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Service Code CPT 93923
Hospital Charge Code 5376662
Hospital Revenue Code 921
Min. Negotiated Rate $154.39
Max. Negotiated Rate $1,128.84
Rate for Payer: Aetna Commercial $1,104.30
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,055.22
Rate for Payer: Aetna Managed Medicare $154.39
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $797.55
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $613.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $588.96
Rate for Payer: Anthem Medicare Advantage $154.39
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $650.31
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $154.39
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $154.39
Rate for Payer: Cash Price $368.10
Rate for Payer: Cash Price $368.10
Rate for Payer: Cigna Commercial $1,128.84
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $154.39
Rate for Payer: Dean Health DHI/DHP/ASO $686.63
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $154.39
Rate for Payer: Health EOS Commercial $1,092.03
Rate for Payer: HFN Commercial $1,128.84
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $574.33
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $154.39
Rate for Payer: Independent Care Health Plan Medicare $154.39
Rate for Payer: Managed Health Services Medicare Advantage $154.39
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $154.39
Rate for Payer: Multiplan Commercial $981.60
Rate for Payer: NAPHCARE Commercial $231.58
Rate for Payer: Preferred Network Access Commercial $1,128.84
Rate for Payer: Quartz Beloit One Network $601.23
Rate for Payer: Quartz Commercial $797.55
Rate for Payer: Quartz Medicare Advantage $154.39
Rate for Payer: United Healthcare Medicare Advantage $154.39
Rate for Payer: United Healthcare PPO $920.25
Rate for Payer: WEA Trust Commercial $674.85
Rate for Payer: Wellcare Medicare $154.39
Rate for Payer: WPS Commercial $908.84
Service Code CPT 93971 RT
Hospital Charge Code 5376677
Hospital Revenue Code 921
Min. Negotiated Rate $459.48
Max. Negotiated Rate $6,564.00
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,411.26
Rate for Payer: Aetna Managed Medicare $459.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,066.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $820.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $787.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Dean Health DHI/DHP/ASO $918.30
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,230.75
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $1,066.65
Rate for Payer: Quartz Medicare Advantage $984.60
Rate for Payer: The Alliance Commercial $6,564.00
Rate for Payer: United Healthcare PPO $1,230.75
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 93971
Hospital Charge Code 5376671
Hospital Revenue Code 921
Min. Negotiated Rate $108.67
Max. Negotiated Rate $1,509.72
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,411.26
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,066.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $820.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $787.68
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
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 $492.30
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health DHI/DHP/ASO $918.30
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
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 $1,312.80
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $1,066.65
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: United Healthcare PPO $1,230.75
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 93971 LT
Hospital Charge Code 5376719
Hospital Revenue Code 921
Min. Negotiated Rate $459.48
Max. Negotiated Rate $6,564.00
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,411.26
Rate for Payer: Aetna Managed Medicare $459.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,066.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $820.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $787.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Dean Health DHI/DHP/ASO $918.30
