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Service Code HCPCS C1713
Hospital Charge Code 5617673
Hospital Revenue Code 278
Min. Negotiated Rate $4,542.79
Max. Negotiated Rate $8,529.32
Rate for Payer: Aetna Commercial $8,343.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,973.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,913.63
Rate for Payer: Cash Price $2,781.30
Rate for Payer: Cigna Commercial $8,529.32
Rate for Payer: Health EOS Commercial $8,251.19
Rate for Payer: HFN Commercial $8,529.32
Rate for Payer: Multiplan Commercial $7,416.80
Rate for Payer: NAPHCARE Commercial $5,562.60
Rate for Payer: Preferred Network Access Commercial $8,529.32
Rate for Payer: Quartz Beloit One Network $4,542.79
Rate for Payer: Quartz Commercial $5,562.60
Rate for Payer: WEA Trust Commercial $5,099.05
Rate for Payer: WPS Commercial $6,867.03
Service Code HCPCS C1713
Hospital Charge Code 5617695
Hospital Revenue Code 278
Min. Negotiated Rate $4,542.79
Max. Negotiated Rate $8,529.32
Rate for Payer: Aetna Commercial $8,343.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,973.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,913.63
Rate for Payer: Cash Price $2,781.30
Rate for Payer: Cigna Commercial $8,529.32
Rate for Payer: Health EOS Commercial $8,251.19
Rate for Payer: HFN Commercial $8,529.32
Rate for Payer: Multiplan Commercial $7,416.80
Rate for Payer: NAPHCARE Commercial $5,562.60
Rate for Payer: Preferred Network Access Commercial $8,529.32
Rate for Payer: Quartz Beloit One Network $4,542.79
Rate for Payer: Quartz Commercial $5,562.60
Rate for Payer: WEA Trust Commercial $5,099.05
Rate for Payer: WPS Commercial $6,867.03
Service Code HCPCS C1713
Hospital Charge Code 5617695
Hospital Revenue Code 278
Min. Negotiated Rate $2,595.88
Max. Negotiated Rate $37,084.00
Rate for Payer: Aetna Commercial $8,343.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,973.06
Rate for Payer: Aetna Managed Medicare $2,595.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $6,026.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,635.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,450.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,913.63
Rate for Payer: Cash Price $2,781.30
Rate for Payer: Cigna Commercial $8,529.32
Rate for Payer: Dean Health DHI/DHP/ASO $5,188.05
Rate for Payer: Health EOS Commercial $8,251.19
Rate for Payer: HFN Commercial $8,529.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,953.25
Rate for Payer: Multiplan Commercial $7,416.80
Rate for Payer: NAPHCARE Commercial $5,562.60
Rate for Payer: Preferred Network Access Commercial $8,529.32
Rate for Payer: Quartz Beloit One Network $4,542.79
Rate for Payer: Quartz Commercial $6,026.15
Rate for Payer: Quartz Medicare Advantage $5,562.60
Rate for Payer: The Alliance Commercial $37,084.00
Rate for Payer: WEA Trust Commercial $5,099.05
Rate for Payer: WPS Commercial $6,867.03
Service Code HCPCS C1713
Hospital Charge Code 5611633
Hospital Revenue Code 278
Min. Negotiated Rate $4,956.84
Max. Negotiated Rate $9,306.72
Rate for Payer: Aetna Commercial $9,104.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $8,699.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,361.48
Rate for Payer: Cash Price $3,034.80
Rate for Payer: Cigna Commercial $9,306.72
Rate for Payer: Health EOS Commercial $9,003.24
Rate for Payer: HFN Commercial $9,306.72
Rate for Payer: Multiplan Commercial $8,092.80
Rate for Payer: NAPHCARE Commercial $6,069.60
Rate for Payer: Preferred Network Access Commercial $9,306.72
Rate for Payer: Quartz Beloit One Network $4,956.84
Rate for Payer: Quartz Commercial $6,069.60
Rate for Payer: WEA Trust Commercial $5,563.80
Rate for Payer: WPS Commercial $7,492.92
Service Code HCPCS C1713
Hospital Charge Code 5611633
Hospital Revenue Code 278
Min. Negotiated Rate $2,832.48
Max. Negotiated Rate $40,464.00
Rate for Payer: Aetna Commercial $9,104.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $8,699.76
Rate for Payer: Aetna Managed Medicare $2,832.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $6,575.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,058.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,855.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,361.48
Rate for Payer: Cash Price $3,034.80
Rate for Payer: Cigna Commercial $9,306.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,660.91
Rate for Payer: Health EOS Commercial $9,003.24
Rate for Payer: HFN Commercial $9,306.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $7,587.00
Rate for Payer: Multiplan Commercial $8,092.80
Rate for Payer: NAPHCARE Commercial $6,069.60
Rate for Payer: Preferred Network Access Commercial $9,306.72
Rate for Payer: Quartz Beloit One Network $4,956.84
Rate for Payer: Quartz Commercial $6,575.40
