPO SAR 1 | 0.8 | 0.80 | 1 | ||||||
| PATHWELL CARELINK NATIONAL OAP | 1 | 1 | |||||||
| PRIORITY HEALTH ALLIANCE | 1 |
United Healthcare​
| network_a | SELECT PLUS | SELECT EPO | POS NONGATED | OPTIONS PPO | NEXUS ACO OAP | NAVIGATE | HMO NONGATED | HMO GATED | CORE ESSENTIAL HMO | CORE ESSENTIAL EPO | CORE | COMPASS PLUS | COMPASS HMO | CHOICE PLUS | CHOICE EPO | CHARTER PLUS | CHARTER BALANCED | CHARTER |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARTER | 0.8 | 0.80 | 0.60 | 0.80 | 0.90 | 0.80 | 0.60 | 0.50 | 0.90 | 0.90 | 0.90 | 0.30 | 0.30 | 0.90 | 0.90 | 1.0 | 1.0 | 1 |
| CHARTER BALANCED | 0.8 | 0.80 | 0.60 | 0.80 | 0.90 | 0.80 | 0.50 | 0.70 | 0.90 | 0.90 | 0.90 | 0.30 | 0.30 | 0.90 | 0.90 | 1.0 | 1 | |
| CHARTER PLUS | 0.8 | 0.80 | 0.50 | 0.80 | 0.90 | 0.80 | 0.50 | 0.50 | 0.90 | 0.90 | 0.90 | 0.30 | 0.30 | 0.90 | 0.90 | 1 | ||
| CHOICE EPO | 0.95 | 0.95 | 0.50 | 0.80 | 0.90 | 0.90 | 0.50 | 0.60 | 0.90 | 0.90 | 0.90 | 0.20 | 0.20 | 1.0 | 1 | |||
| CHOICE PLUS | 0.95 | 0.95 | 0.60 | 0.80 | 0.90 | 0.90 | 0.40 | 0.50 | 0.90 | 0.90 | 0.90 | 0.20 | 0.20 | 1 | ||||
| COMPASS HMO | 0.2 | 0.20 | 0.30 | 0.10 | 0.20 | 0.20 | 0.20 | 0.30 | 0.30 | 0.30 | 0.30 | 1.0 | 1 | |||||
| COMPASS PLUS | 0.2 | 0.20 | 0.20 | 0.10 | 0.20 | 0.20 | 0.20 | 0.20 | 0.30 | 0.30 | 0.30 | 1 | ||||||
| CORE | 0.8 | 0.80 | 0.60 | 0.80 | 0.80 | 0.90 | 0.60 | 0.50 | 1.0 | 1.0 | 1 | |||||||
| CORE ESSENTIAL EPO | 0.8 | 0.80 | 0.50 | 0.80 | 0.80 | 0.90 | 0.70 | 0.60 | 1.0 | 1 | ||||||||
| CORE ESSENTIAL HMO | 0.8 | 0.90 | 0.60 | 0.80 | 0.80 | 0.90 | 0.50 | 0.50 | 1 | |||||||||
| HMO GATED | 0.4 | 0.60 | 0.95 | 0.40 | 0.60 | 0.50 | 0.95 | 1 | ||||||||||
| HMO NONGATED | 0.5 | 0.40 | 1.0 | 0.50 | 0.50 | 0.50 | 1 | |||||||||||
| NAVIGATE | 0.9 | 0.90 | 0.50 | 0.80 | 0.80 | 1 | ||||||||||||
| NEXUS ACO OAP | 0.8 | 0.80 | 0.60 | 0.80 | 1 | |||||||||||||
| OPTIONS PPO | 0.8 | 0.80 | 0.40 | 1 | ||||||||||||||
| POS NONGATED | 0.5 | 0.50 | 1 | |||||||||||||||
| SELECT EPO | 1 | 1 | ||||||||||||||||
| SELECT PLUS | 1 |
Hospital By Billing Code Type - HCPCS​
Aetna​
| network_a | OPEN ACCESS MANAGED CHOICE | OPEN ACCESS ELECT CHOICE | NATIONAL PPO | NATIONAL EPO |
|---|---|---|---|---|
| NATIONAL EPO | 1 | 1.0 | 0.90 | 1 |
| NATIONAL PPO | 0.9 | 0.90 | 1 | |
| OPEN ACCESS ELECT CHOICE | 1 | 1 | ||
| OPEN ACCESS MANAGED CHOICE | 1 |
Blue Cross Blue Shield of Illinois​
| network_a | PPO PARTICIPATING PROVIDER OPTIONS | BLUE OPTIONS OR BLUE CHOICE OPTIONS | BLUE CHOICE PPO |
|---|---|---|---|
| BLUE CHOICE PPO | 0.6 | 0.70 | 1 |
| BLUE OPTIONS OR BLUE CHOICE OPTIONS | 0.4 | 1 | |
| PPO PARTICIPATING PROVIDER OPTIONS | 1 |
Cigna​
| network_a | PRIORITY HEALTH ALLIANCE | PATHWELL CARELINK NATIONAL OAP | NATIONAL PPO SAR 1 | NATIONAL PPO | NATIONAL OAP | LOCALPLUS SAR | LOCALPLUS | CARELINK NATIONAL OAP | CARELINK |
|---|---|---|---|---|---|---|---|---|---|
| CARELINK | 1 | 1.0 | 0.90 | 0.90 | 1.0 | 0.80 | 0.80 | 1.0 | 1 |
| CARELINK NATIONAL OAP | 1 | 1.0 | 0.90 | 0.90 | 1.0 | 0.80 | 0.80 | 1 | |
| LOCALPLUS | 0.8 | 0.80 | 0.80 | 0.80 | 0.80 | 0.95 | 1 | ||