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,230.75
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $1,066.65
Rate for Payer: Quartz Medicare Advantage $984.60
Rate for Payer: The Alliance Commercial $6,564.00
Rate for Payer: United Healthcare PPO $1,230.75
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 93971 RT
Hospital Charge Code 5376722
Hospital Revenue Code 921
Min. Negotiated Rate $460.32
Max. Negotiated Rate $6,576.00
Rate for Payer: Aetna Commercial $1,479.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,413.84
Rate for Payer: Aetna Managed Medicare $460.32
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,068.60
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $822.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $789.12
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $871.32
Rate for Payer: Cash Price $493.20
Rate for Payer: Cigna Commercial $1,512.48
Rate for Payer: Dean Health DHI/DHP/ASO $919.98
Rate for Payer: Health EOS Commercial $1,463.16
Rate for Payer: HFN Commercial $1,512.48
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,233.00
Rate for Payer: Multiplan Commercial $1,315.20
Rate for Payer: NAPHCARE Commercial $986.40
Rate for Payer: Preferred Network Access Commercial $1,512.48
Rate for Payer: Quartz Beloit One Network $805.56
Rate for Payer: Quartz Commercial $1,068.60
Rate for Payer: Quartz Medicare Advantage $986.40
Rate for Payer: The Alliance Commercial $6,576.00
Rate for Payer: United Healthcare PPO $1,233.00
Rate for Payer: WEA Trust Commercial $904.20
Rate for Payer: WPS Commercial $1,217.71
Service Code CPT 93971 RT
Hospital Charge Code 5376677
Hospital Revenue Code 921
Min. Negotiated Rate $804.09
Max. Negotiated Rate $1,509.72
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $984.60
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 93931 LT
Hospital Charge Code 5376701
Hospital Revenue Code 921
Min. Negotiated Rate $375.76
Max. Negotiated Rate $5,368.00
Rate for Payer: Aetna Commercial $1,207.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,154.12
Rate for Payer: Aetna Managed Medicare $375.76
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $872.30
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $671.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $644.16
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $711.26
Rate for Payer: Cash Price $402.60
Rate for Payer: Cigna Commercial $1,234.64
Rate for Payer: Dean Health DHI/DHP/ASO $750.98
Rate for Payer: Health EOS Commercial $1,194.38
Rate for Payer: HFN Commercial $1,234.64
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,006.50
Rate for Payer: Multiplan Commercial $1,073.60
Rate for Payer: NAPHCARE Commercial $805.20
Rate for Payer: Preferred Network Access Commercial $1,234.64
Rate for Payer: Quartz Beloit One Network $657.58
Rate for Payer: Quartz Commercial $872.30
Rate for Payer: Quartz Medicare Advantage $805.20
Rate for Payer: The Alliance Commercial $5,368.00
Rate for Payer: United Healthcare PPO $1,006.50
Rate for Payer: WEA Trust Commercial $738.10
Rate for Payer: WPS Commercial $994.02
Service Code CPT 93926 RT
Hospital Charge Code 5376659
Hospital Revenue Code 921
Min. Negotiated Rate $624.26
Max. Negotiated Rate $1,172.08
Rate for Payer: Aetna Commercial $1,146.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $675.22
Rate for Payer: Cash Price $382.20
Rate for Payer: Cigna Commercial $1,172.08
Rate for Payer: Health EOS Commercial $1,133.86
Rate for Payer: HFN Commercial $1,172.08
Rate for Payer: Multiplan Commercial $1,019.20
Rate for Payer: NAPHCARE Commercial $764.40
Rate for Payer: Preferred Network Access Commercial $1,172.08
Rate for Payer: Quartz Beloit One Network $624.26
Rate for Payer: Quartz Commercial $764.40
Rate for Payer: WEA Trust Commercial $700.70
Rate for Payer: WPS Commercial $943.65
Service Code CPT 93926 RT
Hospital Charge Code 5375806
Hospital Revenue Code 921
Min. Negotiated Rate $624.26
Max. Negotiated Rate $1,172.08
