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Hospital Charge Code 2972183
Hospital Revenue Code 272
Min. Negotiated Rate $374.08
Max. Negotiated Rate $5,344.00
Rate for Payer: Aetna Commercial $1,202.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,148.96
Rate for Payer: Aetna Managed Medicare $374.08
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $868.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $668.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $641.28
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: Dean Health DHI/DHP/ASO $747.63
Rate for Payer: Health EOS Commercial $1,189.04
Rate for Payer: HFN Commercial $1,229.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,002.00
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 $868.40
Rate for Payer: Quartz Medicare Advantage $801.60
Rate for Payer: The Alliance Commercial $5,344.00
Rate for Payer: WEA Trust Commercial $734.80
Rate for Payer: WPS Commercial $989.58
Service Code HCPCS C1766
Hospital Charge Code 2971632
Hospital Revenue Code 272
Min. Negotiated Rate $383.67
Max. Negotiated Rate $720.36
Rate for Payer: Aetna Commercial $704.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $673.38
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $414.99
Rate for Payer: Cash Price $234.90
Rate for Payer: Cigna Commercial $720.36
Rate for Payer: Health EOS Commercial $696.87
Rate for Payer: HFN Commercial $720.36
Rate for Payer: Multiplan Commercial $626.40
Rate for Payer: NAPHCARE Commercial $469.80
Rate for Payer: Preferred Network Access Commercial $720.36
Rate for Payer: Quartz Beloit One Network $383.67
Rate for Payer: Quartz Commercial $469.80
Rate for Payer: WEA Trust Commercial $430.65
Rate for Payer: WPS Commercial $579.97
Service Code HCPCS C1766
Hospital Charge Code 2971632
Hospital Revenue Code 272
Min. Negotiated Rate $219.24
Max. Negotiated Rate $3,132.00
Rate for Payer: Aetna Commercial $704.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $673.38
Rate for Payer: Aetna Managed Medicare $219.24
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $508.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $391.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $375.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $414.99
Rate for Payer: Cash Price $234.90
Rate for Payer: Cigna Commercial $720.36
Rate for Payer: Dean Health DHI/DHP/ASO $438.17
Rate for Payer: Health EOS Commercial $696.87
Rate for Payer: HFN Commercial $720.36
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $587.25
Rate for Payer: Multiplan Commercial $626.40
Rate for Payer: NAPHCARE Commercial $469.80
Rate for Payer: Preferred Network Access Commercial $720.36
Rate for Payer: Quartz Beloit One Network $383.67
Rate for Payer: Quartz Commercial $508.95
Rate for Payer: Quartz Medicare Advantage $469.80
Rate for Payer: The Alliance Commercial $3,132.00
Rate for Payer: WEA Trust Commercial $430.65
Rate for Payer: WPS Commercial $579.97
Hospital Charge Code 2972555
Hospital Revenue Code 272
Min. Negotiated Rate $780.57
Max. Negotiated Rate $1,465.56
Rate for Payer: Aetna Commercial $1,433.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,369.98
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $844.29
Rate for Payer: Cash Price $477.90
Rate for Payer: Cigna Commercial $1,465.56
Rate for Payer: Health EOS Commercial $1,417.77
Rate for Payer: HFN Commercial $1,465.56
Rate for Payer: Multiplan Commercial $1,274.40
Rate for Payer: NAPHCARE Commercial $955.80
Rate for Payer: Preferred Network Access Commercial $1,465.56
Rate for Payer: Quartz Beloit One Network $780.57
Rate for Payer: Quartz Commercial $955.80
Rate for Payer: WEA Trust Commercial $876.15
Rate for Payer: WPS Commercial $1,179.94
Hospital Charge Code 2972555
Hospital Revenue Code 272
Min. Negotiated Rate $446.04
Max. Negotiated Rate $6,372.00
Rate for Payer: Aetna Commercial $1,433.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,369.98
Rate for Payer: Aetna Managed Medicare $446.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,035.45