| LOCALPLUS SAR | 0.8 | 0.80 | 0.80 | 0.80 | 0.80 | 1 | |||
| NATIONAL OAP | 1 | 1.0 | 0.90 | 0.90 | 1 | ||||
| NATIONAL PPO | 0.9 | 0.90 | 1.0 | 1 | |||||
| NATIONAL PPO SAR 1 | 0.9 | 0.90 | 1 | ||||||
| PATHWELL CARELINK NATIONAL OAP | 1 | 1 | |||||||
| PRIORITY HEALTH ALLIANCE | 1 |
United Healthcare​
| network_a | SELECT PLUS | SELECT EPO | POS NONGATED | OXFORD METRO NETWORK | OPTIONS PPO | NEXUS ACO OAP | NAVIGATE | HMO NONGATED | HMO GATED | CORE ESSENTIAL HMO | CORE ESSENTIAL EPO | CORE | COMPASS PLUS | COMPASS HMO | CHOICE PLUS | CHOICE EPO | CHARTER PLUS | CHARTER BALANCED | CHARTER |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARTER | 0.8 | 0.80 | 0.90 | 0.50 | 0.80 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.40 | 0.40 | 0.90 | 0.90 | 1.0 | 1.0 | 1 |
| CHARTER BALANCED | 0.8 | 0.80 | 0.90 | 0.50 | 0.80 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.40 | 0.40 | 0.90 | 0.90 | 1.0 | 1 | |
| CHARTER PLUS | 0.8 | 0.80 | 0.90 | 0.50 | 0.80 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.40 | 0.40 | 0.90 | 0.90 | 1 | ||
| CHOICE EPO | 0.95 | 0.95 | 0.90 | 0.50 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.30 | 0.30 | 1.0 | 1 | |||
| CHOICE PLUS | 0.95 | 0.95 | 0.90 | 0.50 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.90 | 0.30 | 0.30 | 1 | ||||
| COMPASS HMO | 0.3 | 0.30 | 0.70 | 0.40 | 0.30 | 0.30 | 0.30 | 0.70 | 0.60 | 0.40 | 0.40 | 0.40 | 1.0 | 1 | |||||
| COMPASS PLUS | 0.3 | 0.30 | 0.70 | 0.40 | 0.30 | 0.30 | 0.30 | 0.70 | 0.60 | 0.40 | 0.40 | 0.40 | 1 | ||||||
| CORE | 0.9 | 0.90 | 0.90 | 0.50 | 0.80 | 0.80 | 0.90 | 0.90 | 0.90 | 1.0 | 1.0 | 1 | |||||||
| CORE ESSENTIAL EPO | 0.9 | 0.90 | 0.90 | 0.50 | 0.80 | 0.80 | 0.90 | 0.90 | 0.90 | 1.0 | 1 | ||||||||
| CORE ESSENTIAL HMO | 0.9 | 0.90 | 0.90 | 0.50 | 0.80 | 0.80 | 0.90 | 0.90 | 0.90 | 1 | |||||||||
| HMO GATED | 0.9 | 0.90 | 0.95 | 0.50 | 0.80 | 0.90 | 0.90 | 0.95 | 1 | ||||||||||
| HMO NONGATED | 0.9 | 0.90 | 1.0 | 0.50 | 0.80 | 0.90 | 0.90 | 1 | |||||||||||
| NAVIGATE | 0.9 | 0.90 | 0.90 | 0.50 | 0.80 | 0.80 | 1 | ||||||||||||
| NEXUS ACO OAP | 0.8 | 0.80 | 0.90 | 0.40 | 0.80 | 1 | |||||||||||||
| OPTIONS PPO | 0.8 | 0.80 | 0.80 | 0.50 | 1 | ||||||||||||||
| OXFORD METRO NETWORK | 0.5 | 0.50 | 0.50 | 1 | |||||||||||||||
| POS NONGATED | 0.9 | 0.80 | 1 | ||||||||||||||||
| SELECT EPO | 1 | 1 | |||||||||||||||||
| SELECT PLUS | 1 |
Physician Groups Overall - ALL​
Aetna​
| network_a | OPEN ACCESS MANAGED CHOICE | OPEN ACCESS ELECT CHOICE | NATIONAL PPO | NATIONAL EPO |
|---|---|---|---|---|
| NATIONAL EPO | 1 | 1.0 | 1.0 | 1 |
| NATIONAL PPO | 1 | 1.0 | 1 | |
| OPEN ACCESS ELECT CHOICE | 1 | 1 | ||
| OPEN ACCESS MANAGED CHOICE | 1 |
Blue Cross Blue Shield of Illinois​
| network_a | PPO PARTICIPATING PROVIDER OPTIONS | BLUE OPTIONS OR BLUE CHOICE OPTIONS | BLUE CHOICE PPO |
|---|---|---|---|
| BLUE CHOICE PPO | 0.4 | 0.90 | 1 |
| BLUE OPTIONS OR BLUE CHOICE OPTIONS | 0.5 | 1 | |
| PPO PARTICIPATING PROVIDER OPTIONS | 1 |
Cigna​
