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Service Code CPT 90714
Hospital Charge Code 3455569
Hospital Revenue Code 636
Min. Negotiated Rate $24.91
Max. Negotiated Rate $97.52
Rate for Payer: Aetna Commercial $95.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $91.16
Rate for Payer: Aetna Managed Medicare $29.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $68.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $53.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $50.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $56.18
Rate for Payer: Cash Price $31.80
Rate for Payer: Cash Price $31.80
Rate for Payer: Cigna Commercial $97.52
Rate for Payer: Dean Health DHI/DHP/ASO $24.91
Rate for Payer: Health EOS Commercial $94.34
Rate for Payer: HFN Commercial $97.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $79.50
Rate for Payer: Multiplan Commercial $84.80
Rate for Payer: NAPHCARE Commercial $63.60
Rate for Payer: Preferred Network Access Commercial $97.52
Rate for Payer: Quartz Beloit One Network $51.94
Rate for Payer: Quartz Commercial $68.90
Rate for Payer: Quartz Medicare Advantage $63.60
Rate for Payer: WEA Trust Commercial $58.30
Rate for Payer: WPS Commercial $47.07
Service Code CPT 90714
Hospital Charge Code 3455569
Hospital Revenue Code 636
Min. Negotiated Rate $51.94
Max. Negotiated Rate $97.52
Rate for Payer: Aetna Commercial $95.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $56.18
Rate for Payer: Cash Price $31.80
Rate for Payer: Cigna Commercial $97.52
Rate for Payer: Health EOS Commercial $94.34
Rate for Payer: HFN Commercial $97.52
Rate for Payer: Multiplan Commercial $84.80
Rate for Payer: NAPHCARE Commercial $63.60
Rate for Payer: Preferred Network Access Commercial $97.52
Rate for Payer: Quartz Beloit One Network $51.94
Rate for Payer: Quartz Commercial $63.60
Rate for Payer: WEA Trust Commercial $58.30
Rate for Payer: WPS Commercial $78.51
Hospital Charge Code 2960406
Hospital Revenue Code 360
Min. Negotiated Rate $281.68
Max. Negotiated Rate $4,024.00
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Aetna Managed Medicare $281.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $653.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $503.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $482.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Dean Health DHI/DHP/ASO $562.96
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.50
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $653.90
Rate for Payer: Quartz Medicare Advantage $603.60
Rate for Payer: The Alliance Commercial $4,024.00
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960406
Hospital Revenue Code 360
Min. Negotiated Rate $492.94
Max. Negotiated Rate $925.52
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $603.60
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960408
Hospital Revenue Code 360
Min. Negotiated Rate $281.68
Max. Negotiated Rate $4,024.00
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Aetna Managed Medicare $281.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $653.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $503.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $482.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Dean Health DHI/DHP/ASO $562.96
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.50
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $653.90
Rate for Payer: Quartz Medicare Advantage $603.60
Rate for Payer: The Alliance Commercial $4,024.00
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960408
Hospital Revenue Code 360
Min. Negotiated Rate $492.94
Max. Negotiated Rate $925.52
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $603.60
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960409
Hospital Revenue Code 360
Min. Negotiated Rate $303.52
Max. Negotiated Rate $4,336.00
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $932.24
Rate for Payer: Aetna Managed Medicare $303.52
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $704.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $542.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $520.32
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Dean Health DHI/DHP/ASO $606.61
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $813.00
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $704.60
Rate for Payer: Quartz Medicare Advantage $650.40
Rate for Payer: The Alliance Commercial $4,336.00
