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Service Code HCPCS C1894
Hospital Charge Code 2550848
Hospital Revenue Code 272
Min. Negotiated Rate $157.29
Max. Negotiated Rate $295.32
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $192.60
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550848
Hospital Revenue Code 272
Min. Negotiated Rate $141.24
Max. Negotiated Rate $304.95
Rate for Payer: Aetna Commercial $304.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $304.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $160.50
Rate for Payer: Dean Health DHI/DHP/ASO $192.60
Rate for Payer: Health EOS Commercial $292.11
Rate for Payer: HFN Commercial $304.95
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: Preferred Network Access Commercial $304.95
Rate for Payer: Quartz Beloit One Network $141.24
Rate for Payer: Quartz Commercial $182.97
Rate for Payer: The Alliance Commercial $160.50
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550890
Hospital Revenue Code 272
Min. Negotiated Rate $141.24
Max. Negotiated Rate $304.95
Rate for Payer: Aetna Commercial $304.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $304.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $160.50
Rate for Payer: Dean Health DHI/DHP/ASO $192.60
Rate for Payer: Health EOS Commercial $292.11
Rate for Payer: HFN Commercial $304.95
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: Preferred Network Access Commercial $304.95
Rate for Payer: Quartz Beloit One Network $141.24
Rate for Payer: Quartz Commercial $182.97
Rate for Payer: The Alliance Commercial $160.50
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550890
Hospital Revenue Code 272
Min. Negotiated Rate $157.29
Max. Negotiated Rate $295.32
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $192.60
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550890
Hospital Revenue Code 272
Min. Negotiated Rate $89.88
Max. Negotiated Rate $1,284.00
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Aetna Managed Medicare $89.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $208.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $160.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $154.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Dean Health DHI/DHP/ASO $179.63
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $240.75
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $208.65
Rate for Payer: Quartz Medicare Advantage $192.60
Rate for Payer: The Alliance Commercial $1,284.00
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 6201009
Hospital Revenue Code 272
Min. Negotiated Rate $166.11
Max. Negotiated Rate $311.88
Rate for Payer: Aetna Commercial $305.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $291.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $179.67
Rate for Payer: Cash Price $101.70
Rate for Payer: Cigna Commercial $311.88
Rate for Payer: Health EOS Commercial $301.71
Rate for Payer: HFN Commercial $311.88
Rate for Payer: Multiplan Commercial $271.20
Rate for Payer: NAPHCARE Commercial $203.40
Rate for Payer: Preferred Network Access Commercial $311.88
Rate for Payer: Quartz Beloit One Network $166.11
Rate for Payer: Quartz Commercial $203.40
Rate for Payer: WEA Trust Commercial $186.45
Rate for Payer: WPS Commercial $251.10
Service Code HCPCS C1894
Hospital Charge Code 6201009
Hospital Revenue Code 272
Min. Negotiated Rate $94.92
Max. Negotiated Rate $1,356.00
Rate for Payer: Aetna Commercial $305.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $291.54
Rate for Payer: Aetna Managed Medicare $94.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $220.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $169.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $162.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $179.67
Rate for Payer: Cash Price $101.70
Rate for Payer: Cigna Commercial $311.88
Rate for Payer: Dean Health DHI/DHP/ASO $189.70
Rate for Payer: Health EOS Commercial $301.71
Rate for Payer: HFN Commercial $311.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $254.25
Rate for Payer: Multiplan Commercial $271.20
Rate for Payer: NAPHCARE Commercial $203.40
Rate for Payer: Preferred Network Access Commercial $311.88
Rate for Payer: Quartz Beloit One Network $166.11
Rate for Payer: Quartz Commercial $220.35
Rate for Payer: Quartz Medicare Advantage $203.40
Rate for Payer: The Alliance Commercial $1,356.00
Rate for Payer: WEA Trust Commercial $186.45
Rate for Payer: WPS Commercial $251.10
Service Code HCPCS C1894
Hospital Charge Code 2550850
Hospital Revenue Code 272
Min. Negotiated Rate $89.88
Max. Negotiated Rate $1,284.00
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Aetna Managed Medicare $89.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $208.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $160.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $154.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Dean Health DHI/DHP/ASO $179.63
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $240.75
