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Hospital Charge Code 2966491
Hospital Revenue Code 278
Min. Negotiated Rate $1,195.32
Max. Negotiated Rate $17,076.00
Rate for Payer: Aetna Commercial $3,842.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,671.34
Rate for Payer: Aetna Managed Medicare $1,195.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,774.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,049.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,262.57
Rate for Payer: Cash Price $1,280.70
Rate for Payer: Cigna Commercial $3,927.48
Rate for Payer: Dean Health DHI/DHP/ASO $2,388.93
Rate for Payer: Health EOS Commercial $3,799.41
Rate for Payer: HFN Commercial $3,927.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,201.75
Rate for Payer: Multiplan Commercial $3,415.20
Rate for Payer: NAPHCARE Commercial $2,561.40
Rate for Payer: Preferred Network Access Commercial $3,927.48
Rate for Payer: Quartz Beloit One Network $2,091.81
Rate for Payer: Quartz Commercial $2,774.85
Rate for Payer: Quartz Medicare Advantage $2,561.40
Rate for Payer: The Alliance Commercial $17,076.00
Rate for Payer: WEA Trust Commercial $2,347.95
Rate for Payer: WPS Commercial $3,162.05
Hospital Charge Code 2966492
Hospital Revenue Code 278
Min. Negotiated Rate $1,195.32
Max. Negotiated Rate $17,076.00
Rate for Payer: Aetna Commercial $3,842.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,671.34
Rate for Payer: Aetna Managed Medicare $1,195.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,774.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,049.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,262.57
Rate for Payer: Cash Price $1,280.70
Rate for Payer: Cigna Commercial $3,927.48
Rate for Payer: Dean Health DHI/DHP/ASO $2,388.93
Rate for Payer: Health EOS Commercial $3,799.41
Rate for Payer: HFN Commercial $3,927.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,201.75
Rate for Payer: Multiplan Commercial $3,415.20
Rate for Payer: NAPHCARE Commercial $2,561.40
Rate for Payer: Preferred Network Access Commercial $3,927.48
Rate for Payer: Quartz Beloit One Network $2,091.81
Rate for Payer: Quartz Commercial $2,774.85
Rate for Payer: Quartz Medicare Advantage $2,561.40
Rate for Payer: The Alliance Commercial $17,076.00
Rate for Payer: WEA Trust Commercial $2,347.95
Rate for Payer: WPS Commercial $3,162.05
Hospital Charge Code 2966492
Hospital Revenue Code 278
Min. Negotiated Rate $2,091.81
Max. Negotiated Rate $3,927.48
Rate for Payer: Aetna Commercial $3,842.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,671.34
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,262.57
Rate for Payer: Cash Price $1,280.70
Rate for Payer: Cigna Commercial $3,927.48
Rate for Payer: Health EOS Commercial $3,799.41
Rate for Payer: HFN Commercial $3,927.48
Rate for Payer: Multiplan Commercial $3,415.20
Rate for Payer: NAPHCARE Commercial $2,561.40
Rate for Payer: Preferred Network Access Commercial $3,927.48
Rate for Payer: Quartz Beloit One Network $2,091.81
Rate for Payer: Quartz Commercial $2,561.40
Rate for Payer: WEA Trust Commercial $2,347.95
Rate for Payer: WPS Commercial $3,162.05
Hospital Charge Code 2966493
Hospital Revenue Code 278
Min. Negotiated Rate $2,091.81
Max. Negotiated Rate $3,927.48
Rate for Payer: Aetna Commercial $3,842.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,671.34
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,262.57
Rate for Payer: Cash Price $1,280.70
Rate for Payer: Cigna Commercial $3,927.48
Rate for Payer: Health EOS Commercial $3,799.41
Rate for Payer: HFN Commercial $3,927.48
Rate for Payer: Multiplan Commercial $3,415.20
Rate for Payer: NAPHCARE Commercial $2,561.40
Rate for Payer: Preferred Network Access Commercial $3,927.48
Rate for Payer: Quartz Beloit One Network $2,091.81
Rate for Payer: Quartz Commercial $2,561.40
Rate for Payer: WEA Trust Commercial $2,347.95