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $796.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $764.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $844.29
Rate for Payer: Cash Price $477.90
Rate for Payer: Cigna Commercial $1,465.56
Rate for Payer: Dean Health DHI/DHP/ASO $891.44
Rate for Payer: Health EOS Commercial $1,417.77
Rate for Payer: HFN Commercial $1,465.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,194.75
Rate for Payer: Multiplan Commercial $1,274.40
Rate for Payer: NAPHCARE Commercial $955.80
Rate for Payer: Preferred Network Access Commercial $1,465.56
Rate for Payer: Quartz Beloit One Network $780.57
Rate for Payer: Quartz Commercial $1,035.45
Rate for Payer: Quartz Medicare Advantage $955.80
Rate for Payer: The Alliance Commercial $6,372.00
Rate for Payer: WEA Trust Commercial $876.15
Rate for Payer: WPS Commercial $1,179.94
Service Code HCPCS C1894
Hospital Charge Code 2965867
Hospital Revenue Code 272
Min. Negotiated Rate $110.32
Max. Negotiated Rate $1,576.00
Rate for Payer: Aetna Commercial $354.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $338.84
Rate for Payer: Aetna Managed Medicare $110.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $256.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $197.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $189.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $208.82
Rate for Payer: Cash Price $118.20
Rate for Payer: Cigna Commercial $362.48
Rate for Payer: Dean Health DHI/DHP/ASO $220.48
Rate for Payer: Health EOS Commercial $350.66
Rate for Payer: HFN Commercial $362.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $295.50
Rate for Payer: Multiplan Commercial $315.20
Rate for Payer: NAPHCARE Commercial $236.40
Rate for Payer: Preferred Network Access Commercial $362.48
Rate for Payer: Quartz Beloit One Network $193.06
Rate for Payer: Quartz Commercial $256.10
Rate for Payer: Quartz Medicare Advantage $236.40
Rate for Payer: The Alliance Commercial $1,576.00
Rate for Payer: WEA Trust Commercial $216.70
Rate for Payer: WPS Commercial $291.84
Service Code HCPCS C1894
Hospital Charge Code 2965867
Hospital Revenue Code 272
Min. Negotiated Rate $193.06
Max. Negotiated Rate $362.48
Rate for Payer: Aetna Commercial $354.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $338.84
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $208.82
Rate for Payer: Cash Price $118.20
Rate for Payer: Cigna Commercial $362.48
Rate for Payer: Health EOS Commercial $350.66
Rate for Payer: HFN Commercial $362.48
Rate for Payer: Multiplan Commercial $315.20
Rate for Payer: NAPHCARE Commercial $236.40
Rate for Payer: Preferred Network Access Commercial $362.48
Rate for Payer: Quartz Beloit One Network $193.06
Rate for Payer: Quartz Commercial $236.40
Rate for Payer: WEA Trust Commercial $216.70
Rate for Payer: WPS Commercial $291.84
Hospital Charge Code 2963957
Hospital Revenue Code 271
Min. Negotiated Rate $108.78
Max. Negotiated Rate $204.24
Rate for Payer: Aetna Commercial $199.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $190.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $117.66
Rate for Payer: Cash Price $66.60
Rate for Payer: Cigna Commercial $204.24
Rate for Payer: Health EOS Commercial $197.58
Rate for Payer: HFN Commercial $204.24
Rate for Payer: Multiplan Commercial $177.60
Rate for Payer: NAPHCARE Commercial $133.20
Rate for Payer: Preferred Network Access Commercial $204.24
Rate for Payer: Quartz Beloit One Network $108.78
Rate for Payer: Quartz Commercial $133.20
Rate for Payer: WEA Trust Commercial $122.10
Rate for Payer: WPS Commercial $164.44
Hospital Charge Code 2963957
Hospital Revenue Code 271
Min. Negotiated Rate $62.16
Max. Negotiated Rate $888.00
Rate for Payer: Aetna Commercial $199.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $190.92
Rate for Payer: Aetna Managed Medicare $62.16
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $144.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $111.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $106.56
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $117.66
