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Hospital Charge Code 2973902
Hospital Revenue Code 272
Min. Negotiated Rate $1,323.98
Max. Negotiated Rate $2,485.84
Rate for Payer: Aetna Commercial $2,431.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,323.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,432.06
Rate for Payer: Cash Price $810.60
Rate for Payer: Cigna Commercial $2,485.84
Rate for Payer: Health EOS Commercial $2,404.78
Rate for Payer: HFN Commercial $2,485.84
Rate for Payer: Multiplan Commercial $2,161.60
Rate for Payer: NAPHCARE Commercial $1,621.20
Rate for Payer: Preferred Network Access Commercial $2,485.84
Rate for Payer: Quartz Beloit One Network $1,323.98
Rate for Payer: Quartz Commercial $1,621.20
Rate for Payer: WEA Trust Commercial $1,486.10
Rate for Payer: WPS Commercial $2,001.37
Hospital Charge Code 2973902
Hospital Revenue Code 272
Min. Negotiated Rate $756.56
Max. Negotiated Rate $10,808.00
Rate for Payer: Aetna Commercial $2,431.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,323.72
Rate for Payer: Aetna Managed Medicare $756.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,756.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,351.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,296.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,432.06
Rate for Payer: Cash Price $810.60
Rate for Payer: Cigna Commercial $2,485.84
Rate for Payer: Dean Health DHI/DHP/ASO $1,512.04
Rate for Payer: Health EOS Commercial $2,404.78
Rate for Payer: HFN Commercial $2,485.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,026.50
Rate for Payer: Multiplan Commercial $2,161.60
Rate for Payer: NAPHCARE Commercial $1,621.20
Rate for Payer: Preferred Network Access Commercial $2,485.84
Rate for Payer: Quartz Beloit One Network $1,323.98
Rate for Payer: Quartz Commercial $1,756.30
Rate for Payer: Quartz Medicare Advantage $1,621.20
Rate for Payer: The Alliance Commercial $10,808.00
Rate for Payer: WEA Trust Commercial $1,486.10
Rate for Payer: WPS Commercial $2,001.37
Hospital Charge Code 2973899
Hospital Revenue Code 272
Min. Negotiated Rate $1,289.19
Max. Negotiated Rate $2,420.52
Rate for Payer: Aetna Commercial $2,367.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,262.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,394.43
Rate for Payer: Cash Price $789.30
Rate for Payer: Cigna Commercial $2,420.52
Rate for Payer: Health EOS Commercial $2,341.59
Rate for Payer: HFN Commercial $2,420.52
Rate for Payer: Multiplan Commercial $2,104.80
Rate for Payer: NAPHCARE Commercial $1,578.60
Rate for Payer: Preferred Network Access Commercial $2,420.52
Rate for Payer: Quartz Beloit One Network $1,289.19
Rate for Payer: Quartz Commercial $1,578.60
Rate for Payer: WEA Trust Commercial $1,447.05
Rate for Payer: WPS Commercial $1,948.78
Hospital Charge Code 2973899
Hospital Revenue Code 272
Min. Negotiated Rate $736.68
Max. Negotiated Rate $10,524.00
Rate for Payer: Aetna Commercial $2,367.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,262.66
Rate for Payer: Aetna Managed Medicare $736.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,710.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,315.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,262.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,394.43
Rate for Payer: Cash Price $789.30
Rate for Payer: Cigna Commercial $2,420.52
Rate for Payer: Dean Health DHI/DHP/ASO $1,472.31
Rate for Payer: Health EOS Commercial $2,341.59
Rate for Payer: HFN Commercial $2,420.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,973.25
Rate for Payer: Multiplan Commercial $2,104.80
Rate for Payer: NAPHCARE Commercial $1,578.60
Rate for Payer: Preferred Network Access Commercial $2,420.52
Rate for Payer: Quartz Beloit One Network $1,289.19
Rate for Payer: Quartz Commercial $1,710.15
Rate for Payer: Quartz Medicare Advantage $1,578.60
Rate for Payer: The Alliance Commercial $10,524.00
Rate for Payer: WEA Trust Commercial $1,447.05
Rate for Payer: WPS Commercial $1,948.78
Hospital Charge Code 5415201
Hospital Revenue Code 272