Rate for Payer: WPS Commercial $3,162.05
Hospital Charge Code 2966493
Hospital Revenue Code 278
Min. Negotiated Rate $1,195.32
Max. Negotiated Rate $17,076.00
Rate for Payer: Aetna Commercial $3,842.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,671.34
Rate for Payer: Aetna Managed Medicare $1,195.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,774.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,049.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,262.57
Rate for Payer: Cash Price $1,280.70
Rate for Payer: Cigna Commercial $3,927.48
Rate for Payer: Dean Health DHI/DHP/ASO $2,388.93
Rate for Payer: Health EOS Commercial $3,799.41
Rate for Payer: HFN Commercial $3,927.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,201.75
Rate for Payer: Multiplan Commercial $3,415.20
Rate for Payer: NAPHCARE Commercial $2,561.40
Rate for Payer: Preferred Network Access Commercial $3,927.48
Rate for Payer: Quartz Beloit One Network $2,091.81
Rate for Payer: Quartz Commercial $2,774.85
Rate for Payer: Quartz Medicare Advantage $2,561.40
Rate for Payer: The Alliance Commercial $17,076.00
Rate for Payer: WEA Trust Commercial $2,347.95
Rate for Payer: WPS Commercial $3,162.05
Hospital Charge Code 2966494
Hospital Revenue Code 278
Min. Negotiated Rate $1,138.48
Max. Negotiated Rate $16,264.00
Rate for Payer: Aetna Commercial $3,659.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,496.76
Rate for Payer: Aetna Managed Medicare $1,138.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $2,642.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,033.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,951.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,154.98
Rate for Payer: Cash Price $1,219.80
Rate for Payer: Cigna Commercial $3,740.72
Rate for Payer: Dean Health DHI/DHP/ASO $2,275.33
Rate for Payer: Health EOS Commercial $3,618.74
Rate for Payer: HFN Commercial $3,740.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,049.50
Rate for Payer: Multiplan Commercial $3,252.80
Rate for Payer: NAPHCARE Commercial $2,439.60
Rate for Payer: Preferred Network Access Commercial $3,740.72
Rate for Payer: Quartz Beloit One Network $1,992.34
Rate for Payer: Quartz Commercial $2,642.90
Rate for Payer: Quartz Medicare Advantage $2,439.60
Rate for Payer: The Alliance Commercial $16,264.00
Rate for Payer: WEA Trust Commercial $2,236.30
Rate for Payer: WPS Commercial $3,011.69
Hospital Charge Code 2966494
Hospital Revenue Code 278
Min. Negotiated Rate $1,992.34
Max. Negotiated Rate $3,740.72
Rate for Payer: Aetna Commercial $3,659.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $3,496.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,154.98
Rate for Payer: Cash Price $1,219.80
Rate for Payer: Cigna Commercial $3,740.72
Rate for Payer: Health EOS Commercial $3,618.74
Rate for Payer: HFN Commercial $3,740.72
Rate for Payer: Multiplan Commercial $3,252.80
Rate for Payer: NAPHCARE Commercial $2,439.60
Rate for Payer: Preferred Network Access Commercial $3,740.72
Rate for Payer: Quartz Beloit One Network $1,992.34
Rate for Payer: Quartz Commercial $2,439.60
Rate for Payer: WEA Trust Commercial $2,236.30
Rate for Payer: WPS Commercial $3,011.69
Service Code HCPCS C1713
Hospital Charge Code 4595317
Hospital Revenue Code 278
Min. Negotiated Rate $478.24
Max. Negotiated Rate $6,832.00
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Aetna Managed Medicare $478.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,110.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $854.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $819.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Dean Health DHI/DHP/ASO $955.80
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,281.00
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,110.20
Rate for Payer: Quartz Medicare Advantage $1,024.80
Rate for Payer: The Alliance Commercial $6,832.00
