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Hospital Charge Code 2969905
Hospital Revenue Code 271
Min. Negotiated Rate $48.02
Max. Negotiated Rate $90.16
Rate for Payer: Aetna Commercial $88.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $84.28
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $51.94
Rate for Payer: Cash Price $29.40
Rate for Payer: Cigna Commercial $90.16
Rate for Payer: Health EOS Commercial $87.22
Rate for Payer: HFN Commercial $90.16
Rate for Payer: Multiplan Commercial $78.40
Rate for Payer: NAPHCARE Commercial $58.80
Rate for Payer: Preferred Network Access Commercial $90.16
Rate for Payer: Quartz Beloit One Network $48.02
Rate for Payer: Quartz Commercial $58.80
Rate for Payer: WEA Trust Commercial $53.90
Rate for Payer: WPS Commercial $72.59
Hospital Charge Code 2969905
Hospital Revenue Code 271
Min. Negotiated Rate $27.44
Max. Negotiated Rate $392.00
Rate for Payer: Aetna Commercial $88.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $84.28
Rate for Payer: Aetna Managed Medicare $27.44
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $63.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $49.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $47.04
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $51.94
Rate for Payer: Cash Price $29.40
Rate for Payer: Cigna Commercial $90.16
Rate for Payer: Dean Health DHI/DHP/ASO $54.84
Rate for Payer: Health EOS Commercial $87.22
Rate for Payer: HFN Commercial $90.16
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $73.50
Rate for Payer: Multiplan Commercial $78.40
Rate for Payer: NAPHCARE Commercial $58.80
Rate for Payer: Preferred Network Access Commercial $90.16
Rate for Payer: Quartz Beloit One Network $48.02
Rate for Payer: Quartz Commercial $63.70
Rate for Payer: Quartz Medicare Advantage $58.80
Rate for Payer: The Alliance Commercial $392.00
Rate for Payer: WEA Trust Commercial $53.90
Rate for Payer: WPS Commercial $72.59
Service Code CPT 99211
Hospital Charge Code 3005551
Hospital Revenue Code 510
Min. Negotiated Rate $38.36
Max. Negotiated Rate $548.00
Rate for Payer: Aetna Commercial $123.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $117.82
Rate for Payer: Aetna Managed Medicare $38.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $89.05
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $68.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $65.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $72.61
Rate for Payer: Cash Price $41.10
Rate for Payer: Cigna Commercial $126.04
Rate for Payer: Dean Health DHI/DHP/ASO $76.67
Rate for Payer: Health EOS Commercial $121.93
Rate for Payer: HFN Commercial $126.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $102.75
Rate for Payer: Multiplan Commercial $109.60
Rate for Payer: NAPHCARE Commercial $82.20
Rate for Payer: Preferred Network Access Commercial $126.04
Rate for Payer: Quartz Beloit One Network $67.13
Rate for Payer: Quartz Commercial $89.05
Rate for Payer: Quartz Medicare Advantage $82.20
Rate for Payer: The Alliance Commercial $548.00
Rate for Payer: WEA Trust Commercial $75.35
Rate for Payer: WPS Commercial $101.48
Service Code CPT 99211
Hospital Charge Code 3005551
Hospital Revenue Code 510
Min. Negotiated Rate $67.13
Max. Negotiated Rate $126.04
Rate for Payer: Aetna Commercial $123.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $117.82
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $72.61
Rate for Payer: Cash Price $41.10
Rate for Payer: Cigna Commercial $126.04
Rate for Payer: Health EOS Commercial $121.93
Rate for Payer: HFN Commercial $126.04
Rate for Payer: Multiplan Commercial $109.60
Rate for Payer: NAPHCARE Commercial $82.20
Rate for Payer: Preferred Network Access Commercial $126.04
Rate for Payer: Quartz Beloit One Network $67.13
Rate for Payer: Quartz Commercial $82.20
Rate for Payer: WEA Trust Commercial $75.35
Rate for Payer: WPS Commercial $101.48
Hospital Charge Code 4493817
Hospital Revenue Code 272
Min. Negotiated Rate $193.48
Max. Negotiated Rate $2,764.00
Rate for Payer: Aetna Commercial $621.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $594.26
