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Charge Type Price  
Service Code CPT 49083
Hospital Charge Code 661684
Min. Negotiated Rate $859.46
Max. Negotiated Rate $1,613.68
Rate for Payer: Aetna Commercial $1,578.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $929.62
Rate for Payer: Cash Price $526.20
Rate for Payer: Cigna Commercial $1,613.68
Rate for Payer: Health EOS Commercial $1,561.06
Rate for Payer: HFN Commercial $1,613.68
Rate for Payer: Multiplan Commercial $1,403.20
Rate for Payer: NAPHCARE Commercial $1,052.40
Rate for Payer: Preferred Network Access Commercial $1,613.68
Rate for Payer: Quartz Beloit One Network $859.46
Rate for Payer: Quartz Commercial $1,052.40
Rate for Payer: WEA Trust Commercial $964.70
Rate for Payer: WPS Commercial $1,299.19
Service Code CPT 49083
Hospital Charge Code 661684
Min. Negotiated Rate $841.92
Max. Negotiated Rate $13,286.32
Rate for Payer: Aetna Commercial $1,578.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,508.44
Rate for Payer: Aetna Managed Medicare $895.97
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,140.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $877.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $841.92
Rate for Payer: Anthem Medicare Advantage $895.97
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $929.62
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $895.97
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $895.97
Rate for Payer: Cash Price $526.20
Rate for Payer: Cash Price $526.20
Rate for Payer: Cigna Commercial $1,613.68
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $895.97
Rate for Payer: Dean Health DHI/DHP/ASO $4,757.59
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $895.97
Rate for Payer: Health EOS Commercial $1,561.06
Rate for Payer: HFN Commercial $1,613.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $3,333.01
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $895.97
Rate for Payer: Independent Care Health Plan Medicare $895.97
Rate for Payer: Managed Health Services Medicare Advantage $895.97
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $895.97
Rate for Payer: Multiplan Commercial $1,403.20
Rate for Payer: NAPHCARE Commercial $1,343.96
Rate for Payer: Preferred Network Access Commercial $1,613.68
Rate for Payer: Quartz Beloit One Network $859.46
Rate for Payer: Quartz Commercial $1,140.10
Rate for Payer: Quartz Medicare Advantage $895.97
Rate for Payer: The Alliance Commercial $13,286.32
Rate for Payer: United Healthcare Medicare Advantage $895.97
Rate for Payer: WEA Trust Commercial $964.70
Rate for Payer: Wellcare Medicare $895.97
Rate for Payer: WPS Commercial $1,299.19
Service Code CPT 76536 TC
Hospital Charge Code 2544938
Hospital Revenue Code 402
Min. Negotiated Rate $700.21
Max. Negotiated Rate $1,314.68
Rate for Payer: Aetna Commercial $1,286.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $757.37
Rate for Payer: Cash Price $428.70
Rate for Payer: Cigna Commercial $1,314.68
Rate for Payer: Health EOS Commercial $1,271.81
Rate for Payer: HFN Commercial $1,314.68
Rate for Payer: Multiplan Commercial $1,143.20
Rate for Payer: NAPHCARE Commercial $857.40
Rate for Payer: Preferred Network Access Commercial $1,314.68
Rate for Payer: Quartz Beloit One Network $700.21
Rate for Payer: Quartz Commercial $857.40
Rate for Payer: WEA Trust Commercial $785.95
Rate for Payer: WPS Commercial $1,058.46
Service Code CPT 76536 TC
Hospital Charge Code 2544938
Hospital Revenue Code 402
Min. Negotiated Rate $81.55
Max. Negotiated Rate $1,357.55
Rate for Payer: Aetna Commercial $1,357.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,228.94
Rate for Payer: Aetna Managed Medicare $81.55
Rate for Payer: Anthem Medicare Advantage $81.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $81.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $81.55
Rate for Payer: Cash Price $428.70
Rate for Payer: Cash Price $428.70
Rate for Payer: Cigna Commercial $1,357.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $714.50
