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Service Code CPT 84270
Hospital Charge Code 2943014
Hospital Revenue Code 300
Min. Negotiated Rate $76.71
Max. Negotiated Rate $189.05
Rate for Payer: Aetna Commercial $189.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $171.14
Rate for Payer: Cash Price $59.70
Rate for Payer: Cash Price $59.70
Rate for Payer: Cigna Commercial $189.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $99.50
Rate for Payer: Dean Health DHI/DHP/ASO $119.40
Rate for Payer: Health EOS Commercial $181.09
Rate for Payer: HFN Commercial $189.05
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $76.71
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $76.71
Rate for Payer: Multiplan Commercial $159.20
Rate for Payer: Preferred Network Access Commercial $189.05
Rate for Payer: Quartz Beloit One Network $87.56
Rate for Payer: Quartz Commercial $113.43
Rate for Payer: The Alliance Commercial $99.50
Rate for Payer: WEA Trust Commercial $109.45
Rate for Payer: WPS Commercial $147.40
Service Code CPT 84270
Hospital Charge Code 978066
Hospital Revenue Code 300
Min. Negotiated Rate $145.04
Max. Negotiated Rate $272.32
Rate for Payer: Aetna Commercial $266.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $254.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $156.88
Rate for Payer: Cash Price $88.80
Rate for Payer: Cigna Commercial $272.32
Rate for Payer: Health EOS Commercial $263.44
Rate for Payer: HFN Commercial $272.32
Rate for Payer: Multiplan Commercial $236.80
Rate for Payer: NAPHCARE Commercial $177.60
Rate for Payer: Preferred Network Access Commercial $272.32
Rate for Payer: Quartz Beloit One Network $145.04
Rate for Payer: Quartz Commercial $177.60
Rate for Payer: WEA Trust Commercial $162.80
Rate for Payer: WPS Commercial $219.25
Service Code CPT 84270
Hospital Charge Code 978066
Hospital Revenue Code 300
Min. Negotiated Rate $76.71
Max. Negotiated Rate $281.20
Rate for Payer: Aetna Commercial $281.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $254.56
Rate for Payer: Cash Price $88.80
Rate for Payer: Cash Price $88.80
Rate for Payer: Cigna Commercial $281.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $148.00
Rate for Payer: Dean Health DHI/DHP/ASO $177.60
Rate for Payer: Health EOS Commercial $269.36
Rate for Payer: HFN Commercial $281.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $76.71
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $76.71
Rate for Payer: Multiplan Commercial $236.80
Rate for Payer: Preferred Network Access Commercial $281.20
Rate for Payer: Quartz Beloit One Network $130.24
Rate for Payer: Quartz Commercial $168.72
Rate for Payer: The Alliance Commercial $148.00
Rate for Payer: WEA Trust Commercial $162.80
Rate for Payer: WPS Commercial $219.25
Service Code CPT 84270
Hospital Charge Code 978066
Hospital Revenue Code 300
Min. Negotiated Rate $21.73
Max. Negotiated Rate $272.32
Rate for Payer: Aetna Commercial $266.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $254.56
Rate for Payer: Aetna Managed Medicare $21.73
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $81.49
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $38.03
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $36.07
Rate for Payer: Anthem Medicaid $22.45
Rate for Payer: Anthem Medicare Advantage $21.73
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $156.88
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $21.73
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $21.73
Rate for Payer: Cash Price $88.80
Rate for Payer: Cash Price $88.80
Rate for Payer: Cigna Commercial $272.32
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $21.73
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $22.45
Rate for Payer: Dean Health DHI/DHP/ASO $165.64
Rate for Payer: Dean Health Medicaid $22.45
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $21.73
Rate for Payer: Health EOS Commercial $263.44
Rate for Payer: HFN Commercial $272.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $80.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $21.73
