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Hospital Charge Code 2969245
Hospital Revenue Code 271
Min. Negotiated Rate $264.11
Max. Negotiated Rate $495.88
Rate for Payer: Aetna Commercial $485.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $463.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $285.67
Rate for Payer: Cash Price $161.70
Rate for Payer: Cigna Commercial $495.88
Rate for Payer: Health EOS Commercial $479.71
Rate for Payer: HFN Commercial $495.88
Rate for Payer: Multiplan Commercial $431.20
Rate for Payer: NAPHCARE Commercial $323.40
Rate for Payer: Preferred Network Access Commercial $495.88
Rate for Payer: Quartz Beloit One Network $264.11
Rate for Payer: Quartz Commercial $323.40
Rate for Payer: WEA Trust Commercial $296.45
Rate for Payer: WPS Commercial $399.24
Hospital Charge Code 2969246
Hospital Revenue Code 271
Min. Negotiated Rate $62.44
Max. Negotiated Rate $892.00
Rate for Payer: Aetna Commercial $200.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $191.78
Rate for Payer: Aetna Managed Medicare $62.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $144.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $111.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $107.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $118.19
Rate for Payer: Cash Price $66.90
Rate for Payer: Cigna Commercial $205.16
Rate for Payer: Dean Health DHI/DHP/ASO $124.79
Rate for Payer: Health EOS Commercial $198.47
Rate for Payer: HFN Commercial $205.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $167.25
Rate for Payer: Multiplan Commercial $178.40
Rate for Payer: NAPHCARE Commercial $133.80
Rate for Payer: Preferred Network Access Commercial $205.16
Rate for Payer: Quartz Beloit One Network $109.27
Rate for Payer: Quartz Commercial $144.95
Rate for Payer: Quartz Medicare Advantage $133.80
Rate for Payer: The Alliance Commercial $892.00
Rate for Payer: WEA Trust Commercial $122.65
Rate for Payer: WPS Commercial $165.18
Hospital Charge Code 2969246
Hospital Revenue Code 271
Min. Negotiated Rate $109.27
Max. Negotiated Rate $205.16
Rate for Payer: Aetna Commercial $200.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $191.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $118.19
Rate for Payer: Cash Price $66.90
Rate for Payer: Cigna Commercial $205.16
Rate for Payer: Health EOS Commercial $198.47
Rate for Payer: HFN Commercial $205.16
Rate for Payer: Multiplan Commercial $178.40
Rate for Payer: NAPHCARE Commercial $133.80
Rate for Payer: Preferred Network Access Commercial $205.16
Rate for Payer: Quartz Beloit One Network $109.27
Rate for Payer: Quartz Commercial $133.80
Rate for Payer: WEA Trust Commercial $122.65
Rate for Payer: WPS Commercial $165.18
Hospital Charge Code 2969228
Hospital Revenue Code 271
Min. Negotiated Rate $34.72
Max. Negotiated Rate $496.00
Rate for Payer: Aetna Commercial $111.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $106.64
Rate for Payer: Aetna Managed Medicare $34.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $80.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $62.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $59.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $65.72
Rate for Payer: Cash Price $37.20
Rate for Payer: Cigna Commercial $114.08
Rate for Payer: Dean Health DHI/DHP/ASO $69.39
Rate for Payer: Health EOS Commercial $110.36
Rate for Payer: HFN Commercial $114.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $93.00
Rate for Payer: Multiplan Commercial $99.20
Rate for Payer: NAPHCARE Commercial $74.40
Rate for Payer: Preferred Network Access Commercial $114.08
Rate for Payer: Quartz Beloit One Network $60.76
Rate for Payer: Quartz Commercial $80.60
Rate for Payer: Quartz Medicare Advantage $74.40
Rate for Payer: The Alliance Commercial $496.00
Rate for Payer: WEA Trust Commercial $68.20
Rate for Payer: WPS Commercial $91.85
Hospital Charge Code 2969228
Hospital Revenue Code 271
Min. Negotiated Rate $60.76
Max. Negotiated Rate $114.08
Rate for Payer: Aetna Commercial $111.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $106.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $65.72
Rate for Payer: Cash Price $37.20
Rate for Payer: Cigna Commercial $114.08
Rate for Payer: Health EOS Commercial $110.36
Rate for Payer: HFN Commercial $114.08
Rate for Payer: Multiplan Commercial $99.20
Rate for Payer: NAPHCARE Commercial $74.40
Rate for Payer: Preferred Network Access Commercial $114.08
Rate for Payer: Quartz Beloit One Network $60.76
