Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS C1713
Hospital Charge Code 5496984
Hospital Revenue Code 278
Min. Negotiated Rate $319.48
Max. Negotiated Rate $599.84
Rate for Payer: Aetna Commercial $586.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $560.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $345.56
Rate for Payer: Cash Price $195.60
Rate for Payer: Cigna Commercial $599.84
Rate for Payer: Health EOS Commercial $580.28
Rate for Payer: HFN Commercial $599.84
Rate for Payer: Multiplan Commercial $521.60
Rate for Payer: NAPHCARE Commercial $391.20
Rate for Payer: Preferred Network Access Commercial $599.84
Rate for Payer: Quartz Beloit One Network $319.48
Rate for Payer: Quartz Commercial $391.20
Rate for Payer: WEA Trust Commercial $358.60
Rate for Payer: WPS Commercial $482.94
Service Code HCPCS C1713
Hospital Charge Code 6244121
Hospital Revenue Code 278
Min. Negotiated Rate $287.00
Max. Negotiated Rate $538.85
Rate for Payer: Aetna Commercial $527.14
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $503.71
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $310.43
Rate for Payer: Cash Price $175.71
Rate for Payer: Cigna Commercial $538.85
Rate for Payer: Health EOS Commercial $521.28
Rate for Payer: HFN Commercial $538.85
Rate for Payer: Multiplan Commercial $468.57
Rate for Payer: NAPHCARE Commercial $351.43
Rate for Payer: Preferred Network Access Commercial $538.85
Rate for Payer: Quartz Beloit One Network $287.00
Rate for Payer: Quartz Commercial $351.43
Rate for Payer: WEA Trust Commercial $322.14
Rate for Payer: WPS Commercial $433.84
Service Code HCPCS C1713
Hospital Charge Code 6244121
Hospital Revenue Code 278
Min. Negotiated Rate $164.00
Max. Negotiated Rate $2,342.84
Rate for Payer: Aetna Commercial $527.14
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $503.71
Rate for Payer: Aetna Managed Medicare $164.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $380.71
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $292.86
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $281.14
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $310.43
Rate for Payer: Cash Price $175.71
Rate for Payer: Cigna Commercial $538.85
Rate for Payer: Dean Health DHI/DHP/ASO $327.76
Rate for Payer: Health EOS Commercial $521.28
Rate for Payer: HFN Commercial $538.85
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $439.28
Rate for Payer: Multiplan Commercial $468.57
Rate for Payer: NAPHCARE Commercial $351.43
Rate for Payer: Preferred Network Access Commercial $538.85
Rate for Payer: Quartz Beloit One Network $287.00
Rate for Payer: Quartz Commercial $380.71
Rate for Payer: Quartz Medicare Advantage $351.43
Rate for Payer: The Alliance Commercial $2,342.84
Rate for Payer: WEA Trust Commercial $322.14
Rate for Payer: WPS Commercial $433.84
Service Code HCPCS C1713
Hospital Charge Code 2967049
Hospital Revenue Code 278
Min. Negotiated Rate $83.79
Max. Negotiated Rate $157.32
Rate for Payer: Aetna Commercial $153.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $147.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $90.63
Rate for Payer: Cash Price $51.30
Rate for Payer: Cigna Commercial $157.32
Rate for Payer: Health EOS Commercial $152.19
Rate for Payer: HFN Commercial $157.32
Rate for Payer: Multiplan Commercial $136.80
Rate for Payer: NAPHCARE Commercial $102.60
Rate for Payer: Preferred Network Access Commercial $157.32
Rate for Payer: Quartz Beloit One Network $83.79
Rate for Payer: Quartz Commercial $102.60
Rate for Payer: WEA Trust Commercial $94.05
Rate for Payer: WPS Commercial $126.66
Service Code HCPCS C1713
Hospital Charge Code 2967049
Hospital Revenue Code 278
Min. Negotiated Rate $47.88
Max. Negotiated Rate $684.00
Rate for Payer: Aetna Commercial $153.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $147.06