Min. Negotiated Rate $1,192.80
Max. Negotiated Rate $17,040.00
Rate for Payer: Aetna Commercial $3,834.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,663.60
Rate for Payer: Aetna Managed Medicare $1,192.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,769.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,130.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,044.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,257.80
Rate for Payer: Cash Price $1,278.00
Rate for Payer: Cigna Commercial $3,919.20
Rate for Payer: Dean Health DHI/DHP/ASO $2,383.90
Rate for Payer: Health EOS Commercial $3,791.40
Rate for Payer: HFN Commercial $3,919.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,195.00
Rate for Payer: Multiplan Commercial $3,408.00
Rate for Payer: NAPHCARE Commercial $2,556.00
Rate for Payer: Preferred Network Access Commercial $3,919.20
Rate for Payer: Quartz Beloit One Network $2,087.40
Rate for Payer: Quartz Commercial $2,769.00
Rate for Payer: Quartz Medicare Advantage $2,556.00
Rate for Payer: The Alliance Commercial $17,040.00
Rate for Payer: WEA Trust Commercial $2,343.00
Rate for Payer: WPS Commercial $3,155.38
Hospital Charge Code 5415201
Hospital Revenue Code 272
Min. Negotiated Rate $2,087.40
Max. Negotiated Rate $3,919.20
Rate for Payer: Aetna Commercial $3,834.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,663.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,257.80
Rate for Payer: Cash Price $1,278.00
Rate for Payer: Cigna Commercial $3,919.20
Rate for Payer: Health EOS Commercial $3,791.40
Rate for Payer: HFN Commercial $3,919.20
Rate for Payer: Multiplan Commercial $3,408.00
Rate for Payer: NAPHCARE Commercial $2,556.00
Rate for Payer: Preferred Network Access Commercial $3,919.20
Rate for Payer: Quartz Beloit One Network $2,087.40
Rate for Payer: Quartz Commercial $2,556.00
Rate for Payer: WEA Trust Commercial $2,343.00
Rate for Payer: WPS Commercial $3,155.38
Service Code CPT 68810
Hospital Charge Code 1190821
Hospital Revenue Code 510
Min. Negotiated Rate $82.04
Max. Negotiated Rate $461.70
Rate for Payer: Aetna Commercial $461.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $417.96
Rate for Payer: Cash Price $145.80
Rate for Payer: Cash Price $145.80
Rate for Payer: Cigna Commercial $461.70
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $82.04
Rate for Payer: Dean Health DHI/DHP/ASO $291.60
Rate for Payer: Health EOS Commercial $442.26
Rate for Payer: HFN Commercial $461.70
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $428.79
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $428.79
Rate for Payer: Multiplan Commercial $388.80
Rate for Payer: Preferred Network Access Commercial $461.70
Rate for Payer: Quartz Beloit One Network $213.84
Rate for Payer: Quartz Commercial $277.02
Rate for Payer: The Alliance Commercial $243.00
Rate for Payer: United Healthcare Medicaid $82.04
Rate for Payer: WEA Trust Commercial $267.30
Rate for Payer: WPS Commercial $359.98
Service Code CPT 83880
Hospital Charge Code 977874
Hospital Revenue Code 300
Min. Negotiated Rate $207.76
Max. Negotiated Rate $390.08
Rate for Payer: Aetna Commercial $381.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $364.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $224.72
Rate for Payer: Cash Price $127.20
Rate for Payer: Cigna Commercial $390.08
Rate for Payer: Health EOS Commercial $377.36
Rate for Payer: HFN Commercial $390.08
Rate for Payer: Multiplan Commercial $339.20
Rate for Payer: NAPHCARE Commercial $254.40
Rate for Payer: Preferred Network Access Commercial $390.08
Rate for Payer: Quartz Beloit One Network $207.76
Rate for Payer: Quartz Commercial $254.40
Rate for Payer: WEA Trust Commercial $233.20
Rate for Payer: WPS Commercial $314.06
Service Code CPT 83880
Hospital Charge Code 977874
Hospital Revenue Code 300
Min. Negotiated Rate $138.59
Max. Negotiated Rate $402.80
Rate for Payer: Aetna Commercial $402.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $364.64
Rate for Payer: Cash Price $127.20
Rate for Payer: Cash Price $127.20