Rate for Payer: Quartz Commercial $74.40
Rate for Payer: WEA Trust Commercial $68.20
Rate for Payer: WPS Commercial $91.85
Hospital Charge Code 2969229
Hospital Revenue Code 271
Min. Negotiated Rate $60.76
Max. Negotiated Rate $114.08
Rate for Payer: Aetna Commercial $111.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $106.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $65.72
Rate for Payer: Cash Price $37.20
Rate for Payer: Cigna Commercial $114.08
Rate for Payer: Health EOS Commercial $110.36
Rate for Payer: HFN Commercial $114.08
Rate for Payer: Multiplan Commercial $99.20
Rate for Payer: NAPHCARE Commercial $74.40
Rate for Payer: Preferred Network Access Commercial $114.08
Rate for Payer: Quartz Beloit One Network $60.76
Rate for Payer: Quartz Commercial $74.40
Rate for Payer: WEA Trust Commercial $68.20
Rate for Payer: WPS Commercial $91.85
Hospital Charge Code 2969229
Hospital Revenue Code 271
Min. Negotiated Rate $34.72
Max. Negotiated Rate $496.00
Rate for Payer: Aetna Commercial $111.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $106.64
Rate for Payer: Aetna Managed Medicare $34.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $80.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $62.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $59.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $65.72
Rate for Payer: Cash Price $37.20
Rate for Payer: Cigna Commercial $114.08
Rate for Payer: Dean Health DHI/DHP/ASO $69.39
Rate for Payer: Health EOS Commercial $110.36
Rate for Payer: HFN Commercial $114.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $93.00
Rate for Payer: Multiplan Commercial $99.20
Rate for Payer: NAPHCARE Commercial $74.40
Rate for Payer: Preferred Network Access Commercial $114.08
Rate for Payer: Quartz Beloit One Network $60.76
Rate for Payer: Quartz Commercial $80.60
Rate for Payer: Quartz Medicare Advantage $74.40
Rate for Payer: The Alliance Commercial $496.00
Rate for Payer: WEA Trust Commercial $68.20
Rate for Payer: WPS Commercial $91.85
Hospital Charge Code 2963037
Hospital Revenue Code 271
Min. Negotiated Rate $12.60
Max. Negotiated Rate $180.00
Rate for Payer: Aetna Commercial $40.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $38.70
Rate for Payer: Aetna Managed Medicare $12.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $29.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $22.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $21.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $23.85
Rate for Payer: Cash Price $13.50
Rate for Payer: Cigna Commercial $41.40
Rate for Payer: Dean Health DHI/DHP/ASO $25.18
Rate for Payer: Health EOS Commercial $40.05
Rate for Payer: HFN Commercial $41.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $33.75
Rate for Payer: Multiplan Commercial $36.00
Rate for Payer: NAPHCARE Commercial $27.00
Rate for Payer: Preferred Network Access Commercial $41.40
Rate for Payer: Quartz Beloit One Network $22.05
Rate for Payer: Quartz Commercial $29.25
Rate for Payer: Quartz Medicare Advantage $27.00
Rate for Payer: The Alliance Commercial $180.00
Rate for Payer: WEA Trust Commercial $24.75
Rate for Payer: WPS Commercial $33.33
Hospital Charge Code 2963037
Hospital Revenue Code 271
Min. Negotiated Rate $22.05
Max. Negotiated Rate $41.40
Rate for Payer: Aetna Commercial $40.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $38.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $23.85
Rate for Payer: Cash Price $13.50
Rate for Payer: Cigna Commercial $41.40
Rate for Payer: Health EOS Commercial $40.05
Rate for Payer: HFN Commercial $41.40
Rate for Payer: Multiplan Commercial $36.00
Rate for Payer: NAPHCARE Commercial $27.00
Rate for Payer: Preferred Network Access Commercial $41.40
Rate for Payer: Quartz Beloit One Network $22.05
Rate for Payer: Quartz Commercial $27.00
Rate for Payer: WEA Trust Commercial $24.75
Rate for Payer: WPS Commercial $33.33
Service Code CPT 87110
Hospital Charge Code 2942879
Hospital Revenue Code 300
Min. Negotiated Rate $19.60
Max. Negotiated Rate $200.56
Rate for Payer: Aetna Commercial $196.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $187.48
Rate for Payer: Aetna Managed Medicare $19.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $73.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $34.30
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $32.54
Rate for Payer: Anthem Medicaid $20.25
Rate for Payer: Anthem Medicare Advantage $19.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $115.54
