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Service Code CPT 50081
Hospital Charge Code 5433010
Hospital Revenue Code 360
Min. Negotiated Rate $8,757.28
Max. Negotiated Rate $33,872.50
Rate for Payer: Aetna Commercial $16,084.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $15,369.92
Rate for Payer: Aetna Managed Medicare $9,105.51
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $18,649.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $18,649.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $17,230.00
Rate for Payer: Anthem Medicare Advantage $9,105.51
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $9,472.16
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $9,105.51
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $9,105.51
Rate for Payer: Cash Price $5,361.60
Rate for Payer: Cash Price $5,361.60
Rate for Payer: Cash Price $5,361.60
Rate for Payer: Cigna Commercial $16,442.24
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $9,105.51
Rate for Payer: Dean Health DHI/DHP/ASO $11,874.87
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $9,105.51
Rate for Payer: Health EOS Commercial $15,906.08
Rate for Payer: HFN Commercial $16,442.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $33,872.50
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $9,105.51
Rate for Payer: Independent Care Health Plan Medicare $9,105.51
Rate for Payer: Managed Health Services Medicare Advantage $9,105.51
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $9,105.51
Rate for Payer: Multiplan Commercial $14,297.60
Rate for Payer: NAPHCARE Commercial $13,658.26
Rate for Payer: Preferred Network Access Commercial $16,442.24
Rate for Payer: Quartz Beloit One Network $8,757.28
Rate for Payer: Quartz Commercial $11,616.80
Rate for Payer: Quartz Medicare Advantage $9,105.51
Rate for Payer: The Alliance Commercial $15,479.37
Rate for Payer: United Healthcare Medicare Advantage $9,105.51
Rate for Payer: United Healthcare PPO $9,596.00
Rate for Payer: WEA Trust Commercial $9,829.60
Rate for Payer: Wellcare Medicare $9,105.51
Rate for Payer: WPS Commercial $13,237.79
Service Code CPT 22511
Hospital Charge Code 5232607
Hospital Revenue Code 510
Min. Negotiated Rate $1,330.00
Max. Negotiated Rate $3,762.95
Rate for Payer: Aetna Commercial $3,762.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,406.46
Rate for Payer: Cash Price $1,188.30
Rate for Payer: Cash Price $1,188.30
Rate for Payer: Cigna Commercial $3,762.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,330.00
Rate for Payer: Dean Health DHI/DHP/ASO $2,376.60
Rate for Payer: Health EOS Commercial $3,604.51
Rate for Payer: HFN Commercial $3,762.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,351.78
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,351.78
Rate for Payer: Multiplan Commercial $3,168.80
Rate for Payer: Preferred Network Access Commercial $3,762.95
Rate for Payer: Quartz Beloit One Network $1,742.84
Rate for Payer: Quartz Commercial $2,257.77
Rate for Payer: The Alliance Commercial $1,980.50
Rate for Payer: United Healthcare Medicaid $1,330.00
Rate for Payer: WEA Trust Commercial $2,178.55
Rate for Payer: WPS Commercial $2,933.91
Hospital Charge Code 1188808
Hospital Revenue Code 510
Min. Negotiated Rate $10.12
Max. Negotiated Rate $21.85
Rate for Payer: Aetna Commercial $21.85
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $19.78
Rate for Payer: Cash Price $6.90
Rate for Payer: Cigna Commercial $21.85
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $11.50
Rate for Payer: Dean Health DHI/DHP/ASO $13.80
Rate for Payer: Health EOS Commercial $20.93
Rate for Payer: HFN Commercial $21.85
Rate for Payer: Multiplan Commercial $18.40
Rate for Payer: Preferred Network Access Commercial $21.85
Rate for Payer: Quartz Beloit One Network $10.12
Rate for Payer: Quartz Commercial $13.11
Rate for Payer: The Alliance Commercial $11.50
Rate for Payer: WEA Trust Commercial $12.65
Rate for Payer: WPS Commercial $17.04
Service Code CPT 33017
Hospital Charge Code 6172827
Hospital Revenue Code 481