Rate for Payer: Cigna Commercial $402.80
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $212.00
Rate for Payer: Dean Health DHI/DHP/ASO $254.40
Rate for Payer: Health EOS Commercial $385.84
Rate for Payer: HFN Commercial $402.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $138.59
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $138.59
Rate for Payer: Multiplan Commercial $339.20
Rate for Payer: Preferred Network Access Commercial $402.80
Rate for Payer: Quartz Beloit One Network $186.56
Rate for Payer: Quartz Commercial $241.68
Rate for Payer: The Alliance Commercial $212.00
Rate for Payer: WEA Trust Commercial $233.20
Rate for Payer: WPS Commercial $314.06
Service Code CPT 83880
Hospital Charge Code 977874
Hospital Revenue Code 300
Min. Negotiated Rate $39.26
Max. Negotiated Rate $390.08
Rate for Payer: Aetna Commercial $381.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $364.64
Rate for Payer: Aetna Managed Medicare $39.26
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $147.22
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $68.70
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $65.17
Rate for Payer: Anthem Medicaid $40.57
Rate for Payer: Anthem Medicare Advantage $39.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $224.72
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $39.26
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $39.26
Rate for Payer: Cash Price $127.20
Rate for Payer: Cash Price $127.20
Rate for Payer: Cigna Commercial $390.08
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $39.26
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $40.57
Rate for Payer: Dean Health DHI/DHP/ASO $237.27
Rate for Payer: Dean Health Medicaid $40.57
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $39.26
Rate for Payer: Health EOS Commercial $377.36
Rate for Payer: HFN Commercial $390.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $146.05
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $39.26
Rate for Payer: Independent Care Health Plan Medicaid $40.57
Rate for Payer: Independent Care Health Plan Medicare $39.26
Rate for Payer: Managed Health Services Medicaid $42.19
Rate for Payer: Managed Health Services Medicare Advantage $39.26
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $39.26
Rate for Payer: Multiplan Commercial $339.20
Rate for Payer: NAPHCARE Commercial $58.89
Rate for Payer: Preferred Network Access Commercial $390.08
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $40.57
Rate for Payer: Quartz Beloit One Network $207.76
Rate for Payer: Quartz Commercial $275.60
Rate for Payer: Quartz Medicare Advantage $39.26
Rate for Payer: The Alliance Commercial $157.04
Rate for Payer: United Healthcare Medicaid $40.57
Rate for Payer: United Healthcare Medicare Advantage $39.26
Rate for Payer: United Healthcare PPO $318.00
Rate for Payer: WEA Trust Commercial $233.20
Rate for Payer: Wellcare Medicare $39.26
Rate for Payer: WMAP Medicaid $40.57
Rate for Payer: WPS Commercial $314.06
Service Code CPT 80192
Hospital Charge Code 1043010
Hospital Revenue Code 300
Min. Negotiated Rate $59.13
Max. Negotiated Rate $310.65
Rate for Payer: Aetna Commercial $310.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $281.22
Rate for Payer: Cash Price $98.10
Rate for Payer: Cash Price $98.10
Rate for Payer: Cigna Commercial $310.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $163.50
Rate for Payer: Dean Health DHI/DHP/ASO $196.20
Rate for Payer: Health EOS Commercial $297.57
Rate for Payer: HFN Commercial $310.65
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $59.13
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $59.13
Rate for Payer: Multiplan Commercial $261.60
Rate for Payer: Preferred Network Access Commercial $310.65
Rate for Payer: Quartz Beloit One Network $143.88
Rate for Payer: Quartz Commercial $186.39
Rate for Payer: The Alliance Commercial $163.50
Rate for Payer: WEA Trust Commercial $179.85
Rate for Payer: WPS Commercial $242.21
Service Code CPT 80192
Hospital Charge Code 1043010
Hospital Revenue Code 300
Min. Negotiated Rate $160.23