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960409
Hospital Revenue Code 360
Min. Negotiated Rate $531.16
Max. Negotiated Rate $997.28
Rate for Payer: Aetna Commercial $975.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $574.52
Rate for Payer: Cash Price $325.20
Rate for Payer: Cigna Commercial $997.28
Rate for Payer: Health EOS Commercial $964.76
Rate for Payer: HFN Commercial $997.28
Rate for Payer: Multiplan Commercial $867.20
Rate for Payer: NAPHCARE Commercial $650.40
Rate for Payer: Preferred Network Access Commercial $997.28
Rate for Payer: Quartz Beloit One Network $531.16
Rate for Payer: Quartz Commercial $650.40
Rate for Payer: WEA Trust Commercial $596.20
Rate for Payer: WPS Commercial $802.92
Hospital Charge Code 2960410
Hospital Revenue Code 360
Min. Negotiated Rate $281.68
Max. Negotiated Rate $4,024.00
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Aetna Managed Medicare $281.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $653.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $503.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $482.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Dean Health DHI/DHP/ASO $562.96
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.50
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $653.90
Rate for Payer: Quartz Medicare Advantage $603.60
Rate for Payer: The Alliance Commercial $4,024.00
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960410
Hospital Revenue Code 360
Min. Negotiated Rate $492.94
Max. Negotiated Rate $925.52
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $603.60
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960407
Hospital Revenue Code 360
Min. Negotiated Rate $492.94
Max. Negotiated Rate $925.52
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $603.60
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Hospital Charge Code 2960407
Hospital Revenue Code 360
Min. Negotiated Rate $281.68
Max. Negotiated Rate $4,024.00
Rate for Payer: Aetna Commercial $905.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $865.16
Rate for Payer: Aetna Managed Medicare $281.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $653.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $503.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $482.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $533.18
Rate for Payer: Cash Price $301.80
Rate for Payer: Cigna Commercial $925.52
Rate for Payer: Dean Health DHI/DHP/ASO $562.96
Rate for Payer: Health EOS Commercial $895.34
Rate for Payer: HFN Commercial $925.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $754.50
Rate for Payer: Multiplan Commercial $804.80
Rate for Payer: NAPHCARE Commercial $603.60
Rate for Payer: Preferred Network Access Commercial $925.52
Rate for Payer: Quartz Beloit One Network $492.94
Rate for Payer: Quartz Commercial $653.90
Rate for Payer: Quartz Medicare Advantage $603.60
Rate for Payer: The Alliance Commercial $4,024.00
Rate for Payer: WEA Trust Commercial $553.30
Rate for Payer: WPS Commercial $745.14
Service Code CPT 86331
Hospital Charge Code 983419
Hospital Revenue Code 300
Min. Negotiated Rate $11.98
Max. Negotiated Rate $1,048.00
Rate for Payer: Aetna Commercial $235.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $225.32
Rate for Payer: Aetna Managed Medicare $11.98
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $44.92
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $20.96
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $19.89
Rate for Payer: Anthem Medicaid $12.38
Rate for Payer: Anthem Medicare Advantage $11.98
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $138.86
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $11.98
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $11.98
Rate for Payer: Cash Price $78.60
Rate for Payer: Cash Price $78.60
Rate for Payer: Cigna Commercial $241.04
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $11.98
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $12.38
Rate for Payer: Dean Health Medicaid $12.38
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $11.98
Rate for Payer: Health EOS Commercial $233.18
Rate for Payer: HFN Commercial $241.04
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $44.57
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $11.98
Rate for Payer: Independent Care Health Plan Medicaid $12.38
Rate for Payer: Independent Care Health Plan Medicare $11.98