Rate for Payer: Aetna Commercial $1,146.60
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $675.22
Rate for Payer: Cash Price $382.20
Rate for Payer: Cigna Commercial $1,172.08
Rate for Payer: Health EOS Commercial $1,133.86
Rate for Payer: HFN Commercial $1,172.08
Rate for Payer: Multiplan Commercial $1,019.20
Rate for Payer: NAPHCARE Commercial $764.40
Rate for Payer: Preferred Network Access Commercial $1,172.08
Rate for Payer: Quartz Beloit One Network $624.26
Rate for Payer: Quartz Commercial $764.40
Rate for Payer: WEA Trust Commercial $700.70
Rate for Payer: WPS Commercial $943.65
Service Code CPT 93882 LT
Hospital Charge Code 5375857
Hospital Revenue Code 921
Min. Negotiated Rate $259.28
Max. Negotiated Rate $3,704.00
Rate for Payer: Aetna Commercial $833.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $796.36
Rate for Payer: Aetna Managed Medicare $259.28
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $601.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $463.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $444.48
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $490.78
Rate for Payer: Cash Price $277.80
Rate for Payer: Cigna Commercial $851.92
Rate for Payer: Dean Health DHI/DHP/ASO $518.19
Rate for Payer: Health EOS Commercial $824.14
Rate for Payer: HFN Commercial $851.92
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $694.50
Rate for Payer: Multiplan Commercial $740.80
Rate for Payer: NAPHCARE Commercial $555.60
Rate for Payer: Preferred Network Access Commercial $851.92
Rate for Payer: Quartz Beloit One Network $453.74
Rate for Payer: Quartz Commercial $601.90
Rate for Payer: Quartz Medicare Advantage $555.60
Rate for Payer: The Alliance Commercial $3,704.00
Rate for Payer: United Healthcare PPO $694.50
Rate for Payer: WEA Trust Commercial $509.30
Rate for Payer: WPS Commercial $685.89
Service Code CPT 93926 RT
Hospital Charge Code 5375806
Hospital Revenue Code 921
Min. Negotiated Rate $356.72
Max. Negotiated Rate $5,096.00
Rate for Payer: Aetna Commercial $1,146.60
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,095.64
Rate for Payer: Aetna Managed Medicare $356.72
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $828.10
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $637.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $611.52
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $675.22
Rate for Payer: Cash Price $382.20
Rate for Payer: Cigna Commercial $1,172.08
Rate for Payer: Dean Health DHI/DHP/ASO $712.93
Rate for Payer: Health EOS Commercial $1,133.86
Rate for Payer: HFN Commercial $1,172.08
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $955.50
Rate for Payer: Multiplan Commercial $1,019.20
Rate for Payer: NAPHCARE Commercial $764.40
Rate for Payer: Preferred Network Access Commercial $1,172.08
Rate for Payer: Quartz Beloit One Network $624.26
Rate for Payer: Quartz Commercial $828.10
Rate for Payer: Quartz Medicare Advantage $764.40
Rate for Payer: The Alliance Commercial $5,096.00
Rate for Payer: United Healthcare PPO $955.50
Rate for Payer: WEA Trust Commercial $700.70
Rate for Payer: WPS Commercial $943.65
Service Code CPT 93971 LT
Hospital Charge Code 5376719
Hospital Revenue Code 921
Min. Negotiated Rate $804.09
Max. Negotiated Rate $1,509.72
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $984.60
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 93922
Hospital Charge Code 5376713
Hospital Revenue Code 921
Min. Negotiated Rate $126.26
Max. Negotiated Rate $728.64
Rate for Payer: Aetna Commercial $712.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $681.12
Rate for Payer: Aetna Managed Medicare $126.26
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $514.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $396.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $380.16
Rate for Payer: Anthem Medicare Advantage $126.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $419.76
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 $237.60
Rate for Payer: Cash Price $237.60