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $19.60
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $19.60
Rate for Payer: Cash Price $65.40
Rate for Payer: Cash Price $65.40
Rate for Payer: Cigna Commercial $200.56
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $19.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $20.25
Rate for Payer: Dean Health DHI/DHP/ASO $121.99
Rate for Payer: Dean Health Medicaid $20.25
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $19.60
Rate for Payer: Health EOS Commercial $194.02
Rate for Payer: HFN Commercial $200.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $72.91
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $19.60
Rate for Payer: Independent Care Health Plan Medicaid $20.25
Rate for Payer: Independent Care Health Plan Medicare $19.60
Rate for Payer: Managed Health Services Medicaid $21.06
Rate for Payer: Managed Health Services Medicare Advantage $19.60
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $19.60
Rate for Payer: Multiplan Commercial $174.40
Rate for Payer: NAPHCARE Commercial $29.40
Rate for Payer: Preferred Network Access Commercial $200.56
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $20.25
Rate for Payer: Quartz Beloit One Network $106.82
Rate for Payer: Quartz Commercial $141.70
Rate for Payer: Quartz Medicare Advantage $19.60
Rate for Payer: The Alliance Commercial $78.40
Rate for Payer: United Healthcare Medicaid $20.25
Rate for Payer: United Healthcare Medicare Advantage $19.60
Rate for Payer: United Healthcare PPO $163.50
Rate for Payer: WEA Trust Commercial $119.90
Rate for Payer: Wellcare Medicare $19.60
Rate for Payer: WMAP Medicaid $20.25
Rate for Payer: WPS Commercial $161.47
Service Code CPT 87110
Hospital Charge Code 2942879
Hospital Revenue Code 300
Min. Negotiated Rate $69.19
Max. Negotiated Rate $207.10
Rate for Payer: Aetna Commercial $207.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $187.48
Rate for Payer: Cash Price $65.40
Rate for Payer: Cash Price $65.40
Rate for Payer: Cigna Commercial $207.10
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $109.00
Rate for Payer: Dean Health DHI/DHP/ASO $130.80
Rate for Payer: Health EOS Commercial $198.38
Rate for Payer: HFN Commercial $207.10
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $69.19
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $69.19
Rate for Payer: Multiplan Commercial $174.40
Rate for Payer: Preferred Network Access Commercial $207.10
Rate for Payer: Quartz Beloit One Network $95.92
Rate for Payer: Quartz Commercial $124.26
Rate for Payer: The Alliance Commercial $109.00
Rate for Payer: WEA Trust Commercial $119.90
Rate for Payer: WPS Commercial $161.47
Service Code CPT 87110
Hospital Charge Code 2942879
Hospital Revenue Code 300
Min. Negotiated Rate $106.82
Max. Negotiated Rate $200.56
Rate for Payer: Aetna Commercial $196.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $187.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $115.54
Rate for Payer: Cash Price $65.40
Rate for Payer: Cigna Commercial $200.56
Rate for Payer: Health EOS Commercial $194.02
Rate for Payer: HFN Commercial $200.56
Rate for Payer: Multiplan Commercial $174.40
Rate for Payer: NAPHCARE Commercial $130.80
Rate for Payer: Preferred Network Access Commercial $200.56
Rate for Payer: Quartz Beloit One Network $106.82
Rate for Payer: Quartz Commercial $130.80
Rate for Payer: WEA Trust Commercial $119.90
Rate for Payer: WPS Commercial $161.47
Hospital Charge Code 2778816
Hospital Revenue Code 300
Min. Negotiated Rate $31.92
Max. Negotiated Rate $456.00
Rate for Payer: Aetna Commercial $102.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $98.04
Rate for Payer: Aetna Managed Medicare $31.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $74.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $57.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $54.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $60.42
Rate for Payer: Cash Price $34.20
Rate for Payer: Cigna Commercial $104.88
Rate for Payer: Dean Health DHI/DHP/ASO $63.79
Rate for Payer: Health EOS Commercial $101.46
Rate for Payer: HFN Commercial $104.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $85.50
Rate for Payer: Multiplan Commercial $91.20
Rate for Payer: NAPHCARE Commercial $68.40
Rate for Payer: Preferred Network Access Commercial $104.88
Rate for Payer: Quartz Beloit One Network $55.86
Rate for Payer: Quartz Commercial $74.10
Rate for Payer: Quartz Medicare Advantage $68.40