Rate for Payer: Aetna Managed Medicare $47.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $111.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $85.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $82.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $90.63
Rate for Payer: Cash Price $51.30
Rate for Payer: Cigna Commercial $157.32
Rate for Payer: Dean Health DHI/DHP/ASO $95.69
Rate for Payer: Health EOS Commercial $152.19
Rate for Payer: HFN Commercial $157.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $128.25
Rate for Payer: Multiplan Commercial $136.80
Rate for Payer: NAPHCARE Commercial $102.60
Rate for Payer: Preferred Network Access Commercial $157.32
Rate for Payer: Quartz Beloit One Network $83.79
Rate for Payer: Quartz Commercial $111.15
Rate for Payer: Quartz Medicare Advantage $102.60
Rate for Payer: The Alliance Commercial $684.00
Rate for Payer: WEA Trust Commercial $94.05
Rate for Payer: WPS Commercial $126.66
Service Code HCPCS C1713
Hospital Charge Code 2967050
Hospital Revenue Code 278
Min. Negotiated Rate $102.90
Max. Negotiated Rate $193.20
Rate for Payer: Aetna Commercial $189.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $180.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $111.30
Rate for Payer: Cash Price $63.00
Rate for Payer: Cigna Commercial $193.20
Rate for Payer: Health EOS Commercial $186.90
Rate for Payer: HFN Commercial $193.20
Rate for Payer: Multiplan Commercial $168.00
Rate for Payer: NAPHCARE Commercial $126.00
Rate for Payer: Preferred Network Access Commercial $193.20
Rate for Payer: Quartz Beloit One Network $102.90
Rate for Payer: Quartz Commercial $126.00
Rate for Payer: WEA Trust Commercial $115.50
Rate for Payer: WPS Commercial $155.55
Service Code HCPCS C1713
Hospital Charge Code 2967050
Hospital Revenue Code 278
Min. Negotiated Rate $58.80
Max. Negotiated Rate $840.00
Rate for Payer: Aetna Commercial $189.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $180.60
Rate for Payer: Aetna Managed Medicare $58.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $136.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $105.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $100.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $111.30
Rate for Payer: Cash Price $63.00
Rate for Payer: Cigna Commercial $193.20
Rate for Payer: Dean Health DHI/DHP/ASO $117.52
Rate for Payer: Health EOS Commercial $186.90
Rate for Payer: HFN Commercial $193.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $157.50
Rate for Payer: Multiplan Commercial $168.00
Rate for Payer: NAPHCARE Commercial $126.00
Rate for Payer: Preferred Network Access Commercial $193.20
Rate for Payer: Quartz Beloit One Network $102.90
Rate for Payer: Quartz Commercial $136.50
Rate for Payer: Quartz Medicare Advantage $126.00
Rate for Payer: The Alliance Commercial $840.00
Rate for Payer: WEA Trust Commercial $115.50
Rate for Payer: WPS Commercial $155.55
Service Code HCPCS C1713
Hospital Charge Code 2967051
Hospital Revenue Code 278
Min. Negotiated Rate $83.79
Max. Negotiated Rate $157.32
Rate for Payer: Aetna Commercial $153.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $147.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $90.63
Rate for Payer: Cash Price $51.30
Rate for Payer: Cigna Commercial $157.32
Rate for Payer: Health EOS Commercial $152.19
Rate for Payer: HFN Commercial $157.32
Rate for Payer: Multiplan Commercial $136.80
Rate for Payer: NAPHCARE Commercial $102.60
Rate for Payer: Preferred Network Access Commercial $157.32
Rate for Payer: Quartz Beloit One Network $83.79
Rate for Payer: Quartz Commercial $102.60
Rate for Payer: WEA Trust Commercial $94.05
Rate for Payer: WPS Commercial $126.66
Service Code HCPCS C1713
Hospital Charge Code 2967051
Hospital Revenue Code 278
Min. Negotiated Rate $47.88
Max. Negotiated Rate $684.00
Rate for Payer: Aetna Commercial $153.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $147.06