Rate for Payer: Aetna Managed Medicare $193.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $449.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $345.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $331.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $366.23
Rate for Payer: Cash Price $207.30
Rate for Payer: Cigna Commercial $635.72
Rate for Payer: Dean Health DHI/DHP/ASO $386.68
Rate for Payer: Health EOS Commercial $614.99
Rate for Payer: HFN Commercial $635.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $518.25
Rate for Payer: Multiplan Commercial $552.80
Rate for Payer: NAPHCARE Commercial $414.60
Rate for Payer: Preferred Network Access Commercial $635.72
Rate for Payer: Quartz Beloit One Network $338.59
Rate for Payer: Quartz Commercial $449.15
Rate for Payer: Quartz Medicare Advantage $414.60
Rate for Payer: The Alliance Commercial $2,764.00
Rate for Payer: WEA Trust Commercial $380.05
Rate for Payer: WPS Commercial $511.82
Hospital Charge Code 4493817
Hospital Revenue Code 272
Min. Negotiated Rate $338.59
Max. Negotiated Rate $635.72
Rate for Payer: Aetna Commercial $621.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $594.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $366.23
Rate for Payer: Cash Price $207.30
Rate for Payer: Cigna Commercial $635.72
Rate for Payer: Health EOS Commercial $614.99
Rate for Payer: HFN Commercial $635.72
Rate for Payer: Multiplan Commercial $552.80
Rate for Payer: NAPHCARE Commercial $414.60
Rate for Payer: Preferred Network Access Commercial $635.72
Rate for Payer: Quartz Beloit One Network $338.59
Rate for Payer: Quartz Commercial $414.60
Rate for Payer: WEA Trust Commercial $380.05
Rate for Payer: WPS Commercial $511.82
Hospital Charge Code 5106665
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
Hospital Charge Code 5106665
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
Hospital Charge Code 4493818
Hospital Revenue Code 272
Min. Negotiated Rate $332.22
Max. Negotiated Rate $623.76
Rate for Payer: Aetna Commercial $610.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $583.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $359.34
Rate for Payer: Cash Price $203.40
Rate for Payer: Cigna Commercial $623.76
Rate for Payer: Health EOS Commercial $603.42
Rate for Payer: HFN Commercial $623.76
Rate for Payer: Multiplan Commercial $542.40
Rate for Payer: NAPHCARE Commercial $406.80
Rate for Payer: Preferred Network Access Commercial $623.76
Rate for Payer: Quartz Beloit One Network $332.22
Rate for Payer: Quartz Commercial $406.80
Rate for Payer: WEA Trust Commercial $372.90
Rate for Payer: WPS Commercial $502.19
Hospital Charge Code 4493818
Hospital Revenue Code 272
Min. Negotiated Rate $189.84
Max. Negotiated Rate $2,712.00
Rate for Payer: Aetna Commercial $610.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $583.08
Rate for Payer: Aetna Managed Medicare $189.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $440.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $339.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $325.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $359.34
Rate for Payer: Cash Price $203.40
Rate for Payer: Cigna Commercial $623.76
Rate for Payer: Dean Health DHI/DHP/ASO $379.41
Rate for Payer: Health EOS Commercial $603.42
Rate for Payer: HFN Commercial $623.76
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $508.50
Rate for Payer: Multiplan Commercial $542.40
Rate for Payer: NAPHCARE Commercial $406.80
Rate for Payer: Preferred Network Access Commercial $623.76
Rate for Payer: Quartz Beloit One Network $332.22
Rate for Payer: Quartz Commercial $440.70
Rate for Payer: Quartz Medicare Advantage $406.80
Rate for Payer: The Alliance Commercial $2,712.00
Rate for Payer: WEA Trust Commercial $372.90
Rate for Payer: WPS Commercial $502.19
Service Code MSDRG 571
Min. Negotiated Rate $16,295.40
Max. Negotiated Rate $45,301.00
Rate for Payer: Aetna Managed Medicare $16,295.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $35,456.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $27,176.89
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $25,819.82
Rate for Payer: Anthem Medicare Advantage $16,295.40
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $16,295.40
