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Hospital Charge Code 2971878
Hospital Revenue Code 271
Min. Negotiated Rate $466.48
Max. Negotiated Rate $875.84
Rate for Payer: Aetna Commercial $856.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $504.56
Rate for Payer: Cash Price $285.60
Rate for Payer: Cigna Commercial $875.84
Rate for Payer: Health EOS Commercial $847.28
Rate for Payer: HFN Commercial $875.84
Rate for Payer: Multiplan Commercial $761.60
Rate for Payer: NAPHCARE Commercial $571.20
Rate for Payer: Preferred Network Access Commercial $875.84
Rate for Payer: Quartz Beloit One Network $466.48
Rate for Payer: Quartz Commercial $571.20
Rate for Payer: WEA Trust Commercial $523.60
Rate for Payer: WPS Commercial $705.15
Hospital Charge Code 2971727
Hospital Revenue Code 271
Min. Negotiated Rate $435.12
Max. Negotiated Rate $816.96
Rate for Payer: Aetna Commercial $799.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $470.64
Rate for Payer: Cash Price $266.40
Rate for Payer: Cigna Commercial $816.96
Rate for Payer: Health EOS Commercial $790.32
Rate for Payer: HFN Commercial $816.96
Rate for Payer: Multiplan Commercial $710.40
Rate for Payer: NAPHCARE Commercial $532.80
Rate for Payer: Preferred Network Access Commercial $816.96
Rate for Payer: Quartz Beloit One Network $435.12
Rate for Payer: Quartz Commercial $532.80
Rate for Payer: WEA Trust Commercial $488.40
Rate for Payer: WPS Commercial $657.74
Hospital Charge Code 2971727
Hospital Revenue Code 271
Min. Negotiated Rate $248.64
Max. Negotiated Rate $3,552.00
Rate for Payer: Aetna Managed Medicare $248.64
Rate for Payer: Aetna Commercial $799.20
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $763.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $577.20
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $444.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $426.24
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $470.64
Rate for Payer: Cash Price $266.40
Rate for Payer: Cigna Commercial $816.96
Rate for Payer: Dean Health DHI/DHP/ASO $496.92
Rate for Payer: Health EOS Commercial $790.32
Rate for Payer: HFN Commercial $816.96
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $666.00
Rate for Payer: Multiplan Commercial $710.40
Rate for Payer: NAPHCARE Commercial $532.80
Rate for Payer: Preferred Network Access Commercial $816.96
Rate for Payer: Quartz Beloit One Network $435.12
Rate for Payer: Quartz Commercial $577.20
Rate for Payer: Quartz Medicare Advantage $532.80
Rate for Payer: The Alliance Commercial $3,552.00
Rate for Payer: WEA Trust Commercial $488.40
Rate for Payer: WPS Commercial $657.74
Hospital Charge Code 5415563
Hospital Revenue Code 272
Min. Negotiated Rate $2,354.94
Max. Negotiated Rate $4,421.52
Rate for Payer: Aetna Commercial $4,325.40
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,547.18
Rate for Payer: Cash Price $1,441.80
Rate for Payer: Cigna Commercial $4,421.52
Rate for Payer: Health EOS Commercial $4,277.34
Rate for Payer: HFN Commercial $4,421.52
Rate for Payer: Multiplan Commercial $3,844.80
Rate for Payer: NAPHCARE Commercial $2,883.60
Rate for Payer: Preferred Network Access Commercial $4,421.52
Rate for Payer: Quartz Beloit One Network $2,354.94
Rate for Payer: Quartz Commercial $2,883.60
Rate for Payer: WEA Trust Commercial $2,643.30
Rate for Payer: WPS Commercial $3,559.80
Hospital Charge Code 5415563
Hospital Revenue Code 272
Min. Negotiated Rate $1,345.68
Max. Negotiated Rate $19,224.00
Rate for Payer: Aetna Commercial $4,325.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $4,133.16
Rate for Payer: Aetna Managed Medicare $1,345.68
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $3,123.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $2,403.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $2,306.88
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $2,547.18
Rate for Payer: Cash Price $1,441.80
Rate for Payer: Cigna Commercial $4,421.52
Rate for Payer: Dean Health DHI/DHP/ASO $2,689.44
Rate for Payer: Health EOS Commercial $4,277.34
Rate for Payer: HFN Commercial $4,421.52