Rate for Payer: Aetna Managed Medicare $47.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $111.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $85.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $82.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $90.63
Rate for Payer: Cash Price $51.30
Rate for Payer: Cigna Commercial $157.32
Rate for Payer: Dean Health DHI/DHP/ASO $95.69
Rate for Payer: Health EOS Commercial $152.19
Rate for Payer: HFN Commercial $157.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $128.25
Rate for Payer: Multiplan Commercial $136.80
Rate for Payer: NAPHCARE Commercial $102.60
Rate for Payer: Preferred Network Access Commercial $157.32
Rate for Payer: Quartz Beloit One Network $83.79
Rate for Payer: Quartz Commercial $111.15
Rate for Payer: Quartz Medicare Advantage $102.60
Rate for Payer: The Alliance Commercial $684.00
Rate for Payer: WEA Trust Commercial $94.05
Rate for Payer: WPS Commercial $126.66
Service Code HCPCS C1713
Hospital Charge Code 2967052
Hospital Revenue Code 278
Min. Negotiated Rate $61.04
Max. Negotiated Rate $872.00
Rate for Payer: Aetna Commercial $196.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $187.48
Rate for Payer: Aetna Managed Medicare $61.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $141.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $109.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $104.64
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: Dean Health DHI/DHP/ASO $121.99
Rate for Payer: Health EOS Commercial $194.02
Rate for Payer: HFN Commercial $200.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $163.50
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 $141.70
Rate for Payer: Quartz Medicare Advantage $130.80
Rate for Payer: The Alliance Commercial $872.00
Rate for Payer: WEA Trust Commercial $119.90
Rate for Payer: WPS Commercial $161.47
Service Code HCPCS C1713
Hospital Charge Code 2967052
Hospital Revenue Code 278
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
Service Code HCPCS C1713
Hospital Charge Code 6171772
Hospital Revenue Code 278
Min. Negotiated Rate $295.47
Max. Negotiated Rate $554.76
Rate for Payer: Aetna Commercial $542.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $518.58
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $319.59
Rate for Payer: Cash Price $180.90
Rate for Payer: Cigna Commercial $554.76
Rate for Payer: Health EOS Commercial $536.67
Rate for Payer: HFN Commercial $554.76
Rate for Payer: Multiplan Commercial $482.40
Rate for Payer: NAPHCARE Commercial $361.80
Rate for Payer: Preferred Network Access Commercial $554.76
Rate for Payer: Quartz Beloit One Network $295.47
Rate for Payer: Quartz Commercial $361.80
Rate for Payer: WEA Trust Commercial $331.65
Rate for Payer: WPS Commercial $446.64
Service Code HCPCS C1713
Hospital Charge Code 6171772
Hospital Revenue Code 278
Min. Negotiated Rate $168.84
Max. Negotiated Rate $2,412.00
Rate for Payer: Aetna Commercial $542.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $518.58
Rate for Payer: Aetna Managed Medicare $168.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $391.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $301.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $289.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $319.59
Rate for Payer: Cash Price $180.90
Rate for Payer: Cigna Commercial $554.76
Rate for Payer: Dean Health DHI/DHP/ASO $337.44
Rate for Payer: Health EOS Commercial $536.67
Rate for Payer: HFN Commercial $554.76
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $452.25
Rate for Payer: Multiplan Commercial $482.40
Rate for Payer: NAPHCARE Commercial $361.80
Rate for Payer: Preferred Network Access Commercial $554.76
Rate for Payer: Quartz Beloit One Network $295.47
Rate for Payer: Quartz Commercial $391.95
Rate for Payer: Quartz Medicare Advantage $361.80
Rate for Payer: The Alliance Commercial $2,412.00
Rate for Payer: WEA Trust Commercial $331.65
Rate for Payer: WPS Commercial $446.64
Service Code HCPCS C1713
Hospital Charge Code 2967053