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $16,295.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $16,295.40
Rate for Payer: Dean Health DHI/DHP/ASO $28,662.37
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $16,295.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $32,992.05
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $16,295.40
Rate for Payer: Independent Care Health Plan Medicare $16,295.40
Rate for Payer: Managed Health Services Medicare Advantage $16,295.40
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $16,295.40
Rate for Payer: NAPHCARE Commercial $24,443.10
Rate for Payer: Quartz Medicare Advantage $16,295.40
Rate for Payer: The Alliance Commercial $45,301.00
Rate for Payer: United Healthcare Medicare Advantage $16,295.40
Rate for Payer: United Healthcare PPO $25,684.73
Rate for Payer: Wellcare Medicare $16,295.40
Service Code MSDRG 570
Min. Negotiated Rate $28,061.13
Max. Negotiated Rate $78,010.00
Rate for Payer: Aetna Managed Medicare $28,061.13
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $61,261.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $46,956.52
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $44,611.76
Rate for Payer: Anthem Medicare Advantage $28,061.13
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $28,061.13
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $28,061.13
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $28,061.13
Rate for Payer: Dean Health DHI/DHP/ASO $49,523.14
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $28,061.13
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $56,982.90
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $28,061.13
Rate for Payer: Independent Care Health Plan Medicare $28,061.13
Rate for Payer: Managed Health Services Medicare Advantage $28,061.13
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $28,061.13
Rate for Payer: NAPHCARE Commercial $42,091.70
Rate for Payer: Quartz Medicare Advantage $28,061.13
Rate for Payer: The Alliance Commercial $78,010.00
Rate for Payer: United Healthcare Medicare Advantage $28,061.13
Rate for Payer: United Healthcare PPO $44,361.92
Rate for Payer: Wellcare Medicare $28,061.13
Service Code MSDRG 572
Min. Negotiated Rate $11,013.59
Max. Negotiated Rate $30,618.00
Rate for Payer: Aetna Managed Medicare $11,013.59
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $23,917.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $18,332.34
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $17,416.92
Rate for Payer: Anthem Medicare Advantage $11,013.59
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $11,013.59
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $11,013.59
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $11,013.59
Rate for Payer: Dean Health DHI/DHP/ASO $19,334.38
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $11,013.59
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $22,222.20
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $11,013.59
Rate for Payer: Independent Care Health Plan Medicare $11,013.59
Rate for Payer: Managed Health Services Medicare Advantage $11,013.59
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $11,013.59
Rate for Payer: NAPHCARE Commercial $16,520.38
Rate for Payer: Quartz Medicare Advantage $11,013.59
Rate for Payer: The Alliance Commercial $30,618.00
Rate for Payer: United Healthcare Medicare Advantage $11,013.59
Rate for Payer: United Healthcare PPO $17,300.27
Rate for Payer: Wellcare Medicare $11,013.59
Service Code CPT 15221
Hospital Charge Code 3013642
Hospital Revenue Code 510
Min. Negotiated Rate $212.92
Max. Negotiated Rate $811.30
Rate for Payer: Aetna Commercial $811.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $734.44
Rate for Payer: Cash Price $256.20
Rate for Payer: Cash Price $256.20
Rate for Payer: Cigna Commercial $811.30
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $212.92
Rate for Payer: Dean Health DHI/DHP/ASO $512.40
Rate for Payer: Health EOS Commercial $777.14
Rate for Payer: HFN Commercial $811.30
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $228.50
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $228.50
Rate for Payer: Multiplan Commercial $683.20
Rate for Payer: Preferred Network Access Commercial $811.30