Min. Negotiated Rate $858.20
Max. Negotiated Rate $12,260.00
Rate for Payer: Aetna Commercial $2,758.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,635.90
Rate for Payer: Aetna Managed Medicare $858.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,992.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,532.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,471.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,624.45
Rate for Payer: Cash Price $919.50
Rate for Payer: Cash Price $919.50
Rate for Payer: Cigna Commercial $2,819.80
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Health EOS Commercial $2,727.85
Rate for Payer: HFN Commercial $2,819.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,298.75
Rate for Payer: Multiplan Commercial $2,452.00
Rate for Payer: NAPHCARE Commercial $1,839.00
Rate for Payer: Preferred Network Access Commercial $2,819.80
Rate for Payer: Quartz Beloit One Network $1,501.85
Rate for Payer: Quartz Commercial $1,992.25
Rate for Payer: Quartz Medicare Advantage $1,839.00
Rate for Payer: The Alliance Commercial $12,260.00
Rate for Payer: WEA Trust Commercial $1,685.75
Rate for Payer: WPS Commercial $2,270.25
Service Code CPT 33017
Hospital Charge Code 6172827
Hospital Revenue Code 481
Min. Negotiated Rate $1,501.85
Max. Negotiated Rate $2,819.80
Rate for Payer: Aetna Commercial $2,758.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,635.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,624.45
Rate for Payer: Cash Price $919.50
Rate for Payer: Cigna Commercial $2,819.80
Rate for Payer: Health EOS Commercial $2,727.85
Rate for Payer: HFN Commercial $2,819.80
Rate for Payer: Multiplan Commercial $2,452.00
Rate for Payer: NAPHCARE Commercial $1,839.00
Rate for Payer: Preferred Network Access Commercial $2,819.80
Rate for Payer: Quartz Beloit One Network $1,501.85
Rate for Payer: Quartz Commercial $1,839.00
Rate for Payer: WEA Trust Commercial $1,685.75
Rate for Payer: WPS Commercial $2,270.25
Hospital Charge Code 4494602
Hospital Revenue Code 360
Min. Negotiated Rate $2,076.62
Max. Negotiated Rate $3,898.96
Rate for Payer: Aetna Commercial $3,814.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,644.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,246.14
Rate for Payer: Cash Price $1,271.40
Rate for Payer: Cigna Commercial $3,898.96
Rate for Payer: Health EOS Commercial $3,771.82
Rate for Payer: HFN Commercial $3,898.96
Rate for Payer: Multiplan Commercial $3,390.40
Rate for Payer: NAPHCARE Commercial $2,542.80
Rate for Payer: Preferred Network Access Commercial $3,898.96
Rate for Payer: Quartz Beloit One Network $2,076.62
Rate for Payer: Quartz Commercial $2,542.80
Rate for Payer: WEA Trust Commercial $2,330.90
Rate for Payer: WPS Commercial $3,139.09
Hospital Charge Code 4494602
Hospital Revenue Code 360
Min. Negotiated Rate $1,186.64
Max. Negotiated Rate $16,952.00
Rate for Payer: Aetna Commercial $3,814.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,644.68
Rate for Payer: Aetna Managed Medicare $1,186.64
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,754.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,119.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,034.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,246.14
Rate for Payer: Cash Price $1,271.40
Rate for Payer: Cigna Commercial $3,898.96
Rate for Payer: Dean Health DHI/DHP/ASO $2,371.58
Rate for Payer: Health EOS Commercial $3,771.82
Rate for Payer: HFN Commercial $3,898.96
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,178.50
Rate for Payer: Multiplan Commercial $3,390.40
Rate for Payer: NAPHCARE Commercial $2,542.80
Rate for Payer: Preferred Network Access Commercial $3,898.96
Rate for Payer: Quartz Beloit One Network $2,076.62
Rate for Payer: Quartz Commercial $2,754.70
Rate for Payer: Quartz Medicare Advantage $2,542.80
Rate for Payer: The Alliance Commercial $16,952.00
Rate for Payer: WEA Trust Commercial $2,330.90
Rate for Payer: WPS Commercial $3,139.09
Hospital Charge Code 2960313
Hospital Revenue Code 360
Min. Negotiated Rate $4,341.40