Rate for Payer: Dean Health DHI/DHP/ASO $81.55
Rate for Payer: Health EOS Commercial $1,300.39
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $302.03
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $302.03
Rate for Payer: Independent Care Health Plan Medicare $81.55
Rate for Payer: Multiplan Commercial $1,143.20
Rate for Payer: Preferred Network Access Commercial $1,357.55
Rate for Payer: Quartz Beloit One Network $628.76
Rate for Payer: Quartz Commercial $814.53
Rate for Payer: Quartz Medicare Advantage $81.55
Rate for Payer: The Alliance Commercial $309.89
Rate for Payer: United Healthcare Medicare Advantage $81.55
Rate for Payer: WEA Trust Commercial $785.95
Rate for Payer: WPS Commercial $407.75
Service Code CPT 76536 TC
Hospital Charge Code 2544938
Hospital Revenue Code 402
Min. Negotiated Rate $400.12
Max. Negotiated Rate $5,716.00
Rate for Payer: Aetna Commercial $1,286.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,228.94
Rate for Payer: Aetna Managed Medicare $400.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $816.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $689.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $655.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $757.37
Rate for Payer: Cash Price $428.70
Rate for Payer: Cash Price $428.70
Rate for Payer: Cash Price $428.70
Rate for Payer: Cigna Commercial $1,314.68
Rate for Payer: Health EOS Commercial $1,271.81
Rate for Payer: HFN Commercial $1,314.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,071.75
Rate for Payer: Multiplan Commercial $1,143.20
Rate for Payer: NAPHCARE Commercial $857.40
Rate for Payer: Preferred Network Access Commercial $1,314.68
Rate for Payer: Quartz Beloit One Network $700.21
Rate for Payer: Quartz Commercial $928.85
Rate for Payer: Quartz Medicare Advantage $857.40
Rate for Payer: The Alliance Commercial $5,716.00
Rate for Payer: United Healthcare PPO $574.00
Rate for Payer: WEA Trust Commercial $785.95
Rate for Payer: WPS Commercial $1,058.46
Service Code CPT 76536
Hospital Charge Code 631481
Min. Negotiated Rate $107.72
Max. Negotiated Rate $1,305.30
Rate for Payer: Aetna Commercial $1,305.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,181.64
Rate for Payer: Aetna Managed Medicare $107.72
Rate for Payer: Anthem Medicare Advantage $107.72
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $107.72
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $107.72
Rate for Payer: Cash Price $412.20
Rate for Payer: Cash Price $412.20
Rate for Payer: Cigna Commercial $1,305.30
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $687.00
Rate for Payer: Dean Health DHI/DHP/ASO $107.72
Rate for Payer: Health EOS Commercial $1,250.34
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $396.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $396.84
Rate for Payer: Independent Care Health Plan Medicare $107.72
Rate for Payer: Multiplan Commercial $1,099.20
Rate for Payer: Preferred Network Access Commercial $1,305.30
Rate for Payer: Quartz Beloit One Network $604.56
Rate for Payer: Quartz Commercial $783.18
Rate for Payer: Quartz Medicare Advantage $107.72
Rate for Payer: The Alliance Commercial $409.34
Rate for Payer: United Healthcare Medicare Advantage $107.72
Rate for Payer: WEA Trust Commercial $755.70
Rate for Payer: WPS Commercial $538.60
Service Code CPT 76536
Hospital Charge Code 631481
Min. Negotiated Rate $35.52
Max. Negotiated Rate $1,264.08
Rate for Payer: Aetna Commercial $1,236.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,181.64
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $893.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $687.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $659.52
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $728.22
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $412.20
Rate for Payer: Cash Price $412.20
Rate for Payer: Cigna Commercial $1,264.08
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $1,222.86
Rate for Payer: HFN Commercial $1,264.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $1,099.20