Rate for Payer: Quartz Beloit One Network $375.76
Rate for Payer: Quartz Commercial $486.78
Rate for Payer: The Alliance Commercial $427.00
Rate for Payer: United Healthcare Medicaid $212.92
Rate for Payer: WEA Trust Commercial $469.70
Rate for Payer: WPS Commercial $632.56
Service Code CPT 15260
Hospital Charge Code 3013644
Hospital Revenue Code 510
Min. Negotiated Rate $753.31
Max. Negotiated Rate $3,142.60
Rate for Payer: Aetna Commercial $3,142.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,844.88
Rate for Payer: Cash Price $992.40
Rate for Payer: Cash Price $992.40
Rate for Payer: Cigna Commercial $3,142.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $753.31
Rate for Payer: Dean Health DHI/DHP/ASO $1,984.80
Rate for Payer: Health EOS Commercial $3,010.28
Rate for Payer: HFN Commercial $3,142.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,819.38
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $2,819.38
Rate for Payer: Multiplan Commercial $2,646.40
Rate for Payer: Preferred Network Access Commercial $3,142.60
Rate for Payer: Quartz Beloit One Network $1,455.52
Rate for Payer: Quartz Commercial $1,885.56
Rate for Payer: The Alliance Commercial $1,654.00
Rate for Payer: United Healthcare Medicaid $753.31
Rate for Payer: WEA Trust Commercial $1,819.40
Rate for Payer: WPS Commercial $2,450.24
Service Code CPT 15220
Hospital Charge Code 3013641
Hospital Revenue Code 510
Min. Negotiated Rate $452.00
Max. Negotiated Rate $2,942.15
Rate for Payer: Aetna Commercial $2,942.15
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,663.42
Rate for Payer: Cash Price $929.10
Rate for Payer: Cash Price $929.10
Rate for Payer: Cigna Commercial $2,942.15
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $452.00
Rate for Payer: Dean Health DHI/DHP/ASO $1,858.20
Rate for Payer: Health EOS Commercial $2,818.27
Rate for Payer: HFN Commercial $2,942.15
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,026.29
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $2,026.29
Rate for Payer: Multiplan Commercial $2,477.60
Rate for Payer: Preferred Network Access Commercial $2,942.15
Rate for Payer: Quartz Beloit One Network $1,362.68
Rate for Payer: Quartz Commercial $1,765.29
Rate for Payer: The Alliance Commercial $1,548.50
Rate for Payer: United Healthcare Medicaid $452.00
Rate for Payer: WEA Trust Commercial $1,703.35
Rate for Payer: WPS Commercial $2,293.95
Service Code CPT 15200
Hospital Charge Code 3013640
Hospital Revenue Code 510
Min. Negotiated Rate $363.86
Max. Negotiated Rate $3,286.05
Rate for Payer: Aetna Commercial $3,286.05
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,974.74
Rate for Payer: Cash Price $1,037.70
Rate for Payer: Cash Price $1,037.70
Rate for Payer: Cigna Commercial $3,286.05
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $363.86
Rate for Payer: Dean Health DHI/DHP/ASO $2,075.40
Rate for Payer: Health EOS Commercial $3,147.69
Rate for Payer: HFN Commercial $3,286.05
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,217.44
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $2,217.44
Rate for Payer: Multiplan Commercial $2,767.20
Rate for Payer: Preferred Network Access Commercial $3,286.05
Rate for Payer: Quartz Beloit One Network $1,521.96
Rate for Payer: Quartz Commercial $1,971.63
Rate for Payer: The Alliance Commercial $1,729.50
Rate for Payer: United Healthcare Medicaid $363.86
Rate for Payer: WEA Trust Commercial $1,902.45
Rate for Payer: WPS Commercial $2,562.08
Service Code CPT 15241
Hospital Charge Code 5837662
Hospital Revenue Code 510
Min. Negotiated Rate $252.12
Max. Negotiated Rate $544.35
Rate for Payer: Aetna Commercial $544.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $492.78
Rate for Payer: Cash Price $171.90
Rate for Payer: Cash Price $171.90
Rate for Payer: Cigna Commercial $544.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $309.94
Rate for Payer: Dean Health DHI/DHP/ASO $343.80
Rate for Payer: Health EOS Commercial $521.43
Rate for Payer: HFN Commercial $544.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $350.32
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $350.32
Rate for Payer: Multiplan Commercial $458.40
