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Hospital Charge Code 2974213
Hospital Revenue Code 271
Min. Negotiated Rate $49.98
Max. Negotiated Rate $93.84
Rate for Payer: Aetna Commercial $91.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $87.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $54.06
Rate for Payer: Cash Price $30.60
Rate for Payer: Cigna Commercial $93.84
Rate for Payer: Health EOS Commercial $90.78
Rate for Payer: HFN Commercial $93.84
Rate for Payer: Multiplan Commercial $81.60
Rate for Payer: NAPHCARE Commercial $61.20
Rate for Payer: Preferred Network Access Commercial $93.84
Rate for Payer: Quartz Beloit One Network $49.98
Rate for Payer: Quartz Commercial $61.20
Rate for Payer: WEA Trust Commercial $56.10
Rate for Payer: WPS Commercial $75.55
Hospital Charge Code 2974227
Hospital Revenue Code 271
Min. Negotiated Rate $53.90
Max. Negotiated Rate $101.20
Rate for Payer: Aetna Commercial $99.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $94.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $58.30
Rate for Payer: Cash Price $33.00
Rate for Payer: Cigna Commercial $101.20
Rate for Payer: Health EOS Commercial $97.90
Rate for Payer: HFN Commercial $101.20
Rate for Payer: Multiplan Commercial $88.00
Rate for Payer: NAPHCARE Commercial $66.00
Rate for Payer: Preferred Network Access Commercial $101.20
Rate for Payer: Quartz Beloit One Network $53.90
Rate for Payer: Quartz Commercial $66.00
Rate for Payer: WEA Trust Commercial $60.50
Rate for Payer: WPS Commercial $81.48
Hospital Charge Code 2974227
Hospital Revenue Code 271
Min. Negotiated Rate $30.80
Max. Negotiated Rate $440.00
Rate for Payer: Aetna Commercial $99.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $94.60
Rate for Payer: Aetna Managed Medicare $30.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $71.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $55.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $52.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $58.30
Rate for Payer: Cash Price $33.00
Rate for Payer: Cigna Commercial $101.20
Rate for Payer: Dean Health DHI/DHP/ASO $61.56
Rate for Payer: Health EOS Commercial $97.90
Rate for Payer: HFN Commercial $101.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $82.50
Rate for Payer: Multiplan Commercial $88.00
Rate for Payer: NAPHCARE Commercial $66.00
Rate for Payer: Preferred Network Access Commercial $101.20
Rate for Payer: Quartz Beloit One Network $53.90
Rate for Payer: Quartz Commercial $71.50
Rate for Payer: Quartz Medicare Advantage $66.00
Rate for Payer: The Alliance Commercial $440.00
Rate for Payer: WEA Trust Commercial $60.50
Rate for Payer: WPS Commercial $81.48
Hospital Charge Code 2964034
Hospital Revenue Code 271
Min. Negotiated Rate $58.80
Max. Negotiated Rate $110.40
Rate for Payer: Aetna Commercial $108.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $103.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $63.60
Rate for Payer: Cash Price $36.00
Rate for Payer: Cigna Commercial $110.40
Rate for Payer: Health EOS Commercial $106.80
Rate for Payer: HFN Commercial $110.40
Rate for Payer: Multiplan Commercial $96.00
Rate for Payer: NAPHCARE Commercial $72.00
Rate for Payer: Preferred Network Access Commercial $110.40
Rate for Payer: Quartz Beloit One Network $58.80
Rate for Payer: Quartz Commercial $72.00
Rate for Payer: WEA Trust Commercial $66.00
Rate for Payer: WPS Commercial $88.88
Hospital Charge Code 2964034
Hospital Revenue Code 271
Min. Negotiated Rate $33.60
Max. Negotiated Rate $480.00
Rate for Payer: Aetna Commercial $108.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $103.20
Rate for Payer: Aetna Managed Medicare $33.60
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $78.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $60.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $57.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $63.60
Rate for Payer: Cash Price $36.00
Rate for Payer: Cigna Commercial $110.40
Rate for Payer: Dean Health DHI/DHP/ASO $67.15
Rate for Payer: Health EOS Commercial $106.80
Rate for Payer: HFN Commercial $110.40