Rate for Payer: Cigna Commercial $728.64
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $126.26
Rate for Payer: Dean Health DHI/DHP/ASO $443.20
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $126.26
Rate for Payer: Health EOS Commercial $704.88
Rate for Payer: HFN Commercial $728.64
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 $633.60
Rate for Payer: NAPHCARE Commercial $189.39
Rate for Payer: Preferred Network Access Commercial $728.64
Rate for Payer: Quartz Beloit One Network $388.08
Rate for Payer: Quartz Commercial $514.80
Rate for Payer: Quartz Medicare Advantage $126.26
Rate for Payer: United Healthcare Medicare Advantage $126.26
Rate for Payer: United Healthcare PPO $594.00
Rate for Payer: WEA Trust Commercial $435.60
Rate for Payer: Wellcare Medicare $126.26
Rate for Payer: WPS Commercial $586.63
Service Code CPT 93978
Hospital Charge Code 5376637
Hospital Revenue Code 921
Min. Negotiated Rate $651.21
Max. Negotiated Rate $1,222.68
Rate for Payer: Aetna Commercial $1,196.10
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $704.37
Rate for Payer: Cash Price $398.70
Rate for Payer: Cigna Commercial $1,222.68
Rate for Payer: Health EOS Commercial $1,182.81
Rate for Payer: HFN Commercial $1,222.68
Rate for Payer: Multiplan Commercial $1,063.20
Rate for Payer: NAPHCARE Commercial $797.40
Rate for Payer: Preferred Network Access Commercial $1,222.68
Rate for Payer: Quartz Beloit One Network $651.21
Rate for Payer: Quartz Commercial $797.40
Rate for Payer: WEA Trust Commercial $730.95
Rate for Payer: WPS Commercial $984.39
Service Code CPT 93930
Hospital Charge Code 5376698
Hospital Revenue Code 921
Min. Negotiated Rate $829.08
Max. Negotiated Rate $1,556.64
Rate for Payer: Aetna Commercial $1,522.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $896.76
Rate for Payer: Cash Price $507.60
Rate for Payer: Cigna Commercial $1,556.64
Rate for Payer: Health EOS Commercial $1,505.88
Rate for Payer: HFN Commercial $1,556.64
Rate for Payer: Multiplan Commercial $1,353.60
Rate for Payer: NAPHCARE Commercial $1,015.20
Rate for Payer: Preferred Network Access Commercial $1,556.64
Rate for Payer: Quartz Beloit One Network $829.08
Rate for Payer: Quartz Commercial $1,015.20
Rate for Payer: WEA Trust Commercial $930.60
Rate for Payer: WPS Commercial $1,253.26
Service Code CPT 93931 RT
Hospital Charge Code 5376704
Hospital Revenue Code 921
Min. Negotiated Rate $657.58
Max. Negotiated Rate $1,234.64
Rate for Payer: Aetna Commercial $1,207.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $711.26
Rate for Payer: Cash Price $402.60
Rate for Payer: Cigna Commercial $1,234.64
Rate for Payer: Health EOS Commercial $1,194.38
Rate for Payer: HFN Commercial $1,234.64
Rate for Payer: Multiplan Commercial $1,073.60
Rate for Payer: NAPHCARE Commercial $805.20
Rate for Payer: Preferred Network Access Commercial $1,234.64
Rate for Payer: Quartz Beloit One Network $657.58
Rate for Payer: Quartz Commercial $805.20
Rate for Payer: WEA Trust Commercial $738.10
Rate for Payer: WPS Commercial $994.02
Service Code CPT 93990
Hospital Charge Code 5375869
Hospital Revenue Code 921
Min. Negotiated Rate $108.67
Max. Negotiated Rate $747.04
Rate for Payer: Aetna Commercial $730.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $698.32
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $527.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $406.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $389.76
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $430.36
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 $243.60
Rate for Payer: Cash Price $243.60
Rate for Payer: Cigna Commercial $747.04
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health DHI/DHP/ASO $454.40
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $722.68
Rate for Payer: HFN Commercial $747.04
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 $649.60
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $747.04
Rate for Payer: Quartz Beloit One Network $397.88
Rate for Payer: Quartz Commercial $527.80