Rate for Payer: Cash Price $66.60
Rate for Payer: Cigna Commercial $204.24
Rate for Payer: Dean Health DHI/DHP/ASO $124.23
Rate for Payer: Health EOS Commercial $197.58
Rate for Payer: HFN Commercial $204.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $166.50
Rate for Payer: Multiplan Commercial $177.60
Rate for Payer: NAPHCARE Commercial $133.20
Rate for Payer: Preferred Network Access Commercial $204.24
Rate for Payer: Quartz Beloit One Network $108.78
Rate for Payer: Quartz Commercial $144.30
Rate for Payer: Quartz Medicare Advantage $133.20
Rate for Payer: The Alliance Commercial $888.00
Rate for Payer: WEA Trust Commercial $122.10
Rate for Payer: WPS Commercial $164.44
Hospital Charge Code 2963192
Hospital Revenue Code 272
Min. Negotiated Rate $77.56
Max. Negotiated Rate $1,108.00
Rate for Payer: Aetna Commercial $249.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $238.22
Rate for Payer: Aetna Managed Medicare $77.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $180.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $138.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $132.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $146.81
Rate for Payer: Cash Price $83.10
Rate for Payer: Cigna Commercial $254.84
Rate for Payer: Dean Health DHI/DHP/ASO $155.01
Rate for Payer: Health EOS Commercial $246.53
Rate for Payer: HFN Commercial $254.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $207.75
Rate for Payer: Multiplan Commercial $221.60
Rate for Payer: NAPHCARE Commercial $166.20
Rate for Payer: Preferred Network Access Commercial $254.84
Rate for Payer: Quartz Beloit One Network $135.73
Rate for Payer: Quartz Commercial $180.05
Rate for Payer: Quartz Medicare Advantage $166.20
Rate for Payer: The Alliance Commercial $1,108.00
Rate for Payer: WEA Trust Commercial $152.35
Rate for Payer: WPS Commercial $205.17
Hospital Charge Code 2963192
Hospital Revenue Code 272
Min. Negotiated Rate $135.73
Max. Negotiated Rate $254.84
Rate for Payer: Aetna Commercial $249.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $238.22
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $146.81
Rate for Payer: Cash Price $83.10
Rate for Payer: Cigna Commercial $254.84
Rate for Payer: Health EOS Commercial $246.53
Rate for Payer: HFN Commercial $254.84
Rate for Payer: Multiplan Commercial $221.60
Rate for Payer: NAPHCARE Commercial $166.20
Rate for Payer: Preferred Network Access Commercial $254.84
Rate for Payer: Quartz Beloit One Network $135.73
Rate for Payer: Quartz Commercial $166.20
Rate for Payer: WEA Trust Commercial $152.35
Rate for Payer: WPS Commercial $205.17
Hospital Charge Code 2963253
Hospital Revenue Code 272
Min. Negotiated Rate $59.92
Max. Negotiated Rate $856.00
Rate for Payer: Aetna Commercial $192.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $184.04
Rate for Payer: Aetna Managed Medicare $59.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $139.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $107.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $102.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $113.42
Rate for Payer: Cash Price $64.20
Rate for Payer: Cigna Commercial $196.88
Rate for Payer: Dean Health DHI/DHP/ASO $119.75
Rate for Payer: Health EOS Commercial $190.46
Rate for Payer: HFN Commercial $196.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $160.50
Rate for Payer: Multiplan Commercial $171.20
Rate for Payer: NAPHCARE Commercial $128.40
Rate for Payer: Preferred Network Access Commercial $196.88
Rate for Payer: Quartz Beloit One Network $104.86
Rate for Payer: Quartz Commercial $139.10
Rate for Payer: Quartz Medicare Advantage $128.40
Rate for Payer: The Alliance Commercial $856.00
Rate for Payer: WEA Trust Commercial $117.70
Rate for Payer: WPS Commercial $158.51
Hospital Charge Code 2963253
Hospital Revenue Code 272
Min. Negotiated Rate $104.86
Max. Negotiated Rate $196.88
Rate for Payer: Aetna Commercial $192.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $184.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $113.42