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $90.00
Rate for Payer: Multiplan Commercial $96.00
Rate for Payer: NAPHCARE Commercial $72.00
Rate for Payer: Preferred Network Access Commercial $110.40
Rate for Payer: Quartz Beloit One Network $58.80
Rate for Payer: Quartz Commercial $78.00
Rate for Payer: Quartz Medicare Advantage $72.00
Rate for Payer: The Alliance Commercial $480.00
Rate for Payer: WEA Trust Commercial $66.00
Rate for Payer: WPS Commercial $88.88
Hospital Charge Code 3072427
Hospital Revenue Code 271
Min. Negotiated Rate $53.90
Max. Negotiated Rate $101.20
Rate for Payer: Aetna Commercial $99.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $94.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $58.30
Rate for Payer: Cash Price $33.00
Rate for Payer: Cigna Commercial $101.20
Rate for Payer: Health EOS Commercial $97.90
Rate for Payer: HFN Commercial $101.20
Rate for Payer: Multiplan Commercial $88.00
Rate for Payer: NAPHCARE Commercial $66.00
Rate for Payer: Preferred Network Access Commercial $101.20
Rate for Payer: Quartz Beloit One Network $53.90
Rate for Payer: Quartz Commercial $66.00
Rate for Payer: WEA Trust Commercial $60.50
Rate for Payer: WPS Commercial $81.48
Hospital Charge Code 3072427
Hospital Revenue Code 271
Min. Negotiated Rate $30.80
Max. Negotiated Rate $440.00
Rate for Payer: Aetna Commercial $99.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $94.60
Rate for Payer: Aetna Managed Medicare $30.80
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $71.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $55.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $52.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $58.30
Rate for Payer: Cash Price $33.00
Rate for Payer: Cigna Commercial $101.20
Rate for Payer: Dean Health DHI/DHP/ASO $61.56
Rate for Payer: Health EOS Commercial $97.90
Rate for Payer: HFN Commercial $101.20
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $82.50
Rate for Payer: Multiplan Commercial $88.00
Rate for Payer: NAPHCARE Commercial $66.00
Rate for Payer: Preferred Network Access Commercial $101.20
Rate for Payer: Quartz Beloit One Network $53.90
Rate for Payer: Quartz Commercial $71.50
Rate for Payer: Quartz Medicare Advantage $66.00
Rate for Payer: The Alliance Commercial $440.00
Rate for Payer: WEA Trust Commercial $60.50
Rate for Payer: WPS Commercial $81.48
Hospital Charge Code 2974242
Hospital Revenue Code 271
Min. Negotiated Rate $54.88
Max. Negotiated Rate $103.04
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $67.20
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2974242
Hospital Revenue Code 271
Min. Negotiated Rate $31.36
Max. Negotiated Rate $448.00
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Aetna Managed Medicare $31.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $72.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $56.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $53.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Dean Health DHI/DHP/ASO $62.68
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $84.00
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $72.80
Rate for Payer: Quartz Medicare Advantage $67.20
Rate for Payer: The Alliance Commercial $448.00
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2964024
Hospital Revenue Code 271
Min. Negotiated Rate $45.36
Max. Negotiated Rate $648.00
Rate for Payer: Aetna Commercial $145.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $139.32
Rate for Payer: Aetna Managed Medicare $45.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $105.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $81.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $77.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $85.86
Rate for Payer: Cash Price $48.60
Rate for Payer: Cigna Commercial $149.04
Rate for Payer: Dean Health DHI/DHP/ASO $90.66
Rate for Payer: Health EOS Commercial $144.18
Rate for Payer: HFN Commercial $149.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $121.50
Rate for Payer: Multiplan Commercial $129.60
Rate for Payer: NAPHCARE Commercial $97.20