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $1,264.08
Rate for Payer: Quartz Beloit One Network $673.26
Rate for Payer: Quartz Commercial $893.10
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $35.52
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $755.70
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $1,017.72
Service Code CPT 76536
Hospital Charge Code 631481
Min. Negotiated Rate $673.26
Max. Negotiated Rate $1,264.08
Rate for Payer: Aetna Commercial $1,236.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $728.22
Rate for Payer: Cash Price $412.20
Rate for Payer: Cigna Commercial $1,264.08
Rate for Payer: Health EOS Commercial $1,222.86
Rate for Payer: HFN Commercial $1,264.08
Rate for Payer: Multiplan Commercial $1,099.20
Rate for Payer: NAPHCARE Commercial $824.40
Rate for Payer: Preferred Network Access Commercial $1,264.08
Rate for Payer: Quartz Beloit One Network $673.26
Rate for Payer: Quartz Commercial $824.40
Rate for Payer: WEA Trust Commercial $755.70
Rate for Payer: WPS Commercial $1,017.72
Service Code CPT 76536 TC
Hospital Charge Code 2544940
Hospital Revenue Code 402
Min. Negotiated Rate $400.12
Max. Negotiated Rate $5,716.00
Rate for Payer: Aetna Commercial $1,286.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,228.94
Rate for Payer: Aetna Managed Medicare $400.12
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $816.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $689.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $655.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $757.37
Rate for Payer: Cash Price $428.70
Rate for Payer: Cash Price $428.70
Rate for Payer: Cash Price $428.70
Rate for Payer: Cigna Commercial $1,314.68
Rate for Payer: Health EOS Commercial $1,271.81
Rate for Payer: HFN Commercial $1,314.68
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,071.75
Rate for Payer: Multiplan Commercial $1,143.20
Rate for Payer: NAPHCARE Commercial $857.40
Rate for Payer: Preferred Network Access Commercial $1,314.68
Rate for Payer: Quartz Beloit One Network $700.21
Rate for Payer: Quartz Commercial $928.85
Rate for Payer: Quartz Medicare Advantage $857.40
Rate for Payer: The Alliance Commercial $5,716.00
Rate for Payer: United Healthcare PPO $574.00
Rate for Payer: WEA Trust Commercial $785.95
Rate for Payer: WPS Commercial $1,058.46
Service Code CPT 76536
Hospital Charge Code 631477
Min. Negotiated Rate $107.72
Max. Negotiated Rate $1,305.30
Rate for Payer: Aetna Commercial $1,305.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,181.64
Rate for Payer: Aetna Managed Medicare $107.72
Rate for Payer: Anthem Medicare Advantage $107.72
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $107.72
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $107.72
Rate for Payer: Cash Price $412.20
Rate for Payer: Cash Price $412.20
Rate for Payer: Cigna Commercial $1,305.30
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $687.00
Rate for Payer: Dean Health DHI/DHP/ASO $107.72
Rate for Payer: Health EOS Commercial $1,250.34
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $396.84
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $396.84
Rate for Payer: Independent Care Health Plan Medicare $107.72
Rate for Payer: Multiplan Commercial $1,099.20
Rate for Payer: Preferred Network Access Commercial $1,305.30
Rate for Payer: Quartz Beloit One Network $604.56
Rate for Payer: Quartz Commercial $783.18
Rate for Payer: Quartz Medicare Advantage $107.72
Rate for Payer: The Alliance Commercial $409.34
Rate for Payer: United Healthcare Medicare Advantage $107.72
Rate for Payer: WEA Trust Commercial $755.70
Rate for Payer: WPS Commercial $538.60
Service Code CPT 76536 TC
Hospital Charge Code 2544940
Hospital Revenue Code 402
Min. Negotiated Rate $700.21
Max. Negotiated Rate $1,314.68
Rate for Payer: Aetna Commercial $1,286.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $757.37
Rate for Payer: Cash Price $428.70
Rate for Payer: Cigna Commercial $1,314.68
Rate for Payer: Health EOS Commercial $1,271.81