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,604.50
Rate for Payer: Multiplan Commercial $3,844.80
Rate for Payer: NAPHCARE Commercial $2,883.60
Rate for Payer: Preferred Network Access Commercial $4,421.52
Rate for Payer: Quartz Beloit One Network $2,354.94
Rate for Payer: Quartz Commercial $3,123.90
Rate for Payer: Quartz Medicare Advantage $2,883.60
Rate for Payer: The Alliance Commercial $19,224.00
Rate for Payer: WEA Trust Commercial $2,643.30
Rate for Payer: WPS Commercial $3,559.80
Service Code CPT 94667
Hospital Charge Code 2989709
Hospital Revenue Code 410
Min. Negotiated Rate $64.32
Max. Negotiated Rate $469.69
Rate for Payer: Aetna Commercial $120.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $115.24
Rate for Payer: Aetna Managed Medicare $126.26
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $87.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $67.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $64.32
Rate for Payer: Anthem Medicare Advantage $126.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $71.02
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $126.26
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $126.26
Rate for Payer: Cash Price $40.20
Rate for Payer: Cash Price $40.20
Rate for Payer: Cigna Commercial $123.28
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $126.26
Rate for Payer: Dean Health DHI/DHP/ASO $74.99
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $126.26
Rate for Payer: Health EOS Commercial $119.26
Rate for Payer: HFN Commercial $123.28
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $469.69
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $126.26
Rate for Payer: Independent Care Health Plan Medicare $126.26
Rate for Payer: Managed Health Services Medicare Advantage $126.26
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $126.26
Rate for Payer: Multiplan Commercial $107.20
Rate for Payer: NAPHCARE Commercial $189.39
Rate for Payer: Preferred Network Access Commercial $123.28
Rate for Payer: Quartz Beloit One Network $65.66
Rate for Payer: Quartz Commercial $87.10
Rate for Payer: Quartz Medicare Advantage $126.26
Rate for Payer: United Healthcare Medicare Advantage $126.26
Rate for Payer: United Healthcare PPO $100.50
Rate for Payer: WEA Trust Commercial $73.70
Rate for Payer: Wellcare Medicare $126.26
Rate for Payer: WPS Commercial $99.25
Service Code CPT 94667
Hospital Charge Code 2989709
Hospital Revenue Code 410
Min. Negotiated Rate $65.66
Max. Negotiated Rate $123.28
Rate for Payer: Aetna Commercial $120.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $71.02
Rate for Payer: Cash Price $40.20
Rate for Payer: Cigna Commercial $123.28
Rate for Payer: Health EOS Commercial $119.26
Rate for Payer: HFN Commercial $123.28
Rate for Payer: Multiplan Commercial $107.20
Rate for Payer: NAPHCARE Commercial $80.40
Rate for Payer: Preferred Network Access Commercial $123.28
Rate for Payer: Quartz Beloit One Network $65.66
Rate for Payer: Quartz Commercial $80.40
Rate for Payer: WEA Trust Commercial $73.70
Rate for Payer: WPS Commercial $99.25
Service Code CPT 20526 50
Hospital Charge Code 3190198
Hospital Revenue Code 510
Min. Negotiated Rate $25.89
Max. Negotiated Rate $483.55
Rate for Payer: Aetna Commercial $483.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $437.74
Rate for Payer: Cash Price $152.70
Rate for Payer: Cash Price $152.70
Rate for Payer: Cigna Commercial $483.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $254.50
Rate for Payer: Dean Health DHI/DHP/ASO $305.40
Rate for Payer: Health EOS Commercial $463.19
Rate for Payer: Multiplan Commercial $407.20
Rate for Payer: Preferred Network Access Commercial $483.55
Rate for Payer: Quartz Beloit One Network $223.96
Rate for Payer: Quartz Commercial $290.13
Rate for Payer: The Alliance Commercial $254.50
Rate for Payer: United Healthcare Medicaid $25.89
Rate for Payer: WEA Trust Commercial $279.95
Rate for Payer: WPS Commercial $377.02
Hospital Charge Code 2972013
Hospital Revenue Code 271
Min. Negotiated Rate $538.51
Max. Negotiated Rate $1,011.08