Rate for Payer: Preferred Network Access Commercial $544.35
Rate for Payer: Quartz Beloit One Network $252.12
Rate for Payer: Quartz Commercial $326.61
Rate for Payer: The Alliance Commercial $286.50
Rate for Payer: United Healthcare Medicaid $309.94
Rate for Payer: WEA Trust Commercial $315.15
Rate for Payer: WPS Commercial $424.42
Service Code CPT 15261
Hospital Charge Code 5837663
Hospital Revenue Code 510
Min. Negotiated Rate $290.84
Max. Negotiated Rate $627.95
Rate for Payer: Aetna Commercial $627.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $568.46
Rate for Payer: Cash Price $198.30
Rate for Payer: Cash Price $198.30
Rate for Payer: Cigna Commercial $627.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $361.18
Rate for Payer: Dean Health DHI/DHP/ASO $396.60
Rate for Payer: Health EOS Commercial $601.51
Rate for Payer: HFN Commercial $627.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $455.02
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $455.02
Rate for Payer: Multiplan Commercial $528.80
Rate for Payer: Preferred Network Access Commercial $627.95
Rate for Payer: Quartz Beloit One Network $290.84
Rate for Payer: Quartz Commercial $376.77
Rate for Payer: The Alliance Commercial $330.50
Rate for Payer: United Healthcare Medicaid $361.18
Rate for Payer: WEA Trust Commercial $363.55
Rate for Payer: WPS Commercial $489.60
Service Code CPT 15240
Hospital Charge Code 3013643
Hospital Revenue Code 510
Min. Negotiated Rate $835.27
Max. Negotiated Rate $2,642.56
Rate for Payer: Aetna Commercial $2,496.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,260.08
Rate for Payer: Cash Price $788.40
Rate for Payer: Cash Price $788.40
Rate for Payer: Cigna Commercial $2,496.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $835.27
Rate for Payer: Dean Health DHI/DHP/ASO $1,576.80
Rate for Payer: Health EOS Commercial $2,391.48
Rate for Payer: HFN Commercial $2,496.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $2,642.56
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $2,642.56
Rate for Payer: Multiplan Commercial $2,102.40
Rate for Payer: Preferred Network Access Commercial $2,496.60
Rate for Payer: Quartz Beloit One Network $1,156.32
Rate for Payer: Quartz Commercial $1,497.96
Rate for Payer: The Alliance Commercial $1,314.00
Rate for Payer: United Healthcare Medicaid $835.27
Rate for Payer: WEA Trust Commercial $1,445.40
Rate for Payer: WPS Commercial $1,946.56
Service Code CPT 87101
Hospital Charge Code 3137591
Hospital Revenue Code 300
Min. Negotiated Rate $27.22
Max. Negotiated Rate $250.80
Rate for Payer: Aetna Commercial $250.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $227.04
Rate for Payer: Cash Price $79.20
Rate for Payer: Cash Price $79.20
Rate for Payer: Cigna Commercial $250.80
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $132.00
Rate for Payer: Dean Health DHI/DHP/ASO $158.40
Rate for Payer: Health EOS Commercial $240.24
Rate for Payer: HFN Commercial $250.80
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $27.22
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $27.22
Rate for Payer: Multiplan Commercial $211.20
Rate for Payer: Preferred Network Access Commercial $250.80
Rate for Payer: Quartz Beloit One Network $116.16
Rate for Payer: Quartz Commercial $150.48
Rate for Payer: The Alliance Commercial $132.00
Rate for Payer: WEA Trust Commercial $145.20
Rate for Payer: WPS Commercial $195.54
Service Code CPT 15620
Hospital Charge Code 3013645
Hospital Revenue Code 510
Min. Negotiated Rate $319.14
Max. Negotiated Rate $2,493.75
Rate for Payer: Aetna Commercial $2,493.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,257.50
Rate for Payer: Cash Price $787.50
Rate for Payer: Cash Price $787.50
Rate for Payer: Cigna Commercial $2,493.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $319.14
Rate for Payer: Dean Health DHI/DHP/ASO $1,575.00
Rate for Payer: Health EOS Commercial $2,388.75
Rate for Payer: HFN Commercial $2,493.75
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,080.60
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $1,080.60
Rate for Payer: Multiplan Commercial $2,100.00
Rate for Payer: Preferred Network Access Commercial $2,493.75
Rate for Payer: Quartz Beloit One Network $1,155.00