Max. Negotiated Rate $62,020.00
Rate for Payer: Aetna Commercial $13,954.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,334.30
Rate for Payer: Aetna Managed Medicare $4,341.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $10,078.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $7,752.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $7,442.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,217.65
Rate for Payer: Cash Price $4,651.50
Rate for Payer: Cigna Commercial $14,264.60
Rate for Payer: Dean Health DHI/DHP/ASO $8,676.60
Rate for Payer: Health EOS Commercial $13,799.45
Rate for Payer: HFN Commercial $14,264.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,628.75
Rate for Payer: Multiplan Commercial $12,404.00
Rate for Payer: NAPHCARE Commercial $9,303.00
Rate for Payer: Preferred Network Access Commercial $14,264.60
Rate for Payer: Quartz Beloit One Network $7,597.45
Rate for Payer: Quartz Commercial $10,078.25
Rate for Payer: Quartz Medicare Advantage $9,303.00
Rate for Payer: The Alliance Commercial $62,020.00
Rate for Payer: WEA Trust Commercial $8,527.75
Rate for Payer: WPS Commercial $11,484.55
Hospital Charge Code 2960313
Hospital Revenue Code 360
Min. Negotiated Rate $7,597.45
Max. Negotiated Rate $14,264.60
Rate for Payer: Aetna Commercial $13,954.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,334.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,217.65
Rate for Payer: Cash Price $4,651.50
Rate for Payer: Cigna Commercial $14,264.60
Rate for Payer: Health EOS Commercial $13,799.45
Rate for Payer: HFN Commercial $14,264.60
Rate for Payer: Multiplan Commercial $12,404.00
Rate for Payer: NAPHCARE Commercial $9,303.00
Rate for Payer: Preferred Network Access Commercial $14,264.60
Rate for Payer: Quartz Beloit One Network $7,597.45
Rate for Payer: Quartz Commercial $9,303.00
Rate for Payer: WEA Trust Commercial $8,527.75
Rate for Payer: WPS Commercial $11,484.55
Hospital Charge Code 4125712
Min. Negotiated Rate $253.33
Max. Negotiated Rate $475.64
Rate for Payer: Aetna Commercial $465.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $444.62
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $274.01
Rate for Payer: Cash Price $155.10
Rate for Payer: Cigna Commercial $475.64
Rate for Payer: Health EOS Commercial $460.13
Rate for Payer: HFN Commercial $475.64
Rate for Payer: Multiplan Commercial $413.60
Rate for Payer: NAPHCARE Commercial $310.20
Rate for Payer: Preferred Network Access Commercial $475.64
Rate for Payer: Quartz Beloit One Network $253.33
Rate for Payer: Quartz Commercial $310.20
Rate for Payer: WEA Trust Commercial $284.35
Rate for Payer: WPS Commercial $382.94
Hospital Charge Code 4125712
Min. Negotiated Rate $144.76
Max. Negotiated Rate $2,068.00
Rate for Payer: Aetna Commercial $465.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $444.62
Rate for Payer: Aetna Managed Medicare $144.76
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $336.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $258.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $248.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $274.01
Rate for Payer: Cash Price $155.10
Rate for Payer: Cigna Commercial $475.64
Rate for Payer: Dean Health DHI/DHP/ASO $289.31
Rate for Payer: Health EOS Commercial $460.13
Rate for Payer: HFN Commercial $475.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $387.75
Rate for Payer: Multiplan Commercial $413.60
Rate for Payer: NAPHCARE Commercial $310.20
Rate for Payer: Preferred Network Access Commercial $475.64
Rate for Payer: Quartz Beloit One Network $253.33
Rate for Payer: Quartz Commercial $336.05
Rate for Payer: Quartz Medicare Advantage $310.20
Rate for Payer: The Alliance Commercial $2,068.00
Rate for Payer: WEA Trust Commercial $284.35
Rate for Payer: WPS Commercial $382.94
Service Code CPT 33016
Hospital Charge Code 5565259
Hospital Revenue Code 481
Min. Negotiated Rate $1,377.60
Max. Negotiated Rate $6,331.88
Rate for Payer: Aetna Commercial $2,583.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,468.20