Rate for Payer: Preferred Network Access Commercial $149.04
Rate for Payer: Quartz Beloit One Network $79.38
Rate for Payer: Quartz Commercial $105.30
Rate for Payer: Quartz Medicare Advantage $97.20
Rate for Payer: The Alliance Commercial $648.00
Rate for Payer: WEA Trust Commercial $89.10
Rate for Payer: WPS Commercial $119.99
Hospital Charge Code 2964024
Hospital Revenue Code 271
Min. Negotiated Rate $79.38
Max. Negotiated Rate $149.04
Rate for Payer: Aetna Commercial $145.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $139.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $85.86
Rate for Payer: Cash Price $48.60
Rate for Payer: Cigna Commercial $149.04
Rate for Payer: Health EOS Commercial $144.18
Rate for Payer: HFN Commercial $149.04
Rate for Payer: Multiplan Commercial $129.60
Rate for Payer: NAPHCARE Commercial $97.20
Rate for Payer: Preferred Network Access Commercial $149.04
Rate for Payer: Quartz Beloit One Network $79.38
Rate for Payer: Quartz Commercial $97.20
Rate for Payer: WEA Trust Commercial $89.10
Rate for Payer: WPS Commercial $119.99
Hospital Charge Code 2974240
Hospital Revenue Code 271
Min. Negotiated Rate $54.88
Max. Negotiated Rate $103.04
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $67.20
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2974240
Hospital Revenue Code 271
Min. Negotiated Rate $31.36
Max. Negotiated Rate $448.00
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Aetna Managed Medicare $31.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $72.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $56.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $53.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Dean Health DHI/DHP/ASO $62.68
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $84.00
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $72.80
Rate for Payer: Quartz Medicare Advantage $67.20
Rate for Payer: The Alliance Commercial $448.00
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2974239
Hospital Revenue Code 271
Min. Negotiated Rate $31.36
Max. Negotiated Rate $448.00
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Aetna Managed Medicare $31.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $72.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $56.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $53.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Dean Health DHI/DHP/ASO $62.68
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $84.00
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $72.80
Rate for Payer: Quartz Medicare Advantage $67.20
Rate for Payer: The Alliance Commercial $448.00
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2974239
Hospital Revenue Code 271
Min. Negotiated Rate $54.88
Max. Negotiated Rate $103.04
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $67.20
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2974241
Hospital Revenue Code 271
Min. Negotiated Rate $54.88
Max. Negotiated Rate $103.04
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $67.20
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2974241
Hospital Revenue Code 271
Min. Negotiated Rate $31.36
Max. Negotiated Rate $448.00
Rate for Payer: Aetna Commercial $100.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $96.32
Rate for Payer: Aetna Managed Medicare $31.36
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $72.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $56.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $53.76
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $59.36
Rate for Payer: Cash Price $33.60
Rate for Payer: Cigna Commercial $103.04
Rate for Payer: Dean Health DHI/DHP/ASO $62.68
Rate for Payer: Health EOS Commercial $99.68
Rate for Payer: HFN Commercial $103.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $84.00
Rate for Payer: Multiplan Commercial $89.60
Rate for Payer: NAPHCARE Commercial $67.20
Rate for Payer: Preferred Network Access Commercial $103.04
Rate for Payer: Quartz Beloit One Network $54.88
Rate for Payer: Quartz Commercial $72.80
Rate for Payer: Quartz Medicare Advantage $67.20