Rate for Payer: HFN Commercial $1,314.68
Rate for Payer: Multiplan Commercial $1,143.20
Rate for Payer: NAPHCARE Commercial $857.40
Rate for Payer: Preferred Network Access Commercial $1,314.68
Rate for Payer: Quartz Beloit One Network $700.21
Rate for Payer: Quartz Commercial $857.40
Rate for Payer: WEA Trust Commercial $785.95
Rate for Payer: WPS Commercial $1,058.46
Service Code CPT 76536 TC
Hospital Charge Code 2544940
Hospital Revenue Code 402
Min. Negotiated Rate $81.55
Max. Negotiated Rate $1,357.55
Rate for Payer: Aetna Commercial $1,357.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,228.94
Rate for Payer: Aetna Managed Medicare $81.55
Rate for Payer: Anthem Medicare Advantage $81.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $81.55
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $81.55
Rate for Payer: Cash Price $428.70
Rate for Payer: Cash Price $428.70
Rate for Payer: Cigna Commercial $1,357.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $714.50
Rate for Payer: Dean Health DHI/DHP/ASO $81.55
Rate for Payer: Health EOS Commercial $1,300.39
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $302.03
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $302.03
Rate for Payer: Independent Care Health Plan Medicare $81.55
Rate for Payer: Multiplan Commercial $1,143.20
Rate for Payer: Preferred Network Access Commercial $1,357.55
Rate for Payer: Quartz Beloit One Network $628.76
Rate for Payer: Quartz Commercial $814.53
Rate for Payer: Quartz Medicare Advantage $81.55
Rate for Payer: The Alliance Commercial $309.89
Rate for Payer: United Healthcare Medicare Advantage $81.55
Rate for Payer: WEA Trust Commercial $785.95
Rate for Payer: WPS Commercial $407.75
Service Code CPT 76536
Hospital Charge Code 631477
Min. Negotiated Rate $673.26
Max. Negotiated Rate $1,264.08
Rate for Payer: Aetna Commercial $1,236.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $728.22
Rate for Payer: Cash Price $412.20
Rate for Payer: Cigna Commercial $1,264.08
Rate for Payer: Health EOS Commercial $1,222.86
Rate for Payer: HFN Commercial $1,264.08
Rate for Payer: Multiplan Commercial $1,099.20
Rate for Payer: NAPHCARE Commercial $824.40
Rate for Payer: Preferred Network Access Commercial $1,264.08
Rate for Payer: Quartz Beloit One Network $673.26
Rate for Payer: Quartz Commercial $824.40
Rate for Payer: WEA Trust Commercial $755.70
Rate for Payer: WPS Commercial $1,017.72
Service Code CPT 76536
Hospital Charge Code 631477
Min. Negotiated Rate $35.52
Max. Negotiated Rate $1,264.08
Rate for Payer: Aetna Commercial $1,236.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,181.64
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $893.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $687.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $659.52
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $728.22
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $412.20
Rate for Payer: Cash Price $412.20
Rate for Payer: Cigna Commercial $1,264.08
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $1,222.86
Rate for Payer: HFN Commercial $1,264.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $1,099.20
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $1,264.08
Rate for Payer: Quartz Beloit One Network $673.26
Rate for Payer: Quartz Commercial $893.10
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $35.52
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $755.70
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $1,017.72
Service Code CPT 76856 TC
Hospital Charge Code 3072733
Hospital Revenue Code 402
Min. Negotiated Rate $500.92
Max. Negotiated Rate $7,156.00
Rate for Payer: Aetna Commercial $1,610.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,538.54
Rate for Payer: Aetna Managed Medicare $500.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $816.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $689.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $655.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $948.17