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: United Healthcare PPO $609.00
Rate for Payer: WEA Trust Commercial $446.60
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $601.45
Service Code CPT 93880
Hospital Charge Code 5375854
Hospital Revenue Code 921
Min. Negotiated Rate $242.20
Max. Negotiated Rate $1,647.72
Rate for Payer: Aetna Commercial $1,611.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,540.26
Rate for Payer: Aetna Managed Medicare $242.20
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,164.15
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $895.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $859.68
Rate for Payer: Anthem Medicare Advantage $242.20
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $949.23
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage HMO $242.20
Rate for Payer: Blue Cross Blue Shield of Illinois Medicare Advantage PPO $242.20
Rate for Payer: Cash Price $537.30
Rate for Payer: Cash Price $537.30
Rate for Payer: Cigna Commercial $1,647.72
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $242.20
Rate for Payer: Dean Health DHI/DHP/ASO $1,002.24
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $242.20
Rate for Payer: Health EOS Commercial $1,593.99
Rate for Payer: HFN Commercial $1,647.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $900.98
Rate for Payer: Humana Medicare EPO/Medicare HMO/Medicare PPO $242.20
Rate for Payer: Independent Care Health Plan Medicare $242.20
Rate for Payer: Managed Health Services Medicare Advantage $242.20
Rate for Payer: Molina Healthcare Medicare Advantage/Molina Marketplace $242.20
Rate for Payer: Multiplan Commercial $1,432.80
Rate for Payer: NAPHCARE Commercial $363.30
Rate for Payer: Preferred Network Access Commercial $1,647.72
Rate for Payer: Quartz Beloit One Network $877.59
Rate for Payer: Quartz Commercial $1,164.15
Rate for Payer: Quartz Medicare Advantage $242.20
Rate for Payer: United Healthcare Medicare Advantage $242.20
Rate for Payer: United Healthcare PPO $1,343.25
Rate for Payer: WEA Trust Commercial $985.05
Rate for Payer: Wellcare Medicare $242.20
Rate for Payer: WPS Commercial $1,326.59
Service Code CPT 93971 RT
Hospital Charge Code 6195140
Hospital Revenue Code 921
Min. Negotiated Rate $804.09
Max. Negotiated Rate $1,509.72
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $984.60
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 76937
Hospital Charge Code 5376734
Hospital Revenue Code 921
Min. Negotiated Rate $96.52
Max. Negotiated Rate $543.72
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: 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: 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 $96.52
Rate for Payer: United Healthcare PPO $443.25
Rate for Payer: WEA Trust Commercial $325.05
Rate for Payer: WPS Commercial $437.75
Service Code CPT 93922
Hospital Charge Code 5375850
Hospital Revenue Code 921
Min. Negotiated Rate $126.26
Max. Negotiated Rate $728.64
Rate for Payer: Aetna Commercial $712.80
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $681.12
Rate for Payer: Aetna Managed Medicare $126.26
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $514.80
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $396.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $380.16
Rate for Payer: Anthem Medicare Advantage $126.26
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $419.76
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 $237.60
Rate for Payer: Cash Price $237.60
Rate for Payer: Cigna Commercial $728.64
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $126.26
Rate for Payer: Dean Health DHI/DHP/ASO $443.20
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $126.26
Rate for Payer: Health EOS Commercial $704.88
Rate for Payer: HFN Commercial $728.64
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 $633.60
Rate for Payer: NAPHCARE Commercial $189.39
Rate for Payer: Preferred Network Access Commercial $728.64
Rate for Payer: Quartz Beloit One Network $388.08
Rate for Payer: Quartz Commercial $514.80
Rate for Payer: Quartz Medicare Advantage $126.26