Rate for Payer: The Alliance Commercial $448.00
Rate for Payer: WEA Trust Commercial $61.60
Rate for Payer: WPS Commercial $82.96
Hospital Charge Code 2970185
Hospital Revenue Code 271
Min. Negotiated Rate $714.00
Max. Negotiated Rate $10,200.00
Rate for Payer: Aetna Commercial $2,295.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,193.00
Rate for Payer: Aetna Managed Medicare $714.00
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,657.50
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $1,275.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $1,224.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,351.50
Rate for Payer: Cash Price $765.00
Rate for Payer: Cigna Commercial $2,346.00
Rate for Payer: Dean Health DHI/DHP/ASO $1,426.98
Rate for Payer: Health EOS Commercial $2,269.50
Rate for Payer: HFN Commercial $2,346.00
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,912.50
Rate for Payer: Multiplan Commercial $2,040.00
Rate for Payer: NAPHCARE Commercial $1,530.00
Rate for Payer: Preferred Network Access Commercial $2,346.00
Rate for Payer: Quartz Beloit One Network $1,249.50
Rate for Payer: Quartz Commercial $1,657.50
Rate for Payer: Quartz Medicare Advantage $1,530.00
Rate for Payer: The Alliance Commercial $10,200.00
Rate for Payer: WEA Trust Commercial $1,402.50
Rate for Payer: WPS Commercial $1,888.78
Hospital Charge Code 2970185
Hospital Revenue Code 271
Min. Negotiated Rate $1,249.50
Max. Negotiated Rate $2,346.00
Rate for Payer: Aetna Commercial $2,295.00
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $2,193.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $1,351.50
Rate for Payer: Cash Price $765.00
Rate for Payer: Cigna Commercial $2,346.00
Rate for Payer: Health EOS Commercial $2,269.50
Rate for Payer: HFN Commercial $2,346.00
Rate for Payer: Multiplan Commercial $2,040.00
Rate for Payer: NAPHCARE Commercial $1,530.00
Rate for Payer: Preferred Network Access Commercial $2,346.00
Rate for Payer: Quartz Beloit One Network $1,249.50
Rate for Payer: Quartz Commercial $1,530.00
Rate for Payer: WEA Trust Commercial $1,402.50
Rate for Payer: WPS Commercial $1,888.78
Service Code CPT 57288
Hospital Revenue Code 360
Min. Negotiated Rate $4,240.00
Max. Negotiated Rate $19,665.00
Rate for Payer: Aetna Managed Medicare $4,916.25
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $12,238.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $10,914.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $10,367.00
Rate for Payer: Anthem Medicare Advantage $4,916.25
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $4,916.25
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $4,916.25
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $4,916.25
Rate for Payer: Dean Health DHI/DHP/ASO $11,874.87
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $4,916.25
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $18,288.45
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $4,916.25
Rate for Payer: Independent Care Health Plan Medicare $4,916.25
Rate for Payer: Managed Health Services Medicare Advantage $4,916.25
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $4,916.25
Rate for Payer: NAPHCARE Commercial $7,374.38
Rate for Payer: Quartz Medicare Advantage $4,916.25
Rate for Payer: The Alliance Commercial $19,665.00
Rate for Payer: United Healthcare Medicare Advantage $4,916.25
Rate for Payer: United Healthcare PPO $4,240.00
Rate for Payer: Wellcare Medicare $4,916.25
Service Code HCPCS A4565
Hospital Charge Code 3133607
Hospital Revenue Code 272
Min. Negotiated Rate $12.32
Max. Negotiated Rate $31.84
Rate for Payer: Aetna Commercial $26.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $24.08
Rate for Payer: Cash Price $8.40
Rate for Payer: Cash Price $8.40
Rate for Payer: Cigna Commercial $26.60
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $14.00
Rate for Payer: Dean Health DHI/DHP/ASO $16.80
Rate for Payer: Health EOS Commercial $25.48
Rate for Payer: HFN Commercial $26.60
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $31.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $31.84
Rate for Payer: Multiplan Commercial $22.40