Rate for Payer: Independent Care Health Plan Medicaid $22.45
Rate for Payer: Independent Care Health Plan Medicare $21.73
Rate for Payer: Managed Health Services Medicaid $23.35
Rate for Payer: Managed Health Services Medicare Advantage $21.73
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $21.73
Rate for Payer: Multiplan Commercial $236.80
Rate for Payer: NAPHCARE Commercial $32.60
Rate for Payer: Preferred Network Access Commercial $272.32
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $22.45
Rate for Payer: Quartz Beloit One Network $145.04
Rate for Payer: Quartz Commercial $192.40
Rate for Payer: Quartz Medicare Advantage $21.73
Rate for Payer: The Alliance Commercial $86.92
Rate for Payer: United Healthcare Medicaid $22.45
Rate for Payer: United Healthcare Medicare Advantage $21.73
Rate for Payer: United Healthcare PPO $222.00
Rate for Payer: WEA Trust Commercial $162.80
Rate for Payer: Wellcare Medicare $21.73
Rate for Payer: WMAP Medicaid $22.45
Rate for Payer: WPS Commercial $219.25
Service Code CPT 84270
Hospital Charge Code 2943014
Hospital Revenue Code 300
Min. Negotiated Rate $97.51
Max. Negotiated Rate $183.08
Rate for Payer: Aetna Commercial $179.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $171.14
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $105.47
Rate for Payer: Cash Price $59.70
Rate for Payer: Cigna Commercial $183.08
Rate for Payer: Health EOS Commercial $177.11
Rate for Payer: HFN Commercial $183.08
Rate for Payer: Multiplan Commercial $159.20
Rate for Payer: NAPHCARE Commercial $119.40
Rate for Payer: Preferred Network Access Commercial $183.08
Rate for Payer: Quartz Beloit One Network $97.51
Rate for Payer: Quartz Commercial $119.40
Rate for Payer: WEA Trust Commercial $109.45
Rate for Payer: WPS Commercial $147.40
Service Code CPT 84270
Hospital Charge Code 2943014
Hospital Revenue Code 300
Min. Negotiated Rate $21.73
Max. Negotiated Rate $183.08
Rate for Payer: Aetna Commercial $179.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $171.14
Rate for Payer: Aetna Managed Medicare $21.73
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $81.49
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $38.03
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $36.07
Rate for Payer: Anthem Medicaid $22.45
Rate for Payer: Anthem Medicare Advantage $21.73
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $105.47
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $21.73
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $21.73
Rate for Payer: Cash Price $59.70
Rate for Payer: Cash Price $59.70
Rate for Payer: Cigna Commercial $183.08
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $21.73
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $22.45
Rate for Payer: Dean Health DHI/DHP/ASO $111.36
Rate for Payer: Dean Health Medicaid $22.45
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $21.73
Rate for Payer: Health EOS Commercial $177.11
Rate for Payer: HFN Commercial $183.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $80.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $21.73
Rate for Payer: Independent Care Health Plan Medicaid $22.45
Rate for Payer: Independent Care Health Plan Medicare $21.73
Rate for Payer: Managed Health Services Medicaid $23.35
Rate for Payer: Managed Health Services Medicare Advantage $21.73
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $21.73
Rate for Payer: Multiplan Commercial $159.20
Rate for Payer: NAPHCARE Commercial $32.60
Rate for Payer: Preferred Network Access Commercial $183.08
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $22.45
Rate for Payer: Quartz Beloit One Network $97.51
Rate for Payer: Quartz Commercial $129.35
Rate for Payer: Quartz Medicare Advantage $21.73
Rate for Payer: The Alliance Commercial $86.92
Rate for Payer: United Healthcare Medicaid $22.45
Rate for Payer: United Healthcare Medicare Advantage $21.73
Rate for Payer: United Healthcare PPO $149.25
Rate for Payer: WEA Trust Commercial $109.45
Rate for Payer: Wellcare Medicare $21.73
Rate for Payer: WMAP Medicaid $22.45