Rate for Payer: Aetna Managed Medicare $1,582.97
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,865.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,435.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,377.60
Rate for Payer: Anthem Medicare Advantage $1,582.97
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,521.10
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $1,582.97
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $1,582.97
Rate for Payer: Cash Price $861.00
Rate for Payer: Cash Price $861.00
Rate for Payer: Cigna Commercial $2,640.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $1,582.97
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $1,582.97
Rate for Payer: Health EOS Commercial $2,554.30
Rate for Payer: HFN Commercial $2,640.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,888.65
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,582.97
Rate for Payer: Independent Care Health Plan Medicare $1,582.97
Rate for Payer: Managed Health Services Medicare Advantage $1,582.97
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $1,582.97
Rate for Payer: Multiplan Commercial $2,296.00
Rate for Payer: NAPHCARE Commercial $2,374.46
Rate for Payer: Preferred Network Access Commercial $2,640.40
Rate for Payer: Quartz Beloit One Network $1,406.30
Rate for Payer: Quartz Commercial $1,865.50
Rate for Payer: Quartz Medicare Advantage $1,582.97
Rate for Payer: The Alliance Commercial $6,331.88
Rate for Payer: United Healthcare Medicare Advantage $1,582.97
Rate for Payer: WEA Trust Commercial $1,578.50
Rate for Payer: Wellcare Medicare $1,582.97
Rate for Payer: WPS Commercial $2,125.81
Service Code CPT 33016
Hospital Charge Code 5565259
Hospital Revenue Code 481
Min. Negotiated Rate $1,406.30
Max. Negotiated Rate $2,640.40
Rate for Payer: Aetna Commercial $2,583.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,468.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,521.10
Rate for Payer: Cash Price $861.00
Rate for Payer: Cigna Commercial $2,640.40
Rate for Payer: Health EOS Commercial $2,554.30
Rate for Payer: HFN Commercial $2,640.40
Rate for Payer: Multiplan Commercial $2,296.00
Rate for Payer: NAPHCARE Commercial $1,722.00
Rate for Payer: Preferred Network Access Commercial $2,640.40
Rate for Payer: Quartz Beloit One Network $1,406.30
Rate for Payer: Quartz Commercial $1,722.00
Rate for Payer: WEA Trust Commercial $1,578.50
Rate for Payer: WPS Commercial $2,125.81
Service Code CPT 99394
Hospital Charge Code 1122830
Hospital Revenue Code 510
Min. Negotiated Rate $76.45
Max. Negotiated Rate $291.08
Rate for Payer: Aetna Commercial $257.45
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $233.06
Rate for Payer: Cash Price $81.30
Rate for Payer: Cash Price $81.30
Rate for Payer: Cigna Commercial $257.45
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $76.45
Rate for Payer: Dean Health DHI/DHP/ASO $162.60
Rate for Payer: Health EOS Commercial $246.61
Rate for Payer: HFN Commercial $257.45
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $291.08
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $291.08
Rate for Payer: Multiplan Commercial $216.80
Rate for Payer: Preferred Network Access Commercial $257.45
Rate for Payer: Quartz Beloit One Network $119.24
Rate for Payer: Quartz Commercial $154.47
Rate for Payer: The Alliance Commercial $135.50
Rate for Payer: United Healthcare Medicaid $76.45
Rate for Payer: WEA Trust Commercial $149.05
Rate for Payer: WPS Commercial $200.73
Service Code CPT 99392
Hospital Charge Code 1122828
Hospital Revenue Code 510
Min. Negotiated Rate $70.13
Max. Negotiated Rate $256.81
Rate for Payer: Aetna Commercial $196.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $178.02
Rate for Payer: Cash Price $62.10
Rate for Payer: Cash Price $62.10
Rate for Payer: Cigna Commercial $196.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $70.13
Rate for Payer: Dean Health DHI/DHP/ASO $124.20
Rate for Payer: Health EOS Commercial $188.37
Rate for Payer: HFN Commercial $196.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $256.81
