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Service Code CPT 97033 GO,CO
Hospital Charge Code 5571730
Hospital Revenue Code 430
Min. Negotiated Rate $62.72
Max. Negotiated Rate $896.00
Rate for Payer: Aetna Commercial $201.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $192.64
Rate for Payer: Aetna Managed Medicare $62.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $118.72
Rate for Payer: Cash Price $67.20
Rate for Payer: Cash Price $67.20
Rate for Payer: Cigna Commercial $206.08
Rate for Payer: Dean Health DHI/DHP/ASO $125.35
Rate for Payer: Health EOS Commercial $199.36
Rate for Payer: HFN Commercial $206.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $179.20
Rate for Payer: NAPHCARE Commercial $134.40
Rate for Payer: Preferred Network Access Commercial $206.08
Rate for Payer: Quartz Beloit One Network $109.76
Rate for Payer: Quartz Commercial $145.60
Rate for Payer: Quartz Medicare Advantage $134.40
Rate for Payer: The Alliance Commercial $896.00
Rate for Payer: United Healthcare PPO $168.00
Rate for Payer: WEA Trust Commercial $123.20
Rate for Payer: WPS Commercial $165.92
Service Code CPT 97033 GO,CO
Hospital Charge Code 5571730
Hospital Revenue Code 430
Min. Negotiated Rate $109.76
Max. Negotiated Rate $206.08
Rate for Payer: Aetna Commercial $201.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $192.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $118.72
Rate for Payer: Cash Price $67.20
Rate for Payer: Cigna Commercial $206.08
Rate for Payer: Health EOS Commercial $199.36
Rate for Payer: HFN Commercial $206.08
Rate for Payer: Multiplan Commercial $179.20
Rate for Payer: NAPHCARE Commercial $134.40
Rate for Payer: Preferred Network Access Commercial $206.08
Rate for Payer: Quartz Beloit One Network $109.76
Rate for Payer: Quartz Commercial $134.40
Rate for Payer: WEA Trust Commercial $123.20
Rate for Payer: WPS Commercial $165.92
Service Code CPT 97140 GO,CO
Hospital Charge Code 5571710
Hospital Revenue Code 430
Min. Negotiated Rate $122.99
Max. Negotiated Rate $230.92
Rate for Payer: Aetna Commercial $225.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $215.86
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $133.03
Rate for Payer: Cash Price $75.30
Rate for Payer: Cigna Commercial $230.92
Rate for Payer: Health EOS Commercial $223.39
Rate for Payer: HFN Commercial $230.92
Rate for Payer: Multiplan Commercial $200.80
Rate for Payer: NAPHCARE Commercial $150.60
Rate for Payer: Preferred Network Access Commercial $230.92
Rate for Payer: Quartz Beloit One Network $122.99
Rate for Payer: Quartz Commercial $150.60
Rate for Payer: WEA Trust Commercial $138.05
Rate for Payer: WPS Commercial $185.92
Service Code CPT 97140 GO,CO
Hospital Charge Code 5571710
Hospital Revenue Code 430
Min. Negotiated Rate $70.28
Max. Negotiated Rate $1,004.00
Rate for Payer: Aetna Commercial $225.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $215.86
Rate for Payer: Aetna Managed Medicare $70.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $133.03
Rate for Payer: Cash Price $75.30
Rate for Payer: Cash Price $75.30
Rate for Payer: Cigna Commercial $230.92
Rate for Payer: Dean Health DHI/DHP/ASO $140.46
Rate for Payer: Health EOS Commercial $223.39
Rate for Payer: HFN Commercial $230.92
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $200.80
Rate for Payer: NAPHCARE Commercial $150.60
Rate for Payer: Preferred Network Access Commercial $230.92
Rate for Payer: Quartz Beloit One Network $122.99
Rate for Payer: Quartz Commercial $163.15
Rate for Payer: Quartz Medicare Advantage $150.60
Rate for Payer: The Alliance Commercial $1,004.00
Rate for Payer: United Healthcare PPO $188.25
Rate for Payer: WEA Trust Commercial $138.05
Rate for Payer: WPS Commercial $185.92
Service Code CPT 97124 GO,CO
Hospital Charge Code 5571714
Hospital Revenue Code 430
Min. Negotiated Rate $35.77
Max. Negotiated Rate $67.16
Rate for Payer: Aetna Commercial $65.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $62.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $38.69