Rate for Payer: WPS Commercial $147.40
Service Code CPT 88184
Hospital Charge Code 5364855
Hospital Revenue Code 300
Min. Negotiated Rate $117.60
Max. Negotiated Rate $1,421.12
Rate for Payer: Aetna Commercial $216.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $206.40
Rate for Payer: Aetna Managed Medicare $355.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,332.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $621.74
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $589.76
Rate for Payer: Anthem Medicare Advantage $355.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $127.20
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $355.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $355.28
Rate for Payer: Cash Price $72.00
Rate for Payer: Cash Price $72.00
Rate for Payer: Cigna Commercial $220.80
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $355.28
Rate for Payer: Dean Health DHI/DHP/ASO $134.30
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $355.28
Rate for Payer: Health EOS Commercial $213.60
Rate for Payer: HFN Commercial $220.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,321.64
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $355.28
Rate for Payer: Independent Care Health Plan Medicare $355.28
Rate for Payer: Managed Health Services Medicare Advantage $355.28
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $355.28
Rate for Payer: Multiplan Commercial $192.00
Rate for Payer: NAPHCARE Commercial $532.92
Rate for Payer: Preferred Network Access Commercial $220.80
Rate for Payer: Quartz Beloit One Network $117.60
Rate for Payer: Quartz Commercial $156.00
Rate for Payer: Quartz Medicare Advantage $355.28
Rate for Payer: The Alliance Commercial $1,421.12
Rate for Payer: United Healthcare Medicare Advantage $355.28
Rate for Payer: United Healthcare PPO $180.00
Rate for Payer: WEA Trust Commercial $132.00
Rate for Payer: Wellcare Medicare $355.28
Rate for Payer: WPS Commercial $177.77
Service Code CPT 88184
Hospital Charge Code 5364855
Hospital Revenue Code 300
Min. Negotiated Rate $105.60
Max. Negotiated Rate $230.47
Rate for Payer: Aetna Commercial $228.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $206.40
Rate for Payer: Cash Price $72.00
Rate for Payer: Cash Price $72.00
Rate for Payer: Cigna Commercial $228.00
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $120.00
Rate for Payer: Dean Health DHI/DHP/ASO $144.00
Rate for Payer: Health EOS Commercial $218.40
Rate for Payer: HFN Commercial $228.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $230.47
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $230.47
Rate for Payer: Multiplan Commercial $192.00
Rate for Payer: Preferred Network Access Commercial $228.00
Rate for Payer: Quartz Beloit One Network $105.60
Rate for Payer: Quartz Commercial $136.80
Rate for Payer: The Alliance Commercial $120.00
Rate for Payer: WEA Trust Commercial $132.00
Rate for Payer: WPS Commercial $177.77
Service Code CPT 88184
Hospital Charge Code 5364855
Hospital Revenue Code 300
Min. Negotiated Rate $117.60
Max. Negotiated Rate $220.80
Rate for Payer: Aetna Commercial $216.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $206.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $127.20
Rate for Payer: Cash Price $72.00
Rate for Payer: Cigna Commercial $220.80
Rate for Payer: Health EOS Commercial $213.60
Rate for Payer: HFN Commercial $220.80
Rate for Payer: Multiplan Commercial $192.00
Rate for Payer: NAPHCARE Commercial $144.00
Rate for Payer: Preferred Network Access Commercial $220.80
Rate for Payer: Quartz Beloit One Network $117.60
Rate for Payer: Quartz Commercial $144.00
Rate for Payer: WEA Trust Commercial $132.00
Rate for Payer: WPS Commercial $177.77
Service Code CPT 88184
Hospital Charge Code 6166535
Hospital Revenue Code 300
Min. Negotiated Rate $183.75
Max. Negotiated Rate $345.00
Rate for Payer: Aetna Commercial $337.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $322.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $198.75
Rate for Payer: Cash Price $112.50
Rate for Payer: Cigna Commercial $345.00
