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Service Code HCPCS C1713
Hospital Charge Code 5977644
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 5458969
Hospital Revenue Code 278
Min. Negotiated Rate $372.40
Max. Negotiated Rate $699.20
Rate for Payer: Aetna Commercial $684.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $653.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $402.80
Rate for Payer: Cash Price $228.00
Rate for Payer: Cigna Commercial $699.20
Rate for Payer: Health EOS Commercial $676.40
Rate for Payer: HFN Commercial $699.20
Rate for Payer: Multiplan Commercial $608.00
Rate for Payer: NAPHCARE Commercial $456.00
Rate for Payer: Preferred Network Access Commercial $699.20
Rate for Payer: Quartz Beloit One Network $372.40
Rate for Payer: Quartz Commercial $456.00
Rate for Payer: WEA Trust Commercial $418.00
Rate for Payer: WPS Commercial $562.93
Service Code HCPCS C1713
Hospital Charge Code 5458969
Hospital Revenue Code 278
Min. Negotiated Rate $212.80
Max. Negotiated Rate $3,040.00
Rate for Payer: Aetna Commercial $684.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $653.60
Rate for Payer: Aetna Managed Medicare $212.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $494.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $380.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $364.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $402.80
Rate for Payer: Cash Price $228.00
Rate for Payer: Cigna Commercial $699.20
Rate for Payer: Dean Health DHI/DHP/ASO $425.30
Rate for Payer: Health EOS Commercial $676.40
Rate for Payer: HFN Commercial $699.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $570.00
Rate for Payer: Multiplan Commercial $608.00
Rate for Payer: NAPHCARE Commercial $456.00
Rate for Payer: Preferred Network Access Commercial $699.20
Rate for Payer: Quartz Beloit One Network $372.40
Rate for Payer: Quartz Commercial $494.00
Rate for Payer: Quartz Medicare Advantage $456.00
Rate for Payer: The Alliance Commercial $3,040.00
Rate for Payer: WEA Trust Commercial $418.00
Rate for Payer: WPS Commercial $562.93
Service Code HCPCS C1713
Hospital Charge Code 5563353
Hospital Revenue Code 278
Min. Negotiated Rate $182.56
Max. Negotiated Rate $2,608.00
Rate for Payer: Aetna Commercial $586.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $560.72
Rate for Payer: Aetna Managed Medicare $182.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $423.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $326.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $312.96
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: Dean Health DHI/DHP/ASO $364.86
Rate for Payer: Health EOS Commercial $580.28
Rate for Payer: HFN Commercial $599.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $489.00
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 $423.80
Rate for Payer: Quartz Medicare Advantage $391.20
Rate for Payer: The Alliance Commercial $2,608.00
Rate for Payer: WEA Trust Commercial $358.60
Rate for Payer: WPS Commercial $482.94
Service Code HCPCS C1713
Hospital Charge Code 5563353
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 5627655
Hospital Revenue Code 278
Min. Negotiated Rate $204.68
Max. Negotiated Rate $2,924.00
Rate for Payer: Aetna Commercial $657.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $628.66
Rate for Payer: Aetna Managed Medicare $204.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $475.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $365.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $350.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $387.43
Rate for Payer: Cash Price $219.30
Rate for Payer: Cigna Commercial $672.52
Rate for Payer: Dean Health DHI/DHP/ASO $409.07
Rate for Payer: Health EOS Commercial $650.59
Rate for Payer: HFN Commercial $672.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $548.25
Rate for Payer: Multiplan Commercial $584.80
Rate for Payer: NAPHCARE Commercial $438.60
Rate for Payer: Preferred Network Access Commercial $672.52
Rate for Payer: Quartz Beloit One Network $358.19
Rate for Payer: Quartz Commercial $475.15
Rate for Payer: Quartz Medicare Advantage $438.60
Rate for Payer: The Alliance Commercial $2,924.00
Rate for Payer: WEA Trust Commercial $402.05
Rate for Payer: WPS Commercial $541.45
Service Code HCPCS C1713
Hospital Charge Code 5627655
Hospital Revenue Code 278
Min. Negotiated Rate $358.19
Max. Negotiated Rate $672.52
Rate for Payer: Aetna Commercial $657.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $628.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $387.43
Rate for Payer: Cash Price $219.30