Rate for Payer: Cash Price $21.90
Rate for Payer: Cigna Commercial $67.16
Rate for Payer: Health EOS Commercial $64.97
Rate for Payer: HFN Commercial $67.16
Rate for Payer: Multiplan Commercial $58.40
Rate for Payer: NAPHCARE Commercial $43.80
Rate for Payer: Preferred Network Access Commercial $67.16
Rate for Payer: Quartz Beloit One Network $35.77
Rate for Payer: Quartz Commercial $43.80
Rate for Payer: WEA Trust Commercial $40.15
Rate for Payer: WPS Commercial $54.07
Service Code CPT 97124 GO,CO
Hospital Charge Code 5571714
Hospital Revenue Code 430
Min. Negotiated Rate $20.44
Max. Negotiated Rate $349.00
Rate for Payer: Aetna Commercial $65.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $62.78
Rate for Payer: Aetna Managed Medicare $20.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $38.69
Rate for Payer: Cash Price $21.90
Rate for Payer: Cash Price $21.90
Rate for Payer: Cigna Commercial $67.16
Rate for Payer: Dean Health DHI/DHP/ASO $40.85
Rate for Payer: Health EOS Commercial $64.97
Rate for Payer: HFN Commercial $67.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $58.40
Rate for Payer: NAPHCARE Commercial $43.80
Rate for Payer: Preferred Network Access Commercial $67.16
Rate for Payer: Quartz Beloit One Network $35.77
Rate for Payer: Quartz Commercial $47.45
Rate for Payer: Quartz Medicare Advantage $43.80
Rate for Payer: The Alliance Commercial $292.00
Rate for Payer: United Healthcare PPO $54.75
Rate for Payer: WEA Trust Commercial $40.15
Rate for Payer: WPS Commercial $54.07
Service Code CPT 97112 GO,CO
Hospital Charge Code 5571700
Hospital Revenue Code 430
Min. Negotiated Rate $122.99
Max. Negotiated Rate $230.92
Rate for Payer: Aetna Commercial $225.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $215.86
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $133.03
Rate for Payer: Cash Price $75.30
Rate for Payer: Cigna Commercial $230.92
Rate for Payer: Health EOS Commercial $223.39
Rate for Payer: HFN Commercial $230.92
Rate for Payer: Multiplan Commercial $200.80
Rate for Payer: NAPHCARE Commercial $150.60
Rate for Payer: Preferred Network Access Commercial $230.92
Rate for Payer: Quartz Beloit One Network $122.99
Rate for Payer: Quartz Commercial $150.60
Rate for Payer: WEA Trust Commercial $138.05
Rate for Payer: WPS Commercial $185.92
Service Code CPT 97112 GO,CO
Hospital Charge Code 5571700
Hospital Revenue Code 430
Min. Negotiated Rate $70.28
Max. Negotiated Rate $1,004.00
Rate for Payer: Aetna Commercial $225.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $215.86
Rate for Payer: Aetna Managed Medicare $70.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $133.03
Rate for Payer: Cash Price $75.30
Rate for Payer: Cash Price $75.30
Rate for Payer: Cigna Commercial $230.92
Rate for Payer: Dean Health DHI/DHP/ASO $140.46
Rate for Payer: Health EOS Commercial $223.39
Rate for Payer: HFN Commercial $230.92
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $200.80
Rate for Payer: NAPHCARE Commercial $150.60
Rate for Payer: Preferred Network Access Commercial $230.92
Rate for Payer: Quartz Beloit One Network $122.99
Rate for Payer: Quartz Commercial $163.15
Rate for Payer: Quartz Medicare Advantage $150.60
Rate for Payer: The Alliance Commercial $1,004.00
Rate for Payer: United Healthcare PPO $188.25
Rate for Payer: WEA Trust Commercial $138.05
Rate for Payer: WPS Commercial $185.92
Service Code CPT 97760 GO,CO
Hospital Charge Code 5571704
Hospital Revenue Code 430
Min. Negotiated Rate $73.92
Max. Negotiated Rate $1,056.00
Rate for Payer: Aetna Commercial $237.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.04
Rate for Payer: Aetna Managed Medicare $73.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $139.92
Rate for Payer: Cash Price $79.20
Rate for Payer: Cash Price $79.20
Rate for Payer: Cigna Commercial $242.88
Rate for Payer: Dean Health DHI/DHP/ASO $147.73
Rate for Payer: Health EOS Commercial $234.96
Rate for Payer: HFN Commercial $242.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $211.20