Rate for Payer: Quartz Medicare Advantage $6,069.60
Rate for Payer: The Alliance Commercial $40,464.00
Rate for Payer: WEA Trust Commercial $5,563.80
Rate for Payer: WPS Commercial $7,492.92
Service Code HCPCS C1713
Hospital Charge Code 5603785
Hospital Revenue Code 278
Min. Negotiated Rate $4,244.52
Max. Negotiated Rate $60,636.00
Rate for Payer: Aetna Commercial $13,643.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,036.74
Rate for Payer: Aetna Managed Medicare $4,244.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $9,853.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $7,579.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $7,276.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,034.27
Rate for Payer: Cash Price $4,547.70
Rate for Payer: Cigna Commercial $13,946.28
Rate for Payer: Dean Health DHI/DHP/ASO $8,482.98
Rate for Payer: Health EOS Commercial $13,491.51
Rate for Payer: HFN Commercial $13,946.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $11,369.25
Rate for Payer: Multiplan Commercial $12,127.20
Rate for Payer: NAPHCARE Commercial $9,095.40
Rate for Payer: Preferred Network Access Commercial $13,946.28
Rate for Payer: Quartz Beloit One Network $7,427.91
Rate for Payer: Quartz Commercial $9,853.35
Rate for Payer: Quartz Medicare Advantage $9,095.40
Rate for Payer: The Alliance Commercial $60,636.00
Rate for Payer: WEA Trust Commercial $8,337.45
Rate for Payer: WPS Commercial $11,228.27
Service Code HCPCS C1713
Hospital Charge Code 5603785
Hospital Revenue Code 278
Min. Negotiated Rate $7,427.91
Max. Negotiated Rate $13,946.28
Rate for Payer: Aetna Commercial $13,643.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $13,036.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $8,034.27
Rate for Payer: Cash Price $4,547.70
Rate for Payer: Cigna Commercial $13,946.28
Rate for Payer: Health EOS Commercial $13,491.51
Rate for Payer: HFN Commercial $13,946.28
Rate for Payer: Multiplan Commercial $12,127.20
Rate for Payer: NAPHCARE Commercial $9,095.40
Rate for Payer: Preferred Network Access Commercial $13,946.28
Rate for Payer: Quartz Beloit One Network $7,427.91
Rate for Payer: Quartz Commercial $9,095.40
Rate for Payer: WEA Trust Commercial $8,337.45
Rate for Payer: WPS Commercial $11,228.27
Service Code HCPCS C1713
Hospital Charge Code 5803668
Hospital Revenue Code 278
Min. Negotiated Rate $2,971.36
Max. Negotiated Rate $42,448.00
Rate for Payer: Aetna Commercial $9,550.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,126.32
Rate for Payer: Aetna Managed Medicare $2,971.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $6,897.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,306.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,093.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,624.36
Rate for Payer: Cash Price $3,183.60
Rate for Payer: Cigna Commercial $9,763.04
Rate for Payer: Dean Health DHI/DHP/ASO $5,938.48
Rate for Payer: Health EOS Commercial $9,444.68
Rate for Payer: HFN Commercial $9,763.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $7,959.00
Rate for Payer: Multiplan Commercial $8,489.60
Rate for Payer: NAPHCARE Commercial $6,367.20
Rate for Payer: Preferred Network Access Commercial $9,763.04
Rate for Payer: Quartz Beloit One Network $5,199.88
Rate for Payer: Quartz Commercial $6,897.80
Rate for Payer: Quartz Medicare Advantage $6,367.20
Rate for Payer: The Alliance Commercial $42,448.00
Rate for Payer: WEA Trust Commercial $5,836.60
Rate for Payer: WPS Commercial $7,860.31
Service Code HCPCS C1713
Hospital Charge Code 5803668
Hospital Revenue Code 278
Min. Negotiated Rate $5,199.88
Max. Negotiated Rate $9,763.04
Rate for Payer: Aetna Commercial $9,550.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,126.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,624.36
Rate for Payer: Cash Price $3,183.60
Rate for Payer: Cigna Commercial $9,763.04
Rate for Payer: Health EOS Commercial $9,444.68
Rate for Payer: HFN Commercial $9,763.04
Rate for Payer: Multiplan Commercial $8,489.60
Rate for Payer: NAPHCARE Commercial $6,367.20
Rate for Payer: Preferred Network Access Commercial $9,763.04
Rate for Payer: Quartz Beloit One Network $5,199.88
Rate for Payer: Quartz Commercial $6,367.20
Rate for Payer: WEA Trust Commercial $5,836.60
Rate for Payer: WPS Commercial $7,860.31
Service Code HCPCS C1713
Hospital Charge Code 5611704
Hospital Revenue Code 278
Min. Negotiated Rate $5,199.88
Max. Negotiated Rate $9,763.04
Rate for Payer: Aetna Commercial $9,550.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,126.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,624.36
Rate for Payer: Cash Price $3,183.60
Rate for Payer: Cigna Commercial $9,763.04
Rate for Payer: Health EOS Commercial $9,444.68
Rate for Payer: HFN Commercial $9,763.04
Rate for Payer: Multiplan Commercial $8,489.60