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1713
Hospital Charge Code 4595317
Hospital Revenue Code 278
Min. Negotiated Rate $836.92
Max. Negotiated Rate $1,571.36
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,024.80
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1713
Hospital Charge Code 3297466
Hospital Revenue Code 278
Min. Negotiated Rate $1,169.14
Max. Negotiated Rate $2,195.12
Rate for Payer: Aetna Commercial $2,147.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,051.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,264.58
Rate for Payer: Cash Price $715.80
Rate for Payer: Cigna Commercial $2,195.12
Rate for Payer: Health EOS Commercial $2,123.54
Rate for Payer: HFN Commercial $2,195.12
Rate for Payer: Multiplan Commercial $1,908.80
Rate for Payer: NAPHCARE Commercial $1,431.60
Rate for Payer: Preferred Network Access Commercial $2,195.12
Rate for Payer: Quartz Beloit One Network $1,169.14
Rate for Payer: Quartz Commercial $1,431.60
Rate for Payer: WEA Trust Commercial $1,312.30
Rate for Payer: WPS Commercial $1,767.31
Service Code HCPCS C1713
Hospital Charge Code 3297466
Hospital Revenue Code 278
Min. Negotiated Rate $668.08
Max. Negotiated Rate $9,544.00
Rate for Payer: Aetna Commercial $2,147.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,051.96
Rate for Payer: Aetna Managed Medicare $668.08
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,550.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,193.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,145.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,264.58
Rate for Payer: Cash Price $715.80
Rate for Payer: Cigna Commercial $2,195.12
Rate for Payer: Dean Health DHI/DHP/ASO $1,335.21
Rate for Payer: Health EOS Commercial $2,123.54
Rate for Payer: HFN Commercial $2,195.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,789.50
Rate for Payer: Multiplan Commercial $1,908.80
Rate for Payer: NAPHCARE Commercial $1,431.60
Rate for Payer: Preferred Network Access Commercial $2,195.12
Rate for Payer: Quartz Beloit One Network $1,169.14
Rate for Payer: Quartz Commercial $1,550.90
Rate for Payer: Quartz Medicare Advantage $1,431.60
Rate for Payer: The Alliance Commercial $9,544.00
Rate for Payer: WEA Trust Commercial $1,312.30
Rate for Payer: WPS Commercial $1,767.31
Hospital Charge Code 2967392
Hospital Revenue Code 278
Min. Negotiated Rate $870.73
Max. Negotiated Rate $1,634.84
Rate for Payer: Aetna Commercial $1,599.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,528.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $941.81
Rate for Payer: Cash Price $533.10
Rate for Payer: Cigna Commercial $1,634.84
Rate for Payer: Health EOS Commercial $1,581.53
Rate for Payer: HFN Commercial $1,634.84
Rate for Payer: Multiplan Commercial $1,421.60
Rate for Payer: NAPHCARE Commercial $1,066.20
Rate for Payer: Preferred Network Access Commercial $1,634.84
Rate for Payer: Quartz Beloit One Network $870.73
Rate for Payer: Quartz Commercial $1,066.20
Rate for Payer: WEA Trust Commercial $977.35
Rate for Payer: WPS Commercial $1,316.22
Hospital Charge Code 2967392
Hospital Revenue Code 278
Min. Negotiated Rate $497.56
Max. Negotiated Rate $7,108.00
Rate for Payer: Aetna Commercial $1,599.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,528.22
Rate for Payer: Aetna Managed Medicare $497.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,155.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $888.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $852.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $941.81
Rate for Payer: Cash Price $533.10
Rate for Payer: Cigna Commercial $1,634.84
Rate for Payer: Dean Health DHI/DHP/ASO $994.41
Rate for Payer: Health EOS Commercial $1,581.53
Rate for Payer: HFN Commercial $1,634.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,332.75
Rate for Payer: Multiplan Commercial $1,421.60