| network_a | PRIORITY HEALTH ALLIANCE | PATHWELL CARELINK NATIONAL OAP | NATIONAL PPO SAR 1 | NATIONAL PPO | NATIONAL OAP | LOCALPLUS SAR | LOCALPLUS | CARELINK NATIONAL OAP | CARELINK |
|---|---|---|---|---|---|---|---|---|---|
| CARELINK | 1 | 1.0 | 0.95 | 0.95 | 1.0 | 0.95 | 0.95 | 1.0 | 1 |
| CARELINK NATIONAL OAP | 1 | 1.0 | 0.95 | 0.95 | 1.0 | 0.95 | 0.95 | 1 | |
| LOCALPLUS | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 1.0 | 1 | ||
| LOCALPLUS SAR | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 1 | |||
| NATIONAL OAP | 1 | 1.0 | 0.95 | 0.95 | 1 | ||||
| NATIONAL PPO | 0.95 | 0.95 | 1.0 | 1 | |||||
| NATIONAL PPO SAR 1 | 0.95 | 0.95 | 1 | ||||||
| PATHWELL CARELINK NATIONAL OAP | 1 | 1 | |||||||
| PRIORITY HEALTH ALLIANCE | 1 |
United Healthcare​
| network_a | SELECT PLUS | SELECT EPO | POS NONGATED | OXFORD METRO NETWORK | OPTIONS PPO | NEXUS ACO OAP | NAVIGATE | HMO NONGATED | HMO GATED | CORE ESSENTIAL HMO | CORE ESSENTIAL EPO | CORE | COMPASS PLUS | COMPASS HMO | CHOICE PLUS | CHOICE EPO | CHARTER PLUS | CHARTER BALANCED | CHARTER |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARTER | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.70 | 0.70 | 0.95 | 0.95 | 1.0 | 1.0 | 1 |
| CHARTER BALANCED | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.70 | 0.70 | 0.95 | 0.95 | 1.0 | 1 | |
| CHARTER PLUS | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.70 | 0.70 | 0.95 | 0.95 | 1 | ||
| CHOICE EPO | 1 | 1.0 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 1.0 | 1 | |||
| CHOICE PLUS | 1 | 1.0 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 1 | ||||
| COMPASS HMO | 0.6 | 0.60 | 0.70 | 0.60 | 0.60 | 0.60 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 1.0 | 1 | |||||
| COMPASS PLUS | 0.6 | 0.60 | 0.70 | 0.60 | 0.60 | 0.60 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 1 | ||||||
| CORE | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 1.0 | 1.0 | 1 | |||||||
| CORE ESSENTIAL EPO | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 1.0 | 1 | ||||||||
| CORE ESSENTIAL HMO | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 1 | |||||||||
| HMO GATED | 0.95 | 0.95 | 0.95 | 0.60 | 0.80 | 0.95 | 0.95 | 0.95 | 1 | ||||||||||
| HMO NONGATED | 0.95 | 0.95 | 1.0 | 0.60 | 0.90 | 0.95 | 0.95 | 1 | |||||||||||
| NAVIGATE | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 1 | ||||||||||||
| NEXUS ACO OAP | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 1 | |||||||||||||
| OPTIONS PPO | 0.9 | 0.90 | 0.90 | 0.60 | 1 | ||||||||||||||
| OXFORD METRO NETWORK | 0.6 | 0.60 | 0.60 | 1 | |||||||||||||||
| POS NONGATED | 0.95 | 0.95 | 1 | ||||||||||||||||
| SELECT EPO | 1 | 1 | |||||||||||||||||
| SELECT PLUS | 1 |
Physician Groups By Billing Code Type - HCPCS​
Aetna​
| network_a | OPEN ACCESS MANAGED CHOICE | OPEN ACCESS ELECT CHOICE | NATIONAL PPO | NATIONAL EPO |
|---|---|---|---|---|
| NATIONAL EPO | 1 | 1.0 | 1.0 | 1 |
| NATIONAL PPO | 1 | 1.0 | 1 | |
| OPEN ACCESS ELECT CHOICE | 1 | 1 | ||
| OPEN ACCESS MANAGED CHOICE | 1 |
Blue Cross Blue Shield of Illinois​