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $256.81
Rate for Payer: Multiplan Commercial $165.60
Rate for Payer: Preferred Network Access Commercial $196.65
Rate for Payer: Quartz Beloit One Network $91.08
Rate for Payer: Quartz Commercial $117.99
Rate for Payer: The Alliance Commercial $103.50
Rate for Payer: United Healthcare Medicaid $70.13
Rate for Payer: WEA Trust Commercial $113.85
Rate for Payer: WPS Commercial $153.32
Service Code CPT 99395
Hospital Charge Code 1122831
Hospital Revenue Code 510
Min. Negotiated Rate $78.16
Max. Negotiated Rate $299.56
Rate for Payer: Aetna Commercial $266.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $240.80
Rate for Payer: Cash Price $84.00
Rate for Payer: Cash Price $84.00
Rate for Payer: Cigna Commercial $266.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $78.16
Rate for Payer: Dean Health DHI/DHP/ASO $168.00
Rate for Payer: Health EOS Commercial $254.80
Rate for Payer: HFN Commercial $266.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $299.56
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $299.56
Rate for Payer: Multiplan Commercial $224.00
Rate for Payer: Preferred Network Access Commercial $266.00
Rate for Payer: Quartz Beloit One Network $123.20
Rate for Payer: Quartz Commercial $159.60
Rate for Payer: The Alliance Commercial $140.00
Rate for Payer: United Healthcare Medicaid $78.16
Rate for Payer: WEA Trust Commercial $154.00
Rate for Payer: WPS Commercial $207.40
Service Code CPT 99391
Hospital Charge Code 1122827
Hospital Revenue Code 510
Min. Negotiated Rate $65.77
Max. Negotiated Rate $234.25
Rate for Payer: Aetna Commercial $177.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $160.82
Rate for Payer: Cash Price $56.10
Rate for Payer: Cash Price $56.10
Rate for Payer: Cigna Commercial $177.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $65.77
Rate for Payer: Dean Health DHI/DHP/ASO $112.20
Rate for Payer: Health EOS Commercial $170.17
Rate for Payer: HFN Commercial $177.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $234.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $234.25
Rate for Payer: Multiplan Commercial $149.60
Rate for Payer: Preferred Network Access Commercial $177.65
Rate for Payer: Quartz Beloit One Network $82.28
Rate for Payer: Quartz Commercial $106.59
Rate for Payer: The Alliance Commercial $93.50
Rate for Payer: United Healthcare Medicaid $65.77
Rate for Payer: WEA Trust Commercial $102.85
Rate for Payer: WPS Commercial $138.51
Service Code CPT 99396
Hospital Charge Code 1122832
Hospital Revenue Code 510
Min. Negotiated Rate $83.07
Max. Negotiated Rate $325.36
Rate for Payer: Aetna Commercial $289.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $262.30
Rate for Payer: Cash Price $91.50
Rate for Payer: Cash Price $91.50
Rate for Payer: Cigna Commercial $289.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $83.07
Rate for Payer: Dean Health DHI/DHP/ASO $183.00
Rate for Payer: Health EOS Commercial $277.55
Rate for Payer: HFN Commercial $289.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $325.36
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $325.36
Rate for Payer: Multiplan Commercial $244.00
Rate for Payer: Preferred Network Access Commercial $289.75
Rate for Payer: Quartz Beloit One Network $134.20
Rate for Payer: Quartz Commercial $173.85
Rate for Payer: The Alliance Commercial $152.50
Rate for Payer: United Healthcare Medicaid $83.07
Rate for Payer: WEA Trust Commercial $167.75
Rate for Payer: WPS Commercial $225.91
Service Code CPT 99393
Hospital Charge Code 1122829
Hospital Revenue Code 510
Min. Negotiated Rate $69.90
Max. Negotiated Rate $256.81
Rate for Payer: Aetna Commercial $228.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $206.40
Rate for Payer: Cash Price $72.00
Rate for Payer: Cash Price $72.00
Rate for Payer: Cigna Commercial $228.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $69.90
Rate for Payer: Dean Health DHI/DHP/ASO $144.00
Rate for Payer: Health EOS Commercial $218.40
