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Service Code HCPCS C1894
Hospital Charge Code 3157462
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 3157462
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
Hospital Charge Code 2965316
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
Hospital Charge Code 2965316
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
Service Code HCPCS C1894
Hospital Charge Code 3613494
Hospital Revenue Code 272
Min. Negotiated Rate $399.56
Max. Negotiated Rate $5,708.00
Rate for Payer: Aetna Commercial $1,284.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,227.22
Rate for Payer: Aetna Managed Medicare $399.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $927.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $713.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $684.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $756.31
Rate for Payer: Cash Price $428.10
Rate for Payer: Cigna Commercial $1,312.84
Rate for Payer: Dean Health DHI/DHP/ASO $798.55
Rate for Payer: Health EOS Commercial $1,270.03
Rate for Payer: HFN Commercial $1,312.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,070.25
Rate for Payer: Multiplan Commercial $1,141.60
Rate for Payer: NAPHCARE Commercial $856.20
Rate for Payer: Preferred Network Access Commercial $1,312.84
Rate for Payer: Quartz Beloit One Network $699.23
Rate for Payer: Quartz Commercial $927.55
Rate for Payer: Quartz Medicare Advantage $856.20
Rate for Payer: The Alliance Commercial $5,708.00
Rate for Payer: WEA Trust Commercial $784.85
Rate for Payer: WPS Commercial $1,056.98
Service Code HCPCS C1894
Hospital Charge Code 3613494
Hospital Revenue Code 272
Min. Negotiated Rate $699.23
Max. Negotiated Rate $1,312.84
Rate for Payer: Aetna Commercial $1,284.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,227.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $756.31
Rate for Payer: Cash Price $428.10
Rate for Payer: Cigna Commercial $1,312.84
Rate for Payer: Health EOS Commercial $1,270.03
Rate for Payer: HFN Commercial $1,312.84
Rate for Payer: Multiplan Commercial $1,141.60
Rate for Payer: NAPHCARE Commercial $856.20
Rate for Payer: Preferred Network Access Commercial $1,312.84
Rate for Payer: Quartz Beloit One Network $699.23
Rate for Payer: Quartz Commercial $856.20
Rate for Payer: WEA Trust Commercial $784.85
Rate for Payer: WPS Commercial $1,056.98
Service Code HCPCS C1894
Hospital Charge Code 3477498
Hospital Revenue Code 278
Min. Negotiated Rate $460.11
Max. Negotiated Rate $863.88
Rate for Payer: Aetna Commercial $845.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $807.54
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $497.67
Rate for Payer: Cash Price $281.70
Rate for Payer: Cigna Commercial $863.88
Rate for Payer: Health EOS Commercial $835.71
Rate for Payer: HFN Commercial $863.88
Rate for Payer: Multiplan Commercial $751.20
Rate for Payer: NAPHCARE Commercial $563.40
Rate for Payer: Preferred Network Access Commercial $863.88
Rate for Payer: Quartz Beloit One Network $460.11
Rate for Payer: Quartz Commercial $563.40
Rate for Payer: WEA Trust Commercial $516.45
Rate for Payer: WPS Commercial $695.52
Service Code HCPCS C1894
Hospital Charge Code 3477498
Hospital Revenue Code 278
Min. Negotiated Rate $262.92
Max. Negotiated Rate $3,756.00
Rate for Payer: Aetna Commercial $845.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $807.54
Rate for Payer: Aetna Managed Medicare $262.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $610.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $469.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $450.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $497.67
Rate for Payer: Cash Price $281.70
Rate for Payer: Cigna Commercial $863.88
Rate for Payer: Dean Health DHI/DHP/ASO $525.46
Rate for Payer: Health EOS Commercial $835.71
Rate for Payer: HFN Commercial $863.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $704.25
Rate for Payer: Multiplan Commercial $751.20
Rate for Payer: NAPHCARE Commercial $563.40
Rate for Payer: Preferred Network Access Commercial $863.88
Rate for Payer: Quartz Beloit One Network $460.11
Rate for Payer: Quartz Commercial $610.35