Rate for Payer: NAPHCARE Commercial $158.40
Rate for Payer: Preferred Network Access Commercial $242.88
Rate for Payer: Quartz Beloit One Network $129.36
Rate for Payer: Quartz Commercial $171.60
Rate for Payer: Quartz Medicare Advantage $158.40
Rate for Payer: The Alliance Commercial $1,056.00
Rate for Payer: United Healthcare PPO $198.00
Rate for Payer: WEA Trust Commercial $145.20
Rate for Payer: WPS Commercial $195.54
Service Code CPT 97760 GO,CO
Hospital Charge Code 5571704
Hospital Revenue Code 430
Min. Negotiated Rate $129.36
Max. Negotiated Rate $242.88
Rate for Payer: Aetna Commercial $237.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $139.92
Rate for Payer: Cash Price $79.20
Rate for Payer: Cigna Commercial $242.88
Rate for Payer: Health EOS Commercial $234.96
Rate for Payer: HFN Commercial $242.88
Rate for Payer: Multiplan Commercial $211.20
Rate for Payer: NAPHCARE Commercial $158.40
Rate for Payer: Preferred Network Access Commercial $242.88
Rate for Payer: Quartz Beloit One Network $129.36
Rate for Payer: Quartz Commercial $158.40
Rate for Payer: WEA Trust Commercial $145.20
Rate for Payer: WPS Commercial $195.54
Service Code CPT 97750 GO,CO
Hospital Charge Code 5572121
Hospital Revenue Code 430
Min. Negotiated Rate $48.44
Max. Negotiated Rate $692.00
Rate for Payer: Aetna Commercial $155.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $148.78
Rate for Payer: Aetna Managed Medicare $48.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $91.69
Rate for Payer: Cash Price $51.90
Rate for Payer: Cash Price $51.90
Rate for Payer: Cigna Commercial $159.16
Rate for Payer: Dean Health DHI/DHP/ASO $96.81
Rate for Payer: Health EOS Commercial $153.97
Rate for Payer: HFN Commercial $159.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $138.40
Rate for Payer: NAPHCARE Commercial $103.80
Rate for Payer: Preferred Network Access Commercial $159.16
Rate for Payer: Quartz Beloit One Network $84.77
Rate for Payer: Quartz Commercial $112.45
Rate for Payer: Quartz Medicare Advantage $103.80
Rate for Payer: The Alliance Commercial $692.00
Rate for Payer: United Healthcare PPO $129.75
Rate for Payer: WEA Trust Commercial $95.15
Rate for Payer: WPS Commercial $128.14
Service Code CPT 97750 GO,CO
Hospital Charge Code 5572121
Hospital Revenue Code 430
Min. Negotiated Rate $84.77
Max. Negotiated Rate $159.16
Rate for Payer: Aetna Commercial $155.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $148.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $91.69
Rate for Payer: Cash Price $51.90
Rate for Payer: Cigna Commercial $159.16
Rate for Payer: Health EOS Commercial $153.97
Rate for Payer: HFN Commercial $159.16
Rate for Payer: Multiplan Commercial $138.40
Rate for Payer: NAPHCARE Commercial $103.80
Rate for Payer: Preferred Network Access Commercial $159.16
Rate for Payer: Quartz Beloit One Network $84.77
Rate for Payer: Quartz Commercial $103.80
Rate for Payer: WEA Trust Commercial $95.15
Rate for Payer: WPS Commercial $128.14
Service Code CPT 97750 CO,GO
Hospital Charge Code 5572119
Hospital Revenue Code 430
Min. Negotiated Rate $34.44
Max. Negotiated Rate $492.00
Rate for Payer: Aetna Commercial $110.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $105.78
Rate for Payer: Aetna Managed Medicare $34.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $65.19
Rate for Payer: Cash Price $36.90
Rate for Payer: Cash Price $36.90
Rate for Payer: Cigna Commercial $113.16
Rate for Payer: Dean Health DHI/DHP/ASO $68.83
Rate for Payer: Health EOS Commercial $109.47
Rate for Payer: HFN Commercial $113.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $98.40
Rate for Payer: NAPHCARE Commercial $73.80
Rate for Payer: Preferred Network Access Commercial $113.16
Rate for Payer: Quartz Beloit One Network $60.27
Rate for Payer: Quartz Commercial $79.95
Rate for Payer: Quartz Medicare Advantage $73.80
Rate for Payer: The Alliance Commercial $492.00
Rate for Payer: United Healthcare PPO $92.25
Rate for Payer: WEA Trust Commercial $67.65