Rate for Payer: Cash Price $64.20
Rate for Payer: Cigna Commercial $196.88
Rate for Payer: Health EOS Commercial $190.46
Rate for Payer: HFN Commercial $196.88
Rate for Payer: Multiplan Commercial $171.20
Rate for Payer: NAPHCARE Commercial $128.40
Rate for Payer: Preferred Network Access Commercial $196.88
Rate for Payer: Quartz Beloit One Network $104.86
Rate for Payer: Quartz Commercial $128.40
Rate for Payer: WEA Trust Commercial $117.70
Rate for Payer: WPS Commercial $158.51
Hospital Charge Code 2967368
Hospital Revenue Code 272
Min. Negotiated Rate $593.39
Max. Negotiated Rate $1,114.12
Rate for Payer: Aetna Commercial $1,089.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,041.46
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $641.83
Rate for Payer: Cash Price $363.30
Rate for Payer: Cigna Commercial $1,114.12
Rate for Payer: Health EOS Commercial $1,077.79
Rate for Payer: HFN Commercial $1,114.12
Rate for Payer: Multiplan Commercial $968.80
Rate for Payer: NAPHCARE Commercial $726.60
Rate for Payer: Preferred Network Access Commercial $1,114.12
Rate for Payer: Quartz Beloit One Network $593.39
Rate for Payer: Quartz Commercial $726.60
Rate for Payer: WEA Trust Commercial $666.05
Rate for Payer: WPS Commercial $896.99
Hospital Charge Code 2967368
Hospital Revenue Code 272
Min. Negotiated Rate $339.08
Max. Negotiated Rate $4,844.00
Rate for Payer: Aetna Commercial $1,089.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,041.46
Rate for Payer: Aetna Managed Medicare $339.08
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $787.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $605.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $581.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $641.83
Rate for Payer: Cash Price $363.30
Rate for Payer: Cigna Commercial $1,114.12
Rate for Payer: Dean Health DHI/DHP/ASO $677.68
Rate for Payer: Health EOS Commercial $1,077.79
Rate for Payer: HFN Commercial $1,114.12
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $908.25
Rate for Payer: Multiplan Commercial $968.80
Rate for Payer: NAPHCARE Commercial $726.60
Rate for Payer: Preferred Network Access Commercial $1,114.12
Rate for Payer: Quartz Beloit One Network $593.39
Rate for Payer: Quartz Commercial $787.15
Rate for Payer: Quartz Medicare Advantage $726.60
Rate for Payer: The Alliance Commercial $4,844.00
Rate for Payer: WEA Trust Commercial $666.05
Rate for Payer: WPS Commercial $896.99
Hospital Charge Code 2967369
Hospital Revenue Code 272
Min. Negotiated Rate $368.20
Max. Negotiated Rate $5,260.00
Rate for Payer: Aetna Commercial $1,183.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,130.90
Rate for Payer: Aetna Managed Medicare $368.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $854.75
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $657.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $631.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $696.95
Rate for Payer: Cash Price $394.50
Rate for Payer: Cigna Commercial $1,209.80
Rate for Payer: Dean Health DHI/DHP/ASO $735.87
Rate for Payer: Health EOS Commercial $1,170.35
Rate for Payer: HFN Commercial $1,209.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $986.25
Rate for Payer: Multiplan Commercial $1,052.00
Rate for Payer: NAPHCARE Commercial $789.00
Rate for Payer: Preferred Network Access Commercial $1,209.80
Rate for Payer: Quartz Beloit One Network $644.35
Rate for Payer: Quartz Commercial $854.75
Rate for Payer: Quartz Medicare Advantage $789.00
Rate for Payer: The Alliance Commercial $5,260.00
Rate for Payer: WEA Trust Commercial $723.25
Rate for Payer: WPS Commercial $974.02
Hospital Charge Code 2967369
Hospital Revenue Code 272
Min. Negotiated Rate $644.35
Max. Negotiated Rate $1,209.80
Rate for Payer: Aetna Commercial $1,183.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,130.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $696.95
Rate for Payer: Cash Price $394.50
Rate for Payer: Cigna Commercial $1,209.80
Rate for Payer: Health EOS Commercial $1,170.35