Rate for Payer: Quartz Medicare Advantage $563.40
Rate for Payer: The Alliance Commercial $3,756.00
Rate for Payer: WEA Trust Commercial $516.45
Rate for Payer: WPS Commercial $695.52
Hospital Charge Code 2972709
Hospital Revenue Code 272
Min. Negotiated Rate $81.76
Max. Negotiated Rate $1,168.00
Rate for Payer: Aetna Commercial $262.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $251.12
Rate for Payer: Aetna Managed Medicare $81.76
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $189.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $146.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $140.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $154.76
Rate for Payer: Cash Price $87.60
Rate for Payer: Cigna Commercial $268.64
Rate for Payer: Dean Health DHI/DHP/ASO $163.40
Rate for Payer: Health EOS Commercial $259.88
Rate for Payer: HFN Commercial $268.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $219.00
Rate for Payer: Multiplan Commercial $233.60
Rate for Payer: NAPHCARE Commercial $175.20
Rate for Payer: Preferred Network Access Commercial $268.64
Rate for Payer: Quartz Beloit One Network $143.08
Rate for Payer: Quartz Commercial $189.80
Rate for Payer: Quartz Medicare Advantage $175.20
Rate for Payer: The Alliance Commercial $1,168.00
Rate for Payer: WEA Trust Commercial $160.60
Rate for Payer: WPS Commercial $216.28
Hospital Charge Code 2972709
Hospital Revenue Code 272
Min. Negotiated Rate $143.08
Max. Negotiated Rate $268.64
Rate for Payer: Aetna Commercial $262.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $251.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $154.76
Rate for Payer: Cash Price $87.60
Rate for Payer: Cigna Commercial $268.64
Rate for Payer: Health EOS Commercial $259.88
Rate for Payer: HFN Commercial $268.64
Rate for Payer: Multiplan Commercial $233.60
Rate for Payer: NAPHCARE Commercial $175.20
Rate for Payer: Preferred Network Access Commercial $268.64
Rate for Payer: Quartz Beloit One Network $143.08
Rate for Payer: Quartz Commercial $175.20
Rate for Payer: WEA Trust Commercial $160.60
Rate for Payer: WPS Commercial $216.28
Service Code HCPCS C1894
Hospital Charge Code 2969729
Hospital Revenue Code 272
Min. Negotiated Rate $295.12
Max. Negotiated Rate $4,216.00
Rate for Payer: Aetna Commercial $948.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $906.44
Rate for Payer: Aetna Managed Medicare $295.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $685.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $527.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $505.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $558.62
Rate for Payer: Cash Price $316.20
Rate for Payer: Cigna Commercial $969.68
Rate for Payer: Dean Health DHI/DHP/ASO $589.82
Rate for Payer: Health EOS Commercial $938.06
Rate for Payer: HFN Commercial $969.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $790.50
Rate for Payer: Multiplan Commercial $843.20
Rate for Payer: NAPHCARE Commercial $632.40
Rate for Payer: Preferred Network Access Commercial $969.68
Rate for Payer: Quartz Beloit One Network $516.46
Rate for Payer: Quartz Commercial $685.10
Rate for Payer: Quartz Medicare Advantage $632.40
Rate for Payer: The Alliance Commercial $4,216.00
Rate for Payer: WEA Trust Commercial $579.70
Rate for Payer: WPS Commercial $780.70
Service Code HCPCS C1894
Hospital Charge Code 2969729
Hospital Revenue Code 272
Min. Negotiated Rate $516.46
Max. Negotiated Rate $969.68
Rate for Payer: Aetna Commercial $948.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $906.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $558.62
Rate for Payer: Cash Price $316.20
Rate for Payer: Cigna Commercial $969.68
Rate for Payer: Health EOS Commercial $938.06
Rate for Payer: HFN Commercial $969.68
Rate for Payer: Multiplan Commercial $843.20
Rate for Payer: NAPHCARE Commercial $632.40
Rate for Payer: Preferred Network Access Commercial $969.68
Rate for Payer: Quartz Beloit One Network $516.46
Rate for Payer: Quartz Commercial $632.40
Rate for Payer: WEA Trust Commercial $579.70
Rate for Payer: WPS Commercial $780.70
Service Code HCPCS C1766
Hospital Charge Code 2973605
Hospital Revenue Code 272
Min. Negotiated Rate $497.84
Max. Negotiated Rate $934.72