Rate for Payer: The Alliance Commercial $456.00
Rate for Payer: United Healthcare PPO $85.50
Rate for Payer: WEA Trust Commercial $62.70
Rate for Payer: WPS Commercial $84.44
Hospital Charge Code 2778816
Hospital Revenue Code 300
Min. Negotiated Rate $50.16
Max. Negotiated Rate $108.30
Rate for Payer: Aetna Commercial $108.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $98.04
Rate for Payer: Cash Price $34.20
Rate for Payer: Cigna Commercial $108.30
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $57.00
Rate for Payer: Dean Health DHI/DHP/ASO $68.40
Rate for Payer: Health EOS Commercial $103.74
Rate for Payer: HFN Commercial $108.30
Rate for Payer: Multiplan Commercial $91.20
Rate for Payer: Preferred Network Access Commercial $108.30
Rate for Payer: Quartz Beloit One Network $50.16
Rate for Payer: Quartz Commercial $64.98
Rate for Payer: The Alliance Commercial $57.00
Rate for Payer: WEA Trust Commercial $62.70
Rate for Payer: WPS Commercial $84.44
Hospital Charge Code 2778816
Hospital Revenue Code 300
Min. Negotiated Rate $55.86
Max. Negotiated Rate $104.88
Rate for Payer: Aetna Commercial $102.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $98.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $60.42
Rate for Payer: Cash Price $34.20
Rate for Payer: Cigna Commercial $104.88
Rate for Payer: Health EOS Commercial $101.46
Rate for Payer: HFN Commercial $104.88
Rate for Payer: Multiplan Commercial $91.20
Rate for Payer: NAPHCARE Commercial $68.40
Rate for Payer: Preferred Network Access Commercial $104.88
Rate for Payer: Quartz Beloit One Network $55.86
Rate for Payer: Quartz Commercial $68.40
Rate for Payer: WEA Trust Commercial $62.70
Rate for Payer: WPS Commercial $84.44
Hospital Charge Code 5729721
Hospital Revenue Code 272
Min. Negotiated Rate $434.00
Max. Negotiated Rate $6,200.00
Rate for Payer: Aetna Commercial $1,395.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,333.00
Rate for Payer: Aetna Managed Medicare $434.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,007.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $775.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $744.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $821.50
Rate for Payer: Cash Price $465.00
Rate for Payer: Cigna Commercial $1,426.00
Rate for Payer: Dean Health DHI/DHP/ASO $867.38
Rate for Payer: Health EOS Commercial $1,379.50
Rate for Payer: HFN Commercial $1,426.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,162.50
Rate for Payer: Multiplan Commercial $1,240.00
Rate for Payer: NAPHCARE Commercial $930.00
Rate for Payer: Preferred Network Access Commercial $1,426.00
Rate for Payer: Quartz Beloit One Network $759.50
Rate for Payer: Quartz Commercial $1,007.50
Rate for Payer: Quartz Medicare Advantage $930.00
Rate for Payer: The Alliance Commercial $6,200.00
Rate for Payer: WEA Trust Commercial $852.50
Rate for Payer: WPS Commercial $1,148.08
Hospital Charge Code 5729721
Hospital Revenue Code 272
Min. Negotiated Rate $759.50
Max. Negotiated Rate $1,426.00
Rate for Payer: Aetna Commercial $1,395.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,333.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $821.50
Rate for Payer: Cash Price $465.00
Rate for Payer: Cigna Commercial $1,426.00
Rate for Payer: Health EOS Commercial $1,379.50
Rate for Payer: HFN Commercial $1,426.00
Rate for Payer: Multiplan Commercial $1,240.00
Rate for Payer: NAPHCARE Commercial $930.00
Rate for Payer: Preferred Network Access Commercial $1,426.00
Rate for Payer: Quartz Beloit One Network $759.50
Rate for Payer: Quartz Commercial $930.00
Rate for Payer: WEA Trust Commercial $852.50
Rate for Payer: WPS Commercial $1,148.08
Hospital Charge Code 5729718
Hospital Revenue Code 272
Min. Negotiated Rate $738.92
Max. Negotiated Rate $1,387.36
Rate for Payer: Aetna Commercial $1,357.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,296.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $799.24
Rate for Payer: Cash Price $452.40
Rate for Payer: Cigna Commercial $1,387.36
Rate for Payer: Health EOS Commercial $1,342.12
Rate for Payer: HFN Commercial $1,387.36
Rate for Payer: Multiplan Commercial $1,206.40
Rate for Payer: NAPHCARE Commercial $904.80
Rate for Payer: Preferred Network Access Commercial $1,387.36
Rate for Payer: Quartz Beloit One Network $738.92
Rate for Payer: Quartz Commercial $904.80
Rate for Payer: WEA Trust Commercial $829.40
Rate for Payer: WPS Commercial $1,116.98
Hospital Charge Code 5729718
Hospital Revenue Code 272
Min. Negotiated Rate $422.24