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $208.65
Rate for Payer: Quartz Medicare Advantage $192.60
Rate for Payer: The Alliance Commercial $1,284.00
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550850
Hospital Revenue Code 272
Min. Negotiated Rate $157.29
Max. Negotiated Rate $295.32
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $192.60
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550850
Hospital Revenue Code 272
Min. Negotiated Rate $141.24
Max. Negotiated Rate $304.95
Rate for Payer: Aetna Commercial $304.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $304.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $160.50
Rate for Payer: Dean Health DHI/DHP/ASO $192.60
Rate for Payer: Health EOS Commercial $292.11
Rate for Payer: HFN Commercial $304.95
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: Preferred Network Access Commercial $304.95
Rate for Payer: Quartz Beloit One Network $141.24
Rate for Payer: Quartz Commercial $182.97
Rate for Payer: The Alliance Commercial $160.50
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550892
Hospital Revenue Code 272
Min. Negotiated Rate $141.24
Max. Negotiated Rate $304.95
Rate for Payer: Aetna Commercial $304.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $304.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $160.50
Rate for Payer: Dean Health DHI/DHP/ASO $192.60
Rate for Payer: Health EOS Commercial $292.11
Rate for Payer: HFN Commercial $304.95
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: Preferred Network Access Commercial $304.95
Rate for Payer: Quartz Beloit One Network $141.24
Rate for Payer: Quartz Commercial $182.97
Rate for Payer: The Alliance Commercial $160.50
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550892
Hospital Revenue Code 272
Min. Negotiated Rate $89.88
Max. Negotiated Rate $1,284.00
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Aetna Managed Medicare $89.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $208.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $160.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $154.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Dean Health DHI/DHP/ASO $179.63
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $240.75
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $208.65
Rate for Payer: Quartz Medicare Advantage $192.60
Rate for Payer: The Alliance Commercial $1,284.00
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 2550892
Hospital Revenue Code 272
Min. Negotiated Rate $157.29
Max. Negotiated Rate $295.32
Rate for Payer: Aetna Commercial $288.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $276.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $170.13
Rate for Payer: Cash Price $96.30
Rate for Payer: Cigna Commercial $295.32
Rate for Payer: Health EOS Commercial $285.69
Rate for Payer: HFN Commercial $295.32
Rate for Payer: Multiplan Commercial $256.80
Rate for Payer: NAPHCARE Commercial $192.60
Rate for Payer: Preferred Network Access Commercial $295.32
Rate for Payer: Quartz Beloit One Network $157.29
Rate for Payer: Quartz Commercial $192.60
Rate for Payer: WEA Trust Commercial $176.55
Rate for Payer: WPS Commercial $237.76
Service Code HCPCS C1894
Hospital Charge Code 6201011
Hospital Revenue Code 272
Min. Negotiated Rate $94.92
Max. Negotiated Rate $1,356.00
Rate for Payer: Aetna Commercial $305.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $291.54
Rate for Payer: Aetna Managed Medicare $94.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $220.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $169.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $162.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $179.67
Rate for Payer: Cash Price $101.70
Rate for Payer: Cigna Commercial $311.88
Rate for Payer: Dean Health DHI/DHP/ASO $189.70
Rate for Payer: Health EOS Commercial $301.71
Rate for Payer: HFN Commercial $311.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $254.25
Rate for Payer: Multiplan Commercial $271.20
Rate for Payer: NAPHCARE Commercial $203.40
Rate for Payer: Preferred Network Access Commercial $311.88
Rate for Payer: Quartz Beloit One Network $166.11
Rate for Payer: Quartz Commercial $220.35
Rate for Payer: Quartz Medicare Advantage $203.40
Rate for Payer: The Alliance Commercial $1,356.00
Rate for Payer: WEA Trust Commercial $186.45
Rate for Payer: WPS Commercial $251.10
Service Code HCPCS C1894
Hospital Charge Code 6201011
Hospital Revenue Code 272
Min. Negotiated Rate $166.11
Max. Negotiated Rate $311.88
Rate for Payer: Aetna Commercial $305.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $291.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $179.67
Rate for Payer: Cash Price $101.70
Rate for Payer: Cigna Commercial $311.88
Rate for Payer: Health EOS Commercial $301.71
Rate for Payer: HFN Commercial $311.88
Rate for Payer: Multiplan Commercial $271.20
Rate for Payer: NAPHCARE Commercial $203.40
Rate for Payer: Preferred Network Access Commercial $311.88