Rate for Payer: NAPHCARE Commercial $6,367.20
Rate for Payer: Preferred Network Access Commercial $9,763.04
Rate for Payer: Quartz Beloit One Network $5,199.88
Rate for Payer: Quartz Commercial $6,367.20
Rate for Payer: WEA Trust Commercial $5,836.60
Rate for Payer: WPS Commercial $7,860.31
Service Code HCPCS C1713
Hospital Charge Code 5611704
Hospital Revenue Code 278
Min. Negotiated Rate $2,971.36
Max. Negotiated Rate $42,448.00
Rate for Payer: Aetna Commercial $9,550.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $9,126.32
Rate for Payer: Aetna Managed Medicare $2,971.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $6,897.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,306.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $5,093.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,624.36
Rate for Payer: Cash Price $3,183.60
Rate for Payer: Cigna Commercial $9,763.04
Rate for Payer: Dean Health DHI/DHP/ASO $5,938.48
Rate for Payer: Health EOS Commercial $9,444.68
Rate for Payer: HFN Commercial $9,763.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $7,959.00
Rate for Payer: Multiplan Commercial $8,489.60
Rate for Payer: NAPHCARE Commercial $6,367.20
Rate for Payer: Preferred Network Access Commercial $9,763.04
Rate for Payer: Quartz Beloit One Network $5,199.88
Rate for Payer: Quartz Commercial $6,897.80
Rate for Payer: Quartz Medicare Advantage $6,367.20
Rate for Payer: The Alliance Commercial $42,448.00
Rate for Payer: WEA Trust Commercial $5,836.60
Rate for Payer: WPS Commercial $7,860.31
Service Code HCPCS C1713
Hospital Charge Code 5599755
Hospital Revenue Code 278
Min. Negotiated Rate $1,280.16
Max. Negotiated Rate $18,288.00
Rate for Payer: Aetna Commercial $4,114.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,931.92
Rate for Payer: Aetna Managed Medicare $1,280.16
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,971.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,286.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,194.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,423.16
Rate for Payer: Cash Price $1,371.60
Rate for Payer: Cigna Commercial $4,206.24
Rate for Payer: Dean Health DHI/DHP/ASO $2,558.49
Rate for Payer: Health EOS Commercial $4,069.08
Rate for Payer: HFN Commercial $4,206.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,429.00
Rate for Payer: Multiplan Commercial $3,657.60
Rate for Payer: NAPHCARE Commercial $2,743.20
Rate for Payer: Preferred Network Access Commercial $4,206.24
Rate for Payer: Quartz Beloit One Network $2,240.28
Rate for Payer: Quartz Commercial $2,971.80
Rate for Payer: Quartz Medicare Advantage $2,743.20
Rate for Payer: The Alliance Commercial $18,288.00
Rate for Payer: WEA Trust Commercial $2,514.60
Rate for Payer: WPS Commercial $3,386.48
Service Code HCPCS C1713
Hospital Charge Code 5599755
Hospital Revenue Code 278
Min. Negotiated Rate $2,240.28
Max. Negotiated Rate $4,206.24
Rate for Payer: Aetna Commercial $4,114.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,931.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,423.16
Rate for Payer: Cash Price $1,371.60
Rate for Payer: Cigna Commercial $4,206.24
Rate for Payer: Health EOS Commercial $4,069.08
Rate for Payer: HFN Commercial $4,206.24
Rate for Payer: Multiplan Commercial $3,657.60
Rate for Payer: NAPHCARE Commercial $2,743.20
Rate for Payer: Preferred Network Access Commercial $4,206.24
Rate for Payer: Quartz Beloit One Network $2,240.28
Rate for Payer: Quartz Commercial $2,743.20
Rate for Payer: WEA Trust Commercial $2,514.60
Rate for Payer: WPS Commercial $3,386.48
Hospital Charge Code 2966750
Hospital Revenue Code 278
Min. Negotiated Rate $4,442.34
Max. Negotiated Rate $8,340.72
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,439.60
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966750
Hospital Revenue Code 278
Min. Negotiated Rate $2,538.48
Max. Negotiated Rate $36,264.00
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Aetna Managed Medicare $2,538.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,892.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,533.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,351.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,073.33
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,799.50
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,892.90
Rate for Payer: Quartz Medicare Advantage $5,439.60
Rate for Payer: The Alliance Commercial $36,264.00
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966751
Hospital Revenue Code 278
Min. Negotiated Rate $4,442.34
Max. Negotiated Rate $8,340.72
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,439.60
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966751
Hospital Revenue Code 278
Min. Negotiated Rate $2,538.48
Max. Negotiated Rate $36,264.00