Max. Negotiated Rate $6,032.00
Rate for Payer: Aetna Commercial $1,357.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,296.88
Rate for Payer: Aetna Managed Medicare $422.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $980.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $754.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $723.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $799.24
Rate for Payer: Cash Price $452.40
Rate for Payer: Cigna Commercial $1,387.36
Rate for Payer: Dean Health DHI/DHP/ASO $843.88
Rate for Payer: Health EOS Commercial $1,342.12
Rate for Payer: HFN Commercial $1,387.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,131.00
Rate for Payer: Multiplan Commercial $1,206.40
Rate for Payer: NAPHCARE Commercial $904.80
Rate for Payer: Preferred Network Access Commercial $1,387.36
Rate for Payer: Quartz Beloit One Network $738.92
Rate for Payer: Quartz Commercial $980.20
Rate for Payer: Quartz Medicare Advantage $904.80
Rate for Payer: The Alliance Commercial $6,032.00
Rate for Payer: WEA Trust Commercial $829.40
Rate for Payer: WPS Commercial $1,116.98
Service Code CPT 85045
Hospital Charge Code 633822
Hospital Revenue Code 300
Min. Negotiated Rate $47.04
Max. Negotiated Rate $88.32
Rate for Payer: Aetna Commercial $86.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $82.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $50.88
Rate for Payer: Cash Price $28.80
Rate for Payer: Cigna Commercial $88.32
Rate for Payer: Health EOS Commercial $85.44
Rate for Payer: HFN Commercial $88.32
Rate for Payer: Multiplan Commercial $76.80
Rate for Payer: NAPHCARE Commercial $57.60
Rate for Payer: Preferred Network Access Commercial $88.32
Rate for Payer: Quartz Beloit One Network $47.04
Rate for Payer: Quartz Commercial $57.60
Rate for Payer: WEA Trust Commercial $52.80
Rate for Payer: WPS Commercial $71.11
Service Code CPT 85045
Hospital Charge Code 633822
Hospital Revenue Code 300
Min. Negotiated Rate $14.08
Max. Negotiated Rate $91.20
Rate for Payer: Aetna Commercial $91.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $82.56
Rate for Payer: Cash Price $28.80
Rate for Payer: Cash Price $28.80
Rate for Payer: Cigna Commercial $91.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $48.00
Rate for Payer: Dean Health DHI/DHP/ASO $57.60
Rate for Payer: Health EOS Commercial $87.36
Rate for Payer: HFN Commercial $91.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $14.08
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $14.08
Rate for Payer: Multiplan Commercial $76.80
Rate for Payer: Preferred Network Access Commercial $91.20
Rate for Payer: Quartz Beloit One Network $42.24
Rate for Payer: Quartz Commercial $54.72
Rate for Payer: The Alliance Commercial $48.00
Rate for Payer: WEA Trust Commercial $52.80
Rate for Payer: WPS Commercial $71.11
Service Code CPT 85045
Hospital Charge Code 633822
Hospital Revenue Code 300
Min. Negotiated Rate $3.99
Max. Negotiated Rate $88.32
Rate for Payer: Aetna Commercial $86.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $82.56
Rate for Payer: Aetna Managed Medicare $3.99
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $14.96
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $6.98
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $6.62
Rate for Payer: Anthem Medicaid $4.12
Rate for Payer: Anthem Medicare Advantage $3.99
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $50.88
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $3.99
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $3.99
Rate for Payer: Cash Price $28.80
Rate for Payer: Cash Price $28.80
Rate for Payer: Cigna Commercial $88.32
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $3.99
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $4.12
Rate for Payer: Dean Health DHI/DHP/ASO $53.72
Rate for Payer: Dean Health Medicaid $4.12
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $3.99
Rate for Payer: Health EOS Commercial $85.44
Rate for Payer: HFN Commercial $88.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $14.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $3.99
Rate for Payer: Independent Care Health Plan Medicaid $4.12
Rate for Payer: Independent Care Health Plan Medicare $3.99
Rate for Payer: Managed Health Services Medicaid $4.28
Rate for Payer: Managed Health Services Medicare Advantage $3.99
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $3.99
Rate for Payer: Multiplan Commercial $76.80
Rate for Payer: NAPHCARE Commercial $5.98