Max. Negotiated Rate $300.84
Rate for Payer: Aetna Commercial $294.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $281.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $173.31
Rate for Payer: Cash Price $98.10
Rate for Payer: Cigna Commercial $300.84
Rate for Payer: Health EOS Commercial $291.03
Rate for Payer: HFN Commercial $300.84
Rate for Payer: Multiplan Commercial $261.60
Rate for Payer: NAPHCARE Commercial $196.20
Rate for Payer: Preferred Network Access Commercial $300.84
Rate for Payer: Quartz Beloit One Network $160.23
Rate for Payer: Quartz Commercial $196.20
Rate for Payer: WEA Trust Commercial $179.85
Rate for Payer: WPS Commercial $242.21
Service Code CPT 80192
Hospital Charge Code 1043010
Hospital Revenue Code 300
Min. Negotiated Rate $16.75
Max. Negotiated Rate $300.84
Rate for Payer: Aetna Commercial $294.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $281.22
Rate for Payer: Aetna Managed Medicare $16.75
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $62.81
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $29.31
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $27.80
Rate for Payer: Anthem Medicaid $17.31
Rate for Payer: Anthem Medicare Advantage $16.75
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $173.31
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $16.75
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $16.75
Rate for Payer: Cash Price $98.10
Rate for Payer: Cash Price $98.10
Rate for Payer: Cigna Commercial $300.84
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $16.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $17.31
Rate for Payer: Dean Health DHI/DHP/ASO $182.99
Rate for Payer: Dean Health Medicaid $17.31
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $16.75
Rate for Payer: Health EOS Commercial $291.03
Rate for Payer: HFN Commercial $300.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $62.31
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $16.75
Rate for Payer: Independent Care Health Plan Medicaid $17.31
Rate for Payer: Independent Care Health Plan Medicare $16.75
Rate for Payer: Managed Health Services Medicaid $18.00
Rate for Payer: Managed Health Services Medicare Advantage $16.75
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $16.75
Rate for Payer: Multiplan Commercial $261.60
Rate for Payer: NAPHCARE Commercial $25.12
Rate for Payer: Preferred Network Access Commercial $300.84
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $17.31
Rate for Payer: Quartz Beloit One Network $160.23
Rate for Payer: Quartz Commercial $212.55
Rate for Payer: Quartz Medicare Advantage $16.75
Rate for Payer: The Alliance Commercial $67.00
Rate for Payer: United Healthcare Medicaid $17.31
Rate for Payer: United Healthcare Medicare Advantage $16.75
Rate for Payer: United Healthcare PPO $245.25
Rate for Payer: WEA Trust Commercial $179.85
Rate for Payer: Wellcare Medicare $16.75
Rate for Payer: WMAP Medicaid $17.31
Rate for Payer: WPS Commercial $242.21
Service Code CPT 84145
Hospital Charge Code 4744607
Hospital Revenue Code 300
Min. Negotiated Rate $96.09
Max. Negotiated Rate $294.50
Rate for Payer: Aetna Commercial $294.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $266.60
Rate for Payer: Cash Price $93.00
Rate for Payer: Cash Price $93.00
Rate for Payer: Cigna Commercial $294.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $155.00
Rate for Payer: Dean Health DHI/DHP/ASO $186.00
Rate for Payer: Health EOS Commercial $282.10
Rate for Payer: HFN Commercial $294.50
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $96.09
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $96.09
Rate for Payer: Multiplan Commercial $248.00
Rate for Payer: Preferred Network Access Commercial $294.50
Rate for Payer: Quartz Beloit One Network $136.40
Rate for Payer: Quartz Commercial $176.70
Rate for Payer: The Alliance Commercial $155.00
Rate for Payer: WEA Trust Commercial $170.50
Rate for Payer: WPS Commercial $229.62
Service Code CPT 84145
Hospital Charge Code 4744607
Hospital Revenue Code 300
Min. Negotiated Rate $151.90