Hospital Revenue Code 278
Min. Negotiated Rate $49.84
Max. Negotiated Rate $712.00
Rate for Payer: Aetna Commercial $160.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $153.08
Rate for Payer: Aetna Managed Medicare $49.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $115.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $89.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $85.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $94.34
Rate for Payer: Cash Price $53.40
Rate for Payer: Cigna Commercial $163.76
Rate for Payer: Dean Health DHI/DHP/ASO $99.61
Rate for Payer: Health EOS Commercial $158.42
Rate for Payer: HFN Commercial $163.76
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $133.50
Rate for Payer: Multiplan Commercial $142.40
Rate for Payer: NAPHCARE Commercial $106.80
Rate for Payer: Preferred Network Access Commercial $163.76
Rate for Payer: Quartz Beloit One Network $87.22
Rate for Payer: Quartz Commercial $115.70
Rate for Payer: Quartz Medicare Advantage $106.80
Rate for Payer: The Alliance Commercial $712.00
Rate for Payer: WEA Trust Commercial $97.90
Rate for Payer: WPS Commercial $131.84
Service Code HCPCS C1713
Hospital Charge Code 2967053
Hospital Revenue Code 278
Min. Negotiated Rate $87.22
Max. Negotiated Rate $163.76
Rate for Payer: Aetna Commercial $160.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $153.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $94.34
Rate for Payer: Cash Price $53.40
Rate for Payer: Cigna Commercial $163.76
Rate for Payer: Health EOS Commercial $158.42
Rate for Payer: HFN Commercial $163.76
Rate for Payer: Multiplan Commercial $142.40
Rate for Payer: NAPHCARE Commercial $106.80
Rate for Payer: Preferred Network Access Commercial $163.76
Rate for Payer: Quartz Beloit One Network $87.22
Rate for Payer: Quartz Commercial $106.80
Rate for Payer: WEA Trust Commercial $97.90
Rate for Payer: WPS Commercial $131.84
Service Code HCPCS C1713
Hospital Charge Code 2967054
Hospital Revenue Code 278
Min. Negotiated Rate $102.90
Max. Negotiated Rate $193.20
Rate for Payer: Aetna Commercial $189.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $180.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $111.30
Rate for Payer: Cash Price $63.00
Rate for Payer: Cigna Commercial $193.20
Rate for Payer: Health EOS Commercial $186.90
Rate for Payer: HFN Commercial $193.20
Rate for Payer: Multiplan Commercial $168.00
Rate for Payer: NAPHCARE Commercial $126.00
Rate for Payer: Preferred Network Access Commercial $193.20
Rate for Payer: Quartz Beloit One Network $102.90
Rate for Payer: Quartz Commercial $126.00
Rate for Payer: WEA Trust Commercial $115.50
Rate for Payer: WPS Commercial $155.55
Service Code HCPCS C1713
Hospital Charge Code 2967054
Hospital Revenue Code 278
Min. Negotiated Rate $58.80
Max. Negotiated Rate $840.00
Rate for Payer: Aetna Commercial $189.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $180.60
Rate for Payer: Aetna Managed Medicare $58.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $136.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $105.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $100.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $111.30
Rate for Payer: Cash Price $63.00
Rate for Payer: Cigna Commercial $193.20
Rate for Payer: Dean Health DHI/DHP/ASO $117.52
Rate for Payer: Health EOS Commercial $186.90
Rate for Payer: HFN Commercial $193.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $157.50
Rate for Payer: Multiplan Commercial $168.00
Rate for Payer: NAPHCARE Commercial $126.00
Rate for Payer: Preferred Network Access Commercial $193.20
Rate for Payer: Quartz Beloit One Network $102.90
Rate for Payer: Quartz Commercial $136.50
Rate for Payer: Quartz Medicare Advantage $126.00
Rate for Payer: The Alliance Commercial $840.00
Rate for Payer: WEA Trust Commercial $115.50
Rate for Payer: WPS Commercial $155.55
Service Code HCPCS C1713
Hospital Charge Code 4494437