Rate for Payer: Aetna Commercial $914.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $873.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $538.48
Rate for Payer: Cash Price $304.80
Rate for Payer: Cigna Commercial $934.72
Rate for Payer: Health EOS Commercial $904.24
Rate for Payer: HFN Commercial $934.72
Rate for Payer: Multiplan Commercial $812.80
Rate for Payer: NAPHCARE Commercial $609.60
Rate for Payer: Preferred Network Access Commercial $934.72
Rate for Payer: Quartz Beloit One Network $497.84
Rate for Payer: Quartz Commercial $609.60
Rate for Payer: WEA Trust Commercial $558.80
Rate for Payer: WPS Commercial $752.55
Service Code HCPCS C1766
Hospital Charge Code 2973605
Hospital Revenue Code 272
Min. Negotiated Rate $284.48
Max. Negotiated Rate $4,064.00
Rate for Payer: Aetna Commercial $914.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $873.76
Rate for Payer: Aetna Managed Medicare $284.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $660.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $508.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $487.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $538.48
Rate for Payer: Cash Price $304.80
Rate for Payer: Cigna Commercial $934.72
Rate for Payer: Dean Health DHI/DHP/ASO $568.55
Rate for Payer: Health EOS Commercial $904.24
Rate for Payer: HFN Commercial $934.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $762.00
Rate for Payer: Multiplan Commercial $812.80
Rate for Payer: NAPHCARE Commercial $609.60
Rate for Payer: Preferred Network Access Commercial $934.72
Rate for Payer: Quartz Beloit One Network $497.84
Rate for Payer: Quartz Commercial $660.40
Rate for Payer: Quartz Medicare Advantage $609.60
Rate for Payer: The Alliance Commercial $4,064.00
Rate for Payer: WEA Trust Commercial $558.80
Rate for Payer: WPS Commercial $752.55
Service Code HCPCS C1894
Hospital Charge Code 3107499
Hospital Revenue Code 278
Min. Negotiated Rate $93.52
Max. Negotiated Rate $1,336.00
Rate for Payer: Aetna Commercial $300.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $287.24
Rate for Payer: Aetna Managed Medicare $93.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $217.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $167.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $160.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $177.02
Rate for Payer: Cash Price $100.20
Rate for Payer: Cigna Commercial $307.28
Rate for Payer: Dean Health DHI/DHP/ASO $186.91
Rate for Payer: Health EOS Commercial $297.26
Rate for Payer: HFN Commercial $307.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $250.50
Rate for Payer: Multiplan Commercial $267.20
Rate for Payer: NAPHCARE Commercial $200.40
Rate for Payer: Preferred Network Access Commercial $307.28
Rate for Payer: Quartz Beloit One Network $163.66
Rate for Payer: Quartz Commercial $217.10
Rate for Payer: Quartz Medicare Advantage $200.40
Rate for Payer: The Alliance Commercial $1,336.00
Rate for Payer: WEA Trust Commercial $183.70
Rate for Payer: WPS Commercial $247.39
Service Code HCPCS C1894
Hospital Charge Code 3107499
Hospital Revenue Code 278
Min. Negotiated Rate $163.66
Max. Negotiated Rate $307.28
Rate for Payer: Aetna Commercial $300.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $287.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $177.02
Rate for Payer: Cash Price $100.20
Rate for Payer: Cigna Commercial $307.28
Rate for Payer: Health EOS Commercial $297.26
Rate for Payer: HFN Commercial $307.28
Rate for Payer: Multiplan Commercial $267.20
Rate for Payer: NAPHCARE Commercial $200.40
Rate for Payer: Preferred Network Access Commercial $307.28
Rate for Payer: Quartz Beloit One Network $163.66
Rate for Payer: Quartz Commercial $200.40
Rate for Payer: WEA Trust Commercial $183.70
Rate for Payer: WPS Commercial $247.39
Service Code HCPCS C1894
Hospital Charge Code 3107497
Hospital Revenue Code 272
Min. Negotiated Rate $163.66
Max. Negotiated Rate $307.28
Rate for Payer: Aetna Commercial $300.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $287.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $177.02
Rate for Payer: Cash Price $100.20
Rate for Payer: Cigna Commercial $307.28