Rate for Payer: Quartz Beloit One Network $166.11
Rate for Payer: Quartz Commercial $203.40
Rate for Payer: WEA Trust Commercial $186.45
Rate for Payer: WPS Commercial $251.10
Service Code HCPCS C1894
Hospital Charge Code 4520296
Hospital Revenue Code 272
Min. Negotiated Rate $521.85
Max. Negotiated Rate $979.80
Rate for Payer: Aetna Commercial $958.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $915.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $564.45
Rate for Payer: Cash Price $319.50
Rate for Payer: Cigna Commercial $979.80
Rate for Payer: Health EOS Commercial $947.85
Rate for Payer: HFN Commercial $979.80
Rate for Payer: Multiplan Commercial $852.00
Rate for Payer: NAPHCARE Commercial $639.00
Rate for Payer: Preferred Network Access Commercial $979.80
Rate for Payer: Quartz Beloit One Network $521.85
Rate for Payer: Quartz Commercial $639.00
Rate for Payer: WEA Trust Commercial $585.75
Rate for Payer: WPS Commercial $788.85
Service Code HCPCS C1894
Hospital Charge Code 4520296
Hospital Revenue Code 272
Min. Negotiated Rate $298.20
Max. Negotiated Rate $4,260.00
Rate for Payer: Aetna Commercial $958.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $915.90
Rate for Payer: Aetna Managed Medicare $298.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $692.25
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $532.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $511.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $564.45
Rate for Payer: Cash Price $319.50
Rate for Payer: Cigna Commercial $979.80
Rate for Payer: Dean Health DHI/DHP/ASO $595.97
Rate for Payer: Health EOS Commercial $947.85
Rate for Payer: HFN Commercial $979.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $798.75
Rate for Payer: Multiplan Commercial $852.00
Rate for Payer: NAPHCARE Commercial $639.00
Rate for Payer: Preferred Network Access Commercial $979.80
Rate for Payer: Quartz Beloit One Network $521.85
Rate for Payer: Quartz Commercial $692.25
Rate for Payer: Quartz Medicare Advantage $639.00
Rate for Payer: The Alliance Commercial $4,260.00
Rate for Payer: WEA Trust Commercial $585.75
Rate for Payer: WPS Commercial $788.85
Service Code HCPCS C1766
Hospital Charge Code 2971228
Hospital Revenue Code 272
Min. Negotiated Rate $426.72
Max. Negotiated Rate $6,096.00
Rate for Payer: Aetna Commercial $1,371.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,310.64
Rate for Payer: Aetna Managed Medicare $426.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $990.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $762.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $731.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $807.72
Rate for Payer: Cash Price $457.20
Rate for Payer: Cigna Commercial $1,402.08
Rate for Payer: Dean Health DHI/DHP/ASO $852.83
Rate for Payer: Health EOS Commercial $1,356.36
Rate for Payer: HFN Commercial $1,402.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,143.00
Rate for Payer: Multiplan Commercial $1,219.20
Rate for Payer: NAPHCARE Commercial $914.40
Rate for Payer: Preferred Network Access Commercial $1,402.08
Rate for Payer: Quartz Beloit One Network $746.76
Rate for Payer: Quartz Commercial $990.60
Rate for Payer: Quartz Medicare Advantage $914.40
Rate for Payer: The Alliance Commercial $6,096.00
Rate for Payer: WEA Trust Commercial $838.20
Rate for Payer: WPS Commercial $1,128.83
Service Code HCPCS C1766
Hospital Charge Code 2971228
Hospital Revenue Code 272
Min. Negotiated Rate $746.76
Max. Negotiated Rate $1,402.08
Rate for Payer: Aetna Commercial $1,371.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,310.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $807.72
Rate for Payer: Cash Price $457.20
Rate for Payer: Cigna Commercial $1,402.08
Rate for Payer: Health EOS Commercial $1,356.36
Rate for Payer: HFN Commercial $1,402.08
Rate for Payer: Multiplan Commercial $1,219.20
Rate for Payer: NAPHCARE Commercial $914.40
Rate for Payer: Preferred Network Access Commercial $1,402.08
Rate for Payer: Quartz Beloit One Network $746.76
Rate for Payer: Quartz Commercial $914.40
Rate for Payer: WEA Trust Commercial $838.20
Rate for Payer: WPS Commercial $1,128.83
Hospital Charge Code 2963476
Hospital Revenue Code 272
Min. Negotiated Rate $500.29
Max. Negotiated Rate $939.32
Rate for Payer: Aetna Commercial $918.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $878.06
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $541.13
Rate for Payer: Cash Price $306.30
Rate for Payer: Cigna Commercial $939.32
Rate for Payer: Health EOS Commercial $908.69
Rate for Payer: HFN Commercial $939.32
Rate for Payer: Multiplan Commercial $816.80
Rate for Payer: NAPHCARE Commercial $612.60
Rate for Payer: Preferred Network Access Commercial $939.32
Rate for Payer: Quartz Beloit One Network $500.29
Rate for Payer: Quartz Commercial $612.60
Rate for Payer: WEA Trust Commercial $561.55
Rate for Payer: WPS Commercial $756.25
Hospital Charge Code 2963476
Hospital Revenue Code 272
Min. Negotiated Rate $285.88