Rate for Payer: Cash Price $536.70
Rate for Payer: Cash Price $536.70
Rate for Payer: Cash Price $536.70
Rate for Payer: Cigna Commercial $1,645.88
Rate for Payer: Health EOS Commercial $1,592.21
Rate for Payer: HFN Commercial $1,645.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,341.75
Rate for Payer: Multiplan Commercial $1,431.20
Rate for Payer: NAPHCARE Commercial $1,073.40
Rate for Payer: Preferred Network Access Commercial $1,645.88
Rate for Payer: Quartz Beloit One Network $876.61
Rate for Payer: Quartz Commercial $1,162.85
Rate for Payer: Quartz Medicare Advantage $1,073.40
Rate for Payer: The Alliance Commercial $7,156.00
Rate for Payer: United Healthcare PPO $574.00
Rate for Payer: WEA Trust Commercial $983.95
Rate for Payer: WPS Commercial $1,325.11
Service Code CPT 76856 TC
Hospital Charge Code 3072733
Hospital Revenue Code 402
Min. Negotiated Rate $876.61
Max. Negotiated Rate $1,645.88
Rate for Payer: Aetna Commercial $1,610.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $948.17
Rate for Payer: Cash Price $536.70
Rate for Payer: Cigna Commercial $1,645.88
Rate for Payer: Health EOS Commercial $1,592.21
Rate for Payer: HFN Commercial $1,645.88
Rate for Payer: Multiplan Commercial $1,431.20
Rate for Payer: NAPHCARE Commercial $1,073.40
Rate for Payer: Preferred Network Access Commercial $1,645.88
Rate for Payer: Quartz Beloit One Network $876.61
Rate for Payer: Quartz Commercial $1,073.40
Rate for Payer: WEA Trust Commercial $983.95
Rate for Payer: WPS Commercial $1,325.11
Service Code CPT 76856 TC
Hospital Charge Code 3072733
Hospital Revenue Code 402
Min. Negotiated Rate $70.61
Max. Negotiated Rate $1,699.55
Rate for Payer: Aetna Commercial $1,699.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,538.54
Rate for Payer: Aetna Managed Medicare $70.61
Rate for Payer: Anthem Medicare Advantage $70.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $70.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $70.61
Rate for Payer: Cash Price $536.70
Rate for Payer: Cash Price $536.70
Rate for Payer: Cigna Commercial $1,699.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $894.50
Rate for Payer: Dean Health DHI/DHP/ASO $70.61
Rate for Payer: Health EOS Commercial $1,627.99
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $259.10
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $259.10
Rate for Payer: Independent Care Health Plan Medicare $70.61
Rate for Payer: Multiplan Commercial $1,431.20
Rate for Payer: Preferred Network Access Commercial $1,699.55
Rate for Payer: Quartz Beloit One Network $787.16
Rate for Payer: Quartz Commercial $1,019.73
Rate for Payer: Quartz Medicare Advantage $70.61
Rate for Payer: The Alliance Commercial $268.32
Rate for Payer: United Healthcare Medicare Advantage $70.61
Rate for Payer: WEA Trust Commercial $983.95
Rate for Payer: WPS Commercial $353.05
Service Code CPT 76856
Hospital Charge Code 630929
Min. Negotiated Rate $108.67
Max. Negotiated Rate $1,391.96
Rate for Payer: Aetna Commercial $1,361.70
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,301.18
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $983.45
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $756.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $726.24
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $801.89
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $453.90
Rate for Payer: Cash Price $453.90
Rate for Payer: Cigna Commercial $1,391.96
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $1,346.57
Rate for Payer: HFN Commercial $1,391.96
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $1,210.40
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $1,391.96
Rate for Payer: Quartz Beloit One Network $741.37
Rate for Payer: Quartz Commercial $983.45
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $581.44
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $832.15
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $1,120.68
Service Code CPT 76856 TC
Hospital Charge Code 2544942
Hospital Revenue Code 402
Min. Negotiated Rate $876.61