Max. Negotiated Rate $285.20
Rate for Payer: Aetna Commercial $279.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $266.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $164.30
Rate for Payer: Cash Price $93.00
Rate for Payer: Cigna Commercial $285.20
Rate for Payer: Health EOS Commercial $275.90
Rate for Payer: HFN Commercial $285.20
Rate for Payer: Multiplan Commercial $248.00
Rate for Payer: NAPHCARE Commercial $186.00
Rate for Payer: Preferred Network Access Commercial $285.20
Rate for Payer: Quartz Beloit One Network $151.90
Rate for Payer: Quartz Commercial $186.00
Rate for Payer: WEA Trust Commercial $170.50
Rate for Payer: WPS Commercial $229.62
Service Code CPT 84145
Hospital Charge Code 4744607
Hospital Revenue Code 300
Min. Negotiated Rate $27.22
Max. Negotiated Rate $285.20
Rate for Payer: Aetna Commercial $279.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $266.60
Rate for Payer: Aetna Managed Medicare $27.22
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $102.08
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $47.64
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $45.19
Rate for Payer: Anthem Medicaid $28.13
Rate for Payer: Anthem Medicare Advantage $27.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $164.30
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $27.22
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $27.22
Rate for Payer: Cash Price $93.00
Rate for Payer: Cash Price $93.00
Rate for Payer: Cigna Commercial $285.20
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $27.22
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $28.13
Rate for Payer: Dean Health DHI/DHP/ASO $173.48
Rate for Payer: Dean Health Medicaid $28.13
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $27.22
Rate for Payer: Health EOS Commercial $275.90
Rate for Payer: HFN Commercial $285.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $101.26
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $27.22
Rate for Payer: Independent Care Health Plan Medicaid $28.13
Rate for Payer: Independent Care Health Plan Medicare $27.22
Rate for Payer: Managed Health Services Medicaid $29.26
Rate for Payer: Managed Health Services Medicare Advantage $27.22
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $27.22
Rate for Payer: Multiplan Commercial $248.00
Rate for Payer: NAPHCARE Commercial $40.83
Rate for Payer: Preferred Network Access Commercial $285.20
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $28.13
Rate for Payer: Quartz Beloit One Network $151.90
Rate for Payer: Quartz Commercial $201.50
Rate for Payer: Quartz Medicare Advantage $27.22
Rate for Payer: The Alliance Commercial $108.88
Rate for Payer: United Healthcare Medicaid $28.13
Rate for Payer: United Healthcare Medicare Advantage $27.22
Rate for Payer: United Healthcare PPO $232.50
Rate for Payer: WEA Trust Commercial $170.50
Rate for Payer: Wellcare Medicare $27.22
Rate for Payer: WMAP Medicaid $28.13
Rate for Payer: WPS Commercial $229.62
Hospital Charge Code 5520866
Hospital Revenue Code 272
Min. Negotiated Rate $1,984.92
Max. Negotiated Rate $28,356.00
Rate for Payer: Aetna Commercial $6,380.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,096.54
Rate for Payer: Aetna Managed Medicare $1,984.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,607.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,544.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,402.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,757.17
Rate for Payer: Cash Price $2,126.70
Rate for Payer: Cigna Commercial $6,521.88
Rate for Payer: Dean Health DHI/DHP/ASO $3,967.00
Rate for Payer: Health EOS Commercial $6,309.21
Rate for Payer: HFN Commercial $6,521.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,316.75
Rate for Payer: Multiplan Commercial $5,671.20
Rate for Payer: NAPHCARE Commercial $4,253.40
Rate for Payer: Preferred Network Access Commercial $6,521.88
Rate for Payer: Quartz Beloit One Network $3,473.61
Rate for Payer: Quartz Commercial $4,607.85
Rate for Payer: Quartz Medicare Advantage $4,253.40
