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Charge Type Price  
Service Code HCPCS C1769
Hospital Charge Code 6165984
Hospital Revenue Code 272
Min. Negotiated Rate $760.48
Max. Negotiated Rate $1,427.84
Rate for Payer: Aetna Commercial $1,396.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $822.56
Rate for Payer: Cash Price $465.60
Rate for Payer: Cigna Commercial $1,427.84
Rate for Payer: Health EOS Commercial $1,381.28
Rate for Payer: HFN Commercial $1,427.84
Rate for Payer: Multiplan Commercial $1,241.60
Rate for Payer: NAPHCARE Commercial $931.20
Rate for Payer: Preferred Network Access Commercial $1,427.84
Rate for Payer: Quartz Beloit One Network $760.48
Rate for Payer: Quartz Commercial $931.20
Rate for Payer: WEA Trust Commercial $853.60
Rate for Payer: WPS Commercial $1,149.57
Service Code HCPCS C1769
Hospital Charge Code 6165984
Hospital Revenue Code 272
Min. Negotiated Rate $434.56
Max. Negotiated Rate $1,427.84
Rate for Payer: Aetna Commercial $1,396.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,334.72
Rate for Payer: Aetna Managed Medicare $434.56
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,008.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $776.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $744.96
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $822.56
Rate for Payer: Cash Price $465.60
Rate for Payer: Cigna Commercial $1,427.84
Rate for Payer: Dean Health DHI/DHP/ASO $868.50
Rate for Payer: Health EOS Commercial $1,381.28
Rate for Payer: HFN Commercial $1,427.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,164.00
Rate for Payer: Multiplan Commercial $1,241.60
Rate for Payer: NAPHCARE Commercial $931.20
Rate for Payer: Preferred Network Access Commercial $1,427.84
Rate for Payer: Quartz Beloit One Network $760.48
Rate for Payer: Quartz Commercial $1,008.80
Rate for Payer: Quartz Medicare Advantage $931.20
Rate for Payer: WEA Trust Commercial $853.60
Rate for Payer: WPS Commercial $1,149.57
Service Code HCPCS C1769
Hospital Charge Code 6165988
Hospital Revenue Code 272
Min. Negotiated Rate $792.82
Max. Negotiated Rate $1,488.56
Rate for Payer: Aetna Commercial $1,456.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $857.54
Rate for Payer: Cash Price $485.40
Rate for Payer: Cigna Commercial $1,488.56
Rate for Payer: Health EOS Commercial $1,440.02
Rate for Payer: HFN Commercial $1,488.56
Rate for Payer: Multiplan Commercial $1,294.40
Rate for Payer: NAPHCARE Commercial $970.80
Rate for Payer: Preferred Network Access Commercial $1,488.56
Rate for Payer: Quartz Beloit One Network $792.82
Rate for Payer: Quartz Commercial $970.80
Rate for Payer: WEA Trust Commercial $889.90
Rate for Payer: WPS Commercial $1,198.45
Service Code HCPCS C1769
Hospital Charge Code 6165988
Hospital Revenue Code 272
Min. Negotiated Rate $453.04
Max. Negotiated Rate $1,488.56
Rate for Payer: Aetna Commercial $1,456.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,391.48
Rate for Payer: Aetna Managed Medicare $453.04
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,051.70
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $809.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $776.64
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $857.54
Rate for Payer: Cash Price $485.40
Rate for Payer: Cigna Commercial $1,488.56
Rate for Payer: Dean Health DHI/DHP/ASO $905.43
Rate for Payer: Health EOS Commercial $1,440.02
Rate for Payer: HFN Commercial $1,488.56
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,213.50
Rate for Payer: Multiplan Commercial $1,294.40
Rate for Payer: NAPHCARE Commercial $970.80
Rate for Payer: Preferred Network Access Commercial $1,488.56
Rate for Payer: Quartz Beloit One Network $792.82
Rate for Payer: Quartz Commercial $1,051.70
Rate for Payer: Quartz Medicare Advantage $970.80
Rate for Payer: WEA Trust Commercial $889.90
Rate for Payer: WPS Commercial $1,198.45
Hospital Charge Code 2967424
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967424
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967425
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967425
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967426
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967426
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967427
Hospital Revenue Code 272
Min. Negotiated Rate $136.71
Max. Negotiated Rate $256.68
Rate for Payer: Aetna Commercial $251.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $147.87
Rate for Payer: Cash Price $83.70
Rate for Payer: Cigna Commercial $256.68
Rate for Payer: Health EOS Commercial $248.31
Rate for Payer: HFN Commercial $256.68
Rate for Payer: Multiplan Commercial $223.20
Rate for Payer: NAPHCARE Commercial $167.40
Rate for Payer: Preferred Network Access Commercial $256.68
Rate for Payer: Quartz Beloit One Network $136.71
Rate for Payer: Quartz Commercial $167.40
Rate for Payer: WEA Trust Commercial $153.45
Rate for Payer: WPS Commercial $206.66
Hospital Charge Code 2967427
Hospital Revenue Code 272
Min. Negotiated Rate $78.12
Max. Negotiated Rate $1,116.00
Rate for Payer: Aetna Commercial $251.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $239.94
Rate for Payer: Aetna Managed Medicare $78.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $181.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $139.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $133.92
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $147.87
Rate for Payer: Cash Price $83.70
Rate for Payer: Cigna Commercial $256.68
Rate for Payer: Dean Health DHI/DHP/ASO $156.13
Rate for Payer: Health EOS Commercial $248.31
Rate for Payer: HFN Commercial $256.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $209.25
Rate for Payer: Multiplan Commercial $223.20
Rate for Payer: NAPHCARE Commercial $167.40
Rate for Payer: Preferred Network Access Commercial $256.68
Rate for Payer: Quartz Beloit One Network $136.71
Rate for Payer: Quartz Commercial $181.35
Rate for Payer: Quartz Medicare Advantage $167.40
Rate for Payer: The Alliance Commercial $1,116.00
Rate for Payer: WEA Trust Commercial $153.45
Rate for Payer: WPS Commercial $206.66
Hospital Charge Code 2967428
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967428
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967429
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967429
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967430
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967430
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967431
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967431
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967432
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967432
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967433
Hospital Revenue Code 272
Min. Negotiated Rate $75.32
Max. Negotiated Rate $1,076.00
Rate for Payer: Aetna Managed Medicare $75.32
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $231.34
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $174.85
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $134.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $129.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Dean Health DHI/DHP/ASO $150.53
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $201.75
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $174.85
Rate for Payer: Quartz Medicare Advantage $161.40
Rate for Payer: The Alliance Commercial $1,076.00
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967433
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25
Hospital Charge Code 2967434
Hospital Revenue Code 272
Min. Negotiated Rate $131.81
Max. Negotiated Rate $247.48
Rate for Payer: Aetna Commercial $242.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $142.57
Rate for Payer: Cash Price $80.70
Rate for Payer: Cigna Commercial $247.48
Rate for Payer: Health EOS Commercial $239.41
Rate for Payer: HFN Commercial $247.48
Rate for Payer: Multiplan Commercial $215.20
Rate for Payer: NAPHCARE Commercial $161.40
Rate for Payer: Preferred Network Access Commercial $247.48
Rate for Payer: Quartz Beloit One Network $131.81
Rate for Payer: Quartz Commercial $161.40
Rate for Payer: WEA Trust Commercial $147.95
Rate for Payer: WPS Commercial $199.25