Rate for Payer: Managed Health Services Medicaid $12.88
Rate for Payer: Managed Health Services Medicare Advantage $11.98
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $11.98
Rate for Payer: Multiplan Commercial $209.60
Rate for Payer: NAPHCARE Commercial $17.97
Rate for Payer: Preferred Network Access Commercial $241.04
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $12.38
Rate for Payer: Quartz Beloit One Network $128.38
Rate for Payer: Quartz Commercial $170.30
Rate for Payer: Quartz Medicare Advantage $11.98
Rate for Payer: The Alliance Commercial $1,048.00
Rate for Payer: United Healthcare Medicaid $12.38
Rate for Payer: United Healthcare Medicare Advantage $11.98
Rate for Payer: United Healthcare PPO $196.50
Rate for Payer: WEA Trust Commercial $144.10
Rate for Payer: Wellcare Medicare $11.98
Rate for Payer: WMAP Medicaid $12.38
Rate for Payer: WPS Commercial $194.06
Service Code CPT 86331
Hospital Charge Code 983419
Hospital Revenue Code 300
Min. Negotiated Rate $11.98
Max. Negotiated Rate $248.90
Rate for Payer: Aetna Commercial $248.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $225.32
Rate for Payer: Aetna Managed Medicare $11.98
Rate for Payer: Anthem Medicare Advantage $11.98
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $11.98
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $11.98
Rate for Payer: Cash Price $78.60
Rate for Payer: Cash Price $78.60
Rate for Payer: Cigna Commercial $248.90
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $131.00
Rate for Payer: Dean Health DHI/DHP/ASO $11.98
Rate for Payer: Health EOS Commercial $238.42
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $42.29
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $42.29
Rate for Payer: Independent Care Health Plan Medicare $11.98
Rate for Payer: Multiplan Commercial $209.60
Rate for Payer: Preferred Network Access Commercial $248.90
Rate for Payer: Quartz Beloit One Network $115.28
Rate for Payer: Quartz Commercial $149.34
Rate for Payer: Quartz Medicare Advantage $11.98
Rate for Payer: The Alliance Commercial $47.32
Rate for Payer: United Healthcare Medicare Advantage $11.98
Rate for Payer: WEA Trust Commercial $144.10
Rate for Payer: WPS Commercial $52.71
Service Code CPT 86331
Hospital Charge Code 983419
Hospital Revenue Code 300
Min. Negotiated Rate $128.38
Max. Negotiated Rate $241.04
Rate for Payer: Aetna Commercial $235.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $138.86
Rate for Payer: Cash Price $78.60
Rate for Payer: Cigna Commercial $241.04
Rate for Payer: Health EOS Commercial $233.18
Rate for Payer: HFN Commercial $241.04
Rate for Payer: Multiplan Commercial $209.60
Rate for Payer: NAPHCARE Commercial $157.20
Rate for Payer: Preferred Network Access Commercial $241.04
Rate for Payer: Quartz Beloit One Network $128.38
Rate for Payer: Quartz Commercial $157.20
Rate for Payer: WEA Trust Commercial $144.10
Rate for Payer: WPS Commercial $194.06
Hospital Charge Code 3716170
Hospital Revenue Code 271
Min. Negotiated Rate $289.59
Max. Negotiated Rate $543.72
Rate for Payer: Aetna Commercial $531.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $313.23
Rate for Payer: Cash Price $177.30
Rate for Payer: Cigna Commercial $543.72
Rate for Payer: Health EOS Commercial $525.99
Rate for Payer: HFN Commercial $543.72
Rate for Payer: Multiplan Commercial $472.80
Rate for Payer: NAPHCARE Commercial $354.60
Rate for Payer: Preferred Network Access Commercial $543.72
Rate for Payer: Quartz Beloit One Network $289.59
Rate for Payer: Quartz Commercial $354.60
Rate for Payer: WEA Trust Commercial $325.05
Rate for Payer: WPS Commercial $437.75
Hospital Charge Code 3716170
Hospital Revenue Code 271
Min. Negotiated Rate $165.48
Max. Negotiated Rate $2,364.00
Rate for Payer: Aetna Commercial $531.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $508.26
Rate for Payer: Aetna Managed Medicare $165.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $384.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $295.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $283.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $313.23
Rate for Payer: Cash Price $177.30
Rate for Payer: Cigna Commercial $543.72
Rate for Payer: Dean Health DHI/DHP/ASO $330.72
Rate for Payer: Health EOS Commercial $525.99
Rate for Payer: HFN Commercial $543.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $443.25
Rate for Payer: Multiplan Commercial $472.80