Rate for Payer: Preferred Network Access Commercial $88.32
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $4.12
Rate for Payer: Quartz Beloit One Network $47.04
Rate for Payer: Quartz Commercial $62.40
Rate for Payer: Quartz Medicare Advantage $3.99
Rate for Payer: The Alliance Commercial $15.96
Rate for Payer: United Healthcare Medicaid $4.12
Rate for Payer: United Healthcare Medicare Advantage $3.99
Rate for Payer: United Healthcare PPO $72.00
Rate for Payer: WEA Trust Commercial $52.80
Rate for Payer: Wellcare Medicare $3.99
Rate for Payer: WMAP Medicaid $4.12
Rate for Payer: WPS Commercial $71.11
Service Code MSDRG 815
Min. Negotiated Rate $9,623.09
Max. Negotiated Rate $26,752.00
Rate for Payer: Aetna Managed Medicare $9,623.09
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $20,770.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $15,920.19
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $15,125.22
Rate for Payer: Anthem Medicare Advantage $9,623.09
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $9,623.09
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $9,623.09
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $9,623.09
Rate for Payer: Dean Health DHI/DHP/ASO $16,790.38
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $9,623.09
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $19,386.90
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $9,623.09
Rate for Payer: Independent Care Health Plan Medicare $9,623.09
Rate for Payer: Managed Health Services Medicare Advantage $9,623.09
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $9,623.09
Rate for Payer: NAPHCARE Commercial $14,434.64
Rate for Payer: Quartz Medicare Advantage $9,623.09
Rate for Payer: The Alliance Commercial $26,752.00
Rate for Payer: United Healthcare Medicare Advantage $9,623.09
Rate for Payer: United Healthcare PPO $15,092.95
Rate for Payer: Wellcare Medicare $9,623.09
Service Code MSDRG 814
Min. Negotiated Rate $20,466.90
Max. Negotiated Rate $56,898.00
Rate for Payer: Aetna Managed Medicare $20,466.90
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $44,687.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $34,252.53
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $32,542.14
Rate for Payer: Anthem Medicare Advantage $20,466.90
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $20,466.90
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $20,466.90
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $20,466.90
Rate for Payer: Dean Health DHI/DHP/ASO $36,124.76
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $20,466.90
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $41,497.95
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $20,466.90
Rate for Payer: Independent Care Health Plan Medicare $20,466.90
Rate for Payer: Managed Health Services Medicare Advantage $20,466.90
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $20,466.90
Rate for Payer: NAPHCARE Commercial $30,700.35
Rate for Payer: Quartz Medicare Advantage $20,466.90
Rate for Payer: The Alliance Commercial $56,898.00
Rate for Payer: United Healthcare Medicare Advantage $20,466.90
Rate for Payer: United Healthcare PPO $32,306.69
Rate for Payer: Wellcare Medicare $20,466.90
Service Code MSDRG 816
Min. Negotiated Rate $6,907.12
Max. Negotiated Rate $19,202.00
Rate for Payer: Aetna Managed Medicare $6,907.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $14,895.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $11,417.51
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,847.38
Rate for Payer: Anthem Medicare Advantage $6,907.12
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $6,907.12
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $6,907.12
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $6,907.12
Rate for Payer: Dean Health DHI/DHP/ASO $12,041.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $6,907.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $13,848.90
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $6,907.12
Rate for Payer: Independent Care Health Plan Medicare $6,907.12
Rate for Payer: Managed Health Services Medicare Advantage $6,907.12
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $6,907.12
Rate for Payer: NAPHCARE Commercial $10,360.68
Rate for Payer: Quartz Medicare Advantage $6,907.12
Rate for Payer: The Alliance Commercial $19,202.00
Rate for Payer: United Healthcare Medicare Advantage $6,907.12
Rate for Payer: United Healthcare PPO $10,781.55
Rate for Payer: Wellcare Medicare $6,907.12