Rate for Payer: Aetna Commercial $989.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $582.47
Rate for Payer: Cash Price $329.70
Rate for Payer: Cigna Commercial $1,011.08
Rate for Payer: Health EOS Commercial $978.11
Rate for Payer: HFN Commercial $1,011.08
Rate for Payer: Multiplan Commercial $879.20
Rate for Payer: NAPHCARE Commercial $659.40
Rate for Payer: Preferred Network Access Commercial $1,011.08
Rate for Payer: Quartz Beloit One Network $538.51
Rate for Payer: Quartz Commercial $659.40
Rate for Payer: WEA Trust Commercial $604.45
Rate for Payer: WPS Commercial $814.03
Hospital Charge Code 2972013
Hospital Revenue Code 271
Min. Negotiated Rate $307.72
Max. Negotiated Rate $4,396.00
Rate for Payer: Aetna Commercial $989.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $945.14
Rate for Payer: Aetna Managed Medicare $307.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $714.35
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $549.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $527.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $582.47
Rate for Payer: Cash Price $329.70
Rate for Payer: Cigna Commercial $1,011.08
Rate for Payer: Dean Health DHI/DHP/ASO $615.00
Rate for Payer: Health EOS Commercial $978.11
Rate for Payer: HFN Commercial $1,011.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $824.25
Rate for Payer: Multiplan Commercial $879.20
Rate for Payer: NAPHCARE Commercial $659.40
Rate for Payer: Preferred Network Access Commercial $1,011.08
Rate for Payer: Quartz Beloit One Network $538.51
Rate for Payer: Quartz Commercial $714.35
Rate for Payer: Quartz Medicare Advantage $659.40
Rate for Payer: The Alliance Commercial $4,396.00
Rate for Payer: WEA Trust Commercial $604.45
Rate for Payer: WPS Commercial $814.03
Hospital Charge Code 2964052
Hospital Revenue Code 271
Min. Negotiated Rate $26.32
Max. Negotiated Rate $376.00
Rate for Payer: Aetna Commercial $84.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $80.84
Rate for Payer: Aetna Managed Medicare $26.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $61.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $47.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $45.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $49.82
Rate for Payer: Cash Price $28.20
Rate for Payer: Cigna Commercial $86.48
Rate for Payer: Dean Health DHI/DHP/ASO $52.60
Rate for Payer: Health EOS Commercial $83.66
Rate for Payer: HFN Commercial $86.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $70.50
Rate for Payer: Multiplan Commercial $75.20
Rate for Payer: NAPHCARE Commercial $56.40
Rate for Payer: Preferred Network Access Commercial $86.48
Rate for Payer: Quartz Beloit One Network $46.06
Rate for Payer: Quartz Commercial $61.10
Rate for Payer: Quartz Medicare Advantage $56.40
Rate for Payer: The Alliance Commercial $376.00
Rate for Payer: WEA Trust Commercial $51.70
Rate for Payer: WPS Commercial $69.63
Hospital Charge Code 2964052
Hospital Revenue Code 271
Min. Negotiated Rate $46.06
Max. Negotiated Rate $86.48
Rate for Payer: Aetna Commercial $84.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $49.82
Rate for Payer: Cash Price $28.20
Rate for Payer: Cigna Commercial $86.48
Rate for Payer: Health EOS Commercial $83.66
Rate for Payer: HFN Commercial $86.48
Rate for Payer: Multiplan Commercial $75.20
Rate for Payer: NAPHCARE Commercial $56.40
Rate for Payer: Preferred Network Access Commercial $86.48
Rate for Payer: Quartz Beloit One Network $46.06
Rate for Payer: Quartz Commercial $56.40
Rate for Payer: WEA Trust Commercial $51.70
Rate for Payer: WPS Commercial $69.63
Service Code CPT 62272
Hospital Charge Code 6178533
Hospital Revenue Code 510
Min. Negotiated Rate $80.33
Max. Negotiated Rate $978.50
Rate for Payer: Aetna Commercial $978.50
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $885.80
Rate for Payer: Aetna Managed Medicare $80.33
Rate for Payer: Anthem Medicare Advantage $80.33
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $80.33
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $80.33
Rate for Payer: Cash Price $309.00