Max. Negotiated Rate $1,645.88
Rate for Payer: Aetna Commercial $1,610.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $948.17
Rate for Payer: Cash Price $536.70
Rate for Payer: Cigna Commercial $1,645.88
Rate for Payer: Health EOS Commercial $1,592.21
Rate for Payer: HFN Commercial $1,645.88
Rate for Payer: Multiplan Commercial $1,431.20
Rate for Payer: NAPHCARE Commercial $1,073.40
Rate for Payer: Preferred Network Access Commercial $1,645.88
Rate for Payer: Quartz Beloit One Network $876.61
Rate for Payer: Quartz Commercial $1,073.40
Rate for Payer: WEA Trust Commercial $983.95
Rate for Payer: WPS Commercial $1,325.11
Service Code CPT 76856 TC
Hospital Charge Code 2544942
Hospital Revenue Code 402
Min. Negotiated Rate $500.92
Max. Negotiated Rate $7,156.00
Rate for Payer: Aetna Commercial $1,610.10
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,538.54
Rate for Payer: Aetna Managed Medicare $500.92
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $816.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $689.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $655.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $948.17
Rate for Payer: Cash Price $536.70
Rate for Payer: Cash Price $536.70
Rate for Payer: Cash Price $536.70
Rate for Payer: Cigna Commercial $1,645.88
Rate for Payer: Health EOS Commercial $1,592.21
Rate for Payer: HFN Commercial $1,645.88
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,341.75
Rate for Payer: Multiplan Commercial $1,431.20
Rate for Payer: NAPHCARE Commercial $1,073.40
Rate for Payer: Preferred Network Access Commercial $1,645.88
Rate for Payer: Quartz Beloit One Network $876.61
Rate for Payer: Quartz Commercial $1,162.85
Rate for Payer: Quartz Medicare Advantage $1,073.40
Rate for Payer: The Alliance Commercial $7,156.00
Rate for Payer: United Healthcare PPO $574.00
Rate for Payer: WEA Trust Commercial $983.95
Rate for Payer: WPS Commercial $1,325.11
Service Code CPT 76856
Hospital Charge Code 630929
Min. Negotiated Rate $741.37
Max. Negotiated Rate $1,391.96
Rate for Payer: Aetna Commercial $1,361.70
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $801.89
Rate for Payer: Cash Price $453.90
Rate for Payer: Cigna Commercial $1,391.96
Rate for Payer: Health EOS Commercial $1,346.57
Rate for Payer: HFN Commercial $1,391.96
Rate for Payer: Multiplan Commercial $1,210.40
Rate for Payer: NAPHCARE Commercial $907.80
Rate for Payer: Preferred Network Access Commercial $1,391.96
Rate for Payer: Quartz Beloit One Network $741.37
Rate for Payer: Quartz Commercial $907.80
Rate for Payer: WEA Trust Commercial $832.15
Rate for Payer: WPS Commercial $1,120.68
Service Code CPT 76856
Hospital Charge Code 630929
Min. Negotiated Rate $102.46
Max. Negotiated Rate $1,437.35
Rate for Payer: Aetna Commercial $1,437.35
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,301.18
Rate for Payer: Aetna Managed Medicare $102.46
Rate for Payer: Anthem Medicare Advantage $102.46
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $102.46
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $102.46
Rate for Payer: Cash Price $453.90
Rate for Payer: Cash Price $453.90
Rate for Payer: Cigna Commercial $1,437.35
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $756.50
Rate for Payer: Dean Health DHI/DHP/ASO $102.46
Rate for Payer: Health EOS Commercial $1,376.83
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $374.57
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $374.57
Rate for Payer: Independent Care Health Plan Medicare $102.46
Rate for Payer: Multiplan Commercial $1,210.40
Rate for Payer: Preferred Network Access Commercial $1,437.35
Rate for Payer: Quartz Beloit One Network $665.72
Rate for Payer: Quartz Commercial $862.41
Rate for Payer: Quartz Medicare Advantage $102.46
Rate for Payer: The Alliance Commercial $389.35
Rate for Payer: United Healthcare Medicare Advantage $102.46
Rate for Payer: WEA Trust Commercial $832.15
Rate for Payer: WPS Commercial $512.30
Service Code CPT 76856 TC
Hospital Charge Code 2544942