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Aetna Managed Medicare $2,538.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,892.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,533.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,351.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,073.33
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,799.50
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,892.90
Rate for Payer: Quartz Medicare Advantage $5,439.60
Rate for Payer: The Alliance Commercial $36,264.00
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966752
Hospital Revenue Code 278
Min. Negotiated Rate $2,538.48
Max. Negotiated Rate $36,264.00
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Aetna Managed Medicare $2,538.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,892.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,533.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,351.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,073.33
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,799.50
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,892.90
Rate for Payer: Quartz Medicare Advantage $5,439.60
Rate for Payer: The Alliance Commercial $36,264.00
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966752
Hospital Revenue Code 278
Min. Negotiated Rate $4,442.34
Max. Negotiated Rate $8,340.72
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,439.60
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966753
Hospital Revenue Code 278
Min. Negotiated Rate $2,538.48
Max. Negotiated Rate $36,264.00
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Aetna Managed Medicare $2,538.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,892.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,533.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,351.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,073.33
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,799.50
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,892.90
Rate for Payer: Quartz Medicare Advantage $5,439.60
Rate for Payer: The Alliance Commercial $36,264.00
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966753
Hospital Revenue Code 278
Min. Negotiated Rate $4,442.34
Max. Negotiated Rate $8,340.72
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,439.60
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966754
Hospital Revenue Code 278
Min. Negotiated Rate $2,538.48
Max. Negotiated Rate $36,264.00
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Aetna Managed Medicare $2,538.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,892.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,533.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,351.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,073.33
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,799.50
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,892.90
Rate for Payer: Quartz Medicare Advantage $5,439.60
Rate for Payer: The Alliance Commercial $36,264.00
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966754
Hospital Revenue Code 278
Min. Negotiated Rate $4,442.34
Max. Negotiated Rate $8,340.72
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,439.60
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966749
Hospital Revenue Code 278
Min. Negotiated Rate $2,538.48
Max. Negotiated Rate $36,264.00
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Aetna Managed Medicare $2,538.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $5,892.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $4,533.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,351.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Dean Health DHI/DHP/ASO $5,073.33
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $6,799.50
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,892.90
Rate for Payer: Quartz Medicare Advantage $5,439.60
Rate for Payer: The Alliance Commercial $36,264.00
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19
Hospital Charge Code 2966749
Hospital Revenue Code 278
Min. Negotiated Rate $4,442.34
Max. Negotiated Rate $8,340.72
Rate for Payer: Aetna Commercial $8,159.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $7,796.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $4,804.98
Rate for Payer: Cash Price $2,719.80
Rate for Payer: Cigna Commercial $8,340.72
Rate for Payer: Health EOS Commercial $8,068.74
Rate for Payer: HFN Commercial $8,340.72
Rate for Payer: Multiplan Commercial $7,252.80
Rate for Payer: NAPHCARE Commercial $5,439.60
Rate for Payer: Preferred Network Access Commercial $8,340.72
Rate for Payer: Quartz Beloit One Network $4,442.34
Rate for Payer: Quartz Commercial $5,439.60
Rate for Payer: WEA Trust Commercial $4,986.30
Rate for Payer: WPS Commercial $6,715.19