Rate for Payer: Preferred Network Access Commercial $26.60
Rate for Payer: Quartz Beloit One Network $12.32
Rate for Payer: Quartz Commercial $15.96
Rate for Payer: The Alliance Commercial $14.00
Rate for Payer: WEA Trust Commercial $15.40
Rate for Payer: WPS Commercial $20.74
Service Code HCPCS A4565
Hospital Charge Code 3133607
Hospital Revenue Code 272
Min. Negotiated Rate $7.84
Max. Negotiated Rate $112.00
Rate for Payer: Aetna Commercial $25.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $24.08
Rate for Payer: Aetna Managed Medicare $7.84
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $18.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $14.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $13.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $14.84
Rate for Payer: Cash Price $8.40
Rate for Payer: Cigna Commercial $25.76
Rate for Payer: Dean Health DHI/DHP/ASO $15.67
Rate for Payer: Health EOS Commercial $24.92
Rate for Payer: HFN Commercial $25.76
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $21.00
Rate for Payer: Multiplan Commercial $22.40
Rate for Payer: NAPHCARE Commercial $16.80
Rate for Payer: Preferred Network Access Commercial $25.76
Rate for Payer: Quartz Beloit One Network $13.72
Rate for Payer: Quartz Commercial $18.20
Rate for Payer: Quartz Medicare Advantage $16.80
Rate for Payer: The Alliance Commercial $112.00
Rate for Payer: WEA Trust Commercial $15.40
Rate for Payer: WPS Commercial $20.74
Service Code HCPCS A4565
Hospital Charge Code 3133607
Hospital Revenue Code 272
Min. Negotiated Rate $13.72
Max. Negotiated Rate $25.76
Rate for Payer: Aetna Commercial $25.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $24.08
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $14.84
Rate for Payer: Cash Price $8.40
Rate for Payer: Cigna Commercial $25.76
Rate for Payer: Health EOS Commercial $24.92
Rate for Payer: HFN Commercial $25.76
Rate for Payer: Multiplan Commercial $22.40
Rate for Payer: NAPHCARE Commercial $16.80
Rate for Payer: Preferred Network Access Commercial $25.76
Rate for Payer: Quartz Beloit One Network $13.72
Rate for Payer: Quartz Commercial $16.80
Rate for Payer: WEA Trust Commercial $15.40
Rate for Payer: WPS Commercial $20.74
Hospital Charge Code 2964021
Hospital Revenue Code 271
Min. Negotiated Rate $36.26
Max. Negotiated Rate $68.08
Rate for Payer: Aetna Commercial $66.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $63.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $39.22
Rate for Payer: Cash Price $22.20
Rate for Payer: Cigna Commercial $68.08
Rate for Payer: Health EOS Commercial $65.86
Rate for Payer: HFN Commercial $68.08
Rate for Payer: Multiplan Commercial $59.20
Rate for Payer: NAPHCARE Commercial $44.40
Rate for Payer: Preferred Network Access Commercial $68.08
Rate for Payer: Quartz Beloit One Network $36.26
Rate for Payer: Quartz Commercial $44.40
Rate for Payer: WEA Trust Commercial $40.70
Rate for Payer: WPS Commercial $54.81
Hospital Charge Code 2964021
Hospital Revenue Code 271
Min. Negotiated Rate $20.72
Max. Negotiated Rate $296.00
Rate for Payer: Aetna Commercial $66.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $63.64
Rate for Payer: Aetna Managed Medicare $20.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $48.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $37.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $35.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $39.22
Rate for Payer: Cash Price $22.20
Rate for Payer: Cigna Commercial $68.08
Rate for Payer: Dean Health DHI/DHP/ASO $41.41
Rate for Payer: Health EOS Commercial $65.86
Rate for Payer: HFN Commercial $68.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $55.50
Rate for Payer: Multiplan Commercial $59.20
Rate for Payer: NAPHCARE Commercial $44.40
Rate for Payer: Preferred Network Access Commercial $68.08
Rate for Payer: Quartz Beloit One Network $36.26
Rate for Payer: Quartz Commercial $48.10
Rate for Payer: Quartz Medicare Advantage $44.40
Rate for Payer: The Alliance Commercial $296.00
Rate for Payer: WEA Trust Commercial $40.70
Rate for Payer: WPS Commercial $54.81