Hospital Revenue Code 402
Min. Negotiated Rate $70.61
Max. Negotiated Rate $1,699.55
Rate for Payer: Aetna Commercial $1,699.55
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,538.54
Rate for Payer: Aetna Managed Medicare $70.61
Rate for Payer: Anthem Medicare Advantage $70.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $70.61
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $70.61
Rate for Payer: Cash Price $536.70
Rate for Payer: Cash Price $536.70
Rate for Payer: Cigna Commercial $1,699.55
Rate for Payer: Cook Children's Health Plan (CCHP) Medicaid $894.50
Rate for Payer: Dean Health DHI/DHP/ASO $70.61
Rate for Payer: Health EOS Commercial $1,627.99
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $259.10
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $259.10
Rate for Payer: Independent Care Health Plan Medicare $70.61
Rate for Payer: Multiplan Commercial $1,431.20
Rate for Payer: Preferred Network Access Commercial $1,699.55
Rate for Payer: Quartz Beloit One Network $787.16
Rate for Payer: Quartz Commercial $1,019.73
Rate for Payer: Quartz Medicare Advantage $70.61
Rate for Payer: The Alliance Commercial $268.32
Rate for Payer: United Healthcare Medicare Advantage $70.61
Rate for Payer: WEA Trust Commercial $983.95
Rate for Payer: WPS Commercial $353.05
Service Code CPT 76857 TC
Hospital Charge Code 2544944
Hospital Revenue Code 402
Min. Negotiated Rate $341.88
Max. Negotiated Rate $4,884.00
Rate for Payer: Aetna Commercial $1,098.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,050.06
Rate for Payer: Aetna Managed Medicare $341.88
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $816.00
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $689.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $655.00
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $647.13
Rate for Payer: Cash Price $366.30
Rate for Payer: Cash Price $366.30
Rate for Payer: Cash Price $366.30
Rate for Payer: Cigna Commercial $1,123.32
Rate for Payer: Health EOS Commercial $1,086.69
Rate for Payer: HFN Commercial $1,123.32
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $915.75
Rate for Payer: Multiplan Commercial $976.80
Rate for Payer: NAPHCARE Commercial $732.60
Rate for Payer: Preferred Network Access Commercial $1,123.32
Rate for Payer: Quartz Beloit One Network $598.29
Rate for Payer: Quartz Commercial $793.65
Rate for Payer: Quartz Medicare Advantage $732.60
Rate for Payer: The Alliance Commercial $4,884.00
Rate for Payer: United Healthcare PPO $574.00
Rate for Payer: WEA Trust Commercial $671.55
Rate for Payer: WPS Commercial $904.39
Service Code CPT 76857
Hospital Charge Code 630925
Min. Negotiated Rate $8.28
Max. Negotiated Rate $1,052.48
Rate for Payer: Aetna Commercial $1,029.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $983.84
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $743.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $572.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $549.12
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $606.32
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $108.67
Rate for Payer: Cash Price $343.20
Rate for Payer: Cash Price $343.20
Rate for Payer: Cigna Commercial $1,052.48
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $1,018.16
Rate for Payer: HFN Commercial $1,052.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $404.25
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $108.67
Rate for Payer: Independent Care Health Plan Medicare $108.67
Rate for Payer: Managed Health Services Medicare Advantage $108.67
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $108.67
Rate for Payer: Multiplan Commercial $915.20
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $1,052.48
Rate for Payer: Quartz Beloit One Network $560.56
Rate for Payer: Quartz Commercial $743.60
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: The Alliance Commercial $8.28
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: WEA Trust Commercial $629.20
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $847.36