Rate for Payer: Cigna Commercial $672.52
Rate for Payer: Health EOS Commercial $650.59
Rate for Payer: HFN Commercial $672.52
Rate for Payer: Multiplan Commercial $584.80
Rate for Payer: NAPHCARE Commercial $438.60
Rate for Payer: Preferred Network Access Commercial $672.52
Rate for Payer: Quartz Beloit One Network $358.19
Rate for Payer: Quartz Commercial $438.60
Rate for Payer: WEA Trust Commercial $402.05
Rate for Payer: WPS Commercial $541.45
Service Code HCPCS C1713
Hospital Charge Code 6234199
Hospital Revenue Code 278
Min. Negotiated Rate $198.52
Max. Negotiated Rate $2,836.00
Rate for Payer: Aetna Commercial $638.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $609.74
Rate for Payer: Aetna Managed Medicare $198.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $460.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $354.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $340.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $375.77
Rate for Payer: Cash Price $212.70
Rate for Payer: Cigna Commercial $652.28
Rate for Payer: Dean Health DHI/DHP/ASO $396.76
Rate for Payer: Health EOS Commercial $631.01
Rate for Payer: HFN Commercial $652.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $531.75
Rate for Payer: Multiplan Commercial $567.20
Rate for Payer: NAPHCARE Commercial $425.40
Rate for Payer: Preferred Network Access Commercial $652.28
Rate for Payer: Quartz Beloit One Network $347.41
Rate for Payer: Quartz Commercial $460.85
Rate for Payer: Quartz Medicare Advantage $425.40
Rate for Payer: The Alliance Commercial $2,836.00
Rate for Payer: WEA Trust Commercial $389.95
Rate for Payer: WPS Commercial $525.16
Service Code HCPCS C1713
Hospital Charge Code 6234199
Hospital Revenue Code 278
Min. Negotiated Rate $347.41
Max. Negotiated Rate $652.28
Rate for Payer: Aetna Commercial $638.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $609.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $375.77
Rate for Payer: Cash Price $212.70
Rate for Payer: Cigna Commercial $652.28
Rate for Payer: Health EOS Commercial $631.01
Rate for Payer: HFN Commercial $652.28
Rate for Payer: Multiplan Commercial $567.20
Rate for Payer: NAPHCARE Commercial $425.40
Rate for Payer: Preferred Network Access Commercial $652.28
Rate for Payer: Quartz Beloit One Network $347.41
Rate for Payer: Quartz Commercial $425.40
Rate for Payer: WEA Trust Commercial $389.95
Rate for Payer: WPS Commercial $525.16
Service Code HCPCS C1713
Hospital Charge Code 5885648
Hospital Revenue Code 278
Min. Negotiated Rate $175.56
Max. Negotiated Rate $2,508.00
Rate for Payer: Aetna Commercial $564.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $539.22
Rate for Payer: Aetna Managed Medicare $175.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $407.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $313.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $300.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $332.31
Rate for Payer: Cash Price $188.10
Rate for Payer: Cigna Commercial $576.84
Rate for Payer: Dean Health DHI/DHP/ASO $350.87
Rate for Payer: Health EOS Commercial $558.03
Rate for Payer: HFN Commercial $576.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $470.25
Rate for Payer: Multiplan Commercial $501.60
Rate for Payer: NAPHCARE Commercial $376.20
Rate for Payer: Preferred Network Access Commercial $576.84
Rate for Payer: Quartz Beloit One Network $307.23
Rate for Payer: Quartz Commercial $407.55
Rate for Payer: Quartz Medicare Advantage $376.20
Rate for Payer: The Alliance Commercial $2,508.00
Rate for Payer: WEA Trust Commercial $344.85
Rate for Payer: WPS Commercial $464.42
Service Code HCPCS C1713
Hospital Charge Code 5885648
Hospital Revenue Code 278
Min. Negotiated Rate $307.23
Max. Negotiated Rate $576.84
Rate for Payer: Aetna Commercial $564.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $539.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $332.31
Rate for Payer: Cash Price $188.10
Rate for Payer: Cigna Commercial $576.84
Rate for Payer: Health EOS Commercial $558.03
Rate for Payer: HFN Commercial $576.84
Rate for Payer: Multiplan Commercial $501.60
Rate for Payer: NAPHCARE Commercial $376.20
Rate for Payer: Preferred Network Access Commercial $576.84
Rate for Payer: Quartz Beloit One Network $307.23
Rate for Payer: Quartz Commercial $376.20
Rate for Payer: WEA Trust Commercial $344.85
Rate for Payer: WPS Commercial $464.42
Service Code HCPCS C1713
Hospital Charge Code 5599552
Hospital Revenue Code 278
Min. Negotiated Rate $372.40
Max. Negotiated Rate $699.20