Rate for Payer: Health EOS Commercial $297.26
Rate for Payer: HFN Commercial $307.28
Rate for Payer: Multiplan Commercial $267.20
Rate for Payer: NAPHCARE Commercial $200.40
Rate for Payer: Preferred Network Access Commercial $307.28
Rate for Payer: Quartz Beloit One Network $163.66
Rate for Payer: Quartz Commercial $200.40
Rate for Payer: WEA Trust Commercial $183.70
Rate for Payer: WPS Commercial $247.39
Service Code HCPCS C1894
Hospital Charge Code 3107497
Hospital Revenue Code 272
Min. Negotiated Rate $93.52
Max. Negotiated Rate $1,336.00
Rate for Payer: Aetna Commercial $300.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $287.24
Rate for Payer: Aetna Managed Medicare $93.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $217.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $167.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $160.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $177.02
Rate for Payer: Cash Price $100.20
Rate for Payer: Cigna Commercial $307.28
Rate for Payer: Dean Health DHI/DHP/ASO $186.91
Rate for Payer: Health EOS Commercial $297.26
Rate for Payer: HFN Commercial $307.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $250.50
Rate for Payer: Multiplan Commercial $267.20
Rate for Payer: NAPHCARE Commercial $200.40
Rate for Payer: Preferred Network Access Commercial $307.28
Rate for Payer: Quartz Beloit One Network $163.66
Rate for Payer: Quartz Commercial $217.10
Rate for Payer: Quartz Medicare Advantage $200.40
Rate for Payer: The Alliance Commercial $1,336.00
Rate for Payer: WEA Trust Commercial $183.70
Rate for Payer: WPS Commercial $247.39
Service Code HCPCS C1894
Hospital Charge Code 3449502
Hospital Revenue Code 272
Min. Negotiated Rate $1,281.84
Max. Negotiated Rate $2,406.72
Rate for Payer: Aetna Commercial $2,354.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,249.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,386.48
Rate for Payer: Cash Price $784.80
Rate for Payer: Cigna Commercial $2,406.72
Rate for Payer: Health EOS Commercial $2,328.24
Rate for Payer: HFN Commercial $2,406.72
Rate for Payer: Multiplan Commercial $2,092.80
Rate for Payer: NAPHCARE Commercial $1,569.60
Rate for Payer: Preferred Network Access Commercial $2,406.72
Rate for Payer: Quartz Beloit One Network $1,281.84
Rate for Payer: Quartz Commercial $1,569.60
Rate for Payer: WEA Trust Commercial $1,438.80
Rate for Payer: WPS Commercial $1,937.67
Service Code HCPCS C1894
Hospital Charge Code 3449502
Hospital Revenue Code 272
Min. Negotiated Rate $732.48
Max. Negotiated Rate $10,464.00
Rate for Payer: Aetna Commercial $2,354.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,249.76
Rate for Payer: Aetna Managed Medicare $732.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,700.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,308.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,255.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,386.48
Rate for Payer: Cash Price $784.80
Rate for Payer: Cigna Commercial $2,406.72
Rate for Payer: Dean Health DHI/DHP/ASO $1,463.91
Rate for Payer: Health EOS Commercial $2,328.24
Rate for Payer: HFN Commercial $2,406.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,962.00
Rate for Payer: Multiplan Commercial $2,092.80
Rate for Payer: NAPHCARE Commercial $1,569.60
Rate for Payer: Preferred Network Access Commercial $2,406.72
Rate for Payer: Quartz Beloit One Network $1,281.84
Rate for Payer: Quartz Commercial $1,700.40
Rate for Payer: Quartz Medicare Advantage $1,569.60
Rate for Payer: The Alliance Commercial $10,464.00
Rate for Payer: WEA Trust Commercial $1,438.80
Rate for Payer: WPS Commercial $1,937.67
Service Code HCPCS C1894
Hospital Charge Code 2972102
Hospital Revenue Code 272
Min. Negotiated Rate $732.48
Max. Negotiated Rate $10,464.00
Rate for Payer: Aetna Commercial $2,354.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,249.76
Rate for Payer: Aetna Managed Medicare $732.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,700.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,308.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,255.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,386.48
Rate for Payer: Cash Price $784.80