Rate for Payer: The Alliance Commercial $28,356.00
Rate for Payer: WEA Trust Commercial $3,898.95
Rate for Payer: WPS Commercial $5,250.82
Hospital Charge Code 5520866
Hospital Revenue Code 272
Min. Negotiated Rate $3,473.61
Max. Negotiated Rate $6,521.88
Rate for Payer: Aetna Commercial $6,380.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,096.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,757.17
Rate for Payer: Cash Price $2,126.70
Rate for Payer: Cigna Commercial $6,521.88
Rate for Payer: Health EOS Commercial $6,309.21
Rate for Payer: HFN Commercial $6,521.88
Rate for Payer: Multiplan Commercial $5,671.20
Rate for Payer: NAPHCARE Commercial $4,253.40
Rate for Payer: Preferred Network Access Commercial $6,521.88
Rate for Payer: Quartz Beloit One Network $3,473.61
Rate for Payer: Quartz Commercial $4,253.40
Rate for Payer: WEA Trust Commercial $3,898.95
Rate for Payer: WPS Commercial $5,250.82
Service Code HCPCS C1713
Hospital Charge Code 5264782
Hospital Revenue Code 278
Min. Negotiated Rate $1,984.92
Max. Negotiated Rate $28,356.00
Rate for Payer: Aetna Commercial $6,380.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,096.54
Rate for Payer: Aetna Managed Medicare $1,984.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4,607.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3,544.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3,402.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,757.17
Rate for Payer: Cash Price $2,126.70
Rate for Payer: Cigna Commercial $6,521.88
Rate for Payer: Dean Health DHI/DHP/ASO $3,967.00
Rate for Payer: Health EOS Commercial $6,309.21
Rate for Payer: HFN Commercial $6,521.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5,316.75
Rate for Payer: Multiplan Commercial $5,671.20
Rate for Payer: NAPHCARE Commercial $4,253.40
Rate for Payer: Preferred Network Access Commercial $6,521.88
Rate for Payer: Quartz Beloit One Network $3,473.61
Rate for Payer: Quartz Commercial $4,607.85
Rate for Payer: Quartz Medicare Advantage $4,253.40
Rate for Payer: The Alliance Commercial $28,356.00
Rate for Payer: WEA Trust Commercial $3,898.95
Rate for Payer: WPS Commercial $5,250.82
Service Code HCPCS C1713
Hospital Charge Code 5264782
Hospital Revenue Code 278
Min. Negotiated Rate $3,473.61
Max. Negotiated Rate $6,521.88
Rate for Payer: Aetna Commercial $6,380.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6,096.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3,757.17
Rate for Payer: Cash Price $2,126.70
Rate for Payer: Cigna Commercial $6,521.88
Rate for Payer: Health EOS Commercial $6,309.21
Rate for Payer: HFN Commercial $6,521.88
Rate for Payer: Multiplan Commercial $5,671.20
Rate for Payer: NAPHCARE Commercial $4,253.40
Rate for Payer: Preferred Network Access Commercial $6,521.88
Rate for Payer: Quartz Beloit One Network $3,473.61
Rate for Payer: Quartz Commercial $4,253.40
Rate for Payer: WEA Trust Commercial $3,898.95
Rate for Payer: WPS Commercial $5,250.82
Hospital Charge Code 5885649
Hospital Revenue Code 272
Min. Negotiated Rate $1,290.24
Max. Negotiated Rate $18,432.00
Rate for Payer: Aetna Commercial $4,147.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,962.88
Rate for Payer: Aetna Managed Medicare $1,290.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,995.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,304.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,211.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,442.24
Rate for Payer: Cash Price $1,382.40
Rate for Payer: Cigna Commercial $4,239.36
Rate for Payer: Dean Health DHI/DHP/ASO $2,578.64
Rate for Payer: Health EOS Commercial $4,101.12
Rate for Payer: HFN Commercial $4,239.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,456.00
Rate for Payer: Multiplan Commercial $3,686.40
Rate for Payer: NAPHCARE Commercial $2,764.80
Rate for Payer: Preferred Network Access Commercial $4,239.36
Rate for Payer: Quartz Beloit One Network $2,257.92
Rate for Payer: Quartz Commercial $2,995.20
Rate for Payer: Quartz Medicare Advantage $2,764.80