Rate for Payer: HFN Commercial $228.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $256.81
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $256.81
Rate for Payer: Multiplan Commercial $192.00
Rate for Payer: Preferred Network Access Commercial $228.00
Rate for Payer: Quartz Beloit One Network $105.60
Rate for Payer: Quartz Commercial $136.80
Rate for Payer: The Alliance Commercial $120.00
Rate for Payer: United Healthcare Medicaid $69.90
Rate for Payer: WEA Trust Commercial $132.00
Rate for Payer: WPS Commercial $177.77
Service Code CPT 99397
Hospital Charge Code 1122833
Hospital Revenue Code 510
Min. Negotiated Rate $89.57
Max. Negotiated Rate $351.50
Rate for Payer: Aetna Commercial $351.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $318.20
Rate for Payer: Cash Price $111.00
Rate for Payer: Cash Price $111.00
Rate for Payer: Cigna Commercial $351.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $89.57
Rate for Payer: Dean Health DHI/DHP/ASO $222.00
Rate for Payer: Health EOS Commercial $336.70
Rate for Payer: HFN Commercial $351.50
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $341.53
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $341.53
Rate for Payer: Multiplan Commercial $296.00
Rate for Payer: Preferred Network Access Commercial $351.50
Rate for Payer: Quartz Beloit One Network $162.80
Rate for Payer: Quartz Commercial $210.90
Rate for Payer: The Alliance Commercial $185.00
Rate for Payer: United Healthcare Medicaid $89.57
Rate for Payer: WEA Trust Commercial $203.50
Rate for Payer: WPS Commercial $274.06
Service Code MSDRG 041
Min. Negotiated Rate $21,448.10
Max. Negotiated Rate $59,626.00
Rate for Payer: Aetna Managed Medicare $21,448.10
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $46,785.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $35,860.63
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $34,069.94
Rate for Payer: Anthem Medicare Advantage $21,448.10
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $21,448.10
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $21,448.10
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $21,448.10
Rate for Payer: Dean Health DHI/DHP/ASO $37,820.76
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $21,448.10
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $43,498.65
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $21,448.10
Rate for Payer: Independent Care Health Plan Medicare $21,448.10
Rate for Payer: Managed Health Services Medicare Advantage $21,448.10
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $21,448.10
Rate for Payer: NAPHCARE Commercial $32,172.15
Rate for Payer: Quartz Medicare Advantage $21,448.10
Rate for Payer: The Alliance Commercial $59,626.00
Rate for Payer: United Healthcare Medicare Advantage $21,448.10
Rate for Payer: United Healthcare PPO $33,864.26
Rate for Payer: Wellcare Medicare $21,448.10
Service Code MSDRG 040
Min. Negotiated Rate $36,938.73
Max. Negotiated Rate $102,690.00
Rate for Payer: Aetna Managed Medicare $36,938.73
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $80,773.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $61,911.85
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $58,820.30
Rate for Payer: Anthem Medicare Advantage $36,938.73
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $36,938.73
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $36,938.73
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $36,938.73
Rate for Payer: Dean Health DHI/DHP/ASO $65,295.92
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $36,938.73
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $75,084.75
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $36,938.73
Rate for Payer: Independent Care Health Plan Medicare $36,938.73
Rate for Payer: Managed Health Services Medicare Advantage $36,938.73
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $36,938.73
Rate for Payer: NAPHCARE Commercial $55,408.10
Rate for Payer: Quartz Medicare Advantage $36,938.73
Rate for Payer: The Alliance Commercial $102,690.00
Rate for Payer: United Healthcare Medicare Advantage $36,938.73