Rate for Payer: HFN Commercial $1,209.80
Rate for Payer: Multiplan Commercial $1,052.00
Rate for Payer: NAPHCARE Commercial $789.00
Rate for Payer: Preferred Network Access Commercial $1,209.80
Rate for Payer: Quartz Beloit One Network $644.35
Rate for Payer: Quartz Commercial $789.00
Rate for Payer: WEA Trust Commercial $723.25
Rate for Payer: WPS Commercial $974.02
Hospital Charge Code 2967370
Hospital Revenue Code 272
Min. Negotiated Rate $705.60
Max. Negotiated Rate $1,324.80
Rate for Payer: Aetna Commercial $1,296.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,238.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $763.20
Rate for Payer: Cash Price $432.00
Rate for Payer: Cigna Commercial $1,324.80
Rate for Payer: Health EOS Commercial $1,281.60
Rate for Payer: HFN Commercial $1,324.80
Rate for Payer: Multiplan Commercial $1,152.00
Rate for Payer: NAPHCARE Commercial $864.00
Rate for Payer: Preferred Network Access Commercial $1,324.80
Rate for Payer: Quartz Beloit One Network $705.60
Rate for Payer: Quartz Commercial $864.00
Rate for Payer: WEA Trust Commercial $792.00
Rate for Payer: WPS Commercial $1,066.61
Hospital Charge Code 2967370
Hospital Revenue Code 272
Min. Negotiated Rate $403.20
Max. Negotiated Rate $5,760.00
Rate for Payer: Aetna Commercial $1,296.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,238.40
Rate for Payer: Aetna Managed Medicare $403.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $936.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $720.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $691.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $763.20
Rate for Payer: Cash Price $432.00
Rate for Payer: Cigna Commercial $1,324.80
Rate for Payer: Dean Health DHI/DHP/ASO $805.82
Rate for Payer: Health EOS Commercial $1,281.60
Rate for Payer: HFN Commercial $1,324.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,080.00
Rate for Payer: Multiplan Commercial $1,152.00
Rate for Payer: NAPHCARE Commercial $864.00
Rate for Payer: Preferred Network Access Commercial $1,324.80
Rate for Payer: Quartz Beloit One Network $705.60
Rate for Payer: Quartz Commercial $936.00
Rate for Payer: Quartz Medicare Advantage $864.00
Rate for Payer: The Alliance Commercial $5,760.00
Rate for Payer: WEA Trust Commercial $792.00
Rate for Payer: WPS Commercial $1,066.61
Hospital Charge Code 2974002
Hospital Revenue Code 272
Min. Negotiated Rate $1,285.27
Max. Negotiated Rate $2,413.16
Rate for Payer: Aetna Commercial $2,360.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,255.78
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,390.19
Rate for Payer: Cash Price $786.90
Rate for Payer: Cigna Commercial $2,413.16
Rate for Payer: Health EOS Commercial $2,334.47
Rate for Payer: HFN Commercial $2,413.16
Rate for Payer: Multiplan Commercial $2,098.40
Rate for Payer: NAPHCARE Commercial $1,573.80
Rate for Payer: Preferred Network Access Commercial $2,413.16
Rate for Payer: Quartz Beloit One Network $1,285.27
Rate for Payer: Quartz Commercial $1,573.80
Rate for Payer: WEA Trust Commercial $1,442.65
Rate for Payer: WPS Commercial $1,942.86
Hospital Charge Code 2974002
Hospital Revenue Code 272
Min. Negotiated Rate $734.44
Max. Negotiated Rate $10,492.00
Rate for Payer: Aetna Commercial $2,360.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,255.78
Rate for Payer: Aetna Managed Medicare $734.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,704.95
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,311.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,259.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,390.19
Rate for Payer: Cash Price $786.90
Rate for Payer: Cigna Commercial $2,413.16
Rate for Payer: Dean Health DHI/DHP/ASO $1,467.83
Rate for Payer: Health EOS Commercial $2,334.47
Rate for Payer: HFN Commercial $2,413.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,967.25
Rate for Payer: Multiplan Commercial $2,098.40
Rate for Payer: NAPHCARE Commercial $1,573.80
Rate for Payer: Preferred Network Access Commercial $2,413.16
Rate for Payer: Quartz Beloit One Network $1,285.27