Rate for Payer: Cash Price $309.00
Rate for Payer: Cigna Commercial $978.50
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $515.00
Rate for Payer: Dean Health DHI/DHP/ASO $80.33
Rate for Payer: Health EOS Commercial $937.30
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $282.44
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $282.44
Rate for Payer: Independent Care Health Plan Medicare $80.33
Rate for Payer: Multiplan Commercial $824.00
Rate for Payer: Preferred Network Access Commercial $978.50
Rate for Payer: Quartz Beloit One Network $453.20
Rate for Payer: Quartz Commercial $587.10
Rate for Payer: Quartz Medicare Advantage $80.33
Rate for Payer: The Alliance Commercial $341.40
Rate for Payer: United Healthcare Medicaid $87.46
Rate for Payer: United Healthcare Medicare Advantage $80.33
Rate for Payer: WEA Trust Commercial $566.50
Rate for Payer: WPS Commercial $361.48
Service Code HCPCS J3411
Hospital Charge Code 3407537
Hospital Revenue Code 636
Min. Negotiated Rate $3.43
Max. Negotiated Rate $6.44
Rate for Payer: Aetna Commercial $6.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3.71
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.44
Rate for Payer: Health EOS Commercial $6.23
Rate for Payer: HFN Commercial $6.44
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: NAPHCARE Commercial $4.20
Rate for Payer: Preferred Network Access Commercial $6.44
Rate for Payer: Quartz Beloit One Network $3.43
Rate for Payer: Quartz Commercial $4.20
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $5.18
Service Code HCPCS J3411
Hospital Charge Code 3407537
Hospital Revenue Code 636
Min. Negotiated Rate $2.26
Max. Negotiated Rate $6.88
Rate for Payer: Aetna Commercial $6.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6.02
Rate for Payer: Aetna Managed Medicare $2.50
Rate for Payer: Anthem Medicare Advantage $2.50
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $2.50
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $2.50
Rate for Payer: Cash Price $2.10
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $3.50
Rate for Payer: Dean Health DHI/DHP/ASO $2.26
Rate for Payer: Health EOS Commercial $6.37
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $4.35
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $4.35
Rate for Payer: Independent Care Health Plan Medicare $2.50
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: Preferred Network Access Commercial $6.65
Rate for Payer: Quartz Beloit One Network $3.08
Rate for Payer: Quartz Commercial $3.99
Rate for Payer: Quartz Medicare Advantage $2.50
Rate for Payer: The Alliance Commercial $6.88
Rate for Payer: United Healthcare Medicaid $2.26
Rate for Payer: United Healthcare Medicare Advantage $2.50
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $5.65
Service Code HCPCS J3411
Hospital Charge Code 3407537
Hospital Revenue Code 636
Min. Negotiated Rate $1.96
Max. Negotiated Rate $5,280.84
Rate for Payer: Aetna Commercial $6.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $6.02
Rate for Payer: Aetna Managed Medicare $1.96
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $4.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $3.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $3.36
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $3.71
Rate for Payer: Cash Price $2.10
Rate for Payer: Cash Price $2.10
Rate for Payer: Cigna Commercial $6.44
Rate for Payer: Dean Health DHI/DHP/ASO $2.99
Rate for Payer: Health EOS Commercial $6.23
Rate for Payer: HFN Commercial $6.44
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $5.25
Rate for Payer: Multiplan Commercial $5.60
Rate for Payer: NAPHCARE Commercial $4.20
Rate for Payer: Preferred Network Access Commercial $6.44
Rate for Payer: Quartz Beloit One Network $3.43
Rate for Payer: Quartz Commercial $4.55
Rate for Payer: Quartz Medicare Advantage $4.20
Rate for Payer: The Alliance Commercial $5,280.84
Rate for Payer: WEA Trust Commercial $3.85
Rate for Payer: WPS Commercial $5.65
Service Code CPT 88175
Hospital Charge Code 5460754
Hospital Revenue Code 300
Min. Negotiated Rate $72.03