Rate for Payer: United Healthcare PPO $58,454.44
Rate for Payer: Wellcare Medicare $36,938.73
Service Code MSDRG 042
Min. Negotiated Rate $16,753.49
Max. Negotiated Rate $46,575.00
Rate for Payer: Aetna Managed Medicare $16,753.49
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $36,505.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $27,980.94
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $26,583.72
Rate for Payer: Anthem Medicare Advantage $16,753.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $16,753.49
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $16,753.49
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $16,753.49
Rate for Payer: Dean Health DHI/DHP/ASO $29,510.37
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $16,753.49
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $33,926.10
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $16,753.49
Rate for Payer: Independent Care Health Plan Medicare $16,753.49
Rate for Payer: Managed Health Services Medicare Advantage $16,753.49
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $16,753.49
Rate for Payer: NAPHCARE Commercial $25,130.24
Rate for Payer: Quartz Medicare Advantage $16,753.49
Rate for Payer: The Alliance Commercial $46,575.00
Rate for Payer: United Healthcare Medicare Advantage $16,753.49
Rate for Payer: United Healthcare PPO $26,411.90
Rate for Payer: Wellcare Medicare $16,753.49
Service Code MSDRG 300
Min. Negotiated Rate $10,319.31
Max. Negotiated Rate $28,688.00
Rate for Payer: Aetna Managed Medicare $10,319.31
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $22,448.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $17,206.67
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $16,347.46
Rate for Payer: Anthem Medicare Advantage $10,319.31
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $10,319.31
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $10,319.31
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $10,319.31
Rate for Payer: Dean Health DHI/DHP/ASO $18,147.18
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $10,319.31
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $20,806.50
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $10,319.31
Rate for Payer: Independent Care Health Plan Medicare $10,319.31
Rate for Payer: Managed Health Services Medicare Advantage $10,319.31
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $10,319.31
Rate for Payer: NAPHCARE Commercial $15,478.96
Rate for Payer: Quartz Medicare Advantage $10,319.31
Rate for Payer: The Alliance Commercial $28,688.00
Rate for Payer: United Healthcare Medicare Advantage $10,319.31
Rate for Payer: United Healthcare PPO $16,198.13
Rate for Payer: Wellcare Medicare $10,319.31
Service Code MSDRG 299
Min. Negotiated Rate $15,188.93
Max. Negotiated Rate $42,225.00
Rate for Payer: Aetna Managed Medicare $15,188.93
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $33,148.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $25,407.98
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $24,139.24
Rate for Payer: Anthem Medicare Advantage $15,188.93
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $15,188.93
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $15,188.93
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $15,188.93
Rate for Payer: Dean Health DHI/DHP/ASO $26,796.77
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $15,188.93
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $30,735.90
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $15,188.93
Rate for Payer: Independent Care Health Plan Medicare $15,188.93
Rate for Payer: Managed Health Services Medicare Advantage $15,188.93
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $15,188.93
Rate for Payer: NAPHCARE Commercial $22,783.40
Rate for Payer: Quartz Medicare Advantage $15,188.93
Rate for Payer: The Alliance Commercial $42,225.00
Rate for Payer: United Healthcare Medicare Advantage $15,188.93
Rate for Payer: United Healthcare PPO $23,928.29
Rate for Payer: Wellcare Medicare $15,188.93