Rate for Payer: The Alliance Commercial $18,432.00
Rate for Payer: WEA Trust Commercial $2,534.40
Rate for Payer: WPS Commercial $3,413.15
Hospital Charge Code 5885649
Hospital Revenue Code 272
Min. Negotiated Rate $2,257.92
Max. Negotiated Rate $4,239.36
Rate for Payer: Aetna Commercial $4,147.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,962.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,442.24
Rate for Payer: Cash Price $1,382.40
Rate for Payer: Cigna Commercial $4,239.36
Rate for Payer: Health EOS Commercial $4,101.12
Rate for Payer: HFN Commercial $4,239.36
Rate for Payer: Multiplan Commercial $3,686.40
Rate for Payer: NAPHCARE Commercial $2,764.80
Rate for Payer: Preferred Network Access Commercial $4,239.36
Rate for Payer: Quartz Beloit One Network $2,257.92
Rate for Payer: Quartz Commercial $2,764.80
Rate for Payer: WEA Trust Commercial $2,534.40
Rate for Payer: WPS Commercial $3,413.15
Hospital Charge Code 6131649
Hospital Revenue Code 272
Min. Negotiated Rate $602.70
Max. Negotiated Rate $1,131.60
Rate for Payer: Aetna Commercial $1,107.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,057.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $651.90
Rate for Payer: Cash Price $369.00
Rate for Payer: Cigna Commercial $1,131.60
Rate for Payer: Health EOS Commercial $1,094.70
Rate for Payer: HFN Commercial $1,131.60
Rate for Payer: Multiplan Commercial $984.00
Rate for Payer: NAPHCARE Commercial $738.00
Rate for Payer: Preferred Network Access Commercial $1,131.60
Rate for Payer: Quartz Beloit One Network $602.70
Rate for Payer: Quartz Commercial $738.00
Rate for Payer: WEA Trust Commercial $676.50
Rate for Payer: WPS Commercial $911.06
Hospital Charge Code 6131649
Hospital Revenue Code 272
Min. Negotiated Rate $344.40
Max. Negotiated Rate $4,920.00
Rate for Payer: Aetna Commercial $1,107.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,057.80
Rate for Payer: Aetna Managed Medicare $344.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $799.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $615.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $590.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $651.90
Rate for Payer: Cash Price $369.00
Rate for Payer: Cigna Commercial $1,131.60
Rate for Payer: Dean Health DHI/DHP/ASO $688.31
Rate for Payer: Health EOS Commercial $1,094.70
Rate for Payer: HFN Commercial $1,131.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $922.50
Rate for Payer: Multiplan Commercial $984.00
Rate for Payer: NAPHCARE Commercial $738.00
Rate for Payer: Preferred Network Access Commercial $1,131.60
Rate for Payer: Quartz Beloit One Network $602.70
Rate for Payer: Quartz Commercial $799.50
Rate for Payer: Quartz Medicare Advantage $738.00
Rate for Payer: The Alliance Commercial $4,920.00
Rate for Payer: WEA Trust Commercial $676.50
Rate for Payer: WPS Commercial $911.06
Hospital Charge Code 2974022
Hospital Revenue Code 272
Min. Negotiated Rate $1,045.80
Max. Negotiated Rate $14,940.00
Rate for Payer: Aetna Commercial $3,361.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,212.10
Rate for Payer: Aetna Managed Medicare $1,045.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,427.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,867.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,792.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,979.55
Rate for Payer: Cash Price $1,120.50
Rate for Payer: Cigna Commercial $3,436.20
Rate for Payer: Dean Health DHI/DHP/ASO $2,090.11
Rate for Payer: Health EOS Commercial $3,324.15
Rate for Payer: HFN Commercial $3,436.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,801.25
Rate for Payer: Multiplan Commercial $2,988.00
Rate for Payer: NAPHCARE Commercial $2,241.00
Rate for Payer: Preferred Network Access Commercial $3,436.20
Rate for Payer: Quartz Beloit One Network $1,830.15
Rate for Payer: Quartz Commercial $2,427.75
Rate for Payer: Quartz Medicare Advantage $2,241.00
Rate for Payer: The Alliance Commercial $14,940.00
Rate for Payer: WEA Trust Commercial $2,054.25
Rate for Payer: WPS Commercial $2,766.51