| network_a | PPO PARTICIPATING PROVIDER OPTIONS | BLUE OPTIONS OR BLUE CHOICE OPTIONS | BLUE CHOICE PPO |
|---|---|---|---|
| BLUE CHOICE PPO | 0.4 | 0.90 | 1 |
| BLUE OPTIONS OR BLUE CHOICE OPTIONS | 0.5 | 1 | |
| PPO PARTICIPATING PROVIDER OPTIONS | 1 |
Cigna​
| network_a | PRIORITY HEALTH ALLIANCE | PATHWELL CARELINK NATIONAL OAP | NATIONAL PPO SAR 1 | NATIONAL PPO | NATIONAL OAP | LOCALPLUS SAR | LOCALPLUS | CARELINK NATIONAL OAP | CARELINK |
|---|---|---|---|---|---|---|---|---|---|
| CARELINK | 1 | 1.0 | 0.95 | 0.95 | 1.0 | 0.95 | 0.95 | 1.0 | 1 |
| CARELINK NATIONAL OAP | 1 | 1.0 | 0.95 | 0.95 | 1.0 | 0.95 | 0.95 | 1 | |
| LOCALPLUS | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 1.0 | 1 | ||
| LOCALPLUS SAR | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 1 | |||
| NATIONAL OAP | 1 | 1.0 | 0.95 | 0.95 | 1 | ||||
| NATIONAL PPO | 0.95 | 0.95 | 1.0 | 1 | |||||
| NATIONAL PPO SAR 1 | 0.95 | 0.95 | 1 | ||||||
| PATHWELL CARELINK NATIONAL OAP | 1 | 1 | |||||||
| PRIORITY HEALTH ALLIANCE | 1 |
United Healthcare​
| network_a | SELECT PLUS | SELECT EPO | POS NONGATED | OXFORD METRO NETWORK | OPTIONS PPO | NEXUS ACO OAP | NAVIGATE | HMO NONGATED | HMO GATED | CORE ESSENTIAL HMO | CORE ESSENTIAL EPO | CORE | COMPASS PLUS | COMPASS HMO | CHOICE PLUS | CHOICE EPO | CHARTER PLUS | CHARTER BALANCED | CHARTER |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARTER | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.70 | 0.70 | 0.95 | 0.95 | 1.0 | 1.0 | 1 |
| CHARTER BALANCED | 0.95 | 0.95 | 0.95 | 0.70 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.70 | 0.70 | 0.95 | 0.95 | 1.0 | 1 | |
| CHARTER PLUS | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.70 | 0.70 | 0.95 | 0.95 | 1 | ||
| CHOICE EPO | 1 | 1.0 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 1.0 | 1 | |||
| CHOICE PLUS | 1 | 1.0 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.95 | 0.60 | 0.60 | 1 | ||||
| COMPASS HMO | 0.6 | 0.60 | 0.70 | 0.60 | 0.60 | 0.60 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 1.0 | 1 | |||||
| COMPASS PLUS | 0.6 | 0.60 | 0.70 | 0.60 | 0.60 | 0.60 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 0.70 | 1 | ||||||
| CORE | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 1.0 | 1.0 | 1 | |||||||
| CORE ESSENTIAL EPO | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 1.0 | 1 | ||||||||
| CORE ESSENTIAL HMO | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 0.95 | 1 | |||||||||
| HMO GATED | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 0.95 | 0.95 | 1 | ||||||||||
| HMO NONGATED | 0.95 | 0.95 | 1.0 | 0.60 | 0.90 | 0.95 | 0.95 | 1 | |||||||||||
| NAVIGATE | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 0.95 | 1 | ||||||||||||
| NEXUS ACO OAP | 0.95 | 0.95 | 0.95 | 0.60 | 0.90 | 1 | |||||||||||||
| OPTIONS PPO | 0.9 | 0.90 | 0.90 | 0.60 | 1 | ||||||||||||||
| OXFORD METRO NETWORK | 0.6 | 0.60 | 0.60 | 1 | |||||||||||||||
| POS NONGATED | 0.95 | 0.95 | 1 | ||||||||||||||||
| SELECT EPO | 1 | 1 | |||||||||||||||||
| SELECT PLUS | 1 |