Max. Negotiated Rate $135.24
Rate for Payer: Aetna Commercial $132.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $77.91
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $135.24
Rate for Payer: Health EOS Commercial $130.83
Rate for Payer: HFN Commercial $135.24
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: NAPHCARE Commercial $88.20
Rate for Payer: Preferred Network Access Commercial $135.24
Rate for Payer: Quartz Beloit One Network $72.03
Rate for Payer: Quartz Commercial $88.20
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: WPS Commercial $108.88
Service Code CPT 88175
Hospital Charge Code 5460754
Hospital Revenue Code 300
Min. Negotiated Rate $26.61
Max. Negotiated Rate $139.65
Rate for Payer: Aetna Commercial $139.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $126.42
Rate for Payer: Aetna Managed Medicare $26.61
Rate for Payer: Anthem Medicare Advantage $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $26.61
Rate for Payer: Cash Price $44.10
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $139.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $73.50
Rate for Payer: Dean Health DHI/DHP/ASO $26.61
Rate for Payer: Health EOS Commercial $133.77
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $93.93
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $93.93
Rate for Payer: Independent Care Health Plan Medicare $26.61
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: Preferred Network Access Commercial $139.65
Rate for Payer: Quartz Beloit One Network $64.68
Rate for Payer: Quartz Commercial $83.79
Rate for Payer: Quartz Medicare Advantage $26.61
Rate for Payer: The Alliance Commercial $105.11
Rate for Payer: United Healthcare Medicare Advantage $26.61
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: WPS Commercial $117.08
Service Code CPT 88175
Hospital Charge Code 5460754
Hospital Revenue Code 300
Min. Negotiated Rate $26.61
Max. Negotiated Rate $588.00
Rate for Payer: Aetna Commercial $132.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $126.42
Rate for Payer: Aetna Managed Medicare $26.61
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $99.79
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $46.57
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $44.17
Rate for Payer: Anthem Medicaid $27.50
Rate for Payer: Anthem Medicare Advantage $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $77.91
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $26.61
Rate for Payer: Cash Price $44.10
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $135.24
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $26.61
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $27.50
Rate for Payer: Dean Health Medicaid $27.50
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $26.61
Rate for Payer: Health EOS Commercial $130.83
Rate for Payer: HFN Commercial $135.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $98.99
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $26.61
Rate for Payer: Independent Care Health Plan Medicaid $27.50
Rate for Payer: Independent Care Health Plan Medicare $26.61
Rate for Payer: Managed Health Services Medicaid $28.60
Rate for Payer: Managed Health Services Medicare Advantage $26.61
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $26.61
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: NAPHCARE Commercial $39.92
Rate for Payer: Preferred Network Access Commercial $135.24
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $27.50
Rate for Payer: Quartz Beloit One Network $72.03
Rate for Payer: Quartz Commercial $95.55
Rate for Payer: Quartz Medicare Advantage $26.61
Rate for Payer: The Alliance Commercial $588.00
Rate for Payer: United Healthcare Medicaid $27.50
Rate for Payer: United Healthcare Medicare Advantage $26.61
Rate for Payer: United Healthcare PPO $110.25
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: Wellcare Medicare $26.61
Rate for Payer: WMAP Medicaid $27.50
Rate for Payer: WPS Commercial $108.88
Service Code CPT 88175
Hospital Charge Code 5460756
Hospital Revenue Code 300
Min. Negotiated Rate $26.61