Rate for Payer: NAPHCARE Commercial $1,066.20
Rate for Payer: Preferred Network Access Commercial $1,634.84
Rate for Payer: Quartz Beloit One Network $870.73
Rate for Payer: Quartz Commercial $1,155.05
Rate for Payer: Quartz Medicare Advantage $1,066.20
Rate for Payer: The Alliance Commercial $7,108.00
Rate for Payer: WEA Trust Commercial $977.35
Rate for Payer: WPS Commercial $1,316.22
Hospital Charge Code 2964158
Hospital Revenue Code 278
Min. Negotiated Rate $789.39
Max. Negotiated Rate $1,482.12
Rate for Payer: Aetna Commercial $1,449.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,385.46
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $853.83
Rate for Payer: Cash Price $483.30
Rate for Payer: Cigna Commercial $1,482.12
Rate for Payer: Health EOS Commercial $1,433.79
Rate for Payer: HFN Commercial $1,482.12
Rate for Payer: Multiplan Commercial $1,288.80
Rate for Payer: NAPHCARE Commercial $966.60
Rate for Payer: Preferred Network Access Commercial $1,482.12
Rate for Payer: Quartz Beloit One Network $789.39
Rate for Payer: Quartz Commercial $966.60
Rate for Payer: WEA Trust Commercial $886.05
Rate for Payer: WPS Commercial $1,193.27
Hospital Charge Code 2964158
Hospital Revenue Code 278
Min. Negotiated Rate $451.08
Max. Negotiated Rate $6,444.00
Rate for Payer: Aetna Commercial $1,449.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,385.46
Rate for Payer: Aetna Managed Medicare $451.08
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,047.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $805.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $773.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $853.83
Rate for Payer: Cash Price $483.30
Rate for Payer: Cigna Commercial $1,482.12
Rate for Payer: Dean Health DHI/DHP/ASO $901.52
Rate for Payer: Health EOS Commercial $1,433.79
Rate for Payer: HFN Commercial $1,482.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,208.25
Rate for Payer: Multiplan Commercial $1,288.80
Rate for Payer: NAPHCARE Commercial $966.60
Rate for Payer: Preferred Network Access Commercial $1,482.12
Rate for Payer: Quartz Beloit One Network $789.39
Rate for Payer: Quartz Commercial $1,047.15
Rate for Payer: Quartz Medicare Advantage $966.60
Rate for Payer: The Alliance Commercial $6,444.00
Rate for Payer: WEA Trust Commercial $886.05
Rate for Payer: WPS Commercial $1,193.27
Hospital Charge Code 2964159
Hospital Revenue Code 278
Min. Negotiated Rate $307.72
Max. Negotiated Rate $4,396.00
Rate for Payer: Aetna Commercial $989.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $945.14
Rate for Payer: Aetna Managed Medicare $307.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $714.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $549.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $527.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $582.47
Rate for Payer: Cash Price $329.70
Rate for Payer: Cigna Commercial $1,011.08
Rate for Payer: Dean Health DHI/DHP/ASO $615.00
Rate for Payer: Health EOS Commercial $978.11
Rate for Payer: HFN Commercial $1,011.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $824.25
Rate for Payer: Multiplan Commercial $879.20
Rate for Payer: NAPHCARE Commercial $659.40
Rate for Payer: Preferred Network Access Commercial $1,011.08
Rate for Payer: Quartz Beloit One Network $538.51
Rate for Payer: Quartz Commercial $714.35
Rate for Payer: Quartz Medicare Advantage $659.40
Rate for Payer: The Alliance Commercial $4,396.00
Rate for Payer: WEA Trust Commercial $604.45
Rate for Payer: WPS Commercial $814.03
Hospital Charge Code 2964159
Hospital Revenue Code 278
Min. Negotiated Rate $538.51
Max. Negotiated Rate $1,011.08
Rate for Payer: Aetna Commercial $989.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $945.14
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $582.47
Rate for Payer: Cash Price $329.70
Rate for Payer: Cigna Commercial $1,011.08