Rate for Payer: Health EOS Commercial $333.75
Rate for Payer: HFN Commercial $345.00
Rate for Payer: Multiplan Commercial $300.00
Rate for Payer: NAPHCARE Commercial $225.00
Rate for Payer: Preferred Network Access Commercial $345.00
Rate for Payer: Quartz Beloit One Network $183.75
Rate for Payer: Quartz Commercial $225.00
Rate for Payer: WEA Trust Commercial $206.25
Rate for Payer: WPS Commercial $277.76
Service Code CPT 88184
Hospital Charge Code 6166535
Hospital Revenue Code 300
Min. Negotiated Rate $165.00
Max. Negotiated Rate $356.25
Rate for Payer: Aetna Commercial $356.25
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $322.50
Rate for Payer: Cash Price $112.50
Rate for Payer: Cash Price $112.50
Rate for Payer: Cigna Commercial $356.25
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $187.50
Rate for Payer: Dean Health DHI/DHP/ASO $225.00
Rate for Payer: Health EOS Commercial $341.25
Rate for Payer: HFN Commercial $356.25
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $230.47
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $230.47
Rate for Payer: Multiplan Commercial $300.00
Rate for Payer: Preferred Network Access Commercial $356.25
Rate for Payer: Quartz Beloit One Network $165.00
Rate for Payer: Quartz Commercial $213.75
Rate for Payer: The Alliance Commercial $187.50
Rate for Payer: WEA Trust Commercial $206.25
Rate for Payer: WPS Commercial $277.76
Service Code CPT 88184
Hospital Charge Code 6166535
Hospital Revenue Code 300
Min. Negotiated Rate $183.75
Max. Negotiated Rate $1,421.12
Rate for Payer: Aetna Commercial $337.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $322.50
Rate for Payer: Aetna Managed Medicare $355.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,332.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $621.74
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $589.76
Rate for Payer: Anthem Medicare Advantage $355.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $198.75
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $355.28
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $355.28
Rate for Payer: Cash Price $112.50
Rate for Payer: Cash Price $112.50
Rate for Payer: Cigna Commercial $345.00
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $355.28
Rate for Payer: Dean Health DHI/DHP/ASO $209.85
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $355.28
Rate for Payer: Health EOS Commercial $333.75
Rate for Payer: HFN Commercial $345.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,321.64
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $355.28
Rate for Payer: Independent Care Health Plan Medicare $355.28
Rate for Payer: Managed Health Services Medicare Advantage $355.28
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $355.28
Rate for Payer: Multiplan Commercial $300.00
Rate for Payer: NAPHCARE Commercial $532.92
Rate for Payer: Preferred Network Access Commercial $345.00
Rate for Payer: Quartz Beloit One Network $183.75
Rate for Payer: Quartz Commercial $243.75
Rate for Payer: Quartz Medicare Advantage $355.28
Rate for Payer: The Alliance Commercial $1,421.12
Rate for Payer: United Healthcare Medicare Advantage $355.28
Rate for Payer: United Healthcare PPO $281.25
Rate for Payer: WEA Trust Commercial $206.25
Rate for Payer: Wellcare Medicare $355.28
Rate for Payer: WPS Commercial $277.76
Hospital Charge Code 3072521
Hospital Revenue Code 272
Min. Negotiated Rate $407.68
Max. Negotiated Rate $765.44
Rate for Payer: Aetna Commercial $748.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $715.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $440.96
Rate for Payer: Cash Price $249.60
Rate for Payer: Cigna Commercial $765.44
Rate for Payer: Health EOS Commercial $740.48
Rate for Payer: HFN Commercial $765.44
Rate for Payer: Multiplan Commercial $665.60
Rate for Payer: NAPHCARE Commercial $499.20
Rate for Payer: Preferred Network Access Commercial $765.44
Rate for Payer: Quartz Beloit One Network $407.68
Rate for Payer: Quartz Commercial $499.20
Rate for Payer: WEA Trust Commercial $457.60