Hospital Revenue Code 278
Min. Negotiated Rate $243.04
Max. Negotiated Rate $456.32
Rate for Payer: Aetna Commercial $446.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $426.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $262.88
Rate for Payer: Cash Price $148.80
Rate for Payer: Cigna Commercial $456.32
Rate for Payer: Health EOS Commercial $441.44
Rate for Payer: HFN Commercial $456.32
Rate for Payer: Multiplan Commercial $396.80
Rate for Payer: NAPHCARE Commercial $297.60
Rate for Payer: Preferred Network Access Commercial $456.32
Rate for Payer: Quartz Beloit One Network $243.04
Rate for Payer: Quartz Commercial $297.60
Rate for Payer: WEA Trust Commercial $272.80
Rate for Payer: WPS Commercial $367.39
Service Code HCPCS C1713
Hospital Charge Code 4494437
Hospital Revenue Code 278
Min. Negotiated Rate $138.88
Max. Negotiated Rate $1,984.00
Rate for Payer: Aetna Commercial $446.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $426.56
Rate for Payer: Aetna Managed Medicare $138.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $322.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $248.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $238.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $262.88
Rate for Payer: Cash Price $148.80
Rate for Payer: Cigna Commercial $456.32
Rate for Payer: Dean Health DHI/DHP/ASO $277.56
Rate for Payer: Health EOS Commercial $441.44
Rate for Payer: HFN Commercial $456.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $372.00
Rate for Payer: Multiplan Commercial $396.80
Rate for Payer: NAPHCARE Commercial $297.60
Rate for Payer: Preferred Network Access Commercial $456.32
Rate for Payer: Quartz Beloit One Network $243.04
Rate for Payer: Quartz Commercial $322.40
Rate for Payer: Quartz Medicare Advantage $297.60
Rate for Payer: The Alliance Commercial $1,984.00
Rate for Payer: WEA Trust Commercial $272.80
Rate for Payer: WPS Commercial $367.39
Service Code HCPCS C1713
Hospital Charge Code 4494438
Hospital Revenue Code 278
Min. Negotiated Rate $243.04
Max. Negotiated Rate $456.32
Rate for Payer: Aetna Commercial $446.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $426.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $262.88
Rate for Payer: Cash Price $148.80
Rate for Payer: Cigna Commercial $456.32
Rate for Payer: Health EOS Commercial $441.44
Rate for Payer: HFN Commercial $456.32
Rate for Payer: Multiplan Commercial $396.80
Rate for Payer: NAPHCARE Commercial $297.60
Rate for Payer: Preferred Network Access Commercial $456.32
Rate for Payer: Quartz Beloit One Network $243.04
Rate for Payer: Quartz Commercial $297.60
Rate for Payer: WEA Trust Commercial $272.80
Rate for Payer: WPS Commercial $367.39
Service Code HCPCS C1713
Hospital Charge Code 4494438
Hospital Revenue Code 278
Min. Negotiated Rate $138.88
Max. Negotiated Rate $1,984.00
Rate for Payer: Aetna Commercial $446.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $426.56
Rate for Payer: Aetna Managed Medicare $138.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $322.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $248.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $238.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $262.88
Rate for Payer: Cash Price $148.80
Rate for Payer: Cigna Commercial $456.32
Rate for Payer: Dean Health DHI/DHP/ASO $277.56
Rate for Payer: Health EOS Commercial $441.44
Rate for Payer: HFN Commercial $456.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $372.00
Rate for Payer: Multiplan Commercial $396.80
Rate for Payer: NAPHCARE Commercial $297.60
Rate for Payer: Preferred Network Access Commercial $456.32
Rate for Payer: Quartz Beloit One Network $243.04
Rate for Payer: Quartz Commercial $322.40
Rate for Payer: Quartz Medicare Advantage $297.60
Rate for Payer: The Alliance Commercial $1,984.00
Rate for Payer: WEA Trust Commercial $272.80
Rate for Payer: WPS Commercial $367.39
Service Code HCPCS C1713
Hospital Charge Code 5264967