Rate for Payer: WPS Commercial $91.11
Service Code CPT 97750 CO,GO
Hospital Charge Code 5572119
Hospital Revenue Code 430
Min. Negotiated Rate $60.27
Max. Negotiated Rate $113.16
Rate for Payer: Aetna Commercial $110.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $105.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $65.19
Rate for Payer: Cash Price $36.90
Rate for Payer: Cigna Commercial $113.16
Rate for Payer: Health EOS Commercial $109.47
Rate for Payer: HFN Commercial $113.16
Rate for Payer: Multiplan Commercial $98.40
Rate for Payer: NAPHCARE Commercial $73.80
Rate for Payer: Preferred Network Access Commercial $113.16
Rate for Payer: Quartz Beloit One Network $60.27
Rate for Payer: Quartz Commercial $73.80
Rate for Payer: WEA Trust Commercial $67.65
Rate for Payer: WPS Commercial $91.11
Service Code CPT 97750 GO,CO
Hospital Charge Code 5572125
Hospital Revenue Code 430
Min. Negotiated Rate $287.63
Max. Negotiated Rate $540.04
Rate for Payer: Aetna Commercial $528.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $504.82
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $311.11
Rate for Payer: Cash Price $176.10
Rate for Payer: Cigna Commercial $540.04
Rate for Payer: Health EOS Commercial $522.43
Rate for Payer: HFN Commercial $540.04
Rate for Payer: Multiplan Commercial $469.60
Rate for Payer: NAPHCARE Commercial $352.20
Rate for Payer: Preferred Network Access Commercial $540.04
Rate for Payer: Quartz Beloit One Network $287.63
Rate for Payer: Quartz Commercial $352.20
Rate for Payer: WEA Trust Commercial $322.85
Rate for Payer: WPS Commercial $434.79
Service Code CPT 97750 GO,CO
Hospital Charge Code 5572125
Hospital Revenue Code 430
Min. Negotiated Rate $164.36
Max. Negotiated Rate $2,348.00
Rate for Payer: Aetna Commercial $528.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $504.82
Rate for Payer: Aetna Managed Medicare $164.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $311.11
Rate for Payer: Cash Price $176.10
Rate for Payer: Cash Price $176.10
Rate for Payer: Cigna Commercial $540.04
Rate for Payer: Dean Health DHI/DHP/ASO $328.49
Rate for Payer: Health EOS Commercial $522.43
Rate for Payer: HFN Commercial $540.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $469.60
Rate for Payer: NAPHCARE Commercial $352.20
Rate for Payer: Preferred Network Access Commercial $540.04
Rate for Payer: Quartz Beloit One Network $287.63
Rate for Payer: Quartz Commercial $381.55
Rate for Payer: Quartz Medicare Advantage $352.20
Rate for Payer: The Alliance Commercial $2,348.00
Rate for Payer: United Healthcare PPO $440.25
Rate for Payer: WEA Trust Commercial $322.85
Rate for Payer: WPS Commercial $434.79
Service Code CPT 97750 GO,CO
Hospital Charge Code 5572123
Hospital Revenue Code 430
Min. Negotiated Rate $79.87
Max. Negotiated Rate $149.96
Rate for Payer: Aetna Commercial $146.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $140.18
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $86.39
Rate for Payer: Cash Price $48.90
Rate for Payer: Cigna Commercial $149.96
Rate for Payer: Health EOS Commercial $145.07
Rate for Payer: HFN Commercial $149.96
Rate for Payer: Multiplan Commercial $130.40
Rate for Payer: NAPHCARE Commercial $97.80
Rate for Payer: Preferred Network Access Commercial $149.96
Rate for Payer: Quartz Beloit One Network $79.87
Rate for Payer: Quartz Commercial $97.80
Rate for Payer: WEA Trust Commercial $89.65
Rate for Payer: WPS Commercial $120.73
Service Code CPT 97750 GO,CO
Hospital Charge Code 5572123
Hospital Revenue Code 430
Min. Negotiated Rate $45.64
Max. Negotiated Rate $652.00
Rate for Payer: Aetna Commercial $146.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $140.18
Rate for Payer: Aetna Managed Medicare $45.64
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $86.39
Rate for Payer: Cash Price $48.90
Rate for Payer: Cash Price $48.90
Rate for Payer: Cigna Commercial $149.96
Rate for Payer: Dean Health DHI/DHP/ASO $91.21
Rate for Payer: Health EOS Commercial $145.07