Rate for Payer: WPS Commercial $616.26
Hospital Charge Code 3072521
Hospital Revenue Code 272
Min. Negotiated Rate $232.96
Max. Negotiated Rate $3,328.00
Rate for Payer: Aetna Commercial $748.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $715.52
Rate for Payer: Aetna Managed Medicare $232.96
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $540.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $416.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $399.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $440.96
Rate for Payer: Cash Price $249.60
Rate for Payer: Cigna Commercial $765.44
Rate for Payer: Dean Health DHI/DHP/ASO $465.59
Rate for Payer: Health EOS Commercial $740.48
Rate for Payer: HFN Commercial $765.44
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $624.00
Rate for Payer: Multiplan Commercial $665.60
Rate for Payer: NAPHCARE Commercial $499.20
Rate for Payer: Preferred Network Access Commercial $765.44
Rate for Payer: Quartz Beloit One Network $407.68
Rate for Payer: Quartz Commercial $540.80
Rate for Payer: Quartz Medicare Advantage $499.20
Rate for Payer: The Alliance Commercial $3,328.00
Rate for Payer: WEA Trust Commercial $457.60
Rate for Payer: WPS Commercial $616.26
Hospital Charge Code 5348952
Hospital Revenue Code 272
Min. Negotiated Rate $259.00
Max. Negotiated Rate $3,700.00
Rate for Payer: Aetna Commercial $832.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $795.50
Rate for Payer: Aetna Managed Medicare $259.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $601.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $462.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $444.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $490.25
Rate for Payer: Cash Price $277.50
Rate for Payer: Cigna Commercial $851.00
Rate for Payer: Dean Health DHI/DHP/ASO $517.63
Rate for Payer: Health EOS Commercial $823.25
Rate for Payer: HFN Commercial $851.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $693.75
Rate for Payer: Multiplan Commercial $740.00
Rate for Payer: NAPHCARE Commercial $555.00
Rate for Payer: Preferred Network Access Commercial $851.00
Rate for Payer: Quartz Beloit One Network $453.25
Rate for Payer: Quartz Commercial $601.25
Rate for Payer: Quartz Medicare Advantage $555.00
Rate for Payer: The Alliance Commercial $3,700.00
Rate for Payer: WEA Trust Commercial $508.75
Rate for Payer: WPS Commercial $685.15
Hospital Charge Code 5348952
Hospital Revenue Code 272
Min. Negotiated Rate $453.25
Max. Negotiated Rate $851.00
Rate for Payer: Aetna Commercial $832.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $795.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $490.25
Rate for Payer: Cash Price $277.50
Rate for Payer: Cigna Commercial $851.00
Rate for Payer: Health EOS Commercial $823.25
Rate for Payer: HFN Commercial $851.00
Rate for Payer: Multiplan Commercial $740.00
Rate for Payer: NAPHCARE Commercial $555.00
Rate for Payer: Preferred Network Access Commercial $851.00
Rate for Payer: Quartz Beloit One Network $453.25
Rate for Payer: Quartz Commercial $555.00
Rate for Payer: WEA Trust Commercial $508.75
Rate for Payer: WPS Commercial $685.15
Hospital Charge Code 5190725
Hospital Revenue Code 272
Min. Negotiated Rate $801.36
Max. Negotiated Rate $11,448.00
Rate for Payer: Aetna Commercial $2,575.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,461.32
Rate for Payer: Aetna Managed Medicare $801.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,860.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,431.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,373.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,516.86
Rate for Payer: Cash Price $858.60
Rate for Payer: Cigna Commercial $2,633.04
Rate for Payer: Dean Health DHI/DHP/ASO $1,601.58
Rate for Payer: Health EOS Commercial $2,547.18
Rate for Payer: HFN Commercial $2,633.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,146.50
Rate for Payer: Multiplan Commercial $2,289.60
Rate for Payer: NAPHCARE Commercial $1,717.20
Rate for Payer: Preferred Network Access Commercial $2,633.04