Max. Negotiated Rate $139.65
Rate for Payer: Aetna Commercial $139.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $126.42
Rate for Payer: Aetna Managed Medicare $26.61
Rate for Payer: Anthem Medicare Advantage $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $26.61
Rate for Payer: Cash Price $44.10
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $139.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $73.50
Rate for Payer: Dean Health DHI/DHP/ASO $26.61
Rate for Payer: Health EOS Commercial $133.77
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $93.93
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $93.93
Rate for Payer: Independent Care Health Plan Medicare $26.61
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: Preferred Network Access Commercial $139.65
Rate for Payer: Quartz Beloit One Network $64.68
Rate for Payer: Quartz Commercial $83.79
Rate for Payer: Quartz Medicare Advantage $26.61
Rate for Payer: The Alliance Commercial $105.11
Rate for Payer: United Healthcare Medicare Advantage $26.61
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: WPS Commercial $117.08
Service Code CPT 88175
Hospital Charge Code 5460756
Hospital Revenue Code 300
Min. Negotiated Rate $72.03
Max. Negotiated Rate $135.24
Rate for Payer: Aetna Commercial $132.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $77.91
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $135.24
Rate for Payer: Health EOS Commercial $130.83
Rate for Payer: HFN Commercial $135.24
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: NAPHCARE Commercial $88.20
Rate for Payer: Preferred Network Access Commercial $135.24
Rate for Payer: Quartz Beloit One Network $72.03
Rate for Payer: Quartz Commercial $88.20
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: WPS Commercial $108.88
Service Code CPT 88175
Hospital Charge Code 5460756
Hospital Revenue Code 300
Min. Negotiated Rate $26.61
Max. Negotiated Rate $588.00
Rate for Payer: Aetna Commercial $132.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $126.42
Rate for Payer: Aetna Managed Medicare $26.61
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $99.79
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $46.57
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $44.17
Rate for Payer: Anthem Medicaid $27.50
Rate for Payer: Anthem Medicare Advantage $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $77.91
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $26.61
Rate for Payer: Cash Price $44.10
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $135.24
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $26.61
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $27.50
Rate for Payer: Dean Health Medicaid $27.50
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $26.61
Rate for Payer: Health EOS Commercial $130.83
Rate for Payer: HFN Commercial $135.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $98.99
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $26.61
Rate for Payer: Independent Care Health Plan Medicaid $27.50
Rate for Payer: Independent Care Health Plan Medicare $26.61
Rate for Payer: Managed Health Services Medicaid $28.60
Rate for Payer: Managed Health Services Medicare Advantage $26.61
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $26.61
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: NAPHCARE Commercial $39.92
Rate for Payer: Preferred Network Access Commercial $135.24
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $27.50
Rate for Payer: Quartz Beloit One Network $72.03
Rate for Payer: Quartz Commercial $95.55
Rate for Payer: Quartz Medicare Advantage $26.61
Rate for Payer: The Alliance Commercial $588.00
Rate for Payer: United Healthcare Medicaid $27.50
Rate for Payer: United Healthcare Medicare Advantage $26.61
Rate for Payer: United Healthcare PPO $110.25
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: Wellcare Medicare $26.61
Rate for Payer: WMAP Medicaid $27.50
Rate for Payer: WPS Commercial $108.88
Service Code CPT 88175
Hospital Charge Code 5460757
Hospital Revenue Code 300
Min. Negotiated Rate $72.03