Rate for Payer: United Healthcare Medicare Advantage $126.26
Rate for Payer: United Healthcare PPO $594.00
Rate for Payer: WEA Trust Commercial $435.60
Rate for Payer: Wellcare Medicare $126.26
Rate for Payer: WPS Commercial $586.63
Service Code CPT 93971 LT
Hospital Charge Code 5376728
Hospital Revenue Code 921
Min. Negotiated Rate $804.09
Max. Negotiated Rate $1,509.72
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $984.60
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49
Service Code CPT 93922
Hospital Charge Code 5376713
Hospital Revenue Code 921
Min. Negotiated Rate $388.08
Max. Negotiated Rate $728.64
Rate for Payer: Aetna Commercial $712.80
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $419.76
Rate for Payer: Cash Price $237.60
Rate for Payer: Cigna Commercial $728.64
Rate for Payer: Health EOS Commercial $704.88
Rate for Payer: HFN Commercial $728.64
Rate for Payer: Multiplan Commercial $633.60
Rate for Payer: NAPHCARE Commercial $475.20
Rate for Payer: Preferred Network Access Commercial $728.64
Rate for Payer: Quartz Beloit One Network $388.08
Rate for Payer: Quartz Commercial $475.20
Rate for Payer: WEA Trust Commercial $435.60
Rate for Payer: WPS Commercial $586.63
Service Code CPT 93976
Hospital Charge Code 5375863
Hospital Revenue Code 921
Min. Negotiated Rate $108.67
Max. Negotiated Rate $575.92
Rate for Payer: Aetna Commercial $563.40
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $538.36
Rate for Payer: Aetna Managed Medicare $108.67
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $406.90
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $313.00
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $300.48
Rate for Payer: Anthem Medicare Advantage $108.67
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $331.78
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 $187.80
Rate for Payer: Cash Price $187.80
Rate for Payer: Cigna Commercial $575.92
Rate for Payer: Cook Children's Health Plan (CCHP) Commercial $108.67
Rate for Payer: Dean Health DHI/DHP/ASO $350.31
Rate for Payer: Dean Health Medicare Advantage/Medicare Select $108.67
Rate for Payer: Health EOS Commercial $557.14
Rate for Payer: HFN Commercial $575.92
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 $500.80
Rate for Payer: NAPHCARE Commercial $163.00
Rate for Payer: Preferred Network Access Commercial $575.92
Rate for Payer: Quartz Beloit One Network $306.74
Rate for Payer: Quartz Commercial $406.90
Rate for Payer: Quartz Medicare Advantage $108.67
Rate for Payer: United Healthcare Medicare Advantage $108.67
Rate for Payer: United Healthcare PPO $469.50
Rate for Payer: WEA Trust Commercial $344.30
Rate for Payer: Wellcare Medicare $108.67
Rate for Payer: WPS Commercial $463.68
Service Code CPT 93971 LT
Hospital Charge Code 5376683
Hospital Revenue Code 921
Min. Negotiated Rate $459.48
Max. Negotiated Rate $6,564.00
Rate for Payer: Aetna Commercial $1,476.90
Rate for Payer: Aetna Gatekeeper/Not Gatekeeper $1,411.26
Rate for Payer: Aetna Managed Medicare $459.48
Rate for Payer: Anthem Blue Access PPO/Blue Traditional $1,066.65
Rate for Payer: Anthem Blue Preferred/Blue Preferred Plus $820.50
Rate for Payer: Anthem Blue Priority WI/Blue Priority X-WI $787.68
Rate for Payer: Blue Cross Blue Shield of Illinois Blue Cross PPO $869.73
Rate for Payer: Cash Price $492.30
Rate for Payer: Cigna Commercial $1,509.72
Rate for Payer: Dean Health DHI/DHP/ASO $918.30
Rate for Payer: Health EOS Commercial $1,460.49
Rate for Payer: HFN Commercial $1,509.72
Rate for Payer: Humana Commercial/EPO/HMO/POS/PPO $1,230.75
Rate for Payer: Multiplan Commercial $1,312.80
Rate for Payer: NAPHCARE Commercial $984.60
Rate for Payer: Preferred Network Access Commercial $1,509.72
Rate for Payer: Quartz Beloit One Network $804.09
Rate for Payer: Quartz Commercial $1,066.65
Rate for Payer: Quartz Medicare Advantage $984.60
Rate for Payer: The Alliance Commercial $6,564.00
Rate for Payer: United Healthcare PPO $1,230.75
Rate for Payer: WEA Trust Commercial $902.55
Rate for Payer: WPS Commercial $1,215.49