Rate for Payer: Quartz Beloit One Network $1,402.38
Rate for Payer: Quartz Commercial $1,860.30
Rate for Payer: Quartz Medicare Advantage $1,717.20
Rate for Payer: The Alliance Commercial $11,448.00
Rate for Payer: WEA Trust Commercial $1,574.10
Rate for Payer: WPS Commercial $2,119.88
Hospital Charge Code 5190725
Hospital Revenue Code 272
Min. Negotiated Rate $1,402.38
Max. Negotiated Rate $2,633.04
Rate for Payer: Aetna Commercial $2,575.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,461.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,516.86
Rate for Payer: Cash Price $858.60
Rate for Payer: Cigna Commercial $2,633.04
Rate for Payer: Health EOS Commercial $2,547.18
Rate for Payer: HFN Commercial $2,633.04
Rate for Payer: Multiplan Commercial $2,289.60
Rate for Payer: NAPHCARE Commercial $1,717.20
Rate for Payer: Preferred Network Access Commercial $2,633.04
Rate for Payer: Quartz Beloit One Network $1,402.38
Rate for Payer: Quartz Commercial $1,717.20
Rate for Payer: WEA Trust Commercial $1,574.10
Rate for Payer: WPS Commercial $2,119.88
Hospital Charge Code 5307155
Hospital Revenue Code 272
Min. Negotiated Rate $259.00
Max. Negotiated Rate $3,700.00
Rate for Payer: Aetna Commercial $832.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $795.50
Rate for Payer: Aetna Managed Medicare $259.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $601.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $462.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $444.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $490.25
Rate for Payer: Cash Price $277.50
Rate for Payer: Cigna Commercial $851.00
Rate for Payer: Dean Health DHI/DHP/ASO $517.63
Rate for Payer: Health EOS Commercial $823.25
Rate for Payer: HFN Commercial $851.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $693.75
Rate for Payer: Multiplan Commercial $740.00
Rate for Payer: NAPHCARE Commercial $555.00
Rate for Payer: Preferred Network Access Commercial $851.00
Rate for Payer: Quartz Beloit One Network $453.25
Rate for Payer: Quartz Commercial $601.25
Rate for Payer: Quartz Medicare Advantage $555.00
Rate for Payer: The Alliance Commercial $3,700.00
Rate for Payer: WEA Trust Commercial $508.75
Rate for Payer: WPS Commercial $685.15
Hospital Charge Code 5307155
Hospital Revenue Code 272
Min. Negotiated Rate $453.25
Max. Negotiated Rate $851.00
Rate for Payer: Aetna Commercial $832.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $795.50
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $490.25
Rate for Payer: Cash Price $277.50
Rate for Payer: Cigna Commercial $851.00
Rate for Payer: Health EOS Commercial $823.25
Rate for Payer: HFN Commercial $851.00
Rate for Payer: Multiplan Commercial $740.00
Rate for Payer: NAPHCARE Commercial $555.00
Rate for Payer: Preferred Network Access Commercial $851.00
Rate for Payer: Quartz Beloit One Network $453.25
Rate for Payer: Quartz Commercial $555.00
Rate for Payer: WEA Trust Commercial $508.75
Rate for Payer: WPS Commercial $685.15
Service Code CPT 11313
Hospital Charge Code 3013535
Hospital Revenue Code 510
Min. Negotiated Rate $112.81
Max. Negotiated Rate $474.05
Rate for Payer: Aetna Commercial $474.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $429.14
Rate for Payer: Cash Price $149.70
Rate for Payer: Cash Price $149.70
Rate for Payer: Cigna Commercial $474.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $112.81
Rate for Payer: Dean Health DHI/DHP/ASO $299.40
Rate for Payer: Health EOS Commercial $454.09
Rate for Payer: HFN Commercial $474.05
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $322.18
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $322.18
Rate for Payer: Multiplan Commercial $399.20
Rate for Payer: Preferred Network Access Commercial $474.05
Rate for Payer: Quartz Beloit One Network $219.56
Rate for Payer: Quartz Commercial $284.43
Rate for Payer: The Alliance Commercial $249.50
Rate for Payer: United Healthcare Medicaid $112.81
Rate for Payer: WEA Trust Commercial $274.45
Rate for Payer: WPS Commercial $369.61
Service Code CPT 11310
Hospital Charge Code 3013532