Rate for Payer: Quartz Commercial $1,496.25
Rate for Payer: The Alliance Commercial $1,312.50
Rate for Payer: United Healthcare Medicaid $319.14
Rate for Payer: WEA Trust Commercial $1,443.75
Rate for Payer: WPS Commercial $1,944.34
Service Code MSDRG 577
Min. Negotiated Rate $25,449.40
Max. Negotiated Rate $70,749.00
Rate for Payer: Aetna Managed Medicare $25,449.40
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $55,597.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $42,614.65
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $40,486.70
Rate for Payer: Anthem Medicare Advantage $25,449.40
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $25,449.40
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $25,449.40
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $25,449.40
Rate for Payer: Dean Health DHI/DHP/ASO $44,943.95
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $25,449.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $51,657.45
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $25,449.40
Rate for Payer: Independent Care Health Plan Medicare $25,449.40
Rate for Payer: Managed Health Services Medicare Advantage $25,449.40
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $25,449.40
Rate for Payer: NAPHCARE Commercial $38,174.10
Rate for Payer: Quartz Medicare Advantage $25,449.40
Rate for Payer: The Alliance Commercial $70,749.00
Rate for Payer: United Healthcare Medicare Advantage $25,449.40
Rate for Payer: United Healthcare PPO $40,215.99
Rate for Payer: Wellcare Medicare $25,449.40
Service Code MSDRG 576
Min. Negotiated Rate $54,464.42
Max. Negotiated Rate $151,411.00
Rate for Payer: Aetna Managed Medicare $54,464.42
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $119,166.40
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $91,340.08
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $86,779.04
Rate for Payer: Anthem Medicare Advantage $54,464.42
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $54,464.42
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $54,464.42
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $54,464.42
Rate for Payer: Dean Health DHI/DHP/ASO $96,332.69
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $54,464.42
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $110,820.50
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $54,464.42
Rate for Payer: Independent Care Health Plan Medicare $54,464.42
Rate for Payer: Managed Health Services Medicare Advantage $54,464.42
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $54,464.42
Rate for Payer: NAPHCARE Commercial $81,696.63
Rate for Payer: Quartz Medicare Advantage $54,464.42
Rate for Payer: The Alliance Commercial $151,411.00
Rate for Payer: United Healthcare Medicare Advantage $54,464.42
Rate for Payer: United Healthcare PPO $86,275.14
Rate for Payer: Wellcare Medicare $54,464.42
Service Code MSDRG 578
Min. Negotiated Rate $15,516.95
Max. Negotiated Rate $43,137.00
Rate for Payer: Aetna Managed Medicare $15,516.95
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $33,777.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $25,890.41
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $24,597.58
Rate for Payer: Anthem Medicare Advantage $15,516.95
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $15,516.95
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $15,516.95
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $15,516.95
Rate for Payer: Dean Health DHI/DHP/ASO $27,305.57
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $15,516.95
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $31,404.75
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $15,516.95
Rate for Payer: Independent Care Health Plan Medicare $15,516.95
Rate for Payer: Managed Health Services Medicare Advantage $15,516.95
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $15,516.95
Rate for Payer: NAPHCARE Commercial $23,275.42
Rate for Payer: Quartz Medicare Advantage $15,516.95
Rate for Payer: The Alliance Commercial $43,137.00
Rate for Payer: United Healthcare Medicare Advantage $15,516.95
Rate for Payer: United Healthcare PPO $24,449.00
Rate for Payer: Wellcare Medicare $15,516.95