Rate for Payer: Health EOS Commercial $978.11
Rate for Payer: HFN Commercial $1,011.08
Rate for Payer: Multiplan Commercial $879.20
Rate for Payer: NAPHCARE Commercial $659.40
Rate for Payer: Preferred Network Access Commercial $1,011.08
Rate for Payer: Quartz Beloit One Network $538.51
Rate for Payer: Quartz Commercial $659.40
Rate for Payer: WEA Trust Commercial $604.45
Rate for Payer: WPS Commercial $814.03
Service Code HCPCS C1713
Hospital Charge Code 4494363
Hospital Revenue Code 278
Min. Negotiated Rate $836.92
Max. Negotiated Rate $1,571.36
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,024.80
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1713
Hospital Charge Code 4494363
Hospital Revenue Code 278
Min. Negotiated Rate $478.24
Max. Negotiated Rate $6,832.00
Rate for Payer: Aetna Commercial $1,537.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,468.88
Rate for Payer: Aetna Managed Medicare $478.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,110.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $854.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $819.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $905.24
Rate for Payer: Cash Price $512.40
Rate for Payer: Cigna Commercial $1,571.36
Rate for Payer: Dean Health DHI/DHP/ASO $955.80
Rate for Payer: Health EOS Commercial $1,520.12
Rate for Payer: HFN Commercial $1,571.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,281.00
Rate for Payer: Multiplan Commercial $1,366.40
Rate for Payer: NAPHCARE Commercial $1,024.80
Rate for Payer: Preferred Network Access Commercial $1,571.36
Rate for Payer: Quartz Beloit One Network $836.92
Rate for Payer: Quartz Commercial $1,110.20
Rate for Payer: Quartz Medicare Advantage $1,024.80
Rate for Payer: The Alliance Commercial $6,832.00
Rate for Payer: WEA Trust Commercial $939.40
Rate for Payer: WPS Commercial $1,265.12
Service Code HCPCS C1713
Hospital Charge Code 3529508
Hospital Revenue Code 278
Min. Negotiated Rate $668.08
Max. Negotiated Rate $9,544.00
Rate for Payer: Aetna Commercial $2,147.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,051.96
Rate for Payer: Aetna Managed Medicare $668.08
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,550.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,193.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,145.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,264.58
Rate for Payer: Cash Price $715.80
Rate for Payer: Cigna Commercial $2,195.12
Rate for Payer: Dean Health DHI/DHP/ASO $1,335.21
Rate for Payer: Health EOS Commercial $2,123.54
Rate for Payer: HFN Commercial $2,195.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,789.50
Rate for Payer: Multiplan Commercial $1,908.80
Rate for Payer: NAPHCARE Commercial $1,431.60
Rate for Payer: Preferred Network Access Commercial $2,195.12
Rate for Payer: Quartz Beloit One Network $1,169.14
Rate for Payer: Quartz Commercial $1,550.90
Rate for Payer: Quartz Medicare Advantage $1,431.60
Rate for Payer: The Alliance Commercial $9,544.00
Rate for Payer: WEA Trust Commercial $1,312.30
Rate for Payer: WPS Commercial $1,767.31
Service Code HCPCS C1713
Hospital Charge Code 3529508
Hospital Revenue Code 278
Min. Negotiated Rate $1,169.14
Max. Negotiated Rate $2,195.12
Rate for Payer: Aetna Commercial $2,147.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,051.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,264.58
Rate for Payer: Cash Price $715.80
Rate for Payer: Cigna Commercial $2,195.12
Rate for Payer: Health EOS Commercial $2,123.54
Rate for Payer: HFN Commercial $2,195.12
Rate for Payer: Multiplan Commercial $1,908.80
Rate for Payer: NAPHCARE Commercial $1,431.60
Rate for Payer: Preferred Network Access Commercial $2,195.12
Rate for Payer: Quartz Beloit One Network $1,169.14
Rate for Payer: Quartz Commercial $1,431.60
Rate for Payer: WEA Trust Commercial $1,312.30
Rate for Payer: WPS Commercial $1,767.31