Rate for Payer: NAPHCARE Commercial $354.60
Rate for Payer: Preferred Network Access Commercial $543.72
Rate for Payer: Quartz Beloit One Network $289.59
Rate for Payer: Quartz Commercial $384.15
Rate for Payer: Quartz Medicare Advantage $354.60
Rate for Payer: The Alliance Commercial $2,364.00
Rate for Payer: WEA Trust Commercial $325.05
Rate for Payer: WPS Commercial $437.75
Hospital Charge Code 6240151
Hospital Revenue Code 272
Min. Negotiated Rate $2,819.90
Max. Negotiated Rate $40,284.24
Rate for Payer: Aetna Commercial $9,063.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $8,661.11
Rate for Payer: Aetna Managed Medicare $2,819.90
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $6,546.19
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,035.53
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,834.11
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,337.66
Rate for Payer: Cash Price $3,021.32
Rate for Payer: Cigna Commercial $9,265.38
Rate for Payer: Dean Health DHI/DHP/ASO $5,635.77
Rate for Payer: Health EOS Commercial $8,963.24
Rate for Payer: HFN Commercial $9,265.38
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $7,553.30
Rate for Payer: Multiplan Commercial $8,056.85
Rate for Payer: NAPHCARE Commercial $6,042.64
Rate for Payer: Preferred Network Access Commercial $9,265.38
Rate for Payer: Quartz Beloit One Network $4,934.82
Rate for Payer: Quartz Commercial $6,546.19
Rate for Payer: Quartz Medicare Advantage $6,042.64
Rate for Payer: The Alliance Commercial $40,284.24
Rate for Payer: WEA Trust Commercial $5,539.08
Rate for Payer: WPS Commercial $7,459.63
Hospital Charge Code 6240151
Hospital Revenue Code 272
Min. Negotiated Rate $4,934.82
Max. Negotiated Rate $9,265.38
Rate for Payer: Aetna Commercial $9,063.95
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,337.66
Rate for Payer: Cash Price $3,021.32
Rate for Payer: Cigna Commercial $9,265.38
Rate for Payer: Health EOS Commercial $8,963.24
Rate for Payer: HFN Commercial $9,265.38
Rate for Payer: Multiplan Commercial $8,056.85
Rate for Payer: NAPHCARE Commercial $6,042.64
Rate for Payer: Preferred Network Access Commercial $9,265.38
Rate for Payer: Quartz Beloit One Network $4,934.82
Rate for Payer: Quartz Commercial $6,042.64
Rate for Payer: WEA Trust Commercial $5,539.08
Rate for Payer: WPS Commercial $7,459.63
Hospital Charge Code 6240150
Hospital Revenue Code 272
Min. Negotiated Rate $2,820.09
Max. Negotiated Rate $40,287.04
Rate for Payer: Aetna Commercial $9,064.58
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $8,661.71
Rate for Payer: Aetna Managed Medicare $2,820.09
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $6,546.64
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $5,035.88
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $4,834.44
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,338.03
Rate for Payer: Cash Price $3,021.53
Rate for Payer: Cigna Commercial $9,266.02
Rate for Payer: Dean Health DHI/DHP/ASO $5,636.16
Rate for Payer: Health EOS Commercial $8,963.87
Rate for Payer: HFN Commercial $9,266.02
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $7,553.82
Rate for Payer: Multiplan Commercial $8,057.41
Rate for Payer: NAPHCARE Commercial $6,043.06
Rate for Payer: Preferred Network Access Commercial $9,266.02
Rate for Payer: Quartz Beloit One Network $4,935.16
Rate for Payer: Quartz Commercial $6,546.64
Rate for Payer: Quartz Medicare Advantage $6,043.06
Rate for Payer: The Alliance Commercial $40,287.04
Rate for Payer: WEA Trust Commercial $5,539.47
Rate for Payer: WPS Commercial $7,460.15
Hospital Charge Code 6240150
Hospital Revenue Code 272
Min. Negotiated Rate $4,935.16
Max. Negotiated Rate $9,266.02
Rate for Payer: Aetna Commercial $9,064.58
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $5,338.03
Rate for Payer: Cash Price $3,021.53
Rate for Payer: Cigna Commercial $9,266.02
Rate for Payer: Health EOS Commercial $8,963.87
Rate for Payer: HFN Commercial $9,266.02
Rate for Payer: Multiplan Commercial $8,057.41
Rate for Payer: NAPHCARE Commercial $6,043.06
Rate for Payer: Preferred Network Access Commercial $9,266.02
Rate for Payer: Quartz Beloit One Network $4,935.16
Rate for Payer: Quartz Commercial $6,043.06
Rate for Payer: WEA Trust Commercial $5,539.47
Rate for Payer: WPS Commercial $7,460.15
Service Code CPT 77307 26
Hospital Charge Code 5258631
Hospital Revenue Code 510
Min. Negotiated Rate $148.16
Max. Negotiated Rate $2,075.75