Rate for Payer: HFN Commercial $149.96
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $130.40
Rate for Payer: NAPHCARE Commercial $97.80
Rate for Payer: Preferred Network Access Commercial $149.96
Rate for Payer: Quartz Beloit One Network $79.87
Rate for Payer: Quartz Commercial $105.95
Rate for Payer: Quartz Medicare Advantage $97.80
Rate for Payer: The Alliance Commercial $652.00
Rate for Payer: United Healthcare PPO $122.25
Rate for Payer: WEA Trust Commercial $89.65
Rate for Payer: WPS Commercial $120.73
Service Code CPT 97761 GO,CO
Hospital Charge Code 5571744
Hospital Revenue Code 430
Min. Negotiated Rate $109.27
Max. Negotiated Rate $205.16
Rate for Payer: Aetna Commercial $200.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $191.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $118.19
Rate for Payer: Cash Price $66.90
Rate for Payer: Cigna Commercial $205.16
Rate for Payer: Health EOS Commercial $198.47
Rate for Payer: HFN Commercial $205.16
Rate for Payer: Multiplan Commercial $178.40
Rate for Payer: NAPHCARE Commercial $133.80
Rate for Payer: Preferred Network Access Commercial $205.16
Rate for Payer: Quartz Beloit One Network $109.27
Rate for Payer: Quartz Commercial $133.80
Rate for Payer: WEA Trust Commercial $122.65
Rate for Payer: WPS Commercial $165.18
Service Code CPT 97761 GO,CO
Hospital Charge Code 5571744
Hospital Revenue Code 430
Min. Negotiated Rate $62.44
Max. Negotiated Rate $892.00
Rate for Payer: Aetna Commercial $200.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $191.78
Rate for Payer: Aetna Managed Medicare $62.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $118.19
Rate for Payer: Cash Price $66.90
Rate for Payer: Cash Price $66.90
Rate for Payer: Cigna Commercial $205.16
Rate for Payer: Dean Health DHI/DHP/ASO $124.79
Rate for Payer: Health EOS Commercial $198.47
Rate for Payer: HFN Commercial $205.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $178.40
Rate for Payer: NAPHCARE Commercial $133.80
Rate for Payer: Preferred Network Access Commercial $205.16
Rate for Payer: Quartz Beloit One Network $109.27
Rate for Payer: Quartz Commercial $144.95
Rate for Payer: Quartz Medicare Advantage $133.80
Rate for Payer: The Alliance Commercial $892.00
Rate for Payer: United Healthcare PPO $167.25
Rate for Payer: WEA Trust Commercial $122.65
Rate for Payer: WPS Commercial $165.18
Service Code CPT 97113
Hospital Charge Code 1430829
Hospital Revenue Code 430
Min. Negotiated Rate $120.54
Max. Negotiated Rate $226.32
Rate for Payer: Aetna Commercial $221.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $211.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $130.38
Rate for Payer: Cash Price $73.80
Rate for Payer: Cigna Commercial $226.32
Rate for Payer: Health EOS Commercial $218.94
Rate for Payer: HFN Commercial $226.32
Rate for Payer: Multiplan Commercial $196.80
Rate for Payer: NAPHCARE Commercial $147.60
Rate for Payer: Preferred Network Access Commercial $226.32
Rate for Payer: Quartz Beloit One Network $120.54
Rate for Payer: Quartz Commercial $147.60
Rate for Payer: WEA Trust Commercial $135.30
Rate for Payer: WPS Commercial $182.21
Service Code CPT 97113
Hospital Charge Code 1430829
Hospital Revenue Code 430
Min. Negotiated Rate $68.88
Max. Negotiated Rate $984.00
Rate for Payer: Aetna Commercial $221.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $211.56
Rate for Payer: Aetna Managed Medicare $68.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $130.38
Rate for Payer: Cash Price $73.80
Rate for Payer: Cash Price $73.80
Rate for Payer: Cigna Commercial $226.32
Rate for Payer: Dean Health DHI/DHP/ASO $137.66
Rate for Payer: Health EOS Commercial $218.94
Rate for Payer: HFN Commercial $226.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $196.80
Rate for Payer: NAPHCARE Commercial $147.60
Rate for Payer: Preferred Network Access Commercial $226.32
Rate for Payer: Quartz Beloit One Network $120.54
Rate for Payer: Quartz Commercial $159.90
Rate for Payer: Quartz Medicare Advantage $147.60