Rate for Payer: Cigna Commercial $2,406.72
Rate for Payer: Dean Health DHI/DHP/ASO $1,463.91
Rate for Payer: Health EOS Commercial $2,328.24
Rate for Payer: HFN Commercial $2,406.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,962.00
Rate for Payer: Multiplan Commercial $2,092.80
Rate for Payer: NAPHCARE Commercial $1,569.60
Rate for Payer: Preferred Network Access Commercial $2,406.72
Rate for Payer: Quartz Beloit One Network $1,281.84
Rate for Payer: Quartz Commercial $1,700.40
Rate for Payer: Quartz Medicare Advantage $1,569.60
Rate for Payer: The Alliance Commercial $10,464.00
Rate for Payer: WEA Trust Commercial $1,438.80
Rate for Payer: WPS Commercial $1,937.67
Service Code HCPCS C1894
Hospital Charge Code 2972102
Hospital Revenue Code 272
Min. Negotiated Rate $1,281.84
Max. Negotiated Rate $2,406.72
Rate for Payer: Aetna Commercial $2,354.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,249.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,386.48
Rate for Payer: Cash Price $784.80
Rate for Payer: Cigna Commercial $2,406.72
Rate for Payer: Health EOS Commercial $2,328.24
Rate for Payer: HFN Commercial $2,406.72
Rate for Payer: Multiplan Commercial $2,092.80
Rate for Payer: NAPHCARE Commercial $1,569.60
Rate for Payer: Preferred Network Access Commercial $2,406.72
Rate for Payer: Quartz Beloit One Network $1,281.84
Rate for Payer: Quartz Commercial $1,569.60
Rate for Payer: WEA Trust Commercial $1,438.80
Rate for Payer: WPS Commercial $1,937.67
Service Code HCPCS C1892
Hospital Charge Code 2972099
Hospital Revenue Code 278
Min. Negotiated Rate $155.33
Max. Negotiated Rate $291.64
Rate for Payer: Aetna Commercial $285.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $272.62
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $168.01
Rate for Payer: Cash Price $95.10
Rate for Payer: Cigna Commercial $291.64
Rate for Payer: Health EOS Commercial $282.13
Rate for Payer: HFN Commercial $291.64
Rate for Payer: Multiplan Commercial $253.60
Rate for Payer: NAPHCARE Commercial $190.20
Rate for Payer: Preferred Network Access Commercial $291.64
Rate for Payer: Quartz Beloit One Network $155.33
Rate for Payer: Quartz Commercial $190.20
Rate for Payer: WEA Trust Commercial $174.35
Rate for Payer: WPS Commercial $234.80
Service Code HCPCS C1892
Hospital Charge Code 2972099
Hospital Revenue Code 278
Min. Negotiated Rate $88.76
Max. Negotiated Rate $1,268.00
Rate for Payer: Aetna Commercial $285.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $272.62
Rate for Payer: Aetna Managed Medicare $88.76
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $206.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $158.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $152.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $168.01
Rate for Payer: Cash Price $95.10
Rate for Payer: Cigna Commercial $291.64
Rate for Payer: Dean Health DHI/DHP/ASO $177.39
Rate for Payer: Health EOS Commercial $282.13
Rate for Payer: HFN Commercial $291.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $237.75
Rate for Payer: Multiplan Commercial $253.60
Rate for Payer: NAPHCARE Commercial $190.20
Rate for Payer: Preferred Network Access Commercial $291.64
Rate for Payer: Quartz Beloit One Network $155.33
Rate for Payer: Quartz Commercial $206.05
Rate for Payer: Quartz Medicare Advantage $190.20
Rate for Payer: The Alliance Commercial $1,268.00
Rate for Payer: WEA Trust Commercial $174.35
Rate for Payer: WPS Commercial $234.80
Hospital Charge Code 2972183
Hospital Revenue Code 272
Min. Negotiated Rate $654.64
Max. Negotiated Rate $1,229.12
Rate for Payer: Aetna Commercial $1,202.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,148.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $708.08
Rate for Payer: Cash Price $400.80
Rate for Payer: Cigna Commercial $1,229.12
Rate for Payer: Health EOS Commercial $1,189.04
Rate for Payer: HFN Commercial $1,229.12
Rate for Payer: Multiplan Commercial $1,068.80
Rate for Payer: NAPHCARE Commercial $801.60
Rate for Payer: Preferred Network Access Commercial $1,229.12
Rate for Payer: Quartz Beloit One Network $654.64
Rate for Payer: Quartz Commercial $801.60
Rate for Payer: WEA Trust Commercial $734.80
Rate for Payer: WPS Commercial $989.58