Rate for Payer: Aetna Commercial $2,075.75
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,879.10
Rate for Payer: Aetna Managed Medicare $148.16
Rate for Payer: Anthem Medicare Advantage $148.16
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $148.16
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $148.16
Rate for Payer: Cash Price $655.50
Rate for Payer: Cash Price $655.50
Rate for Payer: Cigna Commercial $2,075.75
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $1,092.50
Rate for Payer: Dean Health DHI/DHP/ASO $148.16
Rate for Payer: Health EOS Commercial $1,988.35
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $523.64
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $523.64
Rate for Payer: Independent Care Health Plan Medicare $148.16
Rate for Payer: Multiplan Commercial $1,748.00
Rate for Payer: Preferred Network Access Commercial $2,075.75
Rate for Payer: Quartz Beloit One Network $961.40
Rate for Payer: Quartz Commercial $1,245.45
Rate for Payer: Quartz Medicare Advantage $148.16
Rate for Payer: The Alliance Commercial $563.01
Rate for Payer: United Healthcare Medicare Advantage $148.16
Rate for Payer: WEA Trust Commercial $1,201.75
Rate for Payer: WPS Commercial $740.80
Service Code CPT 77306 26
Hospital Charge Code 5258630
Hospital Revenue Code 510
Min. Negotiated Rate $71.58
Max. Negotiated Rate $817.95
Rate for Payer: Aetna Commercial $817.95
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $740.46
Rate for Payer: Aetna Managed Medicare $71.58
Rate for Payer: Anthem Medicare Advantage $71.58
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $71.58
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $71.58
Rate for Payer: Cash Price $258.30
Rate for Payer: Cash Price $258.30
Rate for Payer: Cigna Commercial $817.95
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $430.50
Rate for Payer: Dean Health DHI/DHP/ASO $71.58
Rate for Payer: Health EOS Commercial $783.51
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $252.01
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $252.01
Rate for Payer: Independent Care Health Plan Medicare $71.58
Rate for Payer: Multiplan Commercial $688.80
Rate for Payer: Preferred Network Access Commercial $817.95
Rate for Payer: Quartz Beloit One Network $378.84
Rate for Payer: Quartz Commercial $490.77
Rate for Payer: Quartz Medicare Advantage $71.58
Rate for Payer: The Alliance Commercial $272.00
Rate for Payer: United Healthcare Medicare Advantage $71.58
Rate for Payer: WEA Trust Commercial $473.55
Rate for Payer: WPS Commercial $357.90
Hospital Charge Code 5877765
Hospital Revenue Code 272
Min. Negotiated Rate $325.36
Max. Negotiated Rate $610.88
Rate for Payer: Aetna Commercial $597.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $351.92
Rate for Payer: Cash Price $199.20
Rate for Payer: Cigna Commercial $610.88
Rate for Payer: Health EOS Commercial $590.96
Rate for Payer: HFN Commercial $610.88
Rate for Payer: Multiplan Commercial $531.20
Rate for Payer: NAPHCARE Commercial $398.40
Rate for Payer: Preferred Network Access Commercial $610.88
Rate for Payer: Quartz Beloit One Network $325.36
Rate for Payer: Quartz Commercial $398.40
Rate for Payer: WEA Trust Commercial $365.20
Rate for Payer: WPS Commercial $491.82
Hospital Charge Code 5877765
Hospital Revenue Code 272
Min. Negotiated Rate $185.92
Max. Negotiated Rate $2,656.00
Rate for Payer: Aetna Commercial $597.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $571.04
Rate for Payer: Aetna Managed Medicare $185.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $431.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $332.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $318.72
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $351.92
Rate for Payer: Cash Price $199.20
Rate for Payer: Cigna Commercial $610.88
Rate for Payer: Dean Health DHI/DHP/ASO $371.57
Rate for Payer: Health EOS Commercial $590.96
Rate for Payer: HFN Commercial $610.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $498.00
Rate for Payer: Multiplan Commercial $531.20
Rate for Payer: NAPHCARE Commercial $398.40
Rate for Payer: Preferred Network Access Commercial $610.88
Rate for Payer: Quartz Beloit One Network $325.36
Rate for Payer: Quartz Commercial $431.60
Rate for Payer: Quartz Medicare Advantage $398.40
Rate for Payer: The Alliance Commercial $2,656.00
Rate for Payer: WEA Trust Commercial $365.20
Rate for Payer: WPS Commercial $491.82