Max. Negotiated Rate $135.24
Rate for Payer: Aetna Commercial $132.30
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $77.91
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $135.24
Rate for Payer: Health EOS Commercial $130.83
Rate for Payer: HFN Commercial $135.24
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: NAPHCARE Commercial $88.20
Rate for Payer: Preferred Network Access Commercial $135.24
Rate for Payer: Quartz Beloit One Network $72.03
Rate for Payer: Quartz Commercial $88.20
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: WPS Commercial $108.88
Service Code CPT 88175
Hospital Charge Code 5460757
Hospital Revenue Code 300
Min. Negotiated Rate $26.61
Max. Negotiated Rate $139.65
Rate for Payer: Aetna Commercial $139.65
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $126.42
Rate for Payer: Aetna Managed Medicare $26.61
Rate for Payer: Anthem Medicare Advantage $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $26.61
Rate for Payer: Cash Price $44.10
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $139.65
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $73.50
Rate for Payer: Dean Health DHI/DHP/ASO $26.61
Rate for Payer: Health EOS Commercial $133.77
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $93.93
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $93.93
Rate for Payer: Independent Care Health Plan Medicare $26.61
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: Preferred Network Access Commercial $139.65
Rate for Payer: Quartz Beloit One Network $64.68
Rate for Payer: Quartz Commercial $83.79
Rate for Payer: Quartz Medicare Advantage $26.61
Rate for Payer: The Alliance Commercial $105.11
Rate for Payer: United Healthcare Medicare Advantage $26.61
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: WPS Commercial $117.08
Service Code CPT 88175
Hospital Charge Code 5460757
Hospital Revenue Code 300
Min. Negotiated Rate $26.61
Max. Negotiated Rate $588.00
Rate for Payer: Aetna Commercial $132.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $126.42
Rate for Payer: Aetna Managed Medicare $26.61
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $99.79
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $46.57
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $44.17
Rate for Payer: Anthem Medicaid $27.50
Rate for Payer: Anthem Medicare Advantage $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $77.91
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $26.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $26.61
Rate for Payer: Cash Price $44.10
Rate for Payer: Cash Price $44.10
Rate for Payer: Cigna Commercial $135.24
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $26.61
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $27.50
Rate for Payer: Dean Health Medicaid $27.50
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $26.61
Rate for Payer: Health EOS Commercial $130.83
Rate for Payer: HFN Commercial $135.24
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $98.99
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $26.61
Rate for Payer: Independent Care Health Plan Medicaid $27.50
Rate for Payer: Independent Care Health Plan Medicare $26.61
Rate for Payer: Managed Health Services Medicaid $28.60
Rate for Payer: Managed Health Services Medicare Advantage $26.61
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $26.61
Rate for Payer: Multiplan Commercial $117.60
Rate for Payer: NAPHCARE Commercial $39.92
Rate for Payer: Preferred Network Access Commercial $135.24
Rate for Payer: Quartz Badgercare/Employee Trust Funds/QHP $27.50
Rate for Payer: Quartz Beloit One Network $72.03
Rate for Payer: Quartz Commercial $95.55
Rate for Payer: Quartz Medicare Advantage $26.61
Rate for Payer: The Alliance Commercial $588.00
Rate for Payer: United Healthcare Medicaid $27.50
Rate for Payer: United Healthcare Medicare Advantage $26.61
Rate for Payer: United Healthcare PPO $110.25
Rate for Payer: WEA Trust Commercial $80.85
Rate for Payer: Wellcare Medicare $26.61
Rate for Payer: WMAP Medicaid $27.50
Rate for Payer: WPS Commercial $108.88