Rate for Payer: Quartz Commercial $1,704.95
Rate for Payer: Quartz Medicare Advantage $1,573.80
Rate for Payer: The Alliance Commercial $10,492.00
Rate for Payer: WEA Trust Commercial $1,442.65
Rate for Payer: WPS Commercial $1,942.86
Hospital Charge Code 2969466
Hospital Revenue Code 272
Min. Negotiated Rate $482.16
Max. Negotiated Rate $905.28
Rate for Payer: Aetna Commercial $885.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $846.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $521.52
Rate for Payer: Cash Price $295.20
Rate for Payer: Cigna Commercial $905.28
Rate for Payer: Health EOS Commercial $875.76
Rate for Payer: HFN Commercial $905.28
Rate for Payer: Multiplan Commercial $787.20
Rate for Payer: NAPHCARE Commercial $590.40
Rate for Payer: Preferred Network Access Commercial $905.28
Rate for Payer: Quartz Beloit One Network $482.16
Rate for Payer: Quartz Commercial $590.40
Rate for Payer: WEA Trust Commercial $541.20
Rate for Payer: WPS Commercial $728.85
Hospital Charge Code 2969466
Hospital Revenue Code 272
Min. Negotiated Rate $275.52
Max. Negotiated Rate $3,936.00
Rate for Payer: Aetna Commercial $885.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $846.24
Rate for Payer: Aetna Managed Medicare $275.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $639.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $492.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $472.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $521.52
Rate for Payer: Cash Price $295.20
Rate for Payer: Cigna Commercial $905.28
Rate for Payer: Dean Health DHI/DHP/ASO $550.65
Rate for Payer: Health EOS Commercial $875.76
Rate for Payer: HFN Commercial $905.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $738.00
Rate for Payer: Multiplan Commercial $787.20
Rate for Payer: NAPHCARE Commercial $590.40
Rate for Payer: Preferred Network Access Commercial $905.28
Rate for Payer: Quartz Beloit One Network $482.16
Rate for Payer: Quartz Commercial $639.60
Rate for Payer: Quartz Medicare Advantage $590.40
Rate for Payer: The Alliance Commercial $3,936.00
Rate for Payer: WEA Trust Commercial $541.20
Rate for Payer: WPS Commercial $728.85
Hospital Charge Code 2963306
Hospital Revenue Code 272
Min. Negotiated Rate $34.30
Max. Negotiated Rate $64.40
Rate for Payer: Aetna Commercial $63.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $60.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $37.10
Rate for Payer: Cash Price $21.00
Rate for Payer: Cigna Commercial $64.40
Rate for Payer: Health EOS Commercial $62.30
Rate for Payer: HFN Commercial $64.40
Rate for Payer: Multiplan Commercial $56.00
Rate for Payer: NAPHCARE Commercial $42.00
Rate for Payer: Preferred Network Access Commercial $64.40
Rate for Payer: Quartz Beloit One Network $34.30
Rate for Payer: Quartz Commercial $42.00
Rate for Payer: WEA Trust Commercial $38.50
Rate for Payer: WPS Commercial $51.85
Hospital Charge Code 2963306
Hospital Revenue Code 272
Min. Negotiated Rate $19.60
Max. Negotiated Rate $280.00
Rate for Payer: Aetna Commercial $63.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $60.20
Rate for Payer: Aetna Managed Medicare $19.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $45.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $35.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $33.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $37.10
Rate for Payer: Cash Price $21.00
Rate for Payer: Cigna Commercial $64.40
Rate for Payer: Dean Health DHI/DHP/ASO $39.17
Rate for Payer: Health EOS Commercial $62.30
Rate for Payer: HFN Commercial $64.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $52.50
Rate for Payer: Multiplan Commercial $56.00
Rate for Payer: NAPHCARE Commercial $42.00
Rate for Payer: Preferred Network Access Commercial $64.40
Rate for Payer: Quartz Beloit One Network $34.30
Rate for Payer: Quartz Commercial $45.50
Rate for Payer: Quartz Medicare Advantage $42.00
Rate for Payer: The Alliance Commercial $280.00
Rate for Payer: WEA Trust Commercial $38.50
Rate for Payer: WPS Commercial $51.85