Hospital Charge Code 2964156
Hospital Revenue Code 278
Min. Negotiated Rate $627.69
Max. Negotiated Rate $1,178.52
Rate for Payer: Aetna Commercial $1,152.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,101.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $678.93
Rate for Payer: Cash Price $384.30
Rate for Payer: Cigna Commercial $1,178.52
Rate for Payer: Health EOS Commercial $1,140.09
Rate for Payer: HFN Commercial $1,178.52
Rate for Payer: Multiplan Commercial $1,024.80
Rate for Payer: NAPHCARE Commercial $768.60
Rate for Payer: Preferred Network Access Commercial $1,178.52
Rate for Payer: Quartz Beloit One Network $627.69
Rate for Payer: Quartz Commercial $768.60
Rate for Payer: WEA Trust Commercial $704.55
Rate for Payer: WPS Commercial $948.84
Hospital Charge Code 2964156
Hospital Revenue Code 278
Min. Negotiated Rate $358.68
Max. Negotiated Rate $5,124.00
Rate for Payer: Aetna Commercial $1,152.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,101.66
Rate for Payer: Aetna Managed Medicare $358.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $832.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $640.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $614.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $678.93
Rate for Payer: Cash Price $384.30
Rate for Payer: Cigna Commercial $1,178.52
Rate for Payer: Dean Health DHI/DHP/ASO $716.85
Rate for Payer: Health EOS Commercial $1,140.09
Rate for Payer: HFN Commercial $1,178.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $960.75
Rate for Payer: Multiplan Commercial $1,024.80
Rate for Payer: NAPHCARE Commercial $768.60
Rate for Payer: Preferred Network Access Commercial $1,178.52
Rate for Payer: Quartz Beloit One Network $627.69
Rate for Payer: Quartz Commercial $832.65
Rate for Payer: Quartz Medicare Advantage $768.60
Rate for Payer: The Alliance Commercial $5,124.00
Rate for Payer: WEA Trust Commercial $704.55
Rate for Payer: WPS Commercial $948.84
Hospital Charge Code 2966496
Hospital Revenue Code 278
Min. Negotiated Rate $256.27
Max. Negotiated Rate $481.16
Rate for Payer: Aetna Commercial $470.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $449.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $277.19
Rate for Payer: Cash Price $156.90
Rate for Payer: Cigna Commercial $481.16
Rate for Payer: Health EOS Commercial $465.47
Rate for Payer: HFN Commercial $481.16
Rate for Payer: Multiplan Commercial $418.40
Rate for Payer: NAPHCARE Commercial $313.80
Rate for Payer: Preferred Network Access Commercial $481.16
Rate for Payer: Quartz Beloit One Network $256.27
Rate for Payer: Quartz Commercial $313.80
Rate for Payer: WEA Trust Commercial $287.65
Rate for Payer: WPS Commercial $387.39
Hospital Charge Code 2966496
Hospital Revenue Code 278
Min. Negotiated Rate $146.44
Max. Negotiated Rate $2,092.00
Rate for Payer: Aetna Commercial $470.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $449.78
Rate for Payer: Aetna Managed Medicare $146.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $339.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $261.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $251.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $277.19
Rate for Payer: Cash Price $156.90
Rate for Payer: Cigna Commercial $481.16
Rate for Payer: Dean Health DHI/DHP/ASO $292.67
Rate for Payer: Health EOS Commercial $465.47
Rate for Payer: HFN Commercial $481.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $392.25
Rate for Payer: Multiplan Commercial $418.40
Rate for Payer: NAPHCARE Commercial $313.80
Rate for Payer: Preferred Network Access Commercial $481.16
Rate for Payer: Quartz Beloit One Network $256.27
Rate for Payer: Quartz Commercial $339.95
Rate for Payer: Quartz Medicare Advantage $313.80
Rate for Payer: The Alliance Commercial $2,092.00
Rate for Payer: WEA Trust Commercial $287.65
Rate for Payer: WPS Commercial $387.39