Hospital Revenue Code 510
Min. Negotiated Rate $51.44
Max. Negotiated Rate $152.88
Rate for Payer: Aetna Commercial $148.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $134.16
Rate for Payer: Cash Price $46.80
Rate for Payer: Cash Price $46.80
Rate for Payer: Cigna Commercial $148.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $51.44
Rate for Payer: Dean Health DHI/DHP/ASO $93.60
Rate for Payer: Health EOS Commercial $141.96
Rate for Payer: HFN Commercial $148.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $152.88
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $152.88
Rate for Payer: Multiplan Commercial $124.80
Rate for Payer: Preferred Network Access Commercial $148.20
Rate for Payer: Quartz Beloit One Network $68.64
Rate for Payer: Quartz Commercial $88.92
Rate for Payer: The Alliance Commercial $78.00
Rate for Payer: United Healthcare Medicaid $51.44
Rate for Payer: WEA Trust Commercial $85.80
Rate for Payer: WPS Commercial $115.55
Service Code CPT 11311
Hospital Charge Code 3013533
Hospital Revenue Code 510
Min. Negotiated Rate $73.34
Max. Negotiated Rate $211.02
Rate for Payer: Aetna Commercial $181.45
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $164.26
Rate for Payer: Cash Price $57.30
Rate for Payer: Cash Price $57.30
Rate for Payer: Cigna Commercial $181.45
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $73.34
Rate for Payer: Dean Health DHI/DHP/ASO $114.60
Rate for Payer: Health EOS Commercial $173.81
Rate for Payer: HFN Commercial $181.45
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $211.02
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $211.02
Rate for Payer: Multiplan Commercial $152.80
Rate for Payer: Preferred Network Access Commercial $181.45
Rate for Payer: Quartz Beloit One Network $84.04
Rate for Payer: Quartz Commercial $108.87
Rate for Payer: The Alliance Commercial $95.50
Rate for Payer: United Healthcare Medicaid $73.34
Rate for Payer: WEA Trust Commercial $105.05
Rate for Payer: WPS Commercial $141.47
Service Code CPT 11312
Hospital Charge Code 3013534
Hospital Revenue Code 510
Min. Negotiated Rate $84.61
Max. Negotiated Rate $300.20
Rate for Payer: Aetna Commercial $300.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $271.76
Rate for Payer: Cash Price $94.80
Rate for Payer: Cash Price $94.80
Rate for Payer: Cigna Commercial $300.20
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $84.61
Rate for Payer: Dean Health DHI/DHP/ASO $189.60
Rate for Payer: Health EOS Commercial $287.56
Rate for Payer: HFN Commercial $300.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $249.92
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $249.92
Rate for Payer: Multiplan Commercial $252.80
Rate for Payer: Preferred Network Access Commercial $300.20
Rate for Payer: Quartz Beloit One Network $139.04
Rate for Payer: Quartz Commercial $180.12
Rate for Payer: The Alliance Commercial $158.00
Rate for Payer: United Healthcare Medicaid $84.61
Rate for Payer: WEA Trust Commercial $173.80
Rate for Payer: WPS Commercial $234.06
Service Code CPT 11305
Hospital Charge Code 3013528
Hospital Revenue Code 510
Min. Negotiated Rate $45.48
Max. Negotiated Rate $220.40
Rate for Payer: Aetna Commercial $220.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $199.52
Rate for Payer: Cash Price $69.60
Rate for Payer: Cash Price $69.60
Rate for Payer: Cigna Commercial $220.40
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $45.48
Rate for Payer: Dean Health DHI/DHP/ASO $139.20
Rate for Payer: Health EOS Commercial $211.12
Rate for Payer: HFN Commercial $220.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $128.56
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $128.56
Rate for Payer: Multiplan Commercial $185.60
Rate for Payer: Preferred Network Access Commercial $220.40
Rate for Payer: Quartz Beloit One Network $102.08
Rate for Payer: Quartz Commercial $132.24
Rate for Payer: The Alliance Commercial $116.00
Rate for Payer: United Healthcare Medicaid $45.48
Rate for Payer: WEA Trust Commercial $127.60
Rate for Payer: WPS Commercial $171.84