Rate for Payer: The Alliance Commercial $984.00
Rate for Payer: United Healthcare PPO $184.50
Rate for Payer: WEA Trust Commercial $135.30
Rate for Payer: WPS Commercial $182.21
Service Code CPT 97533 GO,CO
Hospital Charge Code 5571748
Hospital Revenue Code 430
Min. Negotiated Rate $75.60
Max. Negotiated Rate $1,080.00
Rate for Payer: Aetna Commercial $243.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $232.20
Rate for Payer: Aetna Managed Medicare $75.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $143.10
Rate for Payer: Cash Price $81.00
Rate for Payer: Cash Price $81.00
Rate for Payer: Cigna Commercial $248.40
Rate for Payer: Dean Health DHI/DHP/ASO $151.09
Rate for Payer: Health EOS Commercial $240.30
Rate for Payer: HFN Commercial $248.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Multiplan Commercial $216.00
Rate for Payer: NAPHCARE Commercial $162.00
Rate for Payer: Preferred Network Access Commercial $248.40
Rate for Payer: Quartz Beloit One Network $132.30
Rate for Payer: Quartz Commercial $175.50
Rate for Payer: Quartz Medicare Advantage $162.00
Rate for Payer: The Alliance Commercial $1,080.00
Rate for Payer: United Healthcare PPO $202.50
Rate for Payer: WEA Trust Commercial $148.50
Rate for Payer: WPS Commercial $199.99
Service Code CPT 97533 GO,CO
Hospital Charge Code 5571748
Hospital Revenue Code 430
Min. Negotiated Rate $132.30
Max. Negotiated Rate $248.40
Rate for Payer: Aetna Commercial $243.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $232.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $143.10
Rate for Payer: Cash Price $81.00
Rate for Payer: Cigna Commercial $248.40
Rate for Payer: Health EOS Commercial $240.30
Rate for Payer: HFN Commercial $248.40
Rate for Payer: Multiplan Commercial $216.00
Rate for Payer: NAPHCARE Commercial $162.00
Rate for Payer: Preferred Network Access Commercial $248.40
Rate for Payer: Quartz Beloit One Network $132.30
Rate for Payer: Quartz Commercial $162.00
Rate for Payer: WEA Trust Commercial $148.50
Rate for Payer: WPS Commercial $199.99
Service Code CPT 29581 GO,CO
Hospital Charge Code 5571758
Hospital Revenue Code 430
Min. Negotiated Rate $85.26
Max. Negotiated Rate $4,218.22
Rate for Payer: Aetna Commercial $156.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $149.64
Rate for Payer: Aetna Managed Medicare $155.74
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $349.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $287.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $272.00
Rate for Payer: Anthem Medicare Advantage $155.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $92.22
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $155.74
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $155.74
Rate for Payer: Cash Price $52.20
Rate for Payer: Cash Price $52.20
Rate for Payer: Cash Price $52.20
Rate for Payer: Cigna Commercial $160.08
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $155.74
Rate for Payer: Dean Health DHI/DHP/ASO $4,218.22
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $155.74
Rate for Payer: Health EOS Commercial $154.86
Rate for Payer: HFN Commercial $160.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $202.00
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $155.74
Rate for Payer: Independent Care Health Plan Medicare $155.74
Rate for Payer: Managed Health Services Medicare Advantage $155.74
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $155.74
Rate for Payer: Multiplan Commercial $139.20
Rate for Payer: NAPHCARE Commercial $233.61
Rate for Payer: Preferred Network Access Commercial $160.08
Rate for Payer: Quartz Beloit One Network $85.26
Rate for Payer: Quartz Commercial $113.10
Rate for Payer: Quartz Medicare Advantage $155.74
Rate for Payer: The Alliance Commercial $622.96
Rate for Payer: United Healthcare Medicare Advantage $155.74
Rate for Payer: United Healthcare PPO $130.50
Rate for Payer: WEA Trust Commercial $95.70
Rate for Payer: Wellcare Medicare $155.74
Rate for Payer: WPS Commercial $128.88