Hospital Revenue Code 278
Min. Negotiated Rate $207.27
Max. Negotiated Rate $389.16
Rate for Payer: Aetna Commercial $380.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $363.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $224.19
Rate for Payer: Cash Price $126.90
Rate for Payer: Cigna Commercial $389.16
Rate for Payer: Health EOS Commercial $376.47
Rate for Payer: HFN Commercial $389.16
Rate for Payer: Multiplan Commercial $338.40
Rate for Payer: NAPHCARE Commercial $253.80
Rate for Payer: Preferred Network Access Commercial $389.16
Rate for Payer: Quartz Beloit One Network $207.27
Rate for Payer: Quartz Commercial $253.80
Rate for Payer: WEA Trust Commercial $232.65
Rate for Payer: WPS Commercial $313.32
Service Code HCPCS C1713
Hospital Charge Code 5264967
Hospital Revenue Code 278
Min. Negotiated Rate $118.44
Max. Negotiated Rate $1,692.00
Rate for Payer: Aetna Commercial $380.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $363.78
Rate for Payer: Aetna Managed Medicare $118.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $274.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $211.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $203.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $224.19
Rate for Payer: Cash Price $126.90
Rate for Payer: Cigna Commercial $389.16
Rate for Payer: Dean Health DHI/DHP/ASO $236.71
Rate for Payer: Health EOS Commercial $376.47
Rate for Payer: HFN Commercial $389.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $317.25
Rate for Payer: Multiplan Commercial $338.40
Rate for Payer: NAPHCARE Commercial $253.80
Rate for Payer: Preferred Network Access Commercial $389.16
Rate for Payer: Quartz Beloit One Network $207.27
Rate for Payer: Quartz Commercial $274.95
Rate for Payer: Quartz Medicare Advantage $253.80
Rate for Payer: The Alliance Commercial $1,692.00
Rate for Payer: WEA Trust Commercial $232.65
Rate for Payer: WPS Commercial $313.32
Service Code HCPCS C1713
Hospital Charge Code 5603791
Hospital Revenue Code 278
Min. Negotiated Rate $335.44
Max. Negotiated Rate $4,792.00
Rate for Payer: Aetna Commercial $1,078.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,030.28
Rate for Payer: Aetna Managed Medicare $335.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $778.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $599.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $575.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $634.94
Rate for Payer: Cash Price $359.40
Rate for Payer: Cigna Commercial $1,102.16
Rate for Payer: Dean Health DHI/DHP/ASO $670.40
Rate for Payer: Health EOS Commercial $1,066.22
Rate for Payer: HFN Commercial $1,102.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $898.50
Rate for Payer: Multiplan Commercial $958.40
Rate for Payer: NAPHCARE Commercial $718.80
Rate for Payer: Preferred Network Access Commercial $1,102.16
Rate for Payer: Quartz Beloit One Network $587.02
Rate for Payer: Quartz Commercial $778.70
Rate for Payer: Quartz Medicare Advantage $718.80
Rate for Payer: The Alliance Commercial $4,792.00
Rate for Payer: WEA Trust Commercial $658.90
Rate for Payer: WPS Commercial $887.36
Service Code HCPCS C1713
Hospital Charge Code 5603791
Hospital Revenue Code 278
Min. Negotiated Rate $587.02
Max. Negotiated Rate $1,102.16
Rate for Payer: Aetna Commercial $1,078.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,030.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $634.94
Rate for Payer: Cash Price $359.40
Rate for Payer: Cigna Commercial $1,102.16
Rate for Payer: Health EOS Commercial $1,066.22
Rate for Payer: HFN Commercial $1,102.16
Rate for Payer: Multiplan Commercial $958.40
Rate for Payer: NAPHCARE Commercial $718.80
Rate for Payer: Preferred Network Access Commercial $1,102.16
Rate for Payer: Quartz Beloit One Network $587.02
Rate for Payer: Quartz Commercial $718.80
Rate for Payer: WEA Trust Commercial $658.90
Rate for Payer: WPS Commercial $887.36