Max. Negotiated Rate $4,084.00
Rate for Payer: Aetna Commercial $918.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $878.06
Rate for Payer: Aetna Managed Medicare $285.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $663.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $510.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $490.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $541.13
Rate for Payer: Cash Price $306.30
Rate for Payer: Cigna Commercial $939.32
Rate for Payer: Dean Health DHI/DHP/ASO $571.35
Rate for Payer: Health EOS Commercial $908.69
Rate for Payer: HFN Commercial $939.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $765.75
Rate for Payer: Multiplan Commercial $816.80
Rate for Payer: NAPHCARE Commercial $612.60
Rate for Payer: Preferred Network Access Commercial $939.32
Rate for Payer: Quartz Beloit One Network $500.29
Rate for Payer: Quartz Commercial $663.65
Rate for Payer: Quartz Medicare Advantage $612.60
Rate for Payer: The Alliance Commercial $4,084.00
Rate for Payer: WEA Trust Commercial $561.55
Rate for Payer: WPS Commercial $756.25
Hospital Charge Code 2963475
Hospital Revenue Code 272
Min. Negotiated Rate $288.68
Max. Negotiated Rate $4,124.00
Rate for Payer: Aetna Commercial $927.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $886.66
Rate for Payer: Aetna Managed Medicare $288.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $670.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $515.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $494.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $546.43
Rate for Payer: Cash Price $309.30
Rate for Payer: Cigna Commercial $948.52
Rate for Payer: Dean Health DHI/DHP/ASO $576.95
Rate for Payer: Health EOS Commercial $917.59
Rate for Payer: HFN Commercial $948.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $773.25
Rate for Payer: Multiplan Commercial $824.80
Rate for Payer: NAPHCARE Commercial $618.60
Rate for Payer: Preferred Network Access Commercial $948.52
Rate for Payer: Quartz Beloit One Network $505.19
Rate for Payer: Quartz Commercial $670.15
Rate for Payer: Quartz Medicare Advantage $618.60
Rate for Payer: The Alliance Commercial $4,124.00
Rate for Payer: WEA Trust Commercial $567.05
Rate for Payer: WPS Commercial $763.66
Hospital Charge Code 2963475
Hospital Revenue Code 272
Min. Negotiated Rate $505.19
Max. Negotiated Rate $948.52
Rate for Payer: Aetna Commercial $927.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $886.66
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $546.43
Rate for Payer: Cash Price $309.30
Rate for Payer: Cigna Commercial $948.52
Rate for Payer: Health EOS Commercial $917.59
Rate for Payer: HFN Commercial $948.52
Rate for Payer: Multiplan Commercial $824.80
Rate for Payer: NAPHCARE Commercial $618.60
Rate for Payer: Preferred Network Access Commercial $948.52
Rate for Payer: Quartz Beloit One Network $505.19
Rate for Payer: Quartz Commercial $618.60
Rate for Payer: WEA Trust Commercial $567.05
Rate for Payer: WPS Commercial $763.66
Service Code HCPCS C1894
Hospital Charge Code 2965312
Hospital Revenue Code 272
Min. Negotiated Rate $543.41
Max. Negotiated Rate $1,020.28
Rate for Payer: Aetna Commercial $998.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $953.74
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $587.77
Rate for Payer: Cash Price $332.70
Rate for Payer: Cigna Commercial $1,020.28
Rate for Payer: Health EOS Commercial $987.01
Rate for Payer: HFN Commercial $1,020.28
Rate for Payer: Multiplan Commercial $887.20
Rate for Payer: NAPHCARE Commercial $665.40
Rate for Payer: Preferred Network Access Commercial $1,020.28
Rate for Payer: Quartz Beloit One Network $543.41
Rate for Payer: Quartz Commercial $665.40
Rate for Payer: WEA Trust Commercial $609.95
Rate for Payer: WPS Commercial $821.44
Service Code HCPCS C1894
Hospital Charge Code 2965312
Hospital Revenue Code 272
Min. Negotiated Rate $310.52
Max. Negotiated Rate $4,436.00
Rate for Payer: Aetna Commercial $998.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $953.74
Rate for Payer: Aetna Managed Medicare $310.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $720.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $554.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $532.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $587.77
Rate for Payer: Cash Price $332.70
Rate for Payer: Cigna Commercial $1,020.28
Rate for Payer: Dean Health DHI/DHP/ASO $620.60
Rate for Payer: Health EOS Commercial $987.01
Rate for Payer: HFN Commercial $1,020.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $831.75
Rate for Payer: Multiplan Commercial $887.20
Rate for Payer: NAPHCARE Commercial $665.40
Rate for Payer: Preferred Network Access Commercial $1,020.28
Rate for Payer: Quartz Beloit One Network $543.41
Rate for Payer: Quartz Commercial $720.85
Rate for Payer: Quartz Medicare Advantage $665.40
Rate for Payer: The Alliance Commercial $4,436.00
Rate for Payer: WEA Trust Commercial $609.95
Rate for Payer: WPS Commercial $821.44