Rate for Payer: Aetna Commercial $684.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $653.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $402.80
Rate for Payer: Cash Price $228.00
Rate for Payer: Cigna Commercial $699.20
Rate for Payer: Health EOS Commercial $676.40
Rate for Payer: HFN Commercial $699.20
Rate for Payer: Multiplan Commercial $608.00
Rate for Payer: NAPHCARE Commercial $456.00
Rate for Payer: Preferred Network Access Commercial $699.20
Rate for Payer: Quartz Beloit One Network $372.40
Rate for Payer: Quartz Commercial $456.00
Rate for Payer: WEA Trust Commercial $418.00
Rate for Payer: WPS Commercial $562.93
Service Code HCPCS C1713
Hospital Charge Code 5599552
Hospital Revenue Code 278
Min. Negotiated Rate $212.80
Max. Negotiated Rate $3,040.00
Rate for Payer: Aetna Commercial $684.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $653.60
Rate for Payer: Aetna Managed Medicare $212.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $494.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $380.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $364.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $402.80
Rate for Payer: Cash Price $228.00
Rate for Payer: Cigna Commercial $699.20
Rate for Payer: Dean Health DHI/DHP/ASO $425.30
Rate for Payer: Health EOS Commercial $676.40
Rate for Payer: HFN Commercial $699.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $570.00
Rate for Payer: Multiplan Commercial $608.00
Rate for Payer: NAPHCARE Commercial $456.00
Rate for Payer: Preferred Network Access Commercial $699.20
Rate for Payer: Quartz Beloit One Network $372.40
Rate for Payer: Quartz Commercial $494.00
Rate for Payer: Quartz Medicare Advantage $456.00
Rate for Payer: The Alliance Commercial $3,040.00
Rate for Payer: WEA Trust Commercial $418.00
Rate for Payer: WPS Commercial $562.93
Service Code HCPCS C1713
Hospital Charge Code 2966900
Hospital Revenue Code 278
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
Service Code HCPCS C1713
Hospital Charge Code 2966900
Hospital Revenue Code 278
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
Service Code HCPCS C1713
Hospital Charge Code 6001665
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 6001665
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 5416038
Hospital Revenue Code 278
Min. Negotiated Rate $182.56
Max. Negotiated Rate $2,608.00
Rate for Payer: Aetna Commercial $586.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $560.72
Rate for Payer: Aetna Managed Medicare $182.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $423.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $326.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $312.96
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: Dean Health DHI/DHP/ASO $364.86
Rate for Payer: Health EOS Commercial $580.28
Rate for Payer: HFN Commercial $599.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $489.00
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 $423.80
Rate for Payer: Quartz Medicare Advantage $391.20
Rate for Payer: The Alliance Commercial $2,608.00
Rate for Payer: WEA Trust Commercial $358.60
Rate for Payer: WPS Commercial $482.94
Service Code HCPCS C1713
Hospital Charge Code 5416038
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 6105629
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 6105629
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 2966902
Hospital Revenue Code 278
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
Service Code HCPCS C1713
Hospital Charge Code 2966902
Hospital Revenue Code 278
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
Service Code HCPCS C1713
Hospital Charge Code 5416039
Hospital Revenue Code 278
Min. Negotiated Rate $182.56
Max. Negotiated Rate $2,608.00
Rate for Payer: Aetna Commercial $586.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $560.72
Rate for Payer: Aetna Managed Medicare $182.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $423.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $326.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $312.96
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: Dean Health DHI/DHP/ASO $364.86
Rate for Payer: Health EOS Commercial $580.28
Rate for Payer: HFN Commercial $599.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $489.00
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 $423.80
Rate for Payer: Quartz Medicare Advantage $391.20
Rate for Payer: The Alliance Commercial $2,608.00
Rate for Payer: WEA Trust Commercial $358.60
Rate for Payer: WPS Commercial $482.94
Service Code HCPCS